bluuebunny/crossref_metadata_2025 huggingface dataset:
Trends in Overweight and Obesity in Portugal: The National Health Surveys 1995–6 and 1998–9
Authors: Marques‐Vidal Pedro , Dias Carlos Matias
Published: April 2008

Objective: To assess overweight and obesity trends in the Portuguese population.

Research Methods and Procedures: National Health Surveys, conducted in 1995–6 (17, 989 men; 20, 249 women) and 1998–9 (17, 923 men; 20, 302 women), were used.

Results: In men, the prevalence of overweight and obesity increased from 39.9% (95% CI: 39.2 to 40.6) and 10.3% (95% CI: 9.9 to 10.7), respectively, in 1995–6, to 42.5% (95% CI: 41.8 to 43.2) and 11.5% (95% CI: 11.0 to 12.0), respectively, in 1998–9. In women, prevalence of obesity increased from 12.7% (95% CI: 12.2 to 13.2) in 1995–6 to 14.2% (95% CI: 13.7 to 14.6) in 1998–9, whereas the prevalence of overweight remained stable: 32.2% (95% CI: 31.6 to 32.9) in 1995–6 and 32.3% (95% CI: 31.6 to 32.9) in 1998–9. In men, prevalence of overweight and obesity were higher among former smokers and educational group of 6 to 12 years, and prevalence of obesity was higher in the Lisbon region. In women, prevalence of overweight and obesity were higher among never smokers, and prevalence of obesity was higher among educational group of −6 years. Prevalence of obesity was higher in the Alentejo region, and overweight was higher in the Center region. Finally, prevalence of obesity increased in both sexes for all strata studied (age, smoking status, educational level, and geographic region), whereas prevalence of overweight increased only in men.

Discussion: In Portugal, overweight and obesity levels are related to sociodemographic factors; the increase in obesity levels stresses the need for preventive measures.
Consuming Fructose‐sweetened Beverages Increases Body Adiposity in Mice
Authors: Jürgens Hella , Haass Wiltrud , Castañeda Tamara R. , Schürmann Annette , Koebnick Corinna , Dombrowski Frank , Otto Bärbel , Nawrocki Andrea R. , Scherer Philipp E. , Spranger Jochen , Ristow Michael , Joost Hans‐Georg , Havel Peter J. , Tschöp Matthias H.
Published: April 2008

Objective: The marked increase in the prevalence of obesity in the United States has recently been attributed to the increased fructose consumption. To determine if and how fructose might promote obesity in an animal model, we measured body composition, energy intake, energy expenditure, substrate oxidation, and several endocrine parameters related to energy homeostasis in mice consuming fructose.

Research Methods and Procedures: We compared the effects of ad libitum access to fructose (15% solution in water), sucrose (10%, popular soft drink), and artificial sweetener (0% calories, popular diet soft drink) on adipogenesis and energy metabolism in mice.

Results: Exposure to fructose water increased adiposity, whereas increased fat mass after consumption of soft drinks or diet soft drinks did not reach statistical significance (n = 9 each group). Total intake of energy was unaltered, because mice proportionally reduced their caloric intake from chow. There was a trend toward reduced energy expenditure and increased respiratory quotient, albeit not significant, in the fructose group. Furthermore, fructose produced a hepatic lipid accumulation with a characteristic pericentral pattern.

Discussion: These data are compatible with the conclusion that a high intake of fructose selectively enhances adipogenesis, possibly through a shift of substrate use to lipogenesis.
Increased Cortisol Bioavailability, Abdominal Obesity, and the Metabolic Syndrome in Obese Women
Authors: Duclos Martine , Pereira Patricia Marquez , Barat Pascal , Gatta Blandin , Roger Patrick
Published: April 2008

Objective: This study was conducted to obtain a detailed profile of hypothalamo‐pituitary‐adrenal (HPA) axis activity and reactivity and its differential relationships with body fat distribution and total fat mass in premenopausal obese women.

Research Methods and Procedures: Cortisol responses to stimulation (awakening, food intake, exercise) and suppression (0.25 mg dexamethasone), cortisol metabolism, and tissue sensitivity to glucocorticoids were studied in 53 premenopausal obese women grouped according to their waist‐to hip ratio: women with abdominal body fat distribution (A‐BFD; n = 31) and women with peripheral fat distribution (P‐BFD; n = 22).

Results: Comparatively, A‐BFD women had 1) lower awakening salivary cortisol levels; 2) increased salivary responsiveness to a standardized lunch; 3) similar pituitary sensitivity to dexamethasone but decreased sensitivity of monocytes to dexamethasone; 4) similar 24‐hour urinary free cortisol but increased 24‐hour urinary ratio of cortisone‐to‐cortisol; and 5) no difference in corticosteroid binding protein parameters.

Discussion: Although abdominal obesity is not very different from generalized obesity in terms of HPA function, subtle variations in HPA axis activity and reactivity are evidenced in A‐BFD premenopausal obese women.
Obstructive Sleep Apnea in Extremely Overweight Adolescents undergoing Bariatric Surgery
Authors: Kalra Maninder , Inge Thomas , Garcia Victor , Daniels Stephen , Lawson Louise , Curti Rebecca , Cohen Aliza , Amin Raouf
Published: April 2008

Objectives: To determine the prevalence of obstructive sleep apnea (OSA) in extremely overweight adolescents and to examine the effect of significant weight loss on OSA severity.

Research Methods and Procedures: We reviewed the anthropometric and polysomnographic data on all extremely overweight adolescents who underwent laparoscopic Roux en Y gastric bypass surgery at Cincinnati Children's Hospital Medical Center from July 2001 to September 2004. Repeat polysomnograms were performed after significant weight loss. Comparisons were made between pre‐ and postoperative polysomnographic data.

