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Background: Variability in body mass index (BMI) (kg/m2) trajectories is associated with body composition and cardiometabolic markers in early childhood, but it is unknown how these associations track to later childhood. Objectives: We aimed to assess associations of BMI trajectories from 0 to 5 y with body composition and cardiometabolic markers at 10 y. Methods: In the Ethiopian infant anthropometry and body composition (iABC) birth cohort, we previously identified 4 distinct BMI trajectories from 0 to 5 y: stable low BMI (19.2%), normal BMI (48.8%), rapid growth to high BMI (17.9%), and slow growth to high BMI (14.1%). At 10 y, we obtained data from 320 children on anthropometry, body composition, abdominal subcutaneous and visceral fat, and cardiometabolic markers. Associations of BMI trajectories and 10-y outcomes were analyzed using multiple linear regression. Results: Compared with children with the normal BMI trajectory, those with rapid growth to high BMI had 1.7 cm (95% CI: 0.1, 3.3) larger waist circumference and those with slow growth to high had 0.63 kg/m2 (95% CI: 0.09, 1.17) greater fat mass index and 0.19 cm (95% CI: 0.02, 0.37) greater abdominal subcutaneous fat, whereas those with stable low BMI had −0.28 kg/m2 (95% CI: −0.59, 0.03) lower fat-free mass at 10 y. Although the confidence bands were wide and included the null value, children with rapid growth to high BMI trajectory had 48.6% (95% CI: −1.4, 123.8) higher C-peptide concentration and those with slow growth to high BMI had 29.8% (95% CI: −0.8, 69.8) higher insulin and 30.3% (95% CI: −1.1, 71.6) higher homeostasis model assessment of insulin resistance, whereas those with rapid growth to high BMI had −0.23 mmol/L (95% CI: −0.47, 0.02) lower total cholesterol concentration. The trajectories were not associated with abdominal visceral fat, blood pressure, glucose, and other lipids at 10 y. Conclusions: Children with rapid and slow growth to high BMI traject

Background: Although birth weight (BW) has been associated with later cardiovascular disease and type 2 diabetes, the role of birth fat mass (BFM) and birth fat-free mass (BFFM) on cardiometabolic health is unclear.Objective: To examine associations of BW, BFM, and BFFM with later anthropometry, body composition, abdominal fat, and cardiometabolic markers.Methods: Birth cohort data on standardized exposure variables (BW, BFM, and BFFM) and follow-up information at age 10 y on anthropometry, body composition, abdominal fat, and cardiometabolic markers were included. A linear regression analysis was used to assess associations of exposures with outcome variables, adjusting for maternal and child characteristics at birth and current body size in separate models.Results: Among 353 children, mean (SD) age was 9.8 (1.0) years, and 51.5% were boys. In the fully adjusted model, 1-SD higher BW and BFFM were associated with 0.81 (95%CI: 0.21, 1.41) and 1.25 (95%CI: 0.64, 1.85) cm greater height at 10 y, respectively. The 1-SD higher BW and BFM were associated with 0.32 kg/m2 (95%CI: 0.14, 0.51 kg/m2) and 0.42 kg/m2 (95%CI: 0.25, 0.59 kg/m2) greater fat mass index at 10 y, respectively. In addition, 1-SD higher BW and BFFM were associated with 0.22 kg/m2 (95% CI: 0.09, 0.34 kg/m2) greater FFM index, whereas a 1-SD greater BFM was associated with a 0.05 cm greater subcutaneous adipose tissue (95% CI: 0.01, 0.11 cm). Furthermore, 1-SD higher BW and BFFM were associated with 10.3% (95% CI: 1.4%, 20.0%) and 8.3% (95% CI: -0.5%, 17.9%) greater insulin, respectively. Similarly, 1-SD higher BW and BFFM were associated with 10.0% (95% CI: 0.9%, 20.0%) and 8.5% (95% CI: -0.6%, 18.5%) greater homeostasis model assessment of insulin resistance, respectively.Conclusions: BW and BFFM rather than BFM are predictors of height and FFM index at 10 y. Children with

