bluuebunny/crossref_metadata_2025 huggingface dataset:
Climate Amenity and BMI
Authors: Lin Ge , Spann Stephen , Hyman David , Pavlik Valary
Published: July 2008

Objectives: Our goal was to examine the relationship between BMI and climate amenable for physical activity at the county level in the U.S.

Research Methods and Procedures: Using Geographic Information Systems tools and 6‐year National Oceanic and Atmospheric Administration station hourly weather records, an index of amenable climate was derived for all U.S. counties. This index was linked to individual BMI in a multi‐level analysis that accounted for other individual characteristics from the 2002 survey of the Behavioral Risk Factor Surveillance System.

Results: There was an inverse relationship between climate amenable to physical activity and BMI at the county level after controlling for individual risk factors, county road density, and median household income and unemployment rate. Residents in high climate‐amenity counties tended to have a lower BMI.

Discussion: The contribution of less amenable climate to overweight and obesity in the U.S. is likely to be substantial because it cuts across wide geographic areas. Health promotion strategies that promote mixed land use or other urban design conducive to walking and other physical activities should consider broader environmental disamenities to mitigate their influence. Strategies for outdoor physical activity should also be tailored for people of different racial groups and educational backgrounds due to observed differences in their response to climate amenity.
Trust in Scientific Experts on Obesity: Implications for Awareness and Behavior Change
Authors: Bleich Sara , Blendon Robert , Adams Alyce
Published: July 2008

Objective: To explore the relationship between public trust in scientific experts on obesity and public attention to nutrition recommendations, to investigate trust as a predictor of weight‐related behaviors, and to identify the sociodemographic characteristics associated with high and low trust in scientific experts on obesity.

Research Methods and Procedures: This analysis used survey data from two sources: 1) a 2005 Harvard School of Public Health Obesity Survey (N = 2033), and 2) the 2004 General Social Survey (N = 2812). Five outcome measures were used. Three were used to explore trust as a predictor of attention and weight‐related behaviors. Two were used to identify the sociodemographic predictors of trust. Logistic regression analysis was used to model the outcome variables.

Results: Trust in scientific experts was the strongest predictor of public attention to nutritional recommendations from scientific experts, but it was not directly related to weight‐related behaviors. Public attention was significantly associated with two weight‐related behaviors: tracking fruit and vegetable intake and exercise. Women and more educated individuals had significantly higher odds of trusting scientific experts. Characteristics associated with distrust in scientific experts included Hispanic race and older age (over 50).

Discussion: Public health experts should work toward building trust as an important step in stemming the obesity epidemic. Further, more research is necessary to better understand the factors driving trust in scientific experts on obesity. A deeper insight in this area will certainly be of great benefit to obesity‐related risk communication and potentially lead to positive behavior change.
High Dietary Sodium Intake Increases White Adipose Tissue Mass and Plasma Leptin in Rats
Authors: Fonseca‐Alaniz Miriam H. , Brito Luciana C. , Borges‐Silva Cristina N. , Takada Julie , Andreotti Sandra , Lima Fabio B.
Published: July 2008

Objective: Salt restriction has been reported to increase white adipose tissue (WAT) mass in rodents. The objective of this study was to investigate the effect of different sodium content diets on the lipogenic and lipolytic activities of WAT.

Research Methods and Procedures: Male Wistar rats were fed on normal‐sodium (NS; 0.5% Na+), high‐sodium (HS; 3.12% Na+), or low‐sodium (LS; 0.06% Na+) diets for 3, 6, and 9 weeks after weaning. Blood pressure (BP) was measured using a computerized tail‐cuff system. At the end of each period, rats were killed and blood samples were collected for leptin determinations. The WAT from abdominal and inguinal subcutaneous (SC), periepididymal (PE) and retroperitoneal (RP) depots was weighed and processed for adipocyte isolation, rate measurement of lipolysis and d‐[U‐14C]‐glucose incorporation into lipids, glucose‐6‐phosphate dehydrogenase (G6PDH) and malic enzyme activity evaluation, and determination of G6PDH and leptin mRNA expression.

Results: After 6 weeks, HS diet significantly increased BP; SC, PE, and RP WAT masses; PE adipocyte size; plasma leptin concentration; G6PDH activity in SC WAT; and PE depots and malic activity only in SC WAT. The leptin levels correlated positively with WAT masses and adipocyte size. An increase in the basal and isoproterenol‐stimulated lipolysis and in the ability to incorporate glucose into lipids was observed in isolated adipocytes from HS rats.

Discussion: HS diet induced higher adiposity characterized by high plasma leptin concentration and adipocyte hypertrophy, probably due to an increased lipogenic capacity of WAT.
Relationship of Plasma Adiponectin With Sex Hormone and Insulin‐like Growth Factor Levels
Authors: Tworoger Shelley S. , Mantzoros Christos , Hankinson Susan E.
Published: July 2008

Objective: Recent studies have suggested that a relationship between adiponectin and sex hormone, prolactin, and insulin‐like growth factor levels could be important for breast cancer risk and insulin sensitivity. Therefore, we assessed the relationship of adiponectin with plasma concentrations of estrone; estradiol; estrone sulfate; testosterone; androstenedione; dehydroepiandrosterone (DHEA); dehydroepiandrosterone sulfate (DHEAS); sex hormone binding globulin (SHBG); prolactin; insulin‐like growth factor (IGF‐1); its binding protein, IGF binding protein 3 (IGFBP‐3); c‐peptide; and IGF binding protein 1 (IGFBP‐1) among 360 postmenopausal women not taking postmenopausal hormones from the Nurses’ Health Study.