Results: Nineteen of 34 patients (55%) who underwent bariatric surgery were diagnosed with OSA. Subsequent to surgery, 10 of these patients returned for follow‐up polysomnographic testing. After significant weight loss (mean, 58 kg), OSA severity markedly decreased in all patients (median apnea‐hypopnea index at baseline vs. after weight loss, 9.1 vs. 0.65).

Discussion: Our study indicated that OSA was highly prevalent in extremely overweight adolescents meeting eligibility criteria for bariatric surgery. The significant weight loss after gastric bypass was associated with a marked reduction in OSA severity.
Effect of Screening Out Implausible Energy Intake Reports on Relationships between Diet and BMI
Authors: Huang Terry T.‐K. , Roberts Susan B. , Howarth Nancy C. , McCrory Megan A.
Published: April 2008

Objective: We present an updated method for identifying physiologically implausible dietary reports by comparing reported energy intake (rEI) with predicted energy requirements (pER), and we examine the impact of excluding these reports.

Research Methods and Procedures: Adult data from the Continuing Survey of Food Intakes by Individuals 1994 to 1996 were used. pER was calculated from the dietary reference intake equations. Within‐subject variations and errors in rEI [coefficient of variation (CV) ∼ 23%] over 2 days (d), pER (CV ∼ 11%), and measured total energy expenditure (mTEE; doubly labeled water, CV ∼ 8.2%) were propagated, where ±1 SD = . Thus, a report was identified as implausible if rEI was not within 78% to 122% of pER. Multiple cut‐offs between ±1 and ±2 SD were tested.

Results: %rEI/pER = 81% in the total sample (n = 6499) and progressively increased to 95% in the ±1 SD sample (n = 2685). The ±1 to 1.4 SD samples yielded rEI‐weight associations closest to the theoretical relationship (mTEE to weight). Weak or spurious diet—BMI associations were present in the total sample; ±1 to 1.4 SD samples showed the strongest set of associations and provided the maximum n while maintaining biological plausibility.

Discussion: Our methodology can be applied to different data sets to evaluate the impact of implausible rEIs on health outcomes. Implausible rEIs reduce the overall validity of a sample, and not excluding them may lead to inappropriate conclusions about potential dietary causes of health outcomes such as obesity.
Parity and Body Weight in the United States: Differences by Race and Size of Place of Residence
Authors: Lee Soo‐Kyung , Sobal Jeffery , Frongillo Edward A. , Olson Christine M. , Wolfe Wendy S.
Published: April 2008

Objective: In women, parity has been studied in relation to body weights. This study examined whether and how relationships between parity and body weight differ by race and size of place of residence, adjusting for sociodemographic factors (age, income, education, working status, and marital status) and health behaviors (alcohol consumption, birth control pills, diet, physical activity, and smoking).

Research Methods and Procedures: A U.S. national sample of 3398 white and black women from the Third National Health and Nutrition Examination Survey was used to study the relationships using multiple linear regression analysis.

Results: The parity—weight relationships varied by race and size of place of residence. After adjusting for the covariates, significant relationships between parity and body weight were found only in black women in metropolitan areas and white women in non‐metropolitan areas. Compared with women with no children, white women with two children living in non‐metropolitan areas tended to have lower BMIs, whereas black women in metropolitan areas with one or two children showed higher BMIs.

Discussion: Overall, the parity—weight relationships in these groups of women were not strong or linear. The parity—weight relationships of black women in non‐metropolitan areas warrant further examination.
Basal Endothelial Nitric Oxide Release Is Preserved in Overweight and Obese Adults
Authors: DeSouza Christopher A. , van Guilder Gary P. , Greiner Jared J. , Smith Derek T. , Hoetzer Greta L. , Stauffer Brian L.
Published: April 2008

Objective: Impaired basal nitric oxide release is associated with a number of cardiovascular disorders including hypertension, arterial spasm, and myocardial infarction. We determined whether basal endothelial nitric oxide release is reduced in otherwise healthy overweight and obese adult humans.

Research Methods and Procedures: Seventy sedentary adults were studied: 32 normal weight (BMI <25 kg/m2), 24 overweight (BMI ≥ 25 < 30 kg/m2), and 14 obese (BMI ≥ 30 kg/m2). Forearm blood flow (FBF) responses to intra‐arterial infusions of Ng‐monomethyl‐l‐arginine (5 mg/min), a nitric oxide synthase inhibitor, were used as an index of basal nitric oxide release.

Results: Ng‐monomethyl‐l‐arginine elicited significant reductions in FBF in the normal weight (from 4.1 ± 0.2 to 2.7 ± 0.2 mL/100 mL tissue/min), overweight (4.1 ± 0.1 to 2.8 ± 0.2 mL/100 mL tissue/min), and obese (3.9 ± 0.3 to 2.7 ± 0.2 mL/100 mL tissue/min) subjects. Importantly, the magnitude of reduction in FBF (∼30%) was similar among the groups.

Discussion: These results indicate that the capacity of the endothelium to release nitric oxide under basal conditions is not compromised in overweight and obese adults.
Childhood Maltreatment in Extremely Obese Male and Female Bariatric Surgery Candidates**
Authors: Grilo Carlos M. , Masheb Robin M. , Brody Michelle , Toth Claudia , Burke‐Martindale Carolyn H. , Rothschild Bruce S.
Published: April 2008

Objective: To examine rates of self‐reported childhood maltreatment in extremely obese bariatric surgery candidates and to explore associations with sex, eating disorder features, and psychological functioning.

