Mieke Hulens

The assessment of dietary habits in obese women: influence of eating behavior patterns.

The objective of this cross-sectional, observational study was to compare the dietary history and the 7-day record method to assess dietary habits in obese women. The second goal was to investigate whether eating behavior characteristics influence self-reported dietary intake. The study took place at the Obesity Outpatient Clinic, University Hospital Gasthuisberg, Leuven, Belgium. Subjects were 137 obese women with a mean age of 40 ± 12 years and a mean body mass index of 38.2 ± 6.0 kg/m2. Dietary intake was assessed both by the dietary history and by the 7-day record method. Resting energy expenditure was measured by continuous indirect calorimetry. Physical activity level was estimated using the Baecke questionnaire. To study different aspects of eating behaviour, the “Dutch Eating Behaviour Questionnaire” was used. Absolute energy intake, as assessed by the 7-day record, was consistently lower than with the dietary history method. Sixteen percent of the obese women were overreporters while 66% clearly underreported energy intake, using dietary history as standard method. Restrained eating was associated with underreporting, while all aspects of emotional and external eating behavior were significantly higher in the group of overreporters. No relationship could be observed between the degree of underreporting and age, body weight or body mass index. Energy intake, as assessed by the dietary history method, correlated better with measured energy expenditure in obese subjects than the 7-day record. Eating behavior characteristics influence the accuracy of self-reported dietary intake in obese women. This study was supported in part by the Fonds voor Wetenschappelijk Onderzoek – Vlaanderen (Project G.0178.96 and ‘Krediet aan Navorsers’ 1.5.006.95).

Evaluation of Body Fat Estimated from Body Mass Index and Impedance in Belgian Male Military Candidates: Comparing Two Methods for Estimating Body Composition

OBJECTIVE The study objective was to evaluate whether a classification based on body mass index (BMI) agrees with a classification based on body fat mass, estimated by bioelectrical impedance. METHODS A random sample of 448 male candidates between 18 and 20 years was selected during their medical visit in a military recruitment center. BMI was determined as weight/height2 and was considered normal between 20.0 and 25.0 kg/m2 (cfr. WHO classification). Percentage of body fat was estimated with bioelectrical impedance, using the Omron Body Fat Analyzer HBF-306. Subjects with a body fat percentage measured by bipolar bioelectrical impedance analysis (BF%(IMP)) < or = 20.9% were considered normal weight, while subjects with a BF%(IMP) > or = 21.0% were considered overweight. We used the following classification: true positives were normal scores for BMI and impedance; false positives were normal scores for BMI but not for impedance; true negatives were overweight scores for BMI and for impedance; and false negatives were overweight scores for BMI but not for impedance. Data were analyzed using the SPSS statistical program. RESULTS BMI ranged from 17.0 to 29.4 kg/m2; percentage of fat mass varied between 5.3 and 31.4% of body weight. Of the total sample, 328 (73.2%) candidates were classified as true positive, 29 (6.5%) as false negative, 47 (10.5%) as false positive, and finally 44 (9.8%) as true negative. The difference in classification in normal weight versus overweight between the BMI method and the bipolar bioelectrical impedance method was statistically significant (chi2 with one df = 86.04; p < 0.001). CONCLUSIONS To limit false-negative classifications, additional impedance measurements in the BMI category between 25.0 and 27.0 kg/m2 is mandatory to determine whether there is really an excess fat mass.

Socioeconomic, health, and dietary determinants of multivitamin supplements use in Belgium.

ObjectiveThis study aimed at investigating the use of multivitamin supplements in relationship to dietary pattern, socio-economic conditions and some health indicators.MethodsA cross-sectional design was used. Mailed questionnaires were sent to 5,000 Belgian military men. Use of multivitamins, frequency and food consumption were recorded during the past year, together with health (BMI, smoking, physical activity) and socioeconomic indicators (education, income). Dietary patterns were determined using the Mediterranean Diet Score (MDS).ResultsUse of multivitamin supplements was associated with healthy lifestyle characteristics, such as a higher physical activity level and non smoking. Moreover, it was found that on average more participants with a Flemish cultural background (19.8%) used supplements compared with participants with a French cultural background (9.3%). The MDS was related to multivitamin supplement use, with 34.9% of users having the highest score range. The socioeconomic indicators ‘education’ and ‘income’ were not related to vitamin supplement use.ConclusionA low BMI, healthy diet, regular physical activity, non-smoking status and cultural background were associated with a higher intake of multivitamin supplements.

