bluuebunny/crossref_metadata_2025 huggingface dataset:
Leisure‐Time Physical Activity and Reduced Plasma Levels of Obesity‐Related Inflammatory Markers
Authors: Pischon Tobias , Hankinson Susan E. , Hotamisligil Gökhan S. , Rifai Nader , Rimm Eric B.
Published: April 2008

Objective: This study investigated the relationship between physical activity and the obesity‐related inflammatory markers C‐reactive protein, interleukin‐6, and soluble tumor necrosis factor receptors (sTNF‐Rs) 1 and 2. Furthermore, we examined the relationship between physical activity and insulin sensitivity (insulin, C‐peptide, and hemoglobin A1c levels) and whether inflammatory markers mediate this association.

Research Methods and Procedures: Biomarkers were measured in 405 healthy men and 454 healthy women from two large ongoing prospective studies. Information about physical activity and other variables was assessed by questionnaires.

Results: After adjustment for other predictors of inflammation, physical activity was inversely associated with plasma levels of sTNF‐R1, sTNF‐R2, interleukin‐6, and C‐reactive protein (p = 0.07, p = 0.004, p = 0.04, and p = 0.009). After further adjustment for BMI and leptin, as a surrogate for fat mass, most of these associations were no longer significant. Physical activity was also inversely related to insulin and C‐peptide levels (p = 0.008 and p < 0.001); however, in contrast to BMI and leptin, levels of inflammatory markers explained only very little of this inverse relationship.

Discussion: These results suggest that frequent physical activity is associated with lower systemic inflammation and improved insulin sensitivity. These associations can partially be explained by a lower degree of obesity in physically active subjects. Although inflammatory markers may mediate obesity‐dependent effects of physical activity on inflammatory related diseases such as type 2 diabetes or coronary heart disease, our study suggests that they do not directly account for the beneficial effects of physical activity on insulin resistance.
Obesity, Fasting Plasma Insulin, and C‐Reactive Protein Levels in Healthy Children
Authors: Shea Steven , Aymong Eve , Zybert Patricia , Shamoon Harry , Tracy Russell P. , Deckelbaum Richard J. , Basch Charles E.
Published: April 2008

Objective: Obesity is associated with hyperinsulinemia and increased level of C‐reactive protein in older children and adults, but little is known about these relationships in very young children. We examined these relationships in healthy 2‐ to 3‐year‐old children.

Research Methods and Procedures: Analyses were performed on data from 491 healthy 2‐ to 3‐year‐old Hispanic children enrolled in a dietary study conducted in New York City, 1992 to 1995.

Results: Body mass index (BMI), ponderal index, and sum of four skinfolds were highly correlated (r > 0.75) in both boys and girls. Fasting insulin and glucose levels were only modestly correlated (r = 0.37 for boys and r = 0.28 for girls; p < 0.001 for both), but essentially all of the variability in a calculated index of insulin resistance was attributable to variability in fasting insulin level. The correlations of BMI with fasting insulin level were r = 0.16 (p < 0.05) in boys and r = 0.14 (p < 0.05) in girls. In separate multivariate regression analyses adjusting for age and sex, BMI and ponderal index were associated with fasting plasma insulin level (p < 0.001 for both obesity measures). In multivariate regression analyses adjusting simultaneously for age, sex, and either BMI or ponderal index, fasting insulin level, but not these obesity measures, was associated with C‐reactive protein level.

Discussion: Obesity is associated with higher fasting insulin level, and fasting insulin is associated with C‐reactive protein level, in healthy 2‐ to 3‐year‐old children.
Effects of Exercise Intensity on Physical Fitness and Risk Factors for Coronary Heart Disease
Authors: Okura Tomohiro , Nakata Yoshio , Tanaka Kiyoji
Published: April 2008

Objective: To determine whether “low‐intensity” exercise (walking) and “high‐intensity” exercise (aerobic dance), when added to a weight loss diet, have different effects on coronary heart disease (CHD) risk factors and physical fitness.

Research Methods and Procedures: Ninety obese women were divided into diet only (DO), diet plus walking (DW), and diet plus aerobic dance (DA) groups. DXA was used to evaluate segmental body composition. Leg‐extension strength and maximal oxygen uptake (V̇o2max) were the indicators of physical fitness. Blood pressure, lipoproteins, and fasting glucose were used as indices for CHD risk factors. These items were measured before and after a 14‐week intervention period.

Results: Whole‐body plus all segmental fat masses were significantly reduced (p < 0.001). Reductions in whole‐body and lower‐limb fat‐ and bone‐free masses were significantly less (p < 0.01) in the DA group (−1.5 and −0.1 kg, respectively) compared with the DO (−2.1 and −0.4 kg, respectively) and DW (−2.5 and −0.5 kg, respectively) groups. Improvements in leg‐extension strength and V̇o2max were significantly greater (p < 0.05) in the DA group compared with the DO group. The CHD risk factors clearly improved (p < 0.05) within each group. Reductions in low density lipoprotein‐cholesterol and fasting glucose were significantly greater (p < 0.05) in the DA group compared with the DO and DW groups.

Discussion: Adding higher intensity aerobic dance to a weight‐loss diet program may help maintain fat‐ and bone‐free mass and may be more effective in improving CHD risk factors compared with low‐intensity walking.
Hypocretin Deficiency in Narcoleptic Humans Is Associated with Abdominal Obesity
Authors: Kok Simon W. , Overeem Sebastiaan , Visscher Tommy L.S. , Lammers Gert Jan , Seidell Jaap C. , Pijl Hanno , Meinders Arend E.
Published: April 2008

Objective: To determine the prevalence of obesity among patients with narcolepsy, to estimate associated long‐term health risks on the basis of waist circumference, and to distinguish the impact of hypocretin deficiency from that of increased daytime sleepiness (i.e., reduced physical activity) on these anthropometric measures.