Research Methods and Procedures: Three hundred forty (58 men and 282 women) extremely obese consecutive candidates for gastric bypass surgery completed a questionnaire battery. The Childhood Trauma Questionnaire was given to assess childhood maltreatment.

Results: Overall, 69% of patients self‐reported childhood maltreatment: 46% reported emotional abuse, 29% reported physical abuse, 32% reported sexual abuse, 49% reported emotional neglect, and 32% reported physical neglect. Except for higher rates of emotional abuse reported by women, different forms of maltreatment did not differ significantly by sex. Different forms of maltreatment were generally not associated with binge eating, current BMI, or eating disorder features. At the Bonferonni‐corrected significance level, emotional abuse was associated with higher eating concerns and body dissatisfaction, and emotional neglect was associated with higher eating concerns. In terms of psychological functioning, at the Bonferonni‐corrected level, emotional abuse and emotional neglect were associated with higher depression and lower self‐esteem, and physical abuse was associated with higher depression.

Discussion: Extremely obese bariatric surgery candidates reported rates of maltreatment comparable with those reported by clinical groups and roughly two to three times higher than normative community samples. Reported experiences of maltreatment differed little by sex and were generally not significantly associated with current BMI, binge eating, or eating disorder features. In contrast, maltreatment—notably emotional abuse and neglect—were significantly associated with higher depression and lower self‐esteem.
Adipocyte Differentiation‐related Protein in Human Skeletal Muscle: Relationship to Insulin Sensitivity
Authors: Phillips Susan A. , Choe Charles C. , Ciaraldi Theodore P. , Greenberg Andrew S. , Kong Alice P. S. , Baxi Sunita C. , Christiansen Louis , Mudaliar Sunder R. , Henry Robert R.
Published: April 2008

Objective: To determine whether adipocyte differentiation‐related protein (ADRP), a lipid droplet—associated protein that binds to and sequesters intracellular fatty acids, is 1) expressed in human skeletal muscle and 2) differentially regulated in human skeletal muscle obtained from obese non‐diabetic (OND) and obese diabetic (OD) subjects.

Research Methods and Procedures: Ten OND subjects and 15 OD subjects underwent a weight loss or pharmacological intervention program to improve insulin sensitivity. Anthropometric data, hemoglobin A1C, fasting glucose, lipids, and glucose disposal rate were determined at baseline and at completion of studies. Biopsies of the vastus lateralis muscle (SkM) were obtained in the fasting state from OND and OD subjects. Protein expression was determined by Western blotting.

Results: ADRP was highly expressed in SkM from OND (4.4 ± 1.54 AU/10 μg, protein, n = 10) and OD (5.02 ± 1.33 AU/10 μg, n = 12) subjects. OND subjects undergoing weight loss had decreased triglyceride levels and improved insulin action. SkM ADRP content increased with weight loss from 5.14 ± 2.15 AU/10 μg to 9.92 ± 1.57 AU/10 μg (p < 0.025). OD subjects were treated with either troglitazone or metformin, together with glyburide, for 3 to 4 months. Both treatments attained similar levels of glycemic control. OD subjects with lower baseline ADRP content (2.85 ± 1.07 AU/10 μg, n = 6) displayed up‐regulation of ADRP expression (to 9.27 ± 2.76 AU/10 μg, p < 0.025).

Discussion: ADRP is the predominant lipid droplet—associated protein in SkM, and low ADRP expression is up‐regulated in circumstances of improved glucose tolerance. Up‐regulation of ADRP may act to sequester fatty acids as triglycerides in discrete lipid droplets that could protect muscle from the detrimental effects of fatty acids on insulin action and glucose tolerance.
Prevalence, Characteristics, and Correlates of Teasing Experiences among Overweight Children vs. Non‐overweight Peers
Authors: Hayden‐Wade Helen A. , Stein Richard I. , Ghaderi Ata , Saelens Brian E. , Zabinski Marion F. , Wilfley Denise E.
Published: April 2008

Objective: Information regarding the prevalence, nature, sources, and psychosocial correlates of teasing was obtained for overweight (OV) children (10 to 14 years of age) vs. non‐overweight (non‐OV) peers. It was hypothesized that weight‐related teasing would be negatively correlated with self‐esteem in specific domains and with enjoyment of physical/social activities and positively correlated with loneliness, bulimic behaviors, body dissatisfaction, and enjoyment of sedentary/isolative activities.

Research Methods and Procedures: Teasing experiences and psychosocial correlates were assessed among OV children from a fitness camp and a demographically similar school sample of non‐OV children.

Results: Among the OV children, appearance‐related teasing was more prevalent, frequent, and upsetting, involved disparaging nicknames focusing more on weight rather than less stigmatized aspects of appearance, and more often perpetrated by peers in general rather than a specific peer. Degree of teasing within the full sample was significantly associated with higher weight concerns, more loneliness, poorer self‐perception of one's physical appearance, higher preference for sedentary/isolative activities, and lower preference for active/social activities, all but the latter association holding up above and beyond actual weight status and demographics. Among OV children, teasing was associated with bulimic behaviors. Associations with type of teasing showed specificity, with weight‐related teasing predicting weight and appearance variables and competency‐related teasing related to social domain factors.