Research Methods and Procedures: Multivariate models were adjusted for physical activity, alcohol consumption, age at blood draw, age at first birth/parity, fasting status, and time of day of blood draw; a separate model was additionally adjusted for BMI at blood draw.

Results: Estrogens were inversely associated with adiponectin levels; however, except for free estradiol, these associations were substantially attenuated after adjustment for BMI. Free estradiol levels were 27% lower among women in the top vs. bottom quartile of adiponectin levels. No consistent associations were observed for the androgens, prolactin, IGF‐1, and IGFBP‐3. However, SHBG, c‐peptide, and IGFBP‐1 were strongly and independently associated with adiponectin levels (r = 0.29, −0.30, 0.24, respectively).

Conclusion: With the exceptions of SHBG, c‐peptide, and IGFBP‐1, the studied analytes were modestly associated with adiponectin and the associations were, in large part, mediated by body fat.
Ultrasound Evaluation of Visceral Fat and Metabolic Risk Factors During Early Pregnancy
Authors: Bartha Jose L. , Marín‐Segura Patricia , González‐González Nieves L. , Wagner Fernando , Aguilar‐Diosdado Manuel , Hervias‐Vivancos Blas
Published: July 2008

Objective: The objective was to study the relationships between ultrasound estimated visceral fat and metabolic risk factors during early pregnancy.

Research Methods and Procedures: Thirty consecutive healthy pregnant women at 11 to 14 weeks of gestation were studied. Maximum subcutaneous fat thickness (SFT) and visceral fat thickness (VFT) were successfully measured by ultrasound. Fasting plasma glucose, insulin, triglycerides, total cholesterol, high‐density lipoprotein cholesterol (HDL‐C), and blood pressure were measured. Insulin resistance was calculated by using the homeostasis model assessment (HOMA).

Results: VFT significantly correlated with diastolic blood pressure (r = 0.37, p = 0.04), glycemia (r = 0.37, p = 0.04), insulinemia (r = 0.59, p = 0.001) insulin sensitivity (HOMA; r = 0.59, p = 0.001), triglycerides (r = 0.58, p = 0.03), HDL‐C (r = −0.39, p = 0.03), and total cholesterol/HDL‐C ratio (p = 0.002), whereas SFT was significantly correlated with only diastolic blood pressure (p = 0.03). VFT better significantly correlated with the metabolic risk factors than pre‐gestational BMI [r = 0.39, p = 0.03 for insulinemia, r = 0.42, p = 0.02 for insulin sensitivity (HOMA), and r = 0.49, p = 0.01 for triglycerides and not significant for the rest].

Discussion: Visceral fat thickness can be easily measured by ultrasound at early pregnancy and correlates better than BMI with metabolic risk factors.
Comparison of Methods for Assessing Abdominal Adipose Tissue from Magnetic Resonance Images
Authors: Arif Hassan , Racette Susan B. , Villareal Dennis T. , Holloszy John O. , Weiss Edward P.
Published: July 2008

Objective: To compare the inter‐rater and intra‐rater reliability and analysis time of two methods for quantifying visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) volumes from magnetic resonance (MR) images.

Research Methods and Procedures: Ten subjects (BMI, 27.0 ± 2.1 kg/m2; 56 years of age ± 4 years) underwent MR imaging of the abdomen. Ten transverse T1‐weighted images were selected from each scan and analyzed using two software packages that differ in principle. The first method, ANALYZE version 5.0, represents the manual threshold method, and the second, HIPPO version 1.3, is based on the fuzzy clustering approach. Inter‐rater reliability for each method was assessed by comparing the intra‐class correlation coefficients (ICCs) for VAT and SAT results from two evaluators, and intra‐rater reliability for each method was assessed by comparing ICCs for VAT and SAT analyses performed 1 week apart by the same evaluator. The total time for analysis also was compared between methods.

Results: The inter‐rater reliability for VAT was greater with HIPPO than with ANALYZE (ICC = 0.996 vs. 0.828), whereas inter‐rater reliability for SAT did not differ between methods (ICC = 0.975 and 0.987). The intra‐rater reliability was equally high with HIPPO and ANALYZE for both VAT (ICC = 0.998 vs. 0.992) and SAT (ICC = 0.996 vs. 0.992). HIPPO required less than one‐half as much analysis time as ANALYZE (15.9 ± 4.4 vs. 36.5 ± 8.2 minutes, p < 0.0001).

Discussion: HIPPO software appears advantageous for the quantification of VAT from multislice MR images because inter‐rater results are more reliable, and it is more time‐efficient than less automated methods.
Sex Differences in Lipolysis‐Regulating Mechanisms in Overweight Subjects: Effect of Exercise Intensity
Authors: Moro Cédric , Pillard Fabien , de Glisezinski Isabelle , Crampes François , Thalamas Claire , Harant Isabelle , Marques Marie‐Adeline , Lafontan Max , Berlan Michel
Published: July 2008

Objective: To explore sex differences in the regulation of lipolysis during exercise, the lipid‐mobilizing mechanisms in the subcutaneous adipose tissue (SCAT) of overweight men and women were studied using microdialysis.

Research Methods and Procedures: Subjects matched for age, BMI, and physical fitness performed two 30‐minute exercise bouts in a randomized fashion: the first test at 30% and 50% of their individual maximal oxygen uptake (Vo2max) and the second test at 30% and 70% of their Vo2max.