Research Methods and Procedures: A cross‐sectional, case‐control study was conducted. Patients with narcolepsy (n = 138) or idiopathic hypersomnia (IH) (n = 33) were included. Age‐matched, healthy members of the Dutch population (Monitoring Project on Risk Factors for Chronic Diseases and Doetinchem Project; n = 10, 526) were used as controls. BMI and waist circumference were determined.

Results: Obesity (BMI ≥ 30 kg/m2) and overweight (BMI 25 to 30 kg/m2) occurred more often among narcolepsy patients [prevalence: 33% (narcoleptics) vs. 12.5% (controls) and 43% (narcoleptics) vs. 36% (controls), respectively; both p < 0.05]. Narcoleptics had a larger waist circumference (mean difference 5 ± 1.4 cm, p < 0.001). The BMI of patients with IH was significantly lower than that of narcolepsy patients (25.6 ± 3.6 vs. 28.5 ± 5.4 kg/m2; p = 0.004).

Discussion: Overweight and obesity occur frequently in patients with narcolepsy. Moreover, these patients have an increased waist circumference, indicating excess fat storage in abdominal depots. The fact that patients with IH had a lower BMI than narcoleptics supports the notion that excessive daytime sleepiness (i.e., inactivity) cannot account for excess body fat in narcoleptic patients.
Relationship between Body Weight Gain and Significant Knee, Hip, and Back Pain in Older Americans
Authors: Andersen Ross E. , Crespo Carlos J. , Bartlett Susan J. , Bathon Joan M. , Fontaine Kevin R.
Published: April 2008

Objective: To examine the association between BMI (kilograms per meter squared) and reports of significant knee, hip, and back pain using data from a nationally representative sample of U.S. adults 60 years or older.

Research Methods and Procedures: Population‐based survey data from the Third National Health and Nutrition Examination Survey, involving 5724 adults 60 years or older, were used. BMI, calculated from measured weight (kilograms) and height (meters squared), was used to categorize participants into six BMI‐defined groups: underweight (<18.5), desirable weight (18.5 to 24.9), overweight (25 to 29.9), obese class I (30 to 34.9), obese class II (35 to 39.9), and obese class III (≥40). The presence of significant knee, hip, and back pain in the groups was studied.

Results: The overall prevalences of knee, hip, and back pain were 21%, 14%, and 22%, respectively. Prevalence estimates for knee (underweight 12.1% to obesity class III 55.7%), hip (underweight 10.4% to obesity class III 23.3%), and back (underweight 20.2% to obesity class III 26.1%) pain increased with increased BMI. Sex‐, race‐, and age‐specific pain prevalence estimates also generally increased at increased levels of BMI.

Discussion: Among U.S. adults 60 years or older, the prevalence of significant knee, hip, and back pain increases with increased levels of BMI.
Reduced Expression of FOXC2 and Brown Adipogenic Genes in Human Subjects with Insulin Resistance
Authors: Yang Xiaolin , Enerbäck Sven , Smith Ulf
Published: April 2008

Objective: We investigated subcutaneous adipose tissue expression of FOXC2 and selected genes involved in brown adipogenesis in adult human subjects in whom we have previously identified a reduced potential of precursor cell commitment to adipose‐lineage differentiation in relation to insulin resistance.

Research Methods and Procedure: Gene expression was studied using quantitative real time polymerase chain reaction. The relation between the expression of brown adipogenic genes and the genes involved in progenitor cell commitment, adipose cell size, and insulin sensitivity in vivo was analyzed.

Results: The expression of FOXC2, MASK, MAP3K5, retinoblastoma protein (pRb), peroxisome proliferator‐activated protein gamma (PPARγ), and retinoid X receptor gamma (RXRγ) was decreased in the insulin‐resistant compared with insulin‐sensitive subjects, whereas PPARγ‐2 and CCAAT/enhancer binding protein alpha (C/EBPα) showed no differential expression. The FOXC2 expression correlated with that of Notch and Wnt signaling genes, as well as of the genes studied participating in brown adipogenesis, including MASK, MAP3K5, PPARγ, pRb, RXRγ, and PGC‐1. A second‐level correlation between PPARγ and UCP‐1 was also significant. In addition, the expression of MASK, MAP3K5, pRb, RXRγ, and PGC‐1 inversely correlated with adipose cell mass and also correlated with the glucose disposal rate in vivo.

Discussion: Our results suggest that a reduced brown adipose phenotype is associated with insulin resistance and that a basal brown adipose phenotype may be important for maintaining normal insulin sensitivity.
Obesity and Alcohol Modulate the Effect of Apolipoprotein E Polymorphism on Lipids and Insulin
Authors: Marques‐Vidal Pedro , Bongard Vanina , Ruidavets Jean‐Bernard , Fauvel Josette , Hanaire‐Broutin Hélène , Perret Bertrand , Ferrières Jean
Published: April 2008

Objective: To assess the interaction between apolipoprotein (apo) E polymorphism, alcohol consumption, and BMI on insulin, lipid, and lipoprotein levels in men.