Discussion: When frequency, intensity, emotional impact, and stigmatized content are examined, findings indicate that teasing is more severe for OV children. Effective interventions are needed to help victims cope with and prevent further weight‐related teasing, which may improve peer functioning, enhance weight control efforts, and reduce risk for future eating disturbance.
Relationship of BMI, Waist Circumference, and Weight Change with Use of Health Services by Older Adults
Authors: León‐Muñoz Luz M. , Guallar‐Castillón Pilar , López García Esther , Banegas José R. , Gutiérrez‐Fisac Juan L. , Rodríguez‐Artalejo Fernando
Published: April 2008

Objective: To examine the relationship of BMI, waist circumference (WC), and weight change with use of health care services by older adults.

Research Methods and Procedures: This was a prospective cohort study conducted from 2001 to 2003 among 2919 persons representative of the non‐institutionalized Spanish population ≥60 years of age. Analyses were performed using logistic regression, with adjustment for age, educational level, size of place of residence, tobacco use, alcohol consumption, and presence of chronic disease.

Results: Obesity (BMI ≥ 30 kg/m2) and abdominal obesity (WC >102 cm in men and >88 cm in women) in 2001 were associated with greater use of certain health care services among men and women in the period 2001–2003. Compared with women with WC ≤ 88 cm, women with abdominal obesity were more likely to visit primary care physicians [odds ratio (OR): 1.36; 95% confidence limit (CL): 1.06–1.73] and receive influenza vaccination (OR: 1.30; 95% CL: 1.03–1.63). Weight gain was not associated with greater health service use by either sex, regardless of baseline BMI. Weight loss was associated with greater health service use by obese and non‐obese subjects of both sexes. In comparison with those who reported no important weight change, non‐obese women who lost weight were more likely to visit hospital specialists (OR: 1.45; 95% CL: 1.02–2.06), receive home medical visits (OR: 1.61; 95% CL: 1.06–2.45), be hospitalized (OR: 1.88; 95% CL: 1.29–2.74), and have more than one hospital admission (OR: 2.31; 95% CL: 1.19–4.47).

Discussion: Obesity and weight loss are associated with greater health service use among the elderly.
Positive Maternal Attitude to the Family Eating Together Decreases the Risk of Adolescent Overweight
Authors: Mamun Abdullah A. , Lawlor Debbie A. , O'Callaghan Michael J. , Williams Gail M. , Najman Jake M.
Published: April 2008

Objectives: To determine whether maternal attitude towards the family regularly eating together and maternal report of how often the family eat together are associated with adolescent offspring overweight.

Research Methods and Procedures: A cross‐sectional mother‐child‐linked analysis was carried out using 14‐year follow‐up data from a population‐based prospective birth cohort of 3795 children (52% males) who were participants in the Mater‐University study of pregnancy, Brisbane, Australia. Maternal reports on family eating pattern reported at age 14 were used.

Results: The prevalence of overweight at age 14 was 24.1% (95% confidence interval (CI), 22.3, 26.1) for males and 27.1% (CI, 25.1, 29.2) for females. The majority of mothers (78%) reported that the family ate together at least once a day, but only 43% reported that they felt that family eating together was important. The offspring of women who felt that the family eating together was not important had increased odds of being overweight at age 14 (odds ratio, 1.27; 95% CI, 1.05, 1.53) in age‐ and sex‐adjusted models. Adjustment for potential confounding factors had no substantive effect on the association. There was no association between maternal reports of how often the family actually did eat together and overweight at age 14 in the offspring.

Discussion: These findings suggest that maternal attitude towards family eating patterns, but not maternal report of how often the family do eat together, are associated with childhood overweight status. Maternal attitude towards family eating (as opposed to a report of actual frequency at one time‐point) may reflect broader maternal influences (beyond family eating pattern) on their child's diet and eating patterns over a long time course.
Ethnic Differences in Visceral Adipose Tissue and Type 2 Diabetes: Filipino, African‐American, and White Women
Authors: Araneta Maria Rosario G. , Barrett‐Connor Elizabeth
Published: April 2008

Objective: To compare ethnic differences in visceral adipose tissue (VAT), assessed by computed tomography, and type 2 diabetes risk among 55‐ to 80‐year‐old Filipino, African‐American, and white women without known cardiovascular disease.

Research Methods and Procedures: Subjects were participants in the Rancho Bernardo Study (n = 196), the Filipino Women's Health Study (n = 181), and the Health Assessment Study of African‐American Women (n = 193). Glucose and anthropometric measurements were assessed between 1995 and 2002.

Results: African‐American women had significantly higher age‐adjusted BMI (29.7 kg/m2) and waist girth (88.1 cm) compared with Filipino (BMI, 25.5 kg/m2; waist girth, 81.9 cm) or white (BMI: 26.0 kg/m2; waist girth: 80.7 cm) women. However, VAT was significantly higher among Filipino (69.1 cm3) compared with white (62.3 cm3; p = 0.037) or African‐American (57.5 cm3, p < 0.001) women. VAT correlated better with BMI (r = 0.69) and waist (r = 0.77) in whites, compared with Filipino (r = 0.42; r = 0.59) or African‐American (r = 0.50; r = 0.56) women. Age‐adjusted type 2 diabetes prevalence was significantly higher in Filipinas (32.1%) than in white (5.8%) or African‐American (12.1%) women. Filipinas had higher type 2 diabetes risk compared with African Americans [adjusted odds ratio, 2.30; 95% confidence interval (CI), 1.09 to 4.86] or whites (adjusted odds ratio, 7.51; 95% CI, 2.51 to 22.5) after adjusting for age, VAT, exercise, education, and alcohol intake.

