bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidemiology of Overweight and Obesity in a Greek Adult Population: the ATTICA Study
Authors: Panagiotakos Demosthenes B. , Pitsavos Christos , Chrysohoou Christina , Risvas Grigoris , Kontogianni Meropi D. , Zampelas Antonis , Stefanadis Christodoulos
Published: April 2008

Objective: To evaluate the status of overweight and obesity in a Greek random sample.

Research Methods and Procedures: From 2001 to 2002, 1514 men (20 to 87 years old) and 1528 women (20 to 89 years old) were enrolled into the study. Among several sociodemographic, lifestyle, and bioclinical factors, anthropometric characteristics were also recorded. Overweight and obesity were defined according to the World Health Organization classification.

Results: The prevalences of overweight and obesity were 53% and 20% in men and 31% and 15% in women (p for gender differences < 0.05). The age‐adjusted peak prevalence of obesity was observed in men older than 40 years old and women between 50 and 59 years old (Bonferonni α < 0.001). Central obesity prevailed in 36% of men and 43% of women (p for gender differences < 0.001). Obesity varied from 10% in rural to 25% in urban areas, but this difference was explained mainly by differences in occupational status (p = 0.9). Moreover, obese and overweight participants were older, less educated, more frequently sedentary, consumed higher quantities of alcoholic beverages, and were devoted to an unhealthier diet as compared with those of normal weight (all p < 0.05). A positive association was also observed between BMI and diastolic and systolic blood pressures, total cholesterol, triglycerides, and glucose levels (all p < 0.001).

Discussion: Overweight and obesity seem to be a great health problem in the Greek population, especially in middle‐aged and older adults. Unfavorable lifestyle habits, low education, and the classical cardiovascular risk factors were associated with the prevalence of these health conditions.
Moderate and Severe Obesity Have Large Differences in Health Care Costs
Authors: Andreyeva Tatiana , Sturm Roland , Ringel Jeanne S.
Published: April 2008

Objective: To analyze health care use and expenditures associated with varying degrees of obesity for a nationally representative sample of individuals 54 to 69 years old.

Research Methods and Procedures: Data from the Health and Retirement Study, a nationwide biennial longitudinal survey of Americans in their 50s, were used to estimate multivariate regression models of the effect of weight class on health care use and costs. The main outcomes were total health care expenditures, the number of outpatient visits, the probability of any inpatient stay, and the number of inpatient days.

Results: The results indicated that there were large differences in obesity‐related health care costs by degree of obesity. Overall, a BMI of 35 to 40 was associated with twice the increase in health care expenditures above normal weight (about a 50% increase) than a BMI of 30 to 35 (about a 25% increase); a BMI of over 40 doubled health care costs (∼100% higher costs above those of normal weight). There was a difference by gender in how health care use and costs changed with obesity class. The primary effect of increasing weight class on health care use appeared to be through elevated use of outpatient health care services.

Discussion: Obesity imposes an increasing burden on the health care system, and that burden grows disproportionately large for the most obese segment of the U.S. population. Because the prevalence of severe obesity is increasing much faster than that of moderate obesity, average estimates of obesity effects obscure real consequences for individuals, physician practices, hospitals, and health plans.
Diet‐induced Obesity Delays Cardiovascular Recovery from Stress in Spontaneously Hypertensive Rats
Authors: Šedová Lucie , Bérubé Julie , Gaudet Daniel , Dumont Marc , Tremblay Johanne , Hamet Pavel , Pausová Zdenka
Published: April 2008

Objective: Blood pressure (BP) and heart rate (HR) responses to stress are significant predictors of cardiovascular morbidity and mortality. Because obesity is a major risk factor for cardiovascular disease, we examined whether diet‐induced obesity alters the BP and HR responses to stress and whether these alterations are associated with augmented cardiovascular morbidity in the rat.

Research Methods and Procedures: Adult male spontaneously hypertensive rats were fed either a normal diet or high‐fat diet (HFD) for 12 weeks. At weeks 0 and 12, body weight was measured, and BP and HR were recorded by radiotelemetry throughout three consecutive day and night periods and in response to 30‐minute immobilization stress. At the end of the 12‐week intervention, the rats were sacrificed, and their organs and sera were collected.

Results: With the intervention, HFD rats showed a significantly greater increase in body weight (as expected) and circulating leptin and free fatty acid levels compared with normal diet rats. In addition, they showed similar increases in BP and HR elevations during stress but significantly slower BP and HR decreases after stress. These HFD‐induced delays in stress recovery were associated with BP and HR elevations during the night (behaviorally active) period and with augmentations in cardiac mass.

Discussion: The results of this study indicate that, in spontaneously hypertensive rats, dietary obesity delays cardiovascular recovery from stress, and, in parallel, it promotes the development of nocturnal hypertension as well as cardiac hypertrophy. This suggests that dietary obesity may significantly potentiate the impact of daily stressful experiences on the cardiovascular system.
Weight and BMI over 6 years in Korean Children: Relationships to Body Image and Weight Loss Efforts
Authors: Lee Kayoung , Sohn Haesook , Lee Sangyeoup , Lee Jinkyoung
Published: April 2008

Objective: To investigate the relationships among longitudinal weight status, body dissatisfaction, and attitude to weight loss among Korean children from the age of 7‐8 to 13‐14 years old.