Research Methods and Procedures: Cross‐sectional study of 266 healthy men without hypolipidemic or antidiabetic drug treatment. BMI, apo E polymorphisms, insulin, and lipid and lipoprotein levels were assessed. Alcohol consumption was assessed by questionnaire. ɛ2/ɛ4 carriers were excluded from the analysis.

Results: On bivariate analysis, ɛ2 carriers had lower levels of total and low‐density lipoprotein cholesterol and higher levels of apo E and lipoparticle B:E than ɛ3 carriers, the opposite being found for ɛ4 carriers compared with ɛ3 carriers; ɛ4 carriers also had significantly higher insulin levels. On multivariate analysis, significant interactions (p < 0.04) between apo E alleles and increased BMI were found for total and low‐density lipoprotein cholesterol and insulin levels, the increase in those parameters with BMI being stronger among ɛ4 carriers than among ɛ3 or ɛ2 carriers. Significant interactions (p < 0.02) between apo E alleles and alcohol consumption were also found for apo B levels, which increased in ɛ2 carriers but remained relatively stable in ɛ3 and tended to decrease in ɛ4 carriers.

Discussion: These data suggest that effects of apo E alleles on lipids and insulin levels are partly dependent on environmental variables such as BMI and alcohol intake. These findings highlight the importance of gene × environment interactions on the deleterious effect of obesity on cardiovascular risk factors.
Adult Female Rats Defend “Appropriate” Energy Intake after Adaptation to Dietary Energy
Authors: Roy Heli J. , Keenan Michael J. , Zablah‐Pimentel Erika , Hegsted Maren , Bulot Lisa , O'Neil Carol E. , Bunting L. Dwain , Fernandez J. Marcos
Published: April 2008

Objective: To determine if adult female rats adapt to lower and higher dietary energy density.

Research Methods and Procedures: Study 1 compared high‐fat (56%), high‐energy density (HD) (21.6 kJ/g) and high‐fat (56%), low‐energy density (LD) (16.0 kJ/g) diets before surgery (two groups, 2 weeks, n = 16) and after surgery [ovariectomy (O) Sham (S); 2 × 2 factorial, n = 8; 6 weeks]. The second study (no surgery) compared high‐fat (60.0%), high‐energy (22.0 kJ/g) and low‐fat (10.0%), low‐energy (15.1 kJ/g) diets (n = 8).

Results: In study 1, food intake was similar for the first 2 weeks, but rats on the LD diet consumed less energy, gained less weight, and had lower nonfasted serum leptin (all p < 0.0001) than rats on the HD diet. After surgery, rats on the LD and HD diets had similar weight gain, but rats on the LD diet consumed more food (p < 0.0001) and less energy (p < 0.009). O rats consumed more food and gained more weight (p < 0.0001) than S rats. Results from study 2 were similar to those from study 1.

Discussion: The results demonstrated that O and S surgery rats and rats with no surgery adjust their food intake to defend a level of energy intake. This defense only occurred after a 2‐week adaptation period. The major differences in final body weights and abdominal fat resulted from the initial 2 weeks before adaptation to energy density. Rats fed higher‐energy diets seemed to “settle” at a higher level of adiposity, and rats fed lower‐energy diets consumed more food to increase energy consumption.
Intelligence Test Score and Educational Level in Relation to BMI Changes and Obesity
Authors: Halkjær Jytte , Holst Claus , Sørensen Thorkild I.A.
Published: April 2008

Objective: To investigate whether intelligence and education are related to subsequent BMI changes and development and persistence of obesity in men from young adulthood through middle‐age.

Research Methods and Procedures: Subjects were selected among men (median age, 19 years; examined between 1956 and 1977) appearing at Danish draft boards: a group with juvenile‐onset obesity, including all men with a BMI of ≥31.0 kg/m2; and a nonobese group randomly selected as a 1% sample of the study population. The obese group and 50% of the nonobese group were invited to participate in follow‐up studies between 1982 and 1984 and between 1992 and 1994. Among 907 men with juvenile‐onset obesity and 883 nonobese men, age, examination region, intelligence test score, education, and BMI from baseline to first follow‐up were analyzed by multiple linear and logistic regressions analyses.

Results: Education and intelligence, analyzed separately, were inversely related to BMI changes in both groups and to the development of obesity in the nonobese group. When adjusted for education, the association between intelligence score and BMI changes and development of obesity vanished, whereas the inverse relationship for education persisted only for BMI changes. Intelligence score was not associated with the persistence of obesity in the obese group, whereas inverse relationships were found for education.

Discussion: Intelligence test score was inversely related to risk of BMI changes and the risk of development of obesity, perhaps with education acting as a mediator or indicator of cognitive ability. Education, but not intelligence, was inversely associated with risk of remaining obese.
Insulin Action, Regional Fat, and Myocyte Lipid: Altered Relationships with Increased Adiposity
Authors: Gan Seng Khee , Kriketos Adamandia D. , Poynten Ann M. , Furler Stuart M. , Thompson Campbell H. , Kraegen Edward W. , Campbell Lesley V. , Chisholm Donald J.
Published: April 2008

Objective: Abdominal fat and myocyte triglyceride levels relate negatively to insulin sensitivity, but their interrelationships are inadequately characterized in the overweight. Using recent methods for measuring intramyocyte triglyceride, these relationships were studied in men with a broad range of adiposity.

