Change in body mass index within the first-year post-injury: a VA Traumatic Brain Injury (TBI) model systems study

Brain Inj. 2018;32(8):986-993. doi: 10.1080/02699052.2018.1468575. Epub 2018 Apr 27.

Abstract

Objective: To describe change in body mass index (BMI) and weight classification 1-year post- traumatic brain injury (TBI) among Veterans and service members.

Design: Prospective observational cohort study.

Setting: VA Polytrauma Rehabilitation Centers.

Participants: Veterans and service members (N = 84) enrolled in VA Traumatic Brain Injury Model Systems (VA TBIMS) study with BMI scores at enrollment and 1-year post-injury.

Interventions: N/A.

Main outcome measures: BMI scores from height and weight and weight classifications (underweight, normal weight, overweight, obese classes 1-3) defined by WHO.

Results: Twenty per cent were obese at time of injury and 24% were obese at 1-year post-injury. Cross-tab analyses revealed 7% of normal weight and 24% overweight participants at time of injury as obese Class 1 one-year post-injury. Univariate models found BMI and tobacco smoking at time of injury were significant predictors of higher BMI scores 1-year post-TBI. Multivariable models found BMI at time of injury and motor functioning, were significant predictors. Preinjury BMI, tobacco smoking and PTSD symptom severity predicted change in weight category.

Conclusion: While obesity among service members and Veterans post-TBI is below national averages, trends in weight gain between time of injury and 1-year follow-up were observed. Implications for health promotion and chronic disease management efforts with regards to rehabilitation for injured military are discussed. List of Abbreviations: BMI, Body mass index; BRFSS, Behavioural Risk Factor Surveillance; GCS, Glasgow Coma Scale; FIM, Functional Independence Measure; NIDILRR, National Institute on Independent Living and Rehabilitation Research; PCL-C, PTSD checklist-civilian; PSTD, Post-traumatic stress disorder; VA, Veterans Affairs; VA PRC, Veterans Affairs Polytrauma Rehabilitation; VA TBIMS, Veterans Affairs TBI Model Systems.

Keywords: Obesity; Veterans; military; service members; traumatic brain injury; weight gain.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Analysis of Variance
  • Body Mass Index*
  • Brain Injuries, Traumatic / epidemiology
  • Brain Injuries, Traumatic / physiopathology*
  • Brain Injuries, Traumatic / rehabilitation
  • Cohort Studies
  • Female
  • Glasgow Coma Scale
  • Hospitals, Veterans
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Obesity / epidemiology
  • Obesity / physiopathology
  • Rehabilitation Centers
  • Self Report
  • Veterans