Results: In both groups, an exercise‐dependent increment in extracellular glycerol concentration (EGC) was observed. Whatever the intensity, phentolamine [α‐adrenergic receptor (AR) antagonist] added to a dialysis probe potentiated exercise‐induced lipolysis only in men. In a probe containing phentolamine plus propranolol (β‐AR antagonist), no changes in EGC occurred when compared with the control probe when exercise was performed at 30% and 50% Vo2max. A significant reduction of EGC (when compared with the control probe) was observed in women at 70% Vo2max. At each exercise power, the plasma non‐esterified fatty acid and glycerol concentrations were higher in women. Exercise‐induced increase in plasma catecholamine levels was lower in women compared with men. Plasma insulin decreased and atrial natriuretic peptide increased similarly in both groups.

Discussion: Overweight women mobilize more lipids (assessed by glycerol) than men during exercise. α2‐Anti‐lipolytic effect was functional in SCAT of men only. The major finding is that during low‐to‐moderate exercise periods (30% and 50% Vo2max), lipid mobilization in SCAT relies less on catecholamine‐dependent stimulation of β‐ARs than on an increase in plasma atrial natriuretic peptide concentrations and the decrease in plasma insulin.
A Two‐Year Randomized Weight Loss Trial Comparing a Vegan Diet to a More Moderate Low‐Fat Diet
Authors: Turner‐McGrievy Gabrielle M. , Barnard Neal D. , Scialli Anthony R.
Published: July 2008

Objective: The objective was to assess the effect of a low‐fat, vegan diet compared with the National Cholesterol Education Program (NCEP) diet on weight loss maintenance at 1 and 2 years.

Research Methods and Procedures: Sixty‐four overweight, postmenopausal women were randomly assigned to a vegan or NCEP diet for 14 weeks, and 62 women began the study. The study was done in two replications. Participants in the first replication (N = 28) received no follow‐up support after the 14 weeks, and those in the second replication (N = 34) were offered group support meetings for 1 year. Weight and diet adherence were measured at 1 and 2 years for all participants. Weight loss is reported as median (interquartile range) and is the difference from baseline weight at years 1 and 2.

Results: Individuals in the vegan group lost more weight than those in the NCEP group at 1 year [−4.9 (−0.5, −8.0) kg vs. −1.8 (0.8, −4.3); p < 0.05] and at 2 years [−3.1 (0.0, −6.0) kg vs. −0.8 (3.1, −4.2) kg; p < 0.05]. Those participants offered group support lost more weight at 1 year (p < 0.01) and 2 years (p < 0.05) than those without support. Attendance at meetings was associated with improved weight loss at 1 year (p < 0.001) and 2 years (p < 0.01).

Discussion: A vegan diet was associated with significantly greater weight loss than the NCEP diet at 1 and 2 years. Both group support and meeting attendance were associated with significant weight loss at follow‐up.
Package Unit Size and Amount of Food: Do Both Influence Intake?
Authors: Raynor Hollie A. , Wing Rena R.
Published: July 2008

Objective: Large portions increase intake and are hypothesized to contribute to the obesity epidemic. However, it is unclear if portion size affects intake through changes in the unit size of available food or the overall amount of food available for consumption. Thus, this study examined the independent effects of package unit size and amount of food on intake. It was hypothesized that both variables would influence intake.

Research Methods and Procedures: Non‐obese (BMI <30 kg/m2), non‐smoking, unrestrained, college‐aged men (n = 12) and women (n = 16) who regularly consumed (≥3 times/wk) snack foods were randomly assigned to one of four groups crossing package unit size (small vs. large) and amount of food (small vs. large). Participants were given a box with 4 snack foods (potato chips, cheese crackers, cookies, and candy) packaged according to their assigned group to take home and eat over 3 days. Dependent variables were energy and gram intake of provided snack foods.

Results: An effect of amount of food was found (p < 0.01). A 100% increase in the amount of food provided produced an 81% increase in energy consumed from the snack foods [small amount, 21,037.6 ± 10,852 kJ (5028 ± 2596 kcal) vs. large amount, 11,640.7 ± 4914.1 kJ (2782 ± 1174 kcal)]. No effect of package unit size was found.

Discussion: These results suggest that the amount of food available to eat strongly influences intake.
The Effect of Obesity Management on Body Image in Patients Seeking Treatment at Medical Centers
Authors: Dalle Grave Riccardo , Cuzzolaro Massimo , Calugi Simona , Tomasi Franco , Temperilli Flavia , Marchesini Giulio ,   QUOVADIS Study Group
Published: July 2008

Objective: Body image dissatisfaction is common in treatment‐seeking patients with obesity. We aimed to investigate the effects of obesity management on body image in patients with obesity attending Italian medical centers for weight loss programs.

Research Methods and Procedures: A total of 473 obese patients seeking treatment in 13 Italian medical centers (80% females; age, 45.9 ± standard deviation 11.0 years; BMI, 36.8 ± 5.7 kg/m2) were evaluated at baseline and after a 6‐month weight loss treatment. Body uneasiness, psychiatric distress, and binge eating were tested by Body Uneasiness Test (BUT, Part A), Symptom CheckList‐90 (SCL‐90), and Binge Eating Scale (BES), respectively.

Results: At 6‐month follow‐up, the percentage weight loss was significantly higher in men (9.0 ± 6.3%) than in women (6.8 ± 7.3%; p = 0.010). Both men and women had a significant improvement in BUT Global Severity Index and in all of the BUT subscales with the exception of the Compulsive Self‐Monitoring subscale. Linear regression analysis selected baseline psychological and behavioral measures (global score of BUT and SCL‐90) and improved psychiatric distress and binge eating as independent predictors of changes in basal body dissatisfaction in females, whereas in males, changes were associated only with baseline BUT‐Global Severity Index score, binge eating, and its treatment‐associated improvement. Pre‐treatment BMI and BMI changes did not enter the regression.