Research Methods and Procedures: 351 Korean school children's heights and weights were measured at the ages of 7‐8 and 13‐14 years old; at the age of 13‐14, they completed a questionnaire about body dissatisfaction and weight loss efforts.

Results: At the age of 7‐8, 15.7% of children were overweight by International Obesity Task Force standards, as compared with 26.2% at the age of 13‐14. Of the 55 7‐ to 8‐year‐old overweight children, 85.5% were still overweight at the age of 13‐14 years old. Greater concerns about body image and stronger desires to be thinner were observed among stable overweight children and among those in whom there had been a rapid increase in BMI over the 6‐year study period. Girls favored thinner shapes than did boys, regardless of their weight status or BMI changes. In girls, the level of body dissatisfaction was related only to weight loss desire, regardless of weight status or changes in BMI. In boys, however, weight loss desire was related only to weight loss attempts and was independent of weight status, BMI changes, and level of body dissatisfaction.

Discussion: Regardless of weight status, changes in BMI should be considered when dealing with body dissatisfaction and attitudes to weight loss in children.
Investigation of Obesity Candidate Genes On Porcine Fat Deposition Quantitative Trait Loci Regions
Authors: Kim Kwan‐Suk , Thomsen Hauke , Bastiaansen John , Nguyen Nguyet Thu , Dekkers Jack C.M. , Plastow Graham S. , Rothschild Max F.
Published: April 2008

Objectives: To investigate possible obesity candidate genes in regions of porcine quantitative trait loci (QTL) for fat deposition and obesity‐related phenotypes.

Research Methods and Procedures: Chromosome mapping and QTL analyses of obesity candidate genes were performed using DNA panels from a reference pig family. Statistical association analyses of these genes were performed for fat deposition phenotypes in several other commercial pig populations.

Results: Eight candidate genes were mapped to QTL regions of pig chromosomes in this study. These candidate genes also served as anchor loci to determine homologous human chromosomal locations of pig fat deposition QTL. Preliminary analyses of relationships among polymorphisms of individual candidate genes and a variety of phenotypic measurements in a large number of pigs were performed. On the basis of available data, gene‐gene interactions were also studied.

Discussion: Comparative analysis of obesity‐related genes in the pig is not only important for development of marker‐assisted selection on growth and fat deposition traits in the pig but also provides for an understanding of their genetic roles in the development of human obesity.
Sarcopenic Obesity Predicts Instrumental Activities of Daily Living Disability in the Elderly
Authors: Baumgartner Richard N. , Wayne Sharon J. , Waters Debra L. , Janssen Ian , Gallagher Dympna , Morley John E.
Published: April 2008

Objective: To determine the association of sarcopenic obesity with the onset of Instrumental Activities of Daily Living (IADL) disability in a cohort of 451 elderly men and women followed for up to 8 years.

Research Methods and Procedures: Sarcopenic obesity was defined at study baseline as appendicular skeletal muscle mass divided by stature squared <7.26 kg/m2 in men and 5.45 kg/m2 in women and percentage body fat greater than the 60th percentile of the study sample (28% body fat in men and 40% in women). Incident disability was defined as a loss of two or more points from baseline score on the IADL. Subjects with disability at baseline (scores < 8) were excluded. Cox proportional hazards analysis was used to determine the association of baseline sarcopenic obesity with onset of IADL disability, controlling for potential confounders.

Results: Subjects with sarcopenic obesity at baseline were two to three times more likely to report onset of IADL disability during follow‐up than lean sarcopenic or nonsarcopenic obese subjects and those with normal body composition. The relative risk for incident disability in sarcopenic obese subjects was 2.63 (95% confidence interval, 1.19 to 5.85), adjusting for age, sex, physical activity level, length of follow‐up, and prevalent morbidity.

Discussion: This is the first study, to our knowledge, to indicate that sarcopenic obesity is independently associated with and precedes the onset of IADL disability in the community‐dwelling elderly. The etiology of sarcopenic obesity is unknown but may include a combination of decreases in anabolic signals and obesity‐associated increases in catabolic signals in old age.
The Eating Inventory and Body Adiposity from Leanness to Massive Obesity: a Study of 2509 Adults
Authors: Bellisle France , Clément Karine , Le Barzic Michelle , Le Gall Annie , Guy‐Grand Bernard , Basdevant Arnaud
Published: April 2008

Objective: To examine how chronic dietary restraint, disinhibition, and hunger, as assessed by the Eating Inventory, vary over a broad range of BMI values from leanness to massive obesity, in subjects with family obesity. Eating Inventory factors were also studied as a function of personal weight history.

Research Methods and Procedures: Subjects were 2509 participants in a genetic study of obesity. BMIs ranged from 15 to 87 kg/m2. Six BMI groups were formed (<27, 27 to 30, 30 to 35, 35 to 40, 40 to 45, and >45).

Results: Multivariate analyses showed that restraint and disinhibition were significantly associated with BMI in men, whereas only disinhibition was in women. Disinhibition scores correlated strongly with hunger scores in both genders in all BMI categories; dietary restraint tended to correlate with the other two factors positively in leaner subjects and negatively in the highest BMI categories. Highly restrained normal‐weight subjects were likely to exhibit disinhibition and hunger, whereas massively obese persons with very high disinhibition scores showed high hunger but little restraint. The highest restraint scores were observed in nonobese adult women with previous obesity in childhood and/or adolescence.