Research Methods and Procedures: Myocyte triglyceride content (1H‐magnetic resonance spectroscopy of soleus and tibialis anterior muscles and biochemical assessment of vastus lateralis biopsies), regional fat distribution (DXA and abdominal magnetic resonance imaging), serum lipids, insulin action (euglycemic hyperinsulinemic clamp), and substrate oxidation rates (indirect calorimetry) were measured in 39 nondiabetic men (35.1 ± 7.8 years) with a broad range of adiposity (BMI 28.6 ± 4.1 kg/m2, range 20.1 to 37.6 kg/m2).

Results: Relationships between insulin‐stimulated glucose disposal and regional body fat depots appeared more appropriately described by nonlinear than linear models. When the group was subdivided using median total body fat as the cut‐point, insulin‐stimulated glucose disposal correlated negatively to all regional body fat measures (all p ≤ 0.004), serum triglycerides and free fatty acids (p < 0.02), and both soleus intramyocellular lipid (p = 0.003) and vastus lateralis triglyceride (p = 0.04) in the normal/less overweight group. In contrast, only visceral abdominal fat showed significant negative correlation with insulin‐stimulated glucose disposal in more overweight men (r = −0.576, p = 0.01), some of whom surprisingly had lower than expected myocyte lipid levels. These findings persisted when the group was subdivided using different cut‐points or measures of adiposity.

Discussion: Interrelationships among body fat depots, myocyte triglyceride, serum lipids, and insulin action are generally absent with increased adiposity. However, visceral abdominal fat, which corresponds less closely to total adiposity, remains an important predictor of insulin resistance in men with both normal and increased adiposity.
The Sweetening of the World's Diet
Authors: Popkin Barry M. , Nielsen Samara Joy
Published: April 2008

Objective: Using data from many countries in the world combined with in‐depth U.S. dietary data, we explored trends in caloric sweetener intake, the role of urbanization and income changes in explaining these trends, and the contribution of specific foods to these changes.

Research Methods and Procedures: Food disappearance data from 103 countries in 1962 and 127 in 2000 were coupled with urbanization and gross national income per capita data in pooled regression analysis to examine associations between these factors and caloric sweetener intake. Three nationally representative surveys from 1977 to 1978, 1989 to 1991, and 1994 to 1996 plus 1998 are used to examine caloric sweetener intake trends in the United States and the foods responsible for these changes.

Results: Increased consumption of caloric sweetener is one element in the world's dietary changes, represented by a 74‐kcal/d increase between 1962 and 2000. Urbanization and income growth represent 82% of the change. U.S. data show an 83‐kcal/d increase of caloric sweetener consumed—a 22% increase in the proportion of energy from caloric sweetener. Of this increase, 80% comes from sugared beverages; restaurant and fast food sources are represented in greater proportions.

Discussion: Caloric sweetener use has increased considerably around the world. Beverage intake seems to be a major contributor.
Which Metric of Relative Weight Best Captures Body Fatness in Children?
Authors: Field Alison E. , Laird Nan , Steinberg Emily , Fallon Erica , Semega‐Janneh Mariama , Yanovski Jack A.
Published: April 2008

Objective: To evaluate the relative merits of BMI (kilograms per meter squared) and age‐ and gender‐adjusted BMI, age‐ and gender‐specific z score of BMI, and age‐ and gender‐specific percentiles of BMI as surrogate measures of body fatness among a sample of youth.

Research Methods and Procedures: The sample comprised 596 children and adolescents 5 to 18.7 years old and was 40% male and 55% white. Height and weight were measured by trained research staff. DXA was used to determine body fat mass. BMI, age‐ and gender‐specific percentile of BMI, and age‐ and gender‐specific z scores of BMI were computed, and these metrics were compared with measured body fatness.

Results: The BMI values in the sample ranged from 12.9 to 55.0 kg/m2, with a mean of 24.9 kg/m2. The Spearman correlations with percentage body fat were similar for all of the BMI metrics (r = 0.82 to 0.88). Linear regression models with age‐ and gender‐specific percentiles of BMI explained significantly less of the variance (65%) than models with log‐transformed BMI (81%) or age‐ and gender‐specific z scores of BMI (75% to 79%). z scores were the most accurate at classifying children who were overfat (sensitivity = 0.84, specificity = 0.96 for z score ≥1). However, using a BMI ≥85th percentile or a BMI ≥20 kg/m2 was also accurate at classifying youth.

Discussion: The BMI metrics had similar correlations with body fatness, but age‐ and gender‐specific percentiles of BMI were the least accurate proxy measure of body fatness. However, a BMI z score ≥1, BMI percentile ≥85, and BMI ≥20 kg/m2 are all useful for identifying children who may be overfat.
Prevalence and Covariates of Obesity in Lebanon: Findings from the First Epidemiological Study
Authors: Sibai Abla Mehio , Hwalla Nahla , Adra Nada , Rahal Boushra
Published: April 2008

Objective: To estimate the prevalence of overweight and obesity and examine associated covariates in the Lebanese population.

Research Methods and Procedures: A cross‐sectional survey of a representative sample of 2104 individuals, 3 years of age and older. Anthropometric measurements and dietary assessments were conducted following standard methods and techniques. Overweight and obesity (classes I to III) were defined according to internationally standardized criteria for classification of BMI.

Results: For children 3 to 19 years of age, prevalence rates of overweight and obesity were higher overall for boys than girls (22.5% vs. 16.1% and 7.5% vs. 3.2%, respectively). For adult men and women (age ≥ 20 years), the prevalence of overweight was 57.7% and 49.4%, respectively. In contrast, obesity (BMI ≥ 30 kg/m2) was higher overall among women (18.8%) than men (14.3%), a trend that became more evident with increasing obesity class. BMI, percentage of body fat, and waist circumference increased to middle age and declined thereafter. Whereas lack of exercise associated significantly with obesity among children, obesity in older adults was more prevalent among the least educated, nonsmokers, and those reporting a family history of obesity.