Discussion: VAT was highest among Filipinas despite similar BMI and waist circumference as whites. BMI and waist circumference were weaker estimates of VAT in Filipino and African‐American women than in whites. Type 2 diabetes prevalence was highest among Filipino women at every level of VAT, but VAT did not explain their elevated type 2 diabetes risk.
Prevalence of the Metabolic Syndrome in a Bulgarian Female Population Referred for Bone Density Testing
Authors: Boyanov Mihail A. , Christov V.G.
Published: April 2008

Objective: To investigate the prevalence of the metabolic syndrome in Bulgarian women referred for bone density screening.

Research Methods and Procedures: This was a cross‐sectional clinical study. Subjects were 444 consecutive 30‐ to 75‐year‐old Bulgarian women recruited from the outpatients referred for bone density testing (mean age, 52.67 ± 15.19 years; mean BMI, 26.10 ± 5.71 kg/m2). Height (centimeters), weight (kilograms), and blood pressure were measured. BMI and waist‐to‐hip ratio were calculated. Fasting plasma glucose, blood lipids, and immunoreactive insulinemia (Bayer Corp.‐Diagnostics Div., Tarrytown, NY) were determined. Body composition was analyzed by bioimpedance on a leg‐to‐leg analyser (Tanita TBF‐215; Tanita Corporation, Tokyo, Japan).

Results: Of all women, 56.76% had a BMI > 25 kg/m2, 45.95% had a waist circumference > 88 cm, and 64.64% had a waist‐to‐hip ratio > 0.8; 59.90% had hypertension; 4.05% had fasting plasma glucose > 7.0 mM, and 42.79% had fasting morning immunoreactive insulinemia = 16 UI/liter; 23.65% had hypercholesterolemia; and 26.35% had hypertriglyceridemia. The prevalence of the metabolic syndrome in this sample, as defined by the National Cholesterol and Education Program‐Adult Treatment Panel III, was 34.91%, and by the modified World Health Organization definition was 37.16%.

Discussion: We concluded that Bulgarian women 30 to 75 years old referred for bone density testing have a high prevalence of the metabolic syndrome. Therefore, large‐scale prevention programs are needed in this field.
Norepinephrine‐ and Epinephrine‐deficient Mice Gain Weight Normally on a High‐fat Diet
Authors: Ste. Marie Linda , Luquet Serge , Curtis Wendy , Palmiter Richard D.
Published: April 2008

Objective: Signaling through adrenergic receptors (ARs) by norepinephrine (NE) and epinephrine (Epi) regulates weight gain when mice are fed a high‐fat diet (HFD) by controlling diet‐induced thermogenesis. Thus, one would predict that mice unable to make NE/Epi because of inactivation of the dopamine β‐hydroxylase gene (Dbh‐null mice) would have a propensity to become obese. We characterized the response of Dbh‐null and control mice to a HFD.

Research Methods and Procedures: Dbh‐null and control mice were fed an HFD or a regular diet (RD) for 2 months. Body weight, adiposity, muscle triglyceride levels, and adipocyte size were measured, as were circulating leptin, adiponectin, triglyceride, glucose, and insulin levels. A glucose tolerance test was also preformed.

Results: Dbh‐null mice gain weight normally on an HFD and have the same adiposity. Their serum triglyceride and leptin levels are normal, but adipocytes are ∼30% smaller than controls. Dbh‐null mice maintain low blood glucose levels and glucose tolerance when exposed to the HFD in contrast to controls.

Discussion: Complete lack of NE/Epi does not predispose to obesity. Because mice lacking all three βARs become obese on an HFD, an imbalance of signaling through α‐ and βARs seems to be responsible for obesity. Surprisingly, Dbh‐null mice maintain glucose tolerance.
Increased A‐ring Reduction of Glucocorticoids in Obese Zucker Rats: Effects of Insulin Sensitization
Authors: Livingstone Dawn E.W. , McInnes Kerry J. , Walker Brian R. , Andrew Ruth
Published: April 2008

Objective: Obesity is associated with altered glucocorticoid metabolism, which may impact on hypothalamic‐pituitary‐adrenal axis activity. Here we characterize hepatic 5α‐ and 5β‐reductase in obese rats and their responses to insulin sensitization.

Research Methods and Procedures: Hepatic A‐ring reductase protein and mRNA were assessed in lean and obese Zucker rats after insulin sensitization with metformin or rosiglitazone (n = 7 to 8/group).

Results: Hepatic 5α‐reductase 1 and 5β‐reductase mRNA and protein (p < 0.01) were increased in obese rats. Insulin sensitization ameliorated increased 5α‐reductase 1 mRNA in obese rats (p < 0.01) and partially reversed increased 5β‐reductase activity.

Discussion: Hepatic clearance of glucocorticoids by 5α‐ and 5β‐reductase is increased in obese Zucker rats, and this increase in clearance is attenuated by insulin sensitization. This increased hepatic clearance may underpin compensatory activation of the hypothalamic‐pituitary‐adrenal axis in obesity.
Regulation of Acetyl CoA Carboxylase and Carnitine Palmitoyl Transferase‐1 in Rat Adipocytes
Authors: Zang Yan , Wang Tong , Xie Weisheng , Wang‐Fischer Yan‐Lin , Getty Lisa , Han Jianrong , Corkey Barbara E. , Guo Wen
Published: April 2008

Objective: Acetyl CoA carboxylase (ACC) is a key enzyme in energy balance. It controls the synthesis of malonyl‐CoA, an allosteric inhibitor of carnitine palmitoyltransferase‐1 (CPT‐I). CPT‐I is the gatekeeper of free fatty acid (FFA) oxidation. To test the hypothesis that both enzymes play critical roles in regulation of FFA partitioning in adipocytes, we compared enzyme mRNA expression and specific activity from fed, fasted, and diabetic rats.

