Abstract P246: Determinants of Remission of Overweight Status in Youth
Bibliographic record
Abstract
Introduction and hypothesis: Spontaneous remission to normal weight status occurs in ~10-20% of overweight youth. The factors that predict remission, particularly modifiable factors such as diet and physical activity (PA) are poorly understood. We hypothesized that the time spent in moderate to vigorous physical activity (MVPA), high fitness and better diet quality would be associated with an increased likelihood of remission to normal weight status among overweight youth. Design and Methods: This was a three year prospective cohort study of 114 youth aged 9-15 years who were overweight or obese (International Obesity task Force (IOTF) cut-points) at baseline. We performed a series of regression analyses to test for predictors of remission to normal weight status at the 3-year follow up visit. The primary exposure variables were accelerometer (Actical) determined physical activity (PA) intensity, cardiorespiratory fitness assessed with a 20m shuttle run and diet quality determined from a web-based 24-hr recall tool that estimated diet quality based on meeting recommendations for daily intake of food groups. The primary outcome measure was remission to normal weight status defined as a BMI within the “healthy weight” range for age and sex in year 3 of the cohort study according to IOTF cut-points. We also tested for differences in BMI Z-score and systolic blood pressure (SBP) between youth that experienced remission and those that didn’t. We adjusted for the potential confounding effects of sedentary time, age and sex. Results: Among the 114 overweight youth studied (12 ± 2 years; BMI Z score = 1.55 ± 0.35), 18 (16%) returned to normal weight status at year 3. Remission did not occur in any youth considered obese (BMI [[Unable to Display Character: ˃]] 95th percentile) at baseline. Neither MVPA nor dietary quality was associated remission. However, remission was associated with a lower BMI Z score at baseline (1.31 ± 0.15 vs. 1.60 ± 0.35, p < 0.05) and a higher cardiorespiratory fitness (shuttle run score = 6.4 ± 2.3 vs. 4.9 ± 1.9, p < 0.05). The odds of remission were 4-fold higher (OR: 4.2 95% CI=1.04-16.7) among youth in the two upper quintiles of cardiorespiratory fitness compared to those in the lowest quintile. Despite a significant decline in BMI Z score over 3 years (-0.67 ± 0.53 vs. -0.019 ± 0.23, p < 0.05) in youth that experienced remission, no differences in SBP were observed compared to youth that remained overweight. Conclusions: Remission to normal weight status was observed in 16% of youth who were overweight at their initial assessment. Obesity and low cardiorespiratory fitness reduced the likelihood of spontaneous remission to normal weight status in overweight youth. The identification of BMI and fitness thresholds at which spontaneous remission is unlikely to occur will tailor interventions to youth with the greatest need to improve lifestyle behaviours, weight status, and overall well-being.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".