Discussion: The results from this national population‐based study in Lebanon show high prevalence rates of overweight and obesity comparable with those observed in developed countries such as the United States. While further studies are needed to examine the underlying social and cultural factors associated with lifestyle and nutritional habits, now is the time to institute multicomponent interventions promoting physical activity and weight control nationwide.
Childhood Obesity: Do Parents Recognize This Health Risk?
Authors: Etelson Debra , Brand Donald A. , Patrick Patricia A. , Shirali Anushree
Published: April 2008

Objective: This study examined parents’ understanding of excess weight as a health risk, knowledge of healthy eating habits, and recognition of obesity in their children.

Research Methods and Procedures: An anonymous questionnaire was distributed during well‐care visits involving children 4 to 8 years of age at a pediatric faculty practice. Parents indicated their level of concern about excess weight and other familiar health risks using a four‐point Likert scale, answered multiple‐choice questions concerning healthy eating patterns, and communicated their perceptions about their child's weight using a visual analog scale. A parent's perception was considered “accurate” if it deviated from the child's growth chart percentile by <30 points.

Results: Of the 83 parents surveyed, 23% (19/83) had overweight children (≥95th percentile of age‐ and gender‐specific BMI growth charts). These parents did not differ from other parents in their level of concern about excess weight as a health risk or in their knowledge of healthy eating patterns, but the two groups of parents did differ in the accuracy of their perceptions about their children's weight. Only 10.5% of parents of overweight children (2/19) perceived their child's weight accurately compared with 59.4% of other parents (38/64; p < 0.001). Parents of overweight children invariably underestimated their children's weight. The median difference between their perception and the growth chart percentile was −45 points.

Discussion: Given that most parents of overweight children fail to recognize that their child has a weight problem, pediatricians should develop strategies to help these parents correct their misperceptions.
Relationship of Psychiatric Diagnosis and Weight Loss Maintenance in Obese Breast Cancer Survivors
Authors: Jenkins Isabella , Djuric Zora , Darga Linda , DiLaura Nora M. , Magnan Morris , Hryniuk William M.
Published: April 2008

Objective: Obese breast cancer survivors are a unique population for weight loss counseling because both obesity and a diagnosis of breast cancer can increase the risk of depression. In this pilot study, weight loss maintenance was examined in obese breast cancer survivors with relationship to psychiatric diagnosis.

Research Methods and Procedures: Forty‐eight subjects were enrolled. The intervention, which used individualized counseling for diet and exercise, lasted 24 months. After a 6‐month period of no contact with study subjects, a follow‐up body weight was obtained at 30 months.

Results: The nine subjects who dropped out of the study before 12 months all failed to complete a structured psychiatric interview. Of the remaining 39 subjects, 9 had major depressive disorder, and 10 had a definable psychiatric disorder of lesser severity such as adjustment disorder. Subjects with any type of psychiatric diagnosis displayed significantly less weight loss at the 12‐month time‐point than those with no diagnosis (6.3% vs. 12.6% loss of baseline weight, respectively). At the 30‐month follow‐up visit, subjects with any psychiatric disorder had a mean weight loss of 1.2% of baseline weight compared with 7.8% weight loss in subjects with no diagnosis.

Discussion: These results suggest that the presence of psychiatric disorders can interfere with weight loss. Therefore, recognition and treatment of psychiatric disorders may be important in attempts at weight reduction, and this will be especially important in populations such as cancer survivors, who seem to have higher rates of depression and other disorders than the general population.
Sibutramine Treatment in Obesity: Predictors of Weight Loss Including Rorschach Personality Data
Authors: Elfhag Kristina , Rössner Stephan , Carlsson Anna Maria , Barkeling Britta
Published: April 2008

Objective: To study personality and clinical factors in weight loss by sibutramine (Meridia and Reductil), an anti‐obesity drug enhancing satiety.

Research Methods and Procedures: The subjects were 30 obese patients [43 ± 12 years (mean ± SD), BMI 40 ± 4 kg/m2]. The treatment comprised 15 mg of sibutramine administered daily and monthly dietary advice. Weight loss after 6 months of treatment was evaluated. For psychological assessment, the Rorschach method (Comprehensive System) and the Beck Depression Inventory were used.

Results: A multiple linear regression model including the Rorschach predictors’ physical demand states (animal movement, designated as FM) being intrusive or difficult to hold and a dependency orientation (food contents) could explain 47% of 6 months of weight loss. A model including initial weight loss in addition to the Rorschach predictors explained 58% of the 6‐month weight loss.

Discussion: The personality factors predicted greater weight loss. In particular, patients with difficulties concerning physical demand states, which would include hunger, could have reduced their eating behavior with enhanced satiety, resulting in greater weight loss. Enhanced satiety could also have helped patients with a dependent need for food to limit food intake. Being enrolled in a treatment program could also have provided essential support for patients with dependency needs. Furthermore, initial weight loss was a predictor of greater weight loss in sibutramine treatment, in accordance with prior research.
Mutational Analysis of the UCP2 Core Promoter and Relationships of Variants with Obesity
Authors: Dalgaard Louise T. , Andersen Gitte , Larsen Lesli H. , Sørensen Thorkild I.A. , Andersen Teis , Drivsholm Thomas , Borch‐Johnsen Knut , Fleckner Jan , Hansen Torben , Din Nanni , Pedersen Oluf
Published: April 2008

Objective: To identify polymorphisms in the human uncoupling protein 2 gene (UCP2) promoter and to investigate whether these were associated with obesity or weight gain.