Discussion: The factor most strongly associated with BMI in this large population was disinhibition, suggesting that obesity treatment should target behaviors associated with disinhibition, especially in individuals showing a low level of dietary restraint. High restraint scores in formerly obese normal‐weight women suggest that dietary restraint may exert a beneficial influence on body weight control under conditions that deserve further investigation.
Anthropometric, Parental, and Psychosocial Correlates of Dietary Intake of African‐American Girls
Authors: Cullen Karen W. , Baranowski Tom , Klesges Lisa M. , Watson Kathy , Sherwood Nancy E. , Story Mary , Zakeri Issa , Leachman‐Slawson Deborah , Pratt Charlotte
Published: April 2008

Objective: This paper identifies the anthropometric, parental, and psychosocial characteristics and meal practices (e.g., breakfast skipping and number of meals and snacks consumed) associated with consumption of total energy, percent energy from fat, fruit, 100% fruit juice, vegetables, sweetened beverages, and water among 8‐ to 10‐year‐old African‐American girls.

Research Methods and Procedures: This study included 114 8‐ to 10‐year‐old African‐American girls and a parent or primary caregiver. Girls and a parent or primary caregiver completed several dietary questionnaires. Two 24‐hour dietary recalls were conducted with each girl. Height and weight were measured. Separate hierarchical regression analyses were conducted for each dependent dietary variable; potential field center differences were examined.

Results: The number of meals and snacks consumed was correlated with energy intake. Lower BMI was related to higher vegetable consumption, and the number of snacks consumed was positively related to sweetened beverage consumption. Greater low‐fat food preparation practices reported by parents were related to lower consumption of fat as a percentage of total energy.

Discussion: Dietary behavior differed across geographic areas. Low‐fat food preparation practices in the home seemed to be an important influence on the percentage of energy consumed from fat. Greater vegetable consumption was associated with lower BMI. Interventions to prevent excessive weight gain in African‐American girls should encourage low‐fat food preparation in the home and greater consumption of vegetables.
Trends in Childhood Obesity in Japan over the Last 25 Years from the National Nutrition Survey
Authors: Matsushita Yumi , Yoshiike Nobuo , Kaneda Fumi , Yoshita Katsushi , Takimoto Hidemi
Published: April 2008

Objective: To describe the 25‐year changes in BMI (measured in kilograms per meters squared) and the prevalence of obesity in Japanese children with special reference to urban‐rural differences.

Research Methods and Procedures: We used the data sets from the cross‐sectional annual nationwide surveys (National Nutrition Survey, Japan) conducted from 1976 to 2000 and comprising 29, 052 boys and 27, 552 girls between 6 and 14 years of age. We carried out the trend analyses with the data on sex and age groups and on residential areas according to the size of the municipality (metropolitan areas, cities, and small towns).

Results: The mean (age‐adjusted) BMI increased by +0.32 kg/m2 per 10 years in boys and by +0.24 kg/m2 per 10 years in girls, increases that were remarkable in small towns. The prevalence of obese boys and girls increased from 6.1% and 7.1%, respectively, in the time‐period 1976 to 1980, to 11.1% and 10.2% in 1996 to 2000. The increasing trend was most evident in 9‐ to 11‐year‐old children of both sexes living in small towns, whereas no changes were observed in girls in metropolitan areas.

Discussion: Our data clearly show increasing trends in obesity prevalence in Japanese school children. Degrees of the increasing trends, however, differed across sex and age groups and residential areas, demonstrating a particular phenomenon that girls in metropolitan areas were unlikely to become obese. These epidemiological aspects indicate the priorities for intervention in population strategies to control obesity in children.
Early Sexual Maturation, Body Composition, and Obesity in African‐American Girls
Authors: Himes John H. , Obarzanek Eva , Baranowski Tom , Wilson Darrell M. , Rochon James , McClanahan Barbara S.
Published: April 2008

Objective: To describe associations between sexual maturation and body composition in a sample of African‐American girls who were participants in phase 1 pilot interventions of the Girls Health Enrichment Multisite Studies.

Research Methods and Procedures: Stature, weight, and waist circumference were measured. Pubic hair and breast development were assessed, and body composition was measured by DXA for 147 African‐American girls who were 8 to 10 years of age from three field centers. Participants had BMI ≥25th percentile for age (one site) or BMI ≥50th percentile for age.

Results: Girls Health Enrichment Multisite Studies girls had greater BMI, fat mass, and percentage body fat than national norms and relatively earlier initiation of breast development and pubic hair. Increasing stages of breast development, but not stages of pubic hair, were related to increased stature, waist circumference, BMI, lean mass, fat mass, and percentage of body fat. Pubescent girls (breast stage ≥ 2) were greater than six times as likely to be classified as at risk of overweight (BMI ≥ 85th percentile) and greater than eight times as likely to be classified as overweight (BMI ≥ 95th percentile) as prepubescent counterparts. Adjusted odds ratios for advanced breast development [breast stage ≥ 2 (8 years) or ≥ 3 (9 and 10 years)] were 3.6 for risk of overweight and for overweight compared to girls with average or less than average breast development.

Discussion: Sexual maturation is important to consider in understanding the classification of overweight and the development of obesity during adolescence. Breast development and pubic hair development should be considered separately for their associations with growth and body composition.
Assessing Weight‐Related Biochemical Cardiovascular Risk Factors in African‐American Girls
Authors: Wilson Darrell M. , Wang Yun , Cullen Karen W. , Baranowski Tom , Himes John H. , Gross Myron , McClanahan Barbara S. , Robinson Thomas N.
Published: April 2008

Objective: Hyperinsulinemia/insulin resistance is a risk factor for future type 2 diabetes. Fasting insulin and blood lipids serve as direct indicators of subsequent risk and as biochemical markers of metabolically significant adiposity. We examined the feasibility of obtaining fasting blood samples and report correlates of these biochemical markers in an understudied population sample.