Research Methods and Procedures: Direct effects of nutritional state, insulin, and FFAs on CPT‐I and ACC mRNA expression were assessed in adipocytes, liver, and cultured adipose tissue explants. We also determined FFA partitioning in adipocytes from donors exposed to different nutritional conditions.

Results: CPT‐I mRNA and activity decreased in adipocytes but increased in liver in response to fasting. ACC mRNA and activity decreased in both adipocytes and liver during fasting. These changes were not caused directly by fasting‐associated changes in plasma insulin and FFA concentrations because insulin suppressed CPT‐I mRNA and did not affect ACC mRNA in vitro, whereas exogenous oleate had no effect on either. Despite the decrease in adipocyte CPT‐I mRNA and specific activity, CO2 production from endogenous FFAs increased, suggesting increased FFA transport through CPT‐I for β‐oxidation.

Discussion: Stimulation of FFA transport through CPT‐I occurs in both tissues, but CPT‐I mRNA and specific activity correlate with FFA transport in liver and not in adipocytes. We conclude that the mechanism responsible for increasing FFA oxidation in adipose tissue during fasting involves mainly allosteric regulation, whereas altered gene expression may play a central role in the liver.
PIXImus DXA with Different Software Needs Individual Calibration to Accurately Predict Fat Mass
Authors: Johnston Sarah L. , Peacock Wendy L. , Bell Lynn M. , Lonchampt Michel , Speakman John R.
Published: April 2008

Objective: To validate GE PIXImus2 DXA fat mass (FM) estimates by chemical analysis, to compare previously published correction equations with an equation from our machine, and to determine intermachine variation.

Research Methods and Procedures: C57BL/6J (n = 16) and Aston (n = 14) mice (including ob/ob), Siberian hamsters (Phodopus sungorus) (n = 15), and bank voles (Clethrionomys glareolus) (n = 37) were DXA scanned postmortem, dried, then fat extracted using a Soxhlet apparatus. We compared extracted FM with DXA‐predicted FM corrected using an equation designed using wild‐type animals from split‐sample validation and multiple regression and two previously published equations. Sixteen animals were scanned on both a GE PIXImus2 DXA in France and a second machine in the United Kingdom.

Results: DXA underestimated FM of obese C57BL/6J by 1.4 ± 0.19 grams but overestimated FM for wild‐type C57BL/6J (2.0 ± 0.11 grams), bank voles (1.1 ± 0.09 grams), and hamsters (1.1 ± 0.13 grams). DXA‐predicted FM corrected using our equation accurately predicted extracted FM (accuracy 0.02 grams), but the other equations did not (accuracy, −1.3 and −1.8 grams; paired Student's t test, p < 0.001). Two similar DXA instruments gave the same FM for obese mutant but not lean wild‐type animals.

Discussion: DXA using the same software could use the same correction equation to accurately predict FM for obese mutant but not lean wild‐type animals. PIXImus machines purchased with new software need validating to accurately predict FM.
Effect of Somatostatin Analog on Postprandial Satiation in Obesity
Authors: Cremonini Filippo , Camilleri Michael , Gonenne Jonathan , Stephens Debra , Oenning LaVonne , Baxter Kari , Foxx‐Orenstein Amy , Burton Duane
Published: April 2008

Objective: Altered satiation may impact postprandial symptoms and potentially change food intake in obesity. Our aim was to compare effects of octreotide and placebo on postprandial symptoms, satiation, and gastric volumes in obesity.

Research Methods and Procedures: In a randomized, parallel‐group, double‐blind, placebo‐controlled study, 26 obese but otherwise healthy participants received 100 μg of octreotide or placebo subcutaneously 30 minutes before each study. Studies were performed on 2 separate days and included validated non‐invasive techniques: 99mTc‐single photon emission computed tomography imaging to measure fasting stomach volume and gastric volume changes after 90 mL of water and 240 mL of Ensure and a standardized nutrient drink test to measure the maximum tolerated volume and postprandial symptoms.

Results: Relative to placebo, octreotide increased gastric volume after 90 mL of water; however, fasting and gastric volume change post‐Ensure and maximum tolerated volume of Ensure were not different. Octreotide decreased sensations of fullness (p = 0.035) and bloating (p = 0.05) and tended to reduce aggregate symptoms (p = 0.07) after the fully satiating meal.

Discussion: In obese individuals, somatostatin analog significantly reduced postprandial sensations after a satiating meal without altering maximum tolerated meal volume or postnutrient gastric volume, suggesting an effect on upper gut sensation. The role of somatostatin as a permissive factor in the development of obesity by reducing postprandial sensations deserves further study.
Accelerometry‐Measured Activity or Sedentary Time and Overweight in Rural Boys and Girls
Authors: Treuth Margarita S. , Hou Ningqi , Young Deborah R. , Maynard L. Michele
Published: April 2008

Objective: The aim of this study was to examine the association between overweight and physical activity or sedentary time measured by accelerometry in rural boys and girls 7 to 19 years old.

Research Methods and Procedures: A cross‐sectional study was conducted involving 130 girls and 99 boys in elementary, middle, and high school in rural Maryland. After weight, height, and body composition were measured, children wore an Actiwatch accelerometer for 6 days. Comparisons for activity counts were made between normal and overweight or at risk for overweight (at‐risk/overweight) participants (≥85th percentile of BMI). The associations between body composition and accelerometry‐defined activity levels (sedentary, light, moderate, and vigorous) were analyzed by age group for boys and girls.