Background: Changes in body composition and muscle strength are common among individuals with HIV. We investigated the associations of inflammation with body composition and grip strength in adults with and without HIV.Methods: Cross-sectional study among Ethiopian treatment-naïve individuals with and without HIV. Fat mass and fat-free mass adjusted for height (kg/m2) were used as indicators of body composition.Results: 288/100 individuals with/without HIV were included between July 2010 and August 2012. Females with HIV had lower fat mass index (FMI) and fat-free mass index (FFMI) than females without HIV, whereas no difference was seen between males with and without HIV. Males and females with HIV had lower grip strength than their counterparts without HIV. Serum alpha-1-acid glycoprotein (s-AGP) was negatively correlated with FMI (-0.71 kg/m2, 95% CI: -1.2; -0.3) among individuals with HIV, and those with HIV and serum C-reactive protein (s-CRP) ≥ 10 mg/l had 0.78 kg/m2 (95% CI -1.4; -0.2) lower FMI than those with s-CRP < 10 mg/l. In contrast, s-AGP was positively correlated with FMI (2.09 kg/m2, 95% CI 0.6; 3.6) in individuals without HIV. S-CRP and AGP were negatively associated with grip strength in individuals with HIV, while no correlation was observed among those without HIV.Conclusion: Inflammation was positively associated with FMI in individuals without HIV while it was negatively associated with FMI in those with HIV, indicating that inflammation may be one of the drivers of depleting energy reserves among treatment-naïve individuals with HIV. Inflammation was associated with decreased muscle quantity and functional capacity among individuals with HIV, but not in those without HIV.

Introduction: Malnutrition is common among people with HIV in sub-Saharan Africa. Nutritional supplementation at initiation of antiretroviral treatment (ART) has shown beneficial effects, but it is not known if supplementation replaces or supplements the habitual energy intake in a context of food insecurity.Methods: As part of a randomised controlled trial among people with HIV initiating ART in Ethiopia, we assessed whether the provision of a lipid-based nutrient supplement (LNS) affected energy intake from the habitual diet. People with HIV aged ≥18 years with a body mass index (BMI) >17 were randomly allocated 2:1 to receive either early (month 1-3 after ART initiation) or delayed (month 4-6 after ART initiation) supplementation with LNS (≈4,600 kJ/day). Participants with BMI 16-17 were all allocated to early supplementation. The daily energy intake from the habitual diet (besides the energy contribution from LNS) was assessed using a 24-h food recall interview at baseline and at monthly follow-up visits. Linear mixed models were used to compare habitual energy intake in (1) early versus delayed supplementation groups and (2) supplemented versus unsupplemented time periods within groups.Results: Of 301 participants included, 67% of the participants were women, mean (±standard deviation [SD]) age was 32.9 (±8.9) years and 68% were living in moderately or severely food insecure households. Mean (±SD) reported habitual energy intake at baseline was 5,357 kJ/day (±2,246) for women and 7,977 kJ/day(±3,557) for men. Among all participants, there were no differences in mean habitual energy intake between supplemented and unsupplemented groups in neither the first 3 (P = 0.72) nor the following 3 months (P = 0.56). Furthermore, habitual energy intake did not differ within groups when comparing periods with or without supplementation (P = 0.15 and P = 0.20). The severity of food insecurity did not modif

Esayas Kebede Gudina,1 Zeleke Mekonnen,2 Daniel Yilma1 1Department of Internal Medicine, Jimma University Institute of Health, Jimma, Ethiopia; 2School of Medical Laboratory Sciences, Jimma University Institute of Health, Jimma, EthiopiaCorrespondence: Esayas Kebede Gudina, Department of Internal Medicine, Jimma University Institute of Health, P. O.Box 5058, Jimma, Ethiopia, Email esayas.gudina@ju.edu.etAbstract: The world has come a long way in the fight against the COVID-19 pandemic by averting the initially feared humanitarian crisis and by producing effective vaccines in a record time. Paradoxically, more new daily cases are being reported today than when there was not any effective vaccine around. The success against the pandemic so far is dented by inadequate vaccine supply in most low-income countries and widespread vaccine hesitancy. By the end of 2021, only half of WHO Member States have reached the target of immunizing 40% of their populations, while only less than 10% of the population in low-income countries have received at least one dose of the vaccine. This happened while more than nine billion doses of the vaccines were administered globally, predominantly in rich countries. On the backdrop of these man-made factors, the evolution of highly mutated variants of the virus is causing more uncertainties than the pre-vaccine time. If the vaccine inequities and hesitancy are not properly addressed, we are likely to enter into the vicious cycle of inequitable vaccine distribution leading to low vaccination rates in most low-income countries where the majority of the world population resides. This will ultimately enhance sustained transmission of the virus, leading to evolution of new variants of concern. As the highly mutated variants are likely to infect both vaccinated and unvaccinated individuals, it will inevitably lead to major doubts in the effectiveness and acceptance of the vaccines. In this review, we present how this vicious cycle may prolong the