bluuebunny/crossref_metadata_2025 huggingface dataset:
Validation of an Elliptical Anthropometric Model to Estimate Visceral Compartment Area
Authors: He Qing , Engelson Ellen S. , Wang Jack , Kenya Sonjia , Ionescu Gabriel , Heymsfield Steven B. , Kotler Donald P.
Published: April 2008

Objective: The visceral compartment is a surrogate for visceral adipose tissue. Cross‐sectional visceral compartment area (VCA) has been approximated from waist circumference using a circular model. However, the two‐dimensional shape of the abdomen is rarely circular. This study validated an elliptical model of cross‐sectional total abdominal area (TAA), subcutaneous adipose tissue (SAT) area, and VCA at the L4–L5 level.

Research Methods and Procedures: We analyzed magnetic resonance images (MRIs) at the level of the L4–L5 intervertebral space from 35 subjects with a wide range of abdominal adiposity. Waist circumference, abdominal thickness (midline sagittal diameter), abdominal width (coronal diameter at one‐half of abdominal thickness), and abdominal SAT thickness at four sites (front, back, right, and left) were measured from MRI images using an image analysis software. The same anatomical regions were also estimated from anthropometrics purely by geometric formulae of circular and elliptical models. A simple linear regression model was used to interpret the association strength between anthropometric estimates and MRI measures.

Results: Estimated TAA by either model was strongly related to MRI TAA (r2 = 0.98, p < 0.0001). The SAT and VCA by MRI analysis showed a stronger association with calculation from an elliptical model (r2 = 0.95 and 0.88, respectively; p < 0.001) than a circular model (r2 = 0.69 and 0.25, respectively; p < 0.001). The absolute prediction residuals and variances were significantly smaller with an elliptical model than a circular model (p < 0.0001).

Discussion: An elliptical anthropometric model might be superior to a circular model to estimate abdominal SAT and VCA.
Ambulatory Management of Childhood Obesity
Authors: Kolagotla Lakshmi , Adams William
Published: April 2008

Objective: Childhood obesity is one of the most challenging issues facing healthcare providers today. The aims of this study were to describe the ambulatory management of childhood obesity by pediatricians (PDs) and family physicians (FPs) and to evaluate knowledge of and adherence to published recommendations.

Research Methods and Procedures: A 42‐item, self‐administered questionnaire was mailed to 1207 randomly selected primary care physicians (PDs = 700, FPs = 507) between September 2001 and January 2002.

Results: Of 339 (28%) responses, 287 were eligible (PDs = 213, FPs = 74). Most respondents were in group or solo practice (87%) in a suburban or urban, non‐inner city location (67%). The average age was 48 years (range = 31 to 85 years), and the mean years in practice was 17 (range = 1 to 55 years). Nineteen percent of physicians were aware of national recommendations. Three percent of physicians reported adherence to all recommendations. Knowledge of recommendations was not associated with a greater likelihood of adherence. However, physicians who were aware of recommendations were more likely to have positive attitudes about personal counseling ability (odds ratio = 2.4, confidence interval = 1.3 to 4.4) and the overall efficacy of obesity counseling (odds ratio = 4.3, confidence interval = 1.7 to 10.8). Poor patient motivation, patient noncompliance, and treatment futility were perceived as the most frequently encountered barriers to obesity treatment.

Discussion: Most physicians are not aware of or adherent to national recommendations regarding childhood obesity. Awareness of recommendations was associated with more positive attitudes about personal counseling ability and the effectiveness of obesity counseling in general.
Improvement of Metabolism among Obese Breast Cancer Survivors in Differing Weight Loss Regimens
Authors: Jen K.‐L. Catherine , Djuric Zora , DiLaura Nora M. , Buison Anne , Redd Jennifer N. , Maranci Vera , Hryniuk William M.
Published: April 2008

Objective: To compare the efficacy of different weight loss regimens on body weight loss and metabolic improvement in breast cancer survivors.

Research Methods and Procedures: Forty‐eight obese breast cancer survivors were randomly divided into four groups and were followed for 1 year: 1) the Control group (subjects did not receive specific nutrition counseling); 2) the Weight Watchers group (subjects were given free coupons to attend weekly Weight Watchers meetings); 3) the Individualized group (a registered dietitian provided one‐on‐one nutritional counseling); and 4) the Comprehensive group (subjects received individualized dietary counseling and free coupons for the weekly Weight Watchers meetings). At baseline and 3‐, 6‐, and 12‐month data collection visits, a fasting blood sample was obtained for assays. A three‐day dietary record was kept during the week before these visits and dietary intake was analyzed.

Results: Subjects in the three intervention groups lost weight (Control: 1.1 ± 1.7 kg; Weight Watchers: −2.7 ± 2.1 kg; Individualized: −8.0 ± 1.9 kg; Comprehensive: −9.5 ± 2.7 kg) and percentage body fat, but only the Individualized and Comprehensive groups had significant losses. Subjects in the Comprehensive group showed the most improvement in cholesterol levels and had reductions in blood leptin levels.

Discussion: Because insulin resistance and high blood leptin levels are associated with breast cancer, losing weight to improve these parameters may reduce the risk of recurrence. Only subjects in the Comprehensive group showed significant reductions in body weight and fat, energy intake, and leptin levels. For breast cancer survivors, different weight loss strategies should be considered to assist them in losing weight.
Effects of Growth Hormone on the Function of β‐Adrenoceptor Subtypes in Rat Adipocytes
Authors: Yang Shumin , Mulder Hindrik , Holm Cecilia , Edén Steffan
Published: April 2008

Objective: The influence of growth hormone (GH) on the regulation of lipolytic response to specific agonists to β‐adrenoceptors and several post‐receptor steps in the lipolytic cascade were investigated.

Research Methods and Procedures: Adipose tissues from rats were incubated with or without GH (1.38 nM). After a 24‐hour incubation, isolated adipocytes were prepared for different assays. Rats were hypophysectomized. One week after operation, l‐thyroxine and hydrocortisone acetate was given to hypophysectomized rats. One group of rats was treated with GH (1.33 mg/kg, daily). After 1 week of