Research Methods and Procedures: Fasting samples were requested from African‐American girls, 8.00 to 10.99 years of age, for insulin, glucose, and lipid concentrations. Indices of insulin sensitivity and secretion were calculated and correlated with anthropometric, dietary, physical activity, and body composition data.

Results: Samples were obtained from 119 of 210 (57%) girls, varying from 5% to 86% across the four field centers. Glucose ranged from 71 to 104 mg/dL. Eleven percent had insulin concentrations >20 mU/liter. One girl had a triglyceride concentration >130 mg/dL. Thirteen percent had total cholesterol >200 mg/dL, whereas all subjects had high‐density lipoprotein (HDL)‐cholesterol of ≥35 mg/dL. Fourteen percent had low‐density lipoprotein levels >130 mg/dL. Insulin concentrations showed consistently strong associations with measures of body weight (rs = 0.54 to 0.67); glucose, HDL, and LDL showed weaker correlations (rs = −0.11 to 0.22). Insulin concentration was highly correlated with indices of both insulin secretion and resistance (rs = 0.99).

Discussion: Fasting blood samples in young African‐American girls were obtained with reasonable cooperation in three of the four field centers involved in this community‐based study. Fasting insulin, glucose, LDL, and HDL concentrations may help evaluate future diabetes and cardiovascular risk in children of this age.
Markers of Increased Cardiovascular Risk: Are We Measuring the Most Appropriate Parameters?
Authors: Hawkins Meredith A.
Published: April 2008

The vital task of evaluating cardiovascular disease risk in individual patients is challenging in light of the ever‐growing list of risk factors. Some of the traditional measures of cardiovascular risk, such as blood lipid levels, have been further refined to provide better risk assessments. Certain specific parameters, such as lipoprotein buoyancy, seem to be better predictors of cardiovascular disease than total lipoprotein levels. Furthermore, as the contribution of systemic inflammation to the pathogenesis of atherosclerosis is increasingly recognized, several inflammatory markers have become associated with disease risk. Consequently, many studies have attempted to determine the individual merits of these factors in predicting cardiovascular risk.
Cardiovascular and Hormonal Aspects of Very‐Low‐Carbohydrate Ketogenic Diets
Authors: Volek Jeff S. , Sharman Matthew J.
Published: April 2008

In recent years, restriction of carbohydrate intake for weight loss has become widespread. Our research group began studying physiological responses to very‐low‐carbohydrate ketogenic diets (VLCKDs) in the late 1990s because we felt there was a significant void in the literature and limited understanding of metabolic responses to VLCKDs. This launched us into a line of research examining the physiological effects of VLCKDs. In this paper, we briefly overview nine studies we have published on isoenergetic and hypoenergetic VLCKDs in men and women. These studies have focused on blood lipid responses to VLCKDs, but we have also addressed changes in body weight, body composition, and hormones. Compared with low‐fat diets, short‐term VLCKDs consistently result in improvements in fat loss, fasting and postprandial triacylglycerols, high‐density lipoprotein‐cholesterol, the distribution of low‐density lipoprotein‐cholesterol subclasses, and insulin resistance. These are the key metabolic abnormalities of metabolic syndrome, a problem of epidemic proportions in the United States. There is substantial variability in total cholesterol and low‐density lipoprotein‐cholesterol responses to VLCKD. The factors responsible for this variability are not known, and studies designed to identify methods to predict blood lipid responses to VLCKD and other dietary approaches represent critical areas for nutrition researchers. Further research is warranted to validate the physiological effects of VLCKD over longer periods of time, including studies that modify the quality of macronutrients (i.e., the type of fat and protein) and the interaction with other interventions (e.g., exercise, dietary supplements, drugs).
A Randomized Trial Comparing Low‐Fat and Low‐Carbohydrate Diets Matched for Energy and Protein
Authors: Segal‐Isaacson CJ , Johnson Shannah , Tomuta Vlad , Cowell Brandy , Stein Daniel T.
Published: April 2008

Several recent studies have found greater weight loss at 6 months among participants on a very‐low‐carbohydrate (VLC) weight‐loss diet compared with a low‐fat (LF) weight‐loss diet. Because most of these studies were not matched for calories, it is not clear whether these results are caused by decreased energy intake or increased energy expenditure. It is hypothesized that several energy‐consuming metabolic pathways are up‐regulated during a VLC diet, leading to increased energy expenditure. The focus of this study was to investigate whether, when protein and energy are held constant, there is a significant difference in fat and weight loss when fat and carbohydrate are dramatically varied in the diet. The preliminary results presented in this paper are for the first four of six postmenopausal overweight or obese participants who followed, in random order, both a VLC and an LF diet for 6 weeks. Other outcome measures were serum lipids, glucose, and insulin, as well as dietary compliance and side effects. Our results showed no significant weight loss, lipid, serum insulin, or glucose differences between the two diets. Lipids were dramatically reduced on both diets, with a trend for greater triglyceride reduction on the VLC diet. Glucose levels were also reduced on both diets, with a trend for insulin reduction on the VLC diet. Compliance was excellent with both diets, and side effects were mild, although participants reported more food cravings and bad breath on the VLC diet and more burping and flatulence on the LF diet.
Clinical Trial Experience with Fat‐Restricted vs. Carbohydrate‐Restricted Weight‐Loss Diets
Authors: Klein Samuel
Published: April 2008