Discussion: Obesity treatment, even with a modest degree of weight loss, is associated with a significant improvement of body image, in both females and males. This effect depends mainly on psychological factors, not on the amount of weight loss.
Media Use and Obesity in Adolescent Females
Authors: Schneider Margaret , Dunton Genevieve Fridlund , Cooper Dan Michael
Published: July 2008

Objective: In the context of growing public health concern with the obesity rates among children and adolescents, much attention has focused on the role of television as a contributor to the problem. Less attention has been devoted to interactive media (internet surfing and video games), despite the fact that these forms of entertainment are fast gaining in popularity among youth. This study investigated the relative associations of TV viewing and interactive media use with body fat and BMI, controlling for both physical activity participation and cardiovascular fitness.

Research Methods and Procedures: Female high‐school adolescents (N = 194) were assessed for cardiovascular fitness (cycle ergometer), percent body fat (DXA), and BMI. Time spent in moderate, vigorous, and sedentary activities was assessed with a 3‐day recall.

Results: Multivariate regression analysis showed that only interactive media use was associated with percentage body fat and BMI, and the relationship remained strong even after controlling for physical activity participation and cardiovascular fitness.

Discussion: It appears that, among this group of adolescent females, the association between interactive media use and obesity is not explained by a reduction in moderate or vigorous activity commensurate with media use.
Protein Array Reveals Differentially Expressed Proteins in Subcutaneous Adipose Tissue in Obesity
Authors: Škopková Martina , Penesová Adela , Sell Henrike , Rádiková Žofia , Vlček Miroslav , Imrich Richard , Koška Juraj , Ukropec Jozef , Eckel Jürgen , Klimeš Iwar , Gašperíková Daniela
Published: July 2008

Objective: Many adipokines, inflammatory cytokines, and other proteins produced by adipose tissue have been shown to be involved in the development of obesity‐related insulin resistance. Nevertheless, new factors that play an important role in these processes are still emerging. Therefore, we screened the level of 120 different proteins in biopsies of subcutaneous adipose tissue (ScAT) of lean and obese subjects.

Research Methods and Procedures: All studied volunteers (12 obese with BMI >30 and 6 lean with BMI <25 kg/m2) were young, clinically healthy, and drug‐naive males with normal glucose tolerance. The ScAT was obtained by a needle biopsy from the umbilical region. Protein levels were assessed in adipose tissue lysates using protein arrays; mRNA levels were determined with the aid of real‐time reverse transcription‐polymerase chain reaction (RT‐PCR).

Results: The obese subjects had higher fasting plasma glucose (although within the normal range) and insulin levels, increased high sensitivity C‐reactive protein (hsCRP) in circulation, and decreased in vivo insulin action. Using the protein array technique, it was shown that of 120 proteins measured, 27 showed higher levels (leptin, HGF, EGF‐R, FGF‐6, IGF‐1sR, Fas/Apo‐1, ENA‐78, PARC, lymphotactin, HCC‐4, IL‐10, IL‐1a, IL‐1R1, IL‐1R4, IL‐12p70, angiopoietin‐2, Axl, Dtk, MIF, MIP‐1a, −1b, −3b, MSP‐a, osteoprotegerin, TECK, TIMP‐1, −2) and only one (RANTES) showed a lower level in ScAT of obese subjects when compared with the lean controls (p < 0.05). The real‐time RT‐PCR confirmed the results of protein arrays for leptin, MIF, MIP‐1a, TIMP‐2, adiponectin, IL‐6, and TNF‐α but not for RANTES.

Discussion: To our knowledge, this is the first protein array data on a very early dysregulation of ScAT protein levels in insulin‐resistant obese, but apparently healthy, subjects with normal glucose tolerance.
Cardiac Fas Receptor‐dependent Apoptotic Pathway in Obese Zucker Rats
Authors: Lee Shin‐Da , Tzang Bor‐Show , Kuo Wei‐Wen , Lin Yueh‐Min , Yang Ai‐Lan , Chen Szu‐Hua , Tsai Fuu‐Jen , Wu Fong‐Li , Lu Min‐Chi , Huang Chih‐Yang
Published: July 2008

Objective:Very limited information regarding the cardiac molecular mechanism in obesity is available. The purpose of this study was to evaluate the cardiac Fas receptor‐dependent (type I) apoptotic pathway in obese Zucker rats.

Research Methods and Procedures:Sixteen obese Zucker rats were studied at 5 to 6 months of age, and 16 age‐matched lean Zucker rats served as controls. Heart weight index, myocardial architecture, key components of the Fas receptor‐dependent apoptotic pathway, apoptotic activity, and fibrosis in the excised left ventricle of rats were measured by weight scales, hematoxylin and eosin staining, Western blotting, TUNEL assay, and Masson trichrome staining.

Results:Body weight, whole heart weight, left ventricular weight, ratio of whole heart weight to tibia length, percentage of TUNEL‐positive cardiac myocytes, and percentage of cardiac fibrosis were significantly increased in the obese group. Cardiomyocyte disarray and increased cardiac interstitial space were observed in obese rats. Protein levels of Fas ligand, Fas death receptors, and Fas‐associated Death Domain were all significantly increased in the obese group. In addition, pro‐caspase‐8 and pro‐caspase‐3 were significantly decreased, whereas activated caspase‐8 and activated caspase‐3 were significantly increased in the obese group, which implies that pro‐forms of caspase‐8 and caspase‐3 were cleaved into active‐forms caspase‐8 and caspase‐3.