Results: Differences in total activity in counts per day or counts per minute were not observed between normal and at‐risk/overweight boys or girls in all age groups. No associations between measures of body composition and time spent in an activity level were seen in boys. Fat mass and percentage fat were positively correlated to time spent in sedentary activity (range r = 0.42 to 0.54, all p < 0.01) for girls. In contrast, fat mass and percentage fat were negatively related to time spent in light activity (range, r = −0.40 to −0.51, p < 0.05) for girls.

Discussion: In girls, but not boys, greater body fat is associated with greater time spent being inactive, and lower levels of body fat are associated with more time spent in light activity. Physical activity interventions targeting inactive children in rural communities are warranted.
The Impact of Obesity on Primary Care Visits
Authors: Bertakis Klea D. , Azari Rahman
Published: April 2008

Objective: To investigate the influence of patient obesity on primary care physician practice style.

Research Methods and Procedures: This was a randomized, prospective study of 509 patients assigned for care by 105 primary care resident physicians. Patient data collected included sociodemographic information, self‐reported health status (Medical Outcomes Study Short Form‐36), evaluation for depression (Beck Depression Index), and satisfaction. Height and weight were measured to calculate the BMI. Videotapes of the visits were analyzed using the Davis Observation Code (DOC).

Results: Regression equations were estimated relating obesity to visit length, each of the 20 individual DOC codes, and the six DOC Physician Practice Behavior Clusters, controlling for patient health status and sociodemographics. Obesity was not significantly associated with the length of the visit, but influenced what happened during the visit. Physicians spent less time educating obese patients about their health (p = 0.0062) and more time discussing exercise (p = 0.0075). Obesity was not related to discussions regarding nutrition. Physicians spent a greater portion of the visit on technical tasks when the patient was obese (p = 0.0528). Mean pre‐visit general satisfaction for obese patients was significantly lower than for non‐obese patients (p = 0.0069); however, there was no difference in post‐visit patient satisfaction.

Discussion: Patient obesity impacts the medical visit. Further research can promote a greater understanding of the relationships between obese patients and their physicians.
Effect of Orlistat in Obese Patients with Binge Eating Disorder
Authors: Golay Alain , Laurent‐Jaccard Anne , Habicht Frank , Gachoud Jean‐Pierre , Chabloz Mireille , Kammer Anne , Schutz Yves
Published: April 2008

Objective: Binge eating disorder represents a significant public health problem, with up to 50% of weight loss program participants displaying this disorder. In previous studies with orlistat, patients with binge eating disorder were excluded. The goal of this study was to assess the efficacy of orlistat in obese patients with binge eating disorder.

Research Methods and Procedures: Eighty‐nine patients with clinically diagnosed binge eating disorder and a BMI ≥ 30 kg/m2 were randomized in double‐blind fashion to 24 weeks of treatment with 120 mg of orlistat or placebo three times daily, in combination with a mildly reduced‐calorie diet.

Results: After 24 weeks, the mean weight loss from baseline for orlistat‐treated patients was significantly greater than for patients receiving placebo (−7.4% vs. −2.3%; p = 0.0001) (intent‐to‐treat analysis). The overall Eating Disorder Inventory 2 score at week 24 was significantly lower in patients treated with orlistat than in those in the placebo group (p = 0.011)

Discussion: Orlistat may be considered as part of the management for patients with obesity and binge eating disorder.
Weight Status in Childhood as a Predictor of Becoming Overweight or Hypertensive in Early Adulthood**
Authors: Field Alison E. , Cook Nancy R. , Gillman Matthew W.
Published: April 2008

Objective: To assess the extent to which weight status in childhood or adolescence predicts becoming overweight or hypertensive by young adulthood.

Research Methods and Procedures: We conducted a prospective study of 314 children, who were 8 to 15 years old at baseline, and were followed up 8 to 12 years later. Weight, height, and blood pressure were measured by trained research staff. Incident overweight was defined as BMI ≥ 25 kg/m2 among participants who had not been overweight as children.

Results: More male subjects (48.3%) than female subjects (23.5%) became overweight or obese between their first childhood visit and the young adult follow‐up (p < 0.001). Being in the upper one half of the normal weight range (i.e., BMI between the 50th and 84th percentiles for age and gender in childhood) was a good predictor of becoming overweight as a young adult. Compared with children with a BMI <50th percentile, girls and boys between the 50th and 74th percentiles of BMI were ∼5 times more likely [boys, odds ratio (OR) = 5.3, p = 0.002; girls, OR = 4.8, p = 0.07] and those with a BMI between the 75th and 84th percentiles were up to 20 times more likely (boys, OR = 4.3, p = 0.02; girls, OR = 20.2, p = 0.001) to become overweight. The incidence of high blood pressure was greater among the male subjects (12.3% vs. 1.9%). Compared with boys who had childhood BMI below the 75th percentile, boys between the 75th and 85th percentiles of BMI as children were four times more likely (OR = 3.6) and those at above the 85th percentile were five times more likely (OR = 5.1) to become hypertensive.

Discussion: High normal weight status in childhood predicted becoming overweight or obese as an adult. Also, among the boys, elevated BMI in childhood predicted risk of hypertension in young adulthood.
Calcium and Dairy Intake and Measures of Obesity in Hyper‐ and Normocholesterolemic Children
Authors: Dixon L. Beth , Pellizzon Michael A. , Jawad Abbas F. , Tershakovec Andrew M.
Published: April 2008

Objective: Calcium intake has been inversely associated with body weight and body fatness in adults and, to a lesser extent, in children. Dairy intake has been inversely associated with metabolic syndrome in overweight but not normal‐weight adults. We assessed whether intakes of calcium and dairy foods were associated with measures of obesity in hypercholesterolemic (HC) and normocholesterolemic (non‐HC) children at baseline and over 1 year.