It is unlikely that one diet is optimal for all overweight or obese persons. Both low‐fat and low‐carbohydrate diets have been shown to induce weight loss and reduce obesity‐related comorbidities. Low‐carbohydrate diets cause greater short‐term (up to 6 months) weight loss than low‐fat diets, but the long‐term clinical safety and efficacy of these diets has not been studied.
Efficacy of Lifestyle Modification for Long‐Term Weight Control
Authors: Wadden Thomas A. , Butryn Meghan L. , Byrne Kirstin J.
Published: April 2008

A comprehensive program of lifestyle modification induces loss of ∼10% of initial weight in 16 to 26 weeks, as revealed by a review of recent randomized controlled trials, including the Diabetes Prevention Program. Long‐term weight control is facilitated by continued patient‐therapist contact, whether provided in person or by telephone, mail, or e‐mail. High levels of physical activity and the consumption of low‐calorie, portion‐controlled meals, including liquid meal replacements, can also help maintain weight loss. Additional studies are needed of the effects of macronutrient content (e.g., low‐fat vs. low‐carbohydrate diets) on long‐term changes in weight and health. Research also is needed on effective methods of providing comprehensive weight loss control to the millions of Americans who need it.
Long‐Term Pharmacotherapy for Obesity
Authors: Klein Samuel
Published: April 2008

Obese patients unable to achieve significant weight loss with lifestyle changes alone may require drug therapy, and such therapy may be needed long term lest weight lost be regained. In the United States, only sibutramine and orlistat are available for the long‐term treatment of obesity. Clinical trials have shown that both drugs can induce and maintain weight loss, even in patients with comorbid conditions such as hypertension or type 2 diabetes. Their use must be combined with behavior modification and a structured meal plan, however, for patients to reap the full benefits of such treatment.
Topiramate: A New Potential Pharmacological Treatment for Obesity*
Authors: Astrup Arne , Toubro Søren
Published: April 2008

Obesity is a growing worldwide epidemic that is associated with serious medical complications. Although diet and exercise are often effective treatment in the short run, the weight lost is usually regained unless intensive intervention is maintained. Pharmacological adjunctive measures are clearly needed, and topiramate is currently being investigated as a possible new therapy for obesity. This paper reviews three clinical trials of topiramate for weight reduction in obese subjects: a 6‐month dose‐ranging study, a 2‐year study of weight loss, and a 44‐week study in subjects who had previously lost weight on a low‐calorie diet. All three studies found topiramate to be significantly more efficacious than placebo. Notably, weight loss continued for 1 year and, perhaps, could have continued for a longer period. Topiramate was generally well tolerated, with adverse events being mild to moderate and mostly related to the central nervous system. Paresthesia was a frequent occurrence, but it did not lead to withdrawal of >5% of the subjects in any study.
Pathophysiology and Long‐Term Management of the Metabolic Syndrome
Authors: Pi‐Sunyer F. Xavier
Published: April 2008

The metabolic syndrome has been characterized by a cluster of abnormalities that include obesity, hyperglycemia, dyslipidemia, and hypertension. Other conditions associated with this syndrome include microalbuminuria, inflammation, a prothrombotic state, and a fatty liver. Together, these abnormalities lead to an environment where the risk of developing both type 2 diabetes and atherosclerotic cardiovascular disease are greatly enhanced. Recognition of this syndrome by practitioners, early treatment, and long‐term management are crucial for disease prevention. Successful treatment requires the introduction of lifestyle changes initially and pharmacotherapy subsequently if lifestyle changes are not sufficient.
Regulation of 11β‐HSD Genes in Human Adipose Tissue: Influence of Central Obesity and Weight Loss
Authors: Engeli Stefan , Böhnke Jana , Feldpausch Mareike , Gorzelniak Kerstin , Heintze Ute , Janke Jürgen , Luft Friedrich C. , Sharma Arya M.
Published: April 2008

Objectives: The activity of adipose 11β‐hydroxysteroid dehydrogenase (11β‐HSD) 1 is increased in obese subjects, and animal data suggest that increased cortisol formation in adipose tissue contributes to the development of the metabolic syndrome. The aim of this study was to determine whether up‐regulation of human adipose 11β‐HSD1 in obesity can also be found at the gene expression level.

Research Methods and Procedures: 11β‐HSD gene expression in subcutaneous adipose tissue biopsies of 70 postmenopausal women was studied by real‐time reverse‐transcription polymerase chain reaction. The influence of weight reduction and in vitro effects of several modulators of adipocyte gene expression on 11β‐HSD genes in human adipocytes were also studied.

Results: The 11β‐HSD1 gene was highly expressed in human adipose tissue. 11β‐HSD2 mRNA was also detectable at lower levels. Adipose 11β‐HSD1 gene expression was increased by two‐fold and was positively correlated with waist circumference and homeostasis model assessment index of insulin resistance. 11β‐HSD2 gene expression was reduced by half in obese women. Weight reduction did not change gene expression levels of 11β‐HSD1 or 11β‐HSD2. Cortisol increased 11β‐HSD1 gene expression in isolated human adipocytes in vitro, whereas estradiol, triiodothyronine, angiotensin II, and pioglitazone had no influence.