Conclusions:Cardiac Fas receptor‐dependent apoptotic pathways were more activated in obese rats’ hearts, which may provide one of the possible apoptotic mechanisms for developing cardiac abnormality in obesity.
Designer Schools: The Role of School Space and Architecture in Obesity Prevention
Authors: Gorman Nicholas , Lackney Jeffery A. , Rollings Kimberly , Huang Terry T.‐K.
Published: July 2008

Spatial features of obesogenic environments studied on a broad community level have been associated with childhood overweight and obesity, but little research has focused on the effects of the design of micro spaces, such as schools, on individual health behaviors. This article aims to generate thinking and research on the link between school space and architecture and obesity prevention by reviewing and synthesizing available literature in architecture, environmental psychology, and obesity research, in an effort to propose promising ideas for school space design and redesign. The school environment is defined through 5 dimensions: physical, legal, policy, social, and cultural domains. Theories underlying environmental interventions and documented associations between the environment and health behaviors and outcomes are reviewed to illustrate how existing environmental research could translate to obesity prevention. Design strategies aimed at promoting physical activity and healthful eating are proposed, with particular emphasis on the design of cafeterias, activity spaces, connectivity with the larger community, and student health centers.
Differences in Basal Energy Expenditure and Obesity
Authors: Flatt Jean‐Pierre
Published: July 2008

Objective: To assess the impact of differences in basal energy expenditure on adiposity.

Research Methods and Procedures: Statistical analysis was performed on a published database giving anthropometric and energy expenditure measurements for 433 women and 335 men. Published equations derived by multiple regression analysis were used to predict basal metabolic rates in women and in men as a function of age, weight, and height. The differences between the observed and predicted rates (i.e., the residuals) were computed and expressed in terms of percentage deviation from the predicted rates of basal energy expenditure (BEE). In addition, individual body fat contents were computed using equations based on National Health and Nutrition Examination Study 3 data relating to body fat content determined by bioimpedance to BMI.

Results: There is no correlation between percentage body fat content and deviations from predicted (which one would refer to as normal) BEE.

Discussion: It can be concluded that relatively high or relatively low rates of BEE do not influence body weights and adiposity in a statistically identifiable manner. This contradicts and challenges the widely held view that low resting metabolic rates promote the development of obesity.
Inhibitory Effect of (−)‐Epigallocatechin‐3‐Gallate on Lipid Accumulation of 3T3‐L1 Cells
Authors: Moon Hyun‐Seuk , Chung Chung‐Soo , Lee Hong‐Gu , Kim Tae‐Gyu , Choi Yun‐Jaie , Cho Chong‐Su
Published: July 2008

Objective: The objective of this study was to investigate the molecular mechanisms underlying the attenuating effect of (−)‐epigallocatechin‐3‐gallate (EGCG) on proliferation and lipid accumulation of 3T3‐L1 cells, with a focus on the duration of EGCG treatment.

Research Methods and Procedures: Cell viability was measured by 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium assay and diamidino‐2‐phenylindole staining. The anti‐adipogenic effect of EGCG on 3T3‐L1 cells was analyzed by glycerol‐3‐phosphate dehydrogenase activity and Oil red O staining. Western blot analysis was used to detect adenosine monophosphate‐activated protein kinase (AMPK) activation and phosphorylation of its substrate, acetyl‐CoA carboxylase (ACC), and expression of insulin (INS) receptor, INS receptor substrate‐1 (IRS‐1), and adipocyte marker proteins.

Results: Exposure to EGCG during the early period of adipogenesis (7 days) was sufficient to prevent lipid accumulation. During this period, EGCG greatly decreased expression of the adipocyte marker proteins peroxisome proliferator‐activated receptor γ2 (PPARγ2) and liver X receptor (LXR)‐α. Furthermore, EGCG significantly induced generation of reactive oxygen species (ROS), which led to AMPK activation, and these effects were eliminated by N‐acetylcysteine (NAC) treatment. Also, EGCG increased the tyrosine phosphorylation of INS receptor and INS‐1 with increasing incubation time. In contrast, EGCG treatment did not alter glycerol release in the presence or absence of 2′,5′‐dideoxyadenosine (DDA), indicating that EGCG had no effect on lipolysis.

Discussion: Our data demonstrate that EGCG decreased cell viability and inhibited differentiation of 3T3‐L1 cells in a manner dependent on the duration of treatment. Also, we showed that inhibition of adipocyte differentiation by EGCG was associated with decreased glycerol‐3‐phosphate dehydrogenase (GPDH) activity accompanied by a strong inhibition of PPARγ2‐induced transcriptional activity. Furthermore, the inhibition of adipocyte differentiation by EGCG involved generation of ROS and activation of AMPK.
Adipocyte‐derived Lipoprotein Lipase Induces Macrophage Activation and Monocyte Adhesion: Role of Fatty Acids
Authors: Li Ling , Renier Geneviève
Published: July 2008

Objective: We evaluated the effect of adipocyte‐derived lipoprotein lipase (LPL) on macrophage activation and monocyte adhesion and the role of fatty acids in these effects.

Research Methods and Procedures: 3T3‐L1 adipocytes were incubated with heparin or insulin to induce LPL secretion; then adipocyte conditioned media (CM) were added to cultured J774 macrophages or human aortic endothelial cells (HAECs). Macrophage cytokine production and monocyte adhesion to HAECs were determined.

Results: Incubation of macrophages with heparin‐ or insulin‐treated adipocyte CM increased tumor necrosis factor α, interleukin‐6, and nitric oxide production by these cells. LPL neutralization and heparinase treatment prevented these effects. Addition of active LPL or palmitate to cultured macrophages replicated these effects. Blockade of leptin also reduced the effect of insulin‐treated adipocyte CM on macrophage inflammatory changes. Induction of macrophage cytokine secretion by leptin was prevented by LPL immunoneutralization. Finally, addition of CM of heparin‐ or insulin‐treated adipocytes to HAECs stimulated monocyte adhesion to these cells, an effect that was abrogated by an anti‐LPL antibody. This effect was reproduced by treating HAECs with active LPL or palmitate.