Research Methods and Procedures: Non‐obese 4‐ to 10‐year‐old HC and non‐HC children (342) completed three 24‐hour dietary recalls and provided measures of relative weight (BMI and BMI z scores) and adiposity (sum of skinfolds, trunk skinfolds) at baseline, 3, 6, and 12 months. Cross‐sectional and longitudinal regression analyses, stratified by cholesterol risk status (HC vs. non‐HC) and age (4 to 6 years and 7 to 10 years) and adjusted for potential confounders, were conducted.

Results: After adjusting for age, sex, energy intake, and percentage energy from fat, calcium intake was inversely associated with BMI, sum of skinfolds, and trunk skinfolds at baseline and over 1 year in the 7‐ to 10‐year‐old non‐HC children. Results from the regression models also indicated an inverse relation between intake of dairy foods and measures of obesity at baseline in these children. Calcium or dairy intake was not associated with measures of obesity in HC children or in the 4‐ to 6‐year‐old non‐HC children.

Discussion: These results suggest a complex relation among intake of calcium and dairy foods, measures of obesity, age, and serum cholesterol in children. Older children without risk of metabolic syndrome may benefit most from increased calcium intake.
Association of Plasma Resistin Levels with Coronary Heart Disease in Women
Authors: Pischon Tobias , Bamberger Christoph M. , Kratzsch Jürgen , Zyriax Birgit‐Christiane , Algenstaedt Petra , Boeing Heiner , Windler Eberhard
Published: April 2008

Objective: To examine the association between plasma resistin levels and the presence of coronary heart disease (CHD) in women.

Research Methods and Procedures: Plasma resistin levels were measured in a case‐control study including 185 women with angiographically confirmed CHD and 227 population‐based female controls from the Coronary Risk Factors for Atherosclerosis in Women (CORA) study.

Results: After adjustment for age, smoking, family history of myocardial infarction, retirement, education, physical activity, menopausal status, hormone replacement use, BMI, hypertension, diabetes, and dyslipidemia, the odds ratio for CHD for women in the highest compared with lowest quintile of plasma resistin levels was 3.19 (95% confidence interval, 1.44 to 7.10; p log trend, 0.001). After additional adjustment for plasma C‐reactive protein levels, this association was substantially attenuated and no longer significant (odds ratio, 1.80; 95% confidence interval, 0.69 ti 4.69; p trend = 0.23).

Discussion: These results suggest that plasma resistin levels are significantly associated with the presence of CHD in women; however, this association can largely be explained by concomitant inflammatory processes. Further studies are needed to determine the causal role of resistin in the development of CHD in humans.
Longitudinal Analyses among Overweight, Insulin Resistance, and Cardiovascular Risk Factors in Children
Authors: Reinehr Thomas , de Sousa Gideon , Andler Werner
Published: April 2008

Objective: It has been questioned whether insulin resistance or obesity is the central abnormality contributing to the cardiovascular risk factors dyslipidemia and hypertension in obesity.

Research Methods and Procedures: We studied weight status [SD score (SDS)‐BMI], lipids (triglycerides, low‐density lipoprotein‐ and high‐density lipoprotein‐cholesterol), blood pressure, and insulin resistance index [as homeostasis model assessment (HOMA) model] over a 1‐year period in 229 obese white children (median age 12 years).

Results: Any degree of decrease in HOMA was associated with significant decreases in triglycerides (p < 0.001), systolic blood pressure (p < 0.001), and diastolic blood pressure (p < 0.001), whereas the children with different changes in HOMA did not differ significantly in their weight changes. Only the children in the highest quartile of weight reduction (decrease in SDS‐BMI > 0.5) demonstrated a significant decrease in systolic blood pressure (p < 0.001), diastolic blood pressure (p < 0.001), and triglycerides (p = 0.012), and an increase in high‐density lipoprotein‐cholesterol (p = 0.023), whereas with a lower degree of weight loss, there were no significant changes in cardiovascular risk factors. In contrast with a lower degree of weight loss, a reduction of >0.5 SDS‐BMI was associated with a significant decrease in HOMA (p < 0.001).

Discussion: Because blood pressure and triglycerides decreased with any degree of decrease in HOMA, independently of changes in weight status, these findings support the hypothesis that insulin resistance is the central abnormality contributing to these cardiovascular risk factors. Therefore, improving insulin resistance seems more important than reducing overweight to prevent or treat hypertension and dyslipidemia in obese children.
The 2.3 Genotype of ESRRA23 of the ERRα Gene Is Associated with a Higher BMI Than the 2.2 Genotype
Authors: Kamei Yasutomi , Lwin Htay , Saito Kyoko , Yokoyama Tetsuji , Yoshiike Nobuo , Ezaki Osamu , Tanaka Heizo
Published: April 2008

ERRα (NR3B1) is an orphan nuclear receptor believed to be involved in energy metabolism and obesity. A 23‐base pair sequence in the 5′‐flanking region of the ERRα gene, referred to as ESRRA23, is polymorphic in human chromosomes. Here, we investigated the influence of the ESRRA23 polymorphism on obesity in 703 Japanese individuals by analyzing indices of obesity and related lifestyle factors. The frequency of genotypes was similar to that reported in whites. The 2.3‐genotype was associated with a significantly higher BMI than was the 2.2‐genotype. An increased number of ESRRA23 repeats may be a genetic factor in human obesity.