Discussion: Our data suggest that increased expression of the 11β‐HSD1 gene is associated with metabolic abnormalities in obese women and that increased expression of this gene may contribute to the previously reported increased local conversion of cortisone to cortisol in adipose tissue of obese individuals.
Gender Differences in Lipoprotein Lipase Activity after Acute Exercise
Authors: Perreault Leigh , Lavely Jennifer M. , Kittelson John M. , Horton Tracy J.
Published: April 2008

Objective: To determine whether gender differences exist in lipoprotein lipase (LPL) activity in response to exercise and/or insulin. Exercise and insulin are known modulators of LPL activity in men, but this is less clear in women. LPL activity may predict propensity for obesity; therefore, understanding its modulators is of considerable importance.

Research Methods and Procedures: Gender differences in skeletal muscle and adipose tissue LPL activity were determined after a single bout of exercise followed by a hyperinsulinemic/euglycemic clamp and compared with an identical rest day in healthy lean men (n = 10) and women (n = 10). Muscle and adipose tissue biopsies were obtained pre‐ (post‐exercise vs. rest) and post‐clamp.

Results: Basal levels of muscle and adipose tissue LPL activity were not different between men and women. There was, however, a significant gender by day interaction for muscle LPL activity (p = 0.023) and adipose tissue LPL activity (p = 0.013). In muscle, this was because of a significant increase in LPL activity on the exercise vs. rest day in men (p < 0.001) but not women. Adipose tissue LPL activity also increased significantly in men on the exercise day relative to rest day (p = 0.04) but decreased in women (p = 0.10). The hyperinulinemic/euglycemic clamp had no independent effect on tissue LPL activity, in either gender, after rest or exercise.

Discussion: In the 3 to 4 hours after exercise, muscle and adipose tissue LPL activity increased significantly in men, whereas LPL activity remained unchanged in women.
Reciprocal Hemizygosity Analysis of Mouse Hepatic Lipase Reveals Influence on Obesity
Authors: Farahani Poupak , Fisler Janis S. , Wong Howard , Diament Adam L. , Yi Nengjun , Warden Craig H.
Published: April 2008

Objectives: We previously demonstrated coincident quantitative trait loci (QTLs) for percentage body fat, plasma hepatic lipase (HL) activity, and plasma cholesterol on mouse chromosome 7. In the present study, we investigated whether hepatic lipase (Lipc) is an obesity gene, whether Lipc interacts with an unknown gene on chromosome 7, and how HL activity is linked to the chromosome 7 locus.

Research Methods and Procedures: BSB mice are a model of complex obesity due to interactions among genes from C57BL/6J and Mus spretus (SPRET) in (C57BL/6J × SPRET) × C57BL/6J backcross mice. Five crosses tested the impact on obesity of combinations of inactive (knockout) and wild‐type Lipc alleles from C57BL/6J or SPRET in a reciprocal hemizygosity analysis.

Results: The combined data from this allelic series suggest that Lipc alleles, and not alleles from a gene linked to Lipc, influence obesity. No interaction between Lipc and chromosome 7 was demonstrated. We confirmed the chromosome 7 QTLs for obesity, HL activity, and cholesterol. Because obesity and HL activity are not consistently associated in the BSB model, linkage of HL activity to chromosome 7 is not secondary to obesity per se. We also report, for the first time to our knowledge, a QTL in mammals for food intake.

Discussion: This use of reciprocal hemizygosity analysis in mammals, which, to our knowledge, is the first reported, reveals its power to detect previously unknown effects of Lipc on obesity.
Cognitive Change in Obese Adolescents Losing Weight
Authors: Barton Stephen B. , Walker Lucy L.M. , Lambert Gillian , Gately Paul J. , Hill Andrew J.
Published: April 2008

Objectives: To investigate how obese adolescents think about themselves in terms of exercise, eating, and appearance and whether these cognitions change over the course of a residential weight loss camp.

Research Methods and Procedures: Obese adolescents [N = 61; age, 14.1 (±0.2) years; BMI, 33.9 (±0.7) kg/m2] completed assessments of body weight and height and self‐esteem and a sentence‐completion test eliciting thoughts and beliefs about exercise, eating, and appearance at the start and end of the camp (mean stay, 26 days). They were compared with a single assessment of 20 normal‐weight adolescents [age, 15.4 (±0.2) years; BMI, 21.8 (±0.5) kg/m2].

Results: The obese adolescents lost 5.7 kg and reduced their BMI SD score by 0.25. Camp residence was associated with a significant reduction in the number of negative automatic thoughts and an increase in positive thoughts, especially related to exercise and appearance. There was no change in conditional beliefs, either functional or dysfunctional. Including BMI SD score change as a covariate took away all the main and interaction effects of time, showing that cognitive change was largely accounted for by the reduction in weight. Despite this improvement, campers remained cognitively more negative and dysfunctional than the normal‐weight comparison adolescents.