Discussion: These results point to an effect of LPL‐mediated lipolysis in macrophage activation and monocyte adhesion.
The Safety Profiles of Orlistat and Sibutramine: Results of Prescription‐Event Monitoring Studies in England
Authors: Perrio Michael J. , Wilton Lynda V. , Shakir Saad A. W.
Published: July 2008

Introduction: Observational cohort studies were conducted using prescription‐event monitoring (PEM) to examine the safety profiles of the anti‐obesity agents orlistat and sibutramine. Adverse events reported as case reports were also evaluated to determine whether these events were also identified by PEM.

Research Methods and Procedures: Patients were identified from dispensed prescriptions written by general practitioners (GPs) in England for orlistat or sibutramine. Patient demographic and clinical event information, including reasons for stopping and adverse drug reactions, were requested on questionnaires posted to GPs at least 6 months after the first prescription for individual patients. Event incidence densities (IDs) (number of first reports of event/1000 patient‐months treatment) were calculated for month 1 (ID1) and months 2–3 (ID2–3). Published case reports were identified by searching Medline and Embase.

Results: The cohorts comprised 16,021 and 12,336 patients prescribed orlistat and sibutramine, respectively. Both cohorts had a median age of 45 years, and ∼80% were female. The most common reason for stopping orlistat within 3 months was diarrhea (332 patients; 2.1% cohort), and for stopping sibutramine it was hypertension (203 patients; 1.6%). Clinical events significantly associated with taking orlistat were mainly gastrointestinal and those for sibutramine included central nervous system effects, nausea/vomiting, palpitation, and sweating. We identified 8 published case reports for orlistat and 10 for sibutramine that had equivalent or similar events assessed as causally related in the PEM studies.

Conclusions: The PEM studies highlighted different adverse event profiles for orlistat and sibutramine that were consistent with their distinct pharmacological mechanisms and other published information.
Effects of a Reimbursement Incentive on Enrollment in a Weight Control Program
Authors: Butsch W. Scott , Ard Jamy D. , Allison David B. , Patki Amit , Henson C. Suzanne , Rueger Miriam M. , Hubbert Katherine A. , Glandon Gerry L. , Heimburger Douglas C.
Published: July 2008

Objective: The objective was to examine the effect of offering a reimbursement incentive on the percentage of inquirers who enrolled in a weight control program and on weight loss and program attendance among enrollees.

Research Methods and Procedures: We used a sequential control‐intervention design to observe how inquirers of the University of Alabama at Birmingham EatRight Lifestyle Program responded to an enrollment incentive for potential 50% ($150) reimbursement of the total program fee if they attended 10 of 12 classes and lost at least 6% of their current body weight. Inquirers had to be adults with a BMI ≥30 kg/m2, seeking information about a weight control program, and informed of the program cost. Outcomes included proportion of inquirers enrolled, overall number of classes attended, and weight loss.

Results: Of the 401 people who inquired during the study periods, 24.5% and 25.0% enrolled in the intervention and control periods, respectively. There was a trend toward higher attendance in the intervention group, compared with the control group; there were no differences in percentage of weight loss. The odds of attending ≥10 classes were 2.4 times as high, and both losing >6% body weight and attending ≥10 classes were three times as high in the intervention subjects compared with controls, although non‐significant.

Discussion: The potential of earning a performance‐based reimbursement incentive did not affect enrollment in the EatRight Lifestyle Program. Performance‐based incentives may be an ideal mechanism for extending coverage of weight‐loss interventions by insurers because of limited financial risk and improved adherence.
Personal, Behavioral, and Environmental Risk and Protective Factors for Adolescent Overweight
Authors: Haines Jess , Neumark‐Sztainer Dianne , Wall Melanie , Story Mary
Published: July 2008

Objective: The objective was to examine a breadth of personal, behavioral, and socio‐environmental factors as potential risk and protective factors of overweight among male and female adolescents.

Research Methods and Procedures: A longitudinal study was conducted with an ethnically and socio‐economically diverse sample of 2516 adolescents who completed surveys at both Time 1 (1998 to 1999) and Time 2 (2003 to 2004) of the Project Eating Among Teens (EAT) study.

Results: In 1998 to 1999, 335 (25.7%) girls and 282 (26.4%) boys met the age‐adjusted criteria for overweight. During the 5‐year study period, 236 (70.5%) of the overweight girls and 185 (65.7%) of the overweight boys remained overweight and 115 (12.0%) girls and 77 (9.9%) boys originally not overweight became overweight. Although differences by sex were found, a number of personal, behavioral, and socio‐environmental factors were associated with overweight among both male and female adolescents. Body dissatisfaction and weight concerns at Time 1 predicted overweight at Time 2 for both male and female adolescents. Dieting and use of unhealthy weight control behaviors at Time 1 also predicted overweight at Time 2. Greater frequency of breakfast consumption at Time 1 was protective against overweight. Higher levels of weight‐related teasing and parental weight‐related concerns and behaviors at Time 1 were positively associated with Time 2 overweight.