Research Methods and Procedures: The human UCP2 promoter was characterized by reporter gene analysis in cell lines derived from skeletal muscle, white adipose tissue, and embryonic tissue. We analyzed the core promoter for polymorphisms in 60 obese subjects. A prevalent polymorphism, the −866 G/A variant, was investigated for association with obesity in 749 men obese as young adults and 816 men of the same age representing the background population. Genotype‐phenotype interaction studies were performed in two other population‐based samples: one group of middle‐aged‐to‐elderly Danish subjects (mean age, 53 years; range, 30 to 88 years) and one group of 60‐year‐old Danish subjects.

Results: The region up to −1202 bp relative to the UCP2 transcription initiation site gave rise to the highest promoter activity. Eight mutations in this region were identified comprising −866 G/A, −850 G/A, −337 G/C, −41 G/T, −28 insertion T, −5 insertion (cactgcgaagccc), +45 C/T, and +53 G/C, but none of these was associated with consistent alterations in BMI, body fat content, weight gain, or fasting levels of plasma glucose and serum insulin.

Discussion: Variation of the UCP2 promoter including the single common variant (−866 A/G) is not associated with obesity or obesity‐related intermediary phenotypes in Danish subjects.
Human Uncoupling Protein‐3 and Obesity: An Update
Authors: Hesselink Matthijs K.C. , Mensink Marco , Schrauwen Patrick
Published: April 2008

The cloning of the uncoupling protein (UCP)1 homologs UCP2 and UCP3 has raised considerable interest in the mechanism. The expression of UCP3 mainly in skeletal muscle mitochondria and the potency of the skeletal muscle as a thermogenic organ made UCP3 an attractive target for studies toward manipulation of energy expenditure to fight disorders such as obesity and type 2 diabetes. Overexpressing UCP3 in mice resulted in lean, hyperphagic mice. However, the lack of an apparent phenotype in mice lacking UCP3 triggered the search for alternative functions of UCP3. The observation that fatty acid levels significantly affect UCP3 expression has given UCP3 a position in fatty acid handling and/or oxidation. Emerging data indicate that the primary physiological role of UCP3 may be the mitochondrial handling of fatty acids rather than the regulation of energy expenditure through thermogenesis. It has been proposed that UCP3 functions to export fatty acid anions away from the mitochondrial matrix. In doing so, fatty acids are exchanged with protons, explaining the uncoupling activity of UCP3. The exported fatty acid anions may originate from hydrolysis of fatty acid esters by a mitochondrial thioesterase, or they may have entered the mitochondria as nonesterified fatty acids by incorporating into and flip‐flopping across the mitochondrial inner membrane. Regardless of the origin of the fatty acid anions, this putative function of UCP3 might be of great importance in protecting mitochondria against fatty acid accumulation and may help to maintain muscular fat oxidative capacity.
Effects of Different Dietary Fat Types on Postprandial Appetite and Energy Expenditure
Authors: Flint Anne , Helt Berit , Raben Anne , Toubro Søren , Astrup Arne
Published: April 2008

Objective: Observational studies suggest that monounsaturated (MUFA) and trans fatty acids (TRANS) are more fattening than polyunsaturated fatty acids (PUFA). Therefore, the aim of this study was to investigate the acute effect of intake of PUFA, MUFA, or TRANS on appetite and energy expenditure (EE).

Research Methods and Procedures: Three test meals were randomly given in a cross‐over design to 19 overweight (BMI: 26.8 ± 0.4 kg/m2), young (25.2 ± 0.7 years) men. The fat‐rich breakfasts (0.8 g fat/kg body weight, 60% energy from fat) varied only in the source of C:18‐fat. EE was measured continuously in a respiration chamber, and appetite sensations were rated by visual analog scales before and every 30 minutes, for 5 hours, after the meal. After 5 hours, an ad libitum meal was served, and energy intake was registered. Sensory evaluations of all meals were given using visual analog scales. Data were analyzed by two‐way ANOVA.

Results: There were no differences in basal or postprandial values of appetite ratings and EE, in subsequent ad libitum energy intake, or in the sensory evaluation of the test meals among the 3 test days.

Discussion: Giving acutely large amounts of MUFA, PUFA, or TRANS did not impose any differences in appetite and EE in overweight humans. However, studies with extended protocols and other subject groups are warranted to investigate the long‐term effect of dietary fat quality on the regulation of energy balance and body weight.
Gastric Pacing for Morbid Obesity: Plasma Levels of Gastrointestinal Peptides and Leptin
Authors: Cigaina Valerio , Hirschberg Angelica L.
Published: April 2008

Objective: A gastric pacemaker has been developed to treat morbid obesity. Patients experience increased satiety, the ability to reduce food intake, and a resultant weight loss. However, the mechanism behind the changed eating behavior in paced patients is still under investigation.

Research Methods and Procedures: This study was performed on 11 morbidly obese patients (mean BMI, 46.0 kg/m2) treated with gastric pacing. The peripheral blood levels of satiety signals of cholecystokinin (CCK), somatostatin, glucagon‐like peptide‐1 (GLP‐1), and leptin were studied 1 month before gastric pacer implantation, 1 month after implantation, and 6 months after activation of electrical stimulation. Blood samples were drawn 12 hours after fasting and in response to a hypocaloric meal (270 kcal). Patients were followed monthly for vital signs and weight level.