Discussion: Obese adolescents not only lost weight, but they improved their self‐representation, specifically in terms of automatic thoughts about exercise and appearance. Although these are short‐term cognitive changes, they reflect positively on the camp experience and show the value of psychological improvement in assessing obesity‐treatment outcomes.
Changes of Body Weight and Plasma Ghrelin Levels after Gastric Banding and Gastric Bypass
Authors: Stoeckli Rolf , Chanda Robin , Langer Igor , Keller Ulrich
Published: April 2008

Objective: Ghrelin is an enteric peptide with strong orexigenic and adipogenic effects. Plasma ghrelin levels are decreased in obese subjects but increase after weight loss; this increase is not observed after Roux‐en‐Y gastric bypass (RYGB). Prospective and comparative data after adjustable silicone gastric banding (ASGB) have not been reported previously.

Research Methods and Procedures: Overnight fasting plasma ghrelin concentration was measured in morbidly obese subjects at baseline and 3, 6, 12, and 24 months after ASGB (n = 8) or RYGB (n = 5) and in nonoperated controls (n = 7).

Results: After RYGB, body weight (BW) decreased by 29.5 ± 5.5 kg (mean ± SE, p < 0.001), whereas plasma ghrelin failed to increase significantly (+167 ± 119 pg/mL, not significant). In contrast, after ASGB, BW decreased less (by 22.8 ± 5.9 kg; p < 0.001), and plasma ghrelin significantly increased by 377 ± 201 pg/mL (p = 0.025). Neither BW nor plasma ghrelin changed in nonoperated controls. Plasma leptin decreased in both operated groups (similarly p < 0.05) but not in nonoperated controls. Plasma growth hormone and insulin‐like growth factor 1 were not correlated with changes in plasma ghrelin concentrations.

Discussion: Plasma ghrelin levels failed to increase during substantial weight loss after RYGB, but did increase in response to lesser weight loss after ASGB. These findings suggest that the plasma ghrelin response after weight loss is impaired after exclusion of major parts of the stomach and the duodenum (RYGB), and the smaller long‐term weight loss after ASGB compared with RYGB may be due, at least in part, to an absent increase in plasma ghrelin after RYGB.
Targeting Parents Exclusively in the Treatment of Childhood Obesity: Long‐Term Results
Authors: Golan Moria , Crow Scott
Published: April 2008

Objective: To report the long‐term change in children's overweight following a family‐based health‐centered approach where only parents were targeted compared with a control intervention where only children were targeted.

Research Methods and Procedures: Fifty of the 60 children who participated in the original study were located 7 years later, and their weight and height were measured. At the point of the 7‐year follow‐up, the children were 14 to 19 years of age. Repeated measure ANOVA was used to test differences between the groups in percent overweight at different time‐points.

Results: Mean reduction in percent overweight was greater at all follow‐up points in children of the parent‐only group compared with those in the children‐only group (p < 0.05). Seven years after the program terminated, mean reduction in children's overweight was 29% in the parent‐only group vs. 20.2% in the children‐only group (p < 0.05).

Discussion: Over the long term, treatment of childhood obesity with the parents as the exclusive agents of change was superior to the conventional approach.
Energy‐Dense Snack Food Intake in Adolescence: Longitudinal Relationship to Weight and Fatness
Authors: Phillips Sarah M. , Bandini Linda G. , Naumova Elena N. , Cyr Helene , Colclough Skye , Dietz William H. , Must Aviva
Published: April 2008

Objective: The longitudinal relationship between the consumption of energy‐dense snack (EDS) foods and relative weight change during adolescence is uncertain. Using data from the Massachusetts Institute of Technology Growth and Development Study, the current analysis was undertaken to examine the longitudinal relationship of EDS food intake with relative weight status and percentage body fat and to examine how EDS food consumption is related to television viewing.

Research Methods and Procedures: One hundred ninety‐six nonobese premenarcheal girls 8 to 12 years old were enrolled between 1990 and 1993 and followed until 4 years after menarche. At each annual follow‐up visit, data were collected on percentage body fat (%BF), BMI z score, and dietary intake. Categories of EDS foods considered were baked goods, ice cream, chips, sugar‐sweetened soda, and candy.

Results: At study entry, girls had a mean ± SD BMI z score of −0.27 ± 0.89, consumed 2.3 ± 1.7 servings of EDS foods per day, and consumed 15.7 ± 8.1% of daily calories from EDS foods. Linear mixed effects modeling indicated no relationship between BMI z score or %BF and total EDS food consumption. Soda was the only EDS food that was significantly related to BMI z score over the 10‐year study period, but it was not related to %BF. In addition, a significant, positive relationship was observed between EDS food consumption and television viewing.

Discussion: In this cohort of initially nonobese girls, overall EDS food consumption does not seem to influence weight status or fatness change over the adolescent period.
Binge Status and Quality of Life after Gastric Bypass Surgery: A One‐Year Study
Authors: Malone Margaret , Alger‐Mayer Sharon
Published: April 2008

Objective: This study evaluated gastric bypass surgery outcomes according to presurgical binge eating severity.

Research Methods and Procedures: Adult patients completed assessment questionnaires including the Short Form‐36, Gormally Binge Eating Scale (BES), and Beck Depression Inventory (BDI) before and 12 months after surgery.

Results: One hundred nine patients (18 men, 91 women) were recruited. Based on their baseline BES scores, patients were non‐ [n = 52 (48%)], moderate [n = 31 (28%)], or severe [n = 26 (24%)] binge eaters. Although the percentage of excess weight loss was greatest after 12 months in the severe binge eaters, the difference among groups was not significant. Severe binge eaters had higher baseline BDI scores than either non‐ or moderate binge eaters (p = 0.001). After surgery, BDI scores declined significantly in all groups from the baseline scores but remained higher postoperatively in the severe binge eaters (p = 0.018). BES scores declined significantly (p = 0.000) after surgery within all groups. There was no difference in the Short Form‐36 physical component summary scores at baseline among groups. Mental component summary scores were significantly lower in the severe binge eaters (p = 0.001). After surgery, there was no difference among groups in either physical or mental component summary scores.