Discussion: Body dissatisfaction, weight concerns, use of unhealthy weight control behaviors, weight‐related stigmatization, and parental concern about the child's weight may increase risk for adolescent overweight. Interventions that enhance adolescents’ body satisfaction while providing them with skills to avoid dieting and to engage in more effective weight‐control behaviors should be developed and tested.
Maternal Obesity Is Associated With Younger Age at Obesity Onset in U.S. Adolescent Offspring Followed Into Adulthood
Authors: Gordon‐Larsen Penny , Adair Linda S. , Suchindran Chirayath M.
Published: July 2008

Objective: The objective was to test the hypothesis that maternal obesity is associated with younger age of offspring's obesity onset.

Research Methods and Procedures: We used prospective, nationally representative, longitudinal data collected across Waves I (1995; 12 to 20 years), II (1996; 13 to 20 years), and III (2001; 18 to 28 years) of the National Longitudinal Study of Adolescent Health (N = 14,654; 49% female). Interval regression analysis was used to assess the association between maternal obesity and age at offspring's obesity onset (International Obesity Task Force BMI ≥30 equivalent age‐ and sex‐specific cut‐off points for adolescents and BMI ≥30 for young adults) using self‐reported heights and weights, adjusting for race/ethnicity, sex, parental education, and family income, accounting for complex sampling design.

Results: The net effect of having an obese mother varied by race/ethnicity and was associated with a significantly earlier age at obesity onset (p = 0.0001) for whites [β= −8.1 year, 95% confidence interval (CI), −9.3; −6.9)], blacks (β = −10.8 years, 95% CI, −12.4; −9.2), Hispanics (β = −7.0 years, 95% CI, −9.2; −4.8), and Asians (β = −8.6 years, 95% CI, −13.3; −3.9). Earlier obesity onset (<18 years) was associated with increased severity at young adulthood (mean BMI, 36.0 ± 0.3 kg/m2) vs. onset after age 18 (mean BMI, 34.4 ± 0.2 kg/m2; p = 0.0001). There were no sex differences in the association of maternal obesity to age at obesity onset.

Conclusions: Having an obese mother was associated with earlier age at obesity onset across all race/ethnic groups, particularly non‐Hispanic blacks. Early obesity onset has important health consequences because of its association with more severe adult obesity.
The Use of BMI and Waist Circumference as Surrogates of Body Fat Differs by Ethnicity
Authors: Lear Scott A. , Humphries Karin H. , Kohli Simi , Birmingham C. Laird
Published: July 2008

Objective: To compare the prediction of percentage body fat using BMI and visceral adipose tissue (VAT) using waist circumference (WC) in individuals of Chinese, European, and South Asian origin.

Research Methods and Procedures: Healthy men and women of Chinese, European, and South Asian origin (n = 627) between the ages of 30 and 65 years were recruited to ensure equal distribution of gender and representation across BMI ranges (18.5 to 24.9, 25 to 29.9, and ≥30 kg/m2). Participants were assessed for demographics, anthropometry, lifestyle, and regional adiposity. Percentage body fat and VAT were measured by DXA and computer tomography scan, respectively.

Results: BMI and WC were highly correlated with total and regional measures of adiposity in each ethnic group. At any BMI, the percentage body fat of Chinese participants was similar to that of Europeans, but that of South Asians was greater by 3.9% (p < 0.001). Above a WC of 71.0 cm, the Chinese participants had an increasingly greater amount of VAT than the Europeans (p = 0.017 for interaction). South Asians had significantly more VAT than the Europeans at all but the most extreme WC (above 105 cm) (p < 0.05).

Discussion: Compared with Europeans, percentage body fat was higher for a given BMI in South Asians, whereas VAT was higher for a given WC in both Chinese and South Asian men and women. These findings support the use of ethnic‐specific anthropometric targets.
Waist Circumference and BMI Cut‐off Based on 10‐year Cardiovascular Risk: Evidence for “Central Pre‐Obesity”
Authors: Ko Gary T. C. , Tang Joyce S. F.
Published: July 2008

Objective: The objective was to assess the waist circumference (WC) cut‐off point that best identifies a level of 10‐year cardiovascular disease (CVD) risk with optimal balance of sensitivity and specificity in Chinese subjects according to their predicted 10‐year CVD risk.

Research Methods and Procedures: A community‐based cross‐sectional observational study involving 14,919 Hong Kong Chinese subjects. The 10‐year CVD risk based on various prediction models was calculated. The projected WC cut‐off points were then determined.

Results: There were 4837 (32.4%) men and 10,082 (67.6%) women (mean age ± standard deviation, 47.3 ± 13.5 years; age range, 18 to 93 years; median age, 45.0 years). The mean optimal WC or BMI predicting a 15% to 30% 10‐year CVD risk were 83 to 88 cm and 25 kg/m2 for men, and 76 cm and 23 kg/m2 for women, respectively. With WC ≥90 cm in men and ≥80 cm in women, the likelihood ratio at various WC cut‐off points to develop a ≥20% 10‐year CVD risk is 1.5 to 2.0 in men and 3.0 in women. The likelihood ratio was 1.5 in men with WC at 84 cm and in women at 70 cm.

Discussion: Our results agree with the present guidelines on the definition of general and central obesity in Asia‐Pacific regions. We propose the creation of an intermediate state of high WC, the “central pre‐obesity” for Chinese men with WC ≥84 to 90 cm (≥33 to 36 inches) and women with WC ≥74 to 80 cm (≥29 to 32 inches). People with central pre‐obesity, similar to those with overweight (BMI ≥23 to 25 kg/m2), already have an increased risk of co‐morbidities.
Overweight and Obesity: Two Predictors for Worse Early Outcome in Total Hip Replacement?
Authors: Kessler Stefan , Käfer Wolfram
Published: July 2008

Objective: Doctors and patients assume that overweight and obesity are negative predictors for good and excellent early outcome after total hip replacement. It was the purpose of this prospective investigation to assess whether overweight or obese patients have worse early postoperative outcome in comparison with normal‐weight patients.