Trends in the evolution of BMI in Belgian army men

OBJECTIVES The first aim was to evaluate BMI cross-sectionally over a period of 14 years (1992 to 2005) in 43,343 army men and the second was to compare BMI using the paired data of 1497 army men. The data were analysed as a function of the military ranking system, used as an indicator for socio-economic position. DESIGN Multiple cross-sectional and longitudinal design. RESULTS A significant increase of BMI between age categories was detected over the 14-year period; BMI remained stable in each age category. In the paired cohort, median BMI increased during the same period from 23.9 (interquartile range 3.3) kg/m2 to 24.7 (interquartile range 3.5) kg/m2 (P < 0.0001). This age-dependent evolution was present in all military rankings. From age 40 years or more, BMI indicated a significant increase in the prevalence of overweight and obesity. CONCLUSION For the total cohort, BMI remained stable in each age category. For the paired cohort, BMI increased over time. The military leadership should emphasize prevention in order to reduce the health-care costs and disease burden in this cohort. This emphasis on prevention should target those aged less than 40 years.

Distribution of Cardiovascular Risk Factors in Belgian Army Men

ABSTRACT The objective was to determine the prevalence of cardiovascular risk factors in Belgian army men. Biomedical data and cardiovascular risk factors were obtained by a mailed questionnaire and by data collected from a medical software program (Total Health). The number of responders to the mailing was 1852; 974 of the 1852 responders and 420 of the 3148 nonresponders were registered in Total Health. The prevalence of obesity was 5.6%, 15.0%, and 19.5%, respectively, for officers, noncommissioned officers, and soldiers. There was a strong socioeconomic gradient in the prevalence of smoking: 12.7% of the officers were smokers, compared with 19.7% of the noncommissioned officers and 29.5% of the soldiers (p < .001). Only 8.5% of the officers had a 10-year risk of more than 5% of developing fatal cardiovascular disease, compared with 18% of the lower socioeconomic positions. In conclusion, high-risk groups in Belgian army men are younger than 40 years of age, and smokers. Active prevention should focus on this group with special attention to the specificity of each rank category.

Electromyography and A Review of the Literature Provide Insights into the Role of Sacral Perineural Cysts in Unexplained Chronic Pelvic, Perineal and Leg Pain Syndromes

Objective: The clinical entity “Symptomatic Tarlov Cysts” is a highly under reported condition. We aimed to perform an electrophysiologic evaluation in patients with Tarlov cysts to determine whether the cysts create electrical abnormalities that could translate into clinical symptoms. The findings are correlated with the data currently available in the literature. Methods: Thirty patients with unexplained pelvic, sacral, perineal and/or leg pain who harbored small and/or large Tarlov cysts were selected at an outpatient clinic for physical medicine in musculoskeletal disorders. An MRI of the lumbosacral spine of each patient was reviewed. An experienced physiatrist acquired information related to pain and paresthesia in addition to bladder, bowel and sphincter symptoms. An expert electrophysiologist performed nerve conduction and electromyography studies on the patient’s legs and the pelvic floor. A review of the case reports on Tarlov cysts was performed. The symptoms of the patients in the study were compared with the symptoms reported in reviews and case reports. Results: In all cases, the presence of Tarlov cysts was associated with sensory neuron symptoms, such as pain and paresthesia, and with bladder, bowel, sexual, and/or sphincter complaints. In all cases, electromyography documented axonal damage in multiple lumbar and sacral nerve root myotomes. Conclusion: Symptomatic Tarlov cysts clinically and electrophysiologically represent a progressive chronic cauda equine syndrome. In patients with intractable sacral, perineal, pelvic or leg pain, symptomatic Tarlov cysts should be included in the differential diagnosis.