Results: Gastric pacing resulted in a significant weight loss of a mean of 10.4 kg (4.4 BMI units). No negative side effects or complications were observed during the treatment. After activation of the pacemaker, meal‐related response of CCK and somatostatin and basal levels of GLP‐1 and leptin were significantly reduced (p < 0.05) compared with the tests before gastric pacing. The weight loss correlated significantly with a decrease of leptin levels (R = 0.79, p < 0.01).

Discussion: Gastric pacing is a novel and promising therapy for morbid obesity. Activation of the gastric pacer was associated with a decrease in plasma levels of CCK, somatostatin, GLP‐1, and leptin. More studies are necessary to elucidate the correlations between satiety, weight loss, and digestive neuro‐hormone changes.
The Relationship of Ethnicity, Socioeconomic Factors, and Overweight in U.S. Adolescents
Authors: Gordon‐Larsen Penny , Adair Linda S. , Popkin Barry M.
Published: April 2008

Objective: To examine the extent to which race/ethnic differences in income and education account for sex‐specific disparities in overweight prevalence in white, African American, Hispanic, and Asian U.S. teens.

Research Methods and Procedures: We used nationally representative data collected from 13,113 U.S. adolescents enrolled in the National Longitudinal Study of Adolescent Health. Logistic regression models were used to examine the relationship of family income and parental education to overweight prevalence (body mass index ≥ 85th percentile of age and sex‐specific cutoff points from the 2000 Centers for Disease Control and Prevention/National Center for Health Statistics growth charts). In addition, we used coefficients from our logistic regression models to project the effects on overweight prevalence of equalizing the socioeconomic status (SES) differences between race/ethnic groups.

Results: Keeping adolescents in their same environments and changing only family income and parental education had a limited effect on the disparities in overweight prevalence. Ethnicity‐SES‐overweight differences were greater among females than males. Given that overweight prevalence decreased with increasing SES among white females and remained elevated and even increased among higher SES African‐American females, African‐American/white disparity in overweight prevalence increased at the highest SES. Conversely, disparity was lessened at the highest SES for white, Hispanic, and Asian females. Among males, disparity was lowest at the average SES level.

Discussion: One cannot automatically assume that the benefits of increased SES found among white adults will transfer to other gender‐age‐ethnic groups. Our findings suggest that efforts to reduce overweight disparities between ethnic groups must look beyond income and education and focus on other factors, such as environmental, contextual, biological, and sociocultural factors.
Obesity Modulates the Association among APOE Genotype, Insulin, and Glucose in Men
Authors: Elosua Roberto , Demissie Serkalem , Cupples L. Adrienne , Meigs James B. , Wilson Peter W.F. , Schaefer Ernst J. , Corella Dolores , Ordovas Jose M.
Published: April 2008

Objective: Obesity, insulin resistance, and apolipoprotein E (APOE) genotype have all been associated with coronary heart disease. We examined the interaction between obesity and APOE genotype in determining fasting insulin and glucose levels.

Research Methods and Procedures: From 1991 to 1995, 3799 subjects underwent a clinical examination and fasting insulin and glucose measurement. APOE genotypes were determined on 3500 participants. Participants taking oral hypoglycemic drugs or insulin preparations or with the rare APOE2/4 genotype were excluded. Finally, 2929 individuals were included in the present analysis.

Results: In men, we observed a statistically significant interaction between obesity and APOE genotype on insulin and glucose level (p = 0.003 and 0.008, respectively). Obese men with the APOE4 genotype presented with higher levels of insulin and glucose than obese men in the other genotype groups. No association between genotype and insulin or glucose in nonobese men was observed. Obesity was associated with higher insulin levels in the three APOE genotypes groups, whereas obesity was directly associated with glucose in those with the APOE4 genotype. In women, the effect of interaction between APOE genotype and obesity on fasting insulin and glucose was not statistically significant. Obesity was associated with higher levels of fasting insulin and glucose. APOE genotype was not associated with insulin or glucose.

Discussion: Obesity modulates the association between the APOE genotype and fasting insulin and glucose levels in men. Although weight control is important in all people, it may be especially important in APOE4 men to modify potentially elevated fasting insulin and glucose levels.
Prior Exercise Increases Dietary Oleate, but Not Palmitate Oxidation
Authors: Votruba Susanne B. , Atkinson Richard L. , Schoeller Dale A.
Published: April 2008

Objective: Higher levels of physical activity have been associated with body weight maintenance, but previous work in our laboratory suggests that this is not purely related to energy balance. We hypothesize that this may be related to the partitioning of dietary fat between oxidation and storage.

Research Methods and Procedures: Healthy women (age 24 ± 1 years, BMI = 21.2 ± 0.4 kg/m2) were recruited to participate in rest (n = 10) or exercise sessions of light (n = 11), moderate (n = 10), and heavy (n = 7) exercise. All exercises (1250 kJ above rest) were performed on a stationary cycle inside of a whole‐body calorimeter. [1‐13C]oleate and [d31]palmitate were given in a liquid meal 30 minutes post‐exercise. An additional study was done with identical exercise sessions, but with administration of an oral dose of [1‐13C]acetate and [d3]acetate 30 minutes post‐exercise to determine label sequestration.

Results: Cumulative oxidation of [1‐13C]oleate was significantly greater after light (45 ± 3%), moderate (54 ± 4%), and heavy (51 ± 4%) exercise than that with rest (33 ± 3%) (p = 0.0008). Cumulative oxidation of [d31]palmitate did not differ among trials (12 ± 2%, 14 ± 1%, 17 ± 2%, and 14 ± 2% for rest, light, moderate, and heavy, respectively; p = 0.30).

