Revisiting the Normal Body Mass Index among Ethiopian Adolescents: A Nationwide Study of 317,000 Males and Females.

אורי חמיאל 1,2 Cole Bendor 3,4 Aya Bardugo 3,4 Zivan Berr 3 Estela Derazne 2,3 Dorit Tzur 3 Ehud Grossman 2,5 Arnon Afek 2,5 Orit Pinhas-Hamiel 2,6 Gilad Twig 2,3,4,7
1Department of Pediatrics, Assaf Harofeh Medical Center, Zerifin, Israel
2Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel
3Surgeon General Headquarters, Israel Defense Forces, Ramat Gan, Israel
4Department of Military Medicine, Hebrew University School of Medicine, Jerusalem, Israel
5Central Management, Chaim Sheba Medical Center, Tel Hashomer, Israel
6Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel
7Department of Medicine and the Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Tel Hashomer, Israel

Aims: Shifts in populations have drastically increased cardiovascular risk factors and disease rates. We assessed the association between body mass index (BMI) and blood pressure (BP) levels among adolescents of Ethiopian origin and their secular trend of overweight and obesity.

Methods: The study cohort comprised of adolescents aged 16-19 years, who were medically examined prior to military service between 1992 through 2016. Participants of Ethiopian origin were classified into Israeli-born (N=15,793) and immigrants (N=23,487), and adolescents from families that are at least 3 generations in Israel served as controls (n=277,789). BMI was stratified by sex and divided to 6 groups:<17, 17.5-18.4, 18.5-19.9, 20.0-22.4, 22.5-24.9, >25.0 kg/m2. Hypertensive-range BP values adjusted for age, sex and height served as outcome.

Results: The occurrence of hypertensive-range measurements increased with the length of residency in Israel: 7.3%, 10.6% and 14.4% in males who immigrated at ages 12-19, 6-12 and 0-6 years respectively, and 11.5%, 16.7% and 19.3% among females, respectively. Israeli- born Ethiopians had significantly higher risk for hypertensive range measurements at any given BMI >20 kg/m2 compared to controls, after accounting for socio-demographic variables and medical history. Between 1992 and 2016, there was a 10-fold and 5-fold increase in overweight and obesity in males and females of Ethiopian origin respectively, compared to a 2-fold increase in the controls.

Conclusions: The association between abnormal BP and BMI is significantly steeper among Israelis of Ethiopian origin. This population requires targeted surveillance and appropriate intervention given the dramatic increase in obesity, especially among females.









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