Research Methods and Procedures: Sixty‐seven consecutive patients receiving a total hip replacement were enrolled in the study. Patients were grouped into three samples according to BMI: normal‐weight (BMI < 25 kg/m2, n = 11), overweight (BMI 25 to 29.9 kg/m2, n = 36), and obese (BMI ≥30 kg/m2, n = 20). At 10 days and at 3 months after surgery, the patient‐centered outcome was analyzed with a self‐administered assessment chart, the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. Statistical analysis was performed with a multiple regression model that took into consideration further confounding parameters (age, sex, affected side, anchorage of the implant, duration of surgery, hospital length of stay, and prior pain, stiffness, and function).

Results: No significant influence of individual BMI on subjective outcome according to the WOMAC questionnaire was observed at either 10 days or 3 months after surgery. Hospital length of stay was comparable, and WOMAC scores did not differ significantly preoperatively, at 10 days, or at 3 months postoperatively among patients with different BMI.

Discussion: These data showed that the BMI of the patients in our study sample had no significant impact on early outcome or hospital length of stay after total hip replacement. Our data suggest, therefore, that body weight should not be a justification for withholding surgery from overweight or obese patients.
A Multimedia Tool for the Informed Consent of Patients prior to Gastric Banding
Authors: Eggers Carsten , Obliers Rainer , Koerfer Armin , Thomas Walter , Koehle Karl , Hoelscher Arnulf H. , Bollschweiler Elfriede
Published: July 2008

Objective: Severe obesity is a clear indication for appropriate, effective weight loss therapy. One option is operative intervention, e.g., gastric banding. Risks of the operation and therapeutic alternatives need to be comprehensibly presented to the patient. The literature has shown that better informed consent is obtained using information presented in a multimedia/video‐based format. The current study developed and evaluated a multimedia program aimed at obtaining informed consent from obese patients before gastric banding.

Research Methods and Procedure: An interactive multimedia program was developed with information about preoperative examinations, the operation itself, hospital stay, operative risks, alternative therapies, and the pathophysiology and health risks of obesity. Two groups (Group 1, n = 20, mean age 38 years, informed consent attained with conventional document information; Group 2, n = 20, mean age 37 years, informed consent attained with additional multimedia information) were interviewed regarding comprehensibility of the information presented, personal satisfaction, and anxiety levels during the informed consent process.

Results: Group 2 showed significantly better (p < 0.05) understanding of the presented information and higher levels of satisfaction with the informed consent process. Anxiety levels did not significantly differ between the two groups.

Discussion: Because patient satisfaction with the informed consent process and understanding of the presented information significantly improved, the multimedia program clearly benefits both surgeons and patients. Personal contact from the surgeon remains essential. High volumes of information presented in multimedia format do not alleviate patient anxiety, and personal contact may be beneficial.
Functional UQCRC1 Polymorphisms Affect Promoter Activity and Body Lipid Accumulation
Authors: Kunej Tanja , Wang Zeping , Michal Jennifer J. , Daniels Tyler F. , Magnuson Nancy S. , Jiang Zhihua
Published: July 2008

Obesity and type 2 diabetes constitute leading public health problems worldwide. Studies have shown that insulin resistance affiliated with these conditions is associated with skeletal muscle lipid accumulation, while the latter is associated with mitochondrial dysfunctions. However, the initiation and regulation of mitochondrial biogenesis rely heavily on ∼1000 nuclear‐encoded mitochondrial regulatory proteins. In this study, we targeted the ubiquinol‐cytochrome c reductase core protein I gene, a nuclear‐encoded component of mitochondrial complex III, for its association with subcutaneous fat depth (SFD) and skeletal muscle lipid accumulation (SMLA) using cattle as a model. Four promoter polymorphisms were identified and genotyped on ∼250 Wagyu × Limousin F2 progeny. Statistical analysis revealed that two completely linked polymorphic sites, g.13487C>T and g.13709G>C (r2 = 1), were significantly associated with both SFD (p < 0.01) and SMLA (p < 0.0001). The difference between TTCC and CCGG haplotypes was 0.178 cm for SFD and 0.624 scores for SMLA. Interestingly, the former haplotype produced higher promoter activities than the latter by 43% to 49% in three cell lines (p < 0.05). In addition to Rett syndrome and breast/ovarian cancer observed in other studies, we report evidence for the first time, to our knowledge, that overexpression of ubiquinol‐cytochrome c reductase core protein I might affect mitochondrial morphology and/or physiology and lead to development of obesity and related conditions.
Sex Difference in Heritability of BMI in South Korean Adolescent Twins
Authors: Hur Yoon‐Mi
Published: July 2008

Twin studies of BMI on the basis of Asian twins are extremely rare. Eight hundred eighty‐eight pairs of twins [279 monozygotic (MZ) and 82 dizygotic (DZ) pairs of male twins, 319 MZ and 82 DZ pairs of female twins, and 126 opposite‐sex pairs of DZ twins] completed items concerning height and weight through a mail and a telephone survey. A general sex‐limitation model was applied to the data. Heritability estimate was greater among women than among men. However, there was little evidence of sex‐specific genes. Under the best‐fitting model, additive genetic variances were 82% [95% confidence interval (CI): 72% to 95%] for men and 87% (95% CI: 77% to 99%) for women; shared environmental variances were negligible in both men and women. These estimates of genetic and environmental factors in BMI found among South Korean adolescent twins were broadly in the range of those reported in previous studies of BMI based on Western twin samples.