Discussion: In conclusion, data from the present study suggest that patients have similar outcomes in terms of improved depression scores, binge eating behavior, and health‐related quality of life regardless of their binge eating severity before surgery. Patients with the most severe binge eating behavior before surgery showed the most improvement when assessed 12 months after surgery.
Hip Circumference and Cardiovascular Morbidity and Mortality in Men and Women
Authors: Heitmann Berit L. , Frederiksen Peder , Lissner Lauren
Published: April 2008

Objective: It has recently been demonstrated that, in middle‐aged women, a wide hip circumference is a protective factor for a number of health endpoints in later years. The effect seems to be independent of both overweight and waist circumference. This paper aims to replicate this finding in another population‐based sample consisting of women and men.

Research Methods and Procedures: This was a prospective observational study consisting of a random subset of adult Danes. A total of 2987 subjects born in 1922, 1932, 1942, or 1952 and 35, 45, 55, or 65 years of age (at examination in 1987 to 1988) participated in the Danish MONICA (MONItoring trends and determinants of CArdiovascular disease) project, with measurements of height, weight, and hip and waist circumference taken. Through personal identification numbers, incidence of coronary heart disease (CHD) and cardiovascular disease (CVD) until the end of 1998 and all causes of death until 2001 were retrieved from the National Registers of Hospital Discharge. There was an average of 10 years of follow‐up for incidence of CVD and CHD and 13 years of follow‐up for total mortality.

Results: Large hip circumference, relative to body size and waist circumference, predicted less incidence of CVD, CHD, and total death in women. This was not the case in men; BMI and waist circumference were the strongest independent predictors.

Discussion: A large hip circumference seems to have independent and positive effects on CVD and CHD morbidity and mortality in women, but no protective effect on cardiovascular health in men. However, a borderline significant protective effect on total mortality was observed.
BMI Is the Main Determinant of the Circulating Leptin in Women after Vertical Banded Gastroplasty
Authors: Zabrocka Liolia , Raczynska Sylwia , Goyke Elzbieta , Sledzinski Zbigniew , Swierczynski Julian
Published: April 2008

Objective: To assess the main determinant of serum leptin concentration changes in morbidly obese patients treated by banded vertical gastroplasty.

Research Methods and Procedures: Serum leptin and insulin concentrations, insulin resistance, BMI, body weight, and body fat mass in 18 obese women and 8 obese men treated by vertical banded gastroplasty were studied. Lean women and men subjects were used as controls.

Results: Before surgery, serum leptin and insulin concentrations and insulin resistance index were significantly higher in morbidly obese patients than in control subjects. BMI, body fat mass, and serum triacylglycerol concentrations were also significantly higher in obese than in lean subjects. All of these parameters gradually decreased during 50 weeks after surgery. Univariate regression analysis displayed significant correlations between the following: serum leptin concentration and BMI (and body fat mass), serum leptin concentration and serum insulin concentration, and serum leptin concentration and insulin resistance index. Multivariate regression analysis indicated that only BMI was independently correlated with the decrease in serum leptin concentration.

Discussion: Obtained data suggest the following: 1) vertical banded gastroplasty causes reduction of body weight, serum leptin and insulin concentration, insulin resistance, and serum triacylglycerol concentration; and 2) BMI is the main determinant of the circulating leptin concentration in morbidly obese women after anti‐obesity surgery.
Fitness Alters the Associations of BMI and Waist Circumference with Total and Abdominal Fat
Authors: Janssen Ian , Katzmarzyk Peter T. , Ross Robert , Leon Arthur S. , Skinner James S. , Rao D.C. , Wilmore Jack H. , Rankinen Tuomo , Bouchard Claude
Published: April 2008

Objective: We tested the following hypotheses in black and white men and women: 1) for a given BMI or waist circumference (WC), individuals with moderate cardiorespiratory fitness (CRF) have lower amounts of total fat mass and abdominal subcutaneous and visceral fat compared with individuals with low CRF; and 2) exercise training is associated with significant reductions in total adiposity and abdominal fat independent of changes in BMI or WC.

Research Methods and Procedures: The sample included 366 sedentary male (111 blacks and 255 whites) and 462 sedentary female (203 blacks and 259 whites) participants in the HERITAGE Family Study. The relationships between BMI and WC with total fat mass (determined by underwater weighing) and abdominal subcutaneous and visceral fat (determined by computed tomography) were compared in subjects with low (lower 50%) and moderate (upper 50%) CRF. The effects of a 20‐week aerobic exercise training program on changes in these adiposity variables were examined in 86% of the subjects.

Results: Individuals with moderate CRF had lower levels of total fat mass and abdominal subcutaneous and visceral fat than individuals with low CRF for a given BMI or WC value. The 20‐week aerobic exercise program was associated with significant reductions in total adiposity and abdominal fat, even after controlling for reductions in BMI and WC. With few exceptions, these observations were true for both men and women and blacks and whites.

Discussion: These findings suggest that a reduction in total adiposity and abdominal fat may be a means by which CRF attenuates the health risk attributable to obesity as determined by BMI and WC.