Discussion: Exercise standardized for energy expenditure increases monounsaturated fat oxidation more than saturated fat oxidation and that the increase occurs regardless of intensity. Recommendations for physical activity for the purposes of weight control may be specific for dietary fat composition.
Cross‐sectional Relationship of Pedometer‐Determined Ambulatory Activity to Indicators of Health
Authors: Chan Catherine B. , Spangler Elizabeth , Valcour James , Tudor‐Locke Catrine
Published: April 2008

Objective: To describe the cross‐sectional relationship between an objective measure of walking (pedometer‐determined steps/day) and general indicators of health, a prior diagnosis of one or more components of the metabolic syndrome, and self‐reported occupational activity in a generally sedentary working population.

Research Methods and Procedures: Steps/day were compared with previous diagnosis of one or more components of the metabolic syndrome (by self‐administered questionnaire) and with general health indicators including BMI, waist circumference, resting heart rate, and blood pressure in 182 subjects in Prince Edward Island, Canada. Study participants were volunteer employees recruited from five workplaces where, in general, the job types were moderately or highly sedentary.

Results: Steps/day were 7230 ± SD 3447 for women (n = 153) and 8265 ± 2849 (n = 21) for men. Pedometer‐determined steps/day were associated inversely with BMI (r = −0.4005, p < 0.0001) in all participants and waist circumference in females only (r = −0.4303, p < 0.0001). There was a low correlation between steps/day and diastolic blood pressure in the whole sample (r = −0.2140, p = 0.0383). Participants who reported a prior diagnosis of one or more components of the metabolic syndrome (hypertension, hypercholesterolemia, heart disease, or type 2 diabetes) took fewer steps/day than healthy participants (p = 0.0254). Pedometer‐determined steps/day were positively associated with self‐reported occupational activity (p = 0.0002).

Discussion: Fewer steps/day are associated with increased BMI, waist circumference, diastolic blood pressure, and components of the metabolic syndrome. Low occupational activity is a contributing factor to low total ambulatory activity.
Parental Weight Status and Girls’ Television Viewing, Snacking, and Body Mass Indexes
Authors: Francis Lori A. , Lee Yoonna , Birch Leann L.
Published: April 2008

Objective: The purpose of this study was to examine whether television viewing (TVV) provides a context for patterns of snacking fostering overweight in young girls from overweight and non‐overweight families.

Research Methods and Procedures: Participants were 173 non‐Hispanic white girls and their parents from central Pennsylvania, assessed longitudinally when girls were 5, 7, and 9 years old. Path analysis was used to test patterns of relationships among girls’ TVV, snacking while watching television, snacking frequency, fat intake from energy‐dense snack food, and girls’ increase in body mass index (BMI) from age 5 to 9.

Results: In both overweight and non‐overweight families, girls who watched more television consumed more snacks in front of the television. In families where neither parent was overweight, television viewing was the only significant predictor of girls’ increase in BMI. In families where one or both parents were overweight, girls who watched more television snacked more frequently, and girls who snacked more frequently had higher intakes of fat from energy‐dense snacks, which predicted their increase in BMI from age 5 to 9. TVV did not directly predict girls’ increase in BMI in girls from overweight families.

Discussion: The results of this study support and extend previous findings that have shown that excessive television viewing and snacking patterns are risk factors for the development of overweight in children; however, patterns of relationships may differ based on parental weight status. For overweight families, TVV may provide a context for excessive snack consumption, in addition to inactivity.
DNA Microarray Analysis of Genes Differentially Expressed in Diet‐Induced (Cafeteria) Obese Rats
Authors: López Iciar P. , Marti Amelia , Milagro Fermin I. , Zulet Maria de los Angeles , Moreno‐Aliaga Maria Jesus , Martinez J. Alfredo , De Miguel Carlos
Published: April 2008

Objective: To better understand the molecular basis of dietary obesity, we examined adipose tissue genes differentially expressed in an obesity model using DNA microarray analysis.

Research Methods and Procedures: We assessed the expression level of over 12, 500 transcripts in epididymal fat pads from (cafeteria) obese and control rats with the aid of the array technology.

Results: Cafeteria (obese) rats weighed 50% more and had 2.5‐fold higher levels of epididymal fat and elevated levels of circulating leptin. Adipose genes differentially expressed in obese and control rats were categorized into five groups: macronutrient metabolism, transcription factors, hormone receptor and signal transduction, redox and stress proteins, and cellular cytoskeleton. Interestingly, the expression levels of a number of genes involved in lipid metabolism such as glycerol‐3‐phosphate dehydrogenase, stearoyl coenzyme A desaturase, together with the transcription factors implicated in adipocyte differentiation (CAAT/enhancer binding protein‐α and peroxisome proliferator‐activated receptor‐γ), were significantly increased in obese animals compared with control. The most up‐regulated transcripts were the ob (49.2‐fold change) and the fatty acid‐binding protein genes (15.7‐ fold change). In contrast, genes related to redox and stress protein were generally down‐regulated in obese animals compared with the control.

Discussion: Our study showed that in diet‐induced obesity, the expression levels of some important genes implicated in lipid metabolism were up‐regulated, whereas those related to redox and stress protein were down‐regulated in obese animals compared with control. This pattern of gene expression may occur in human obesity cases after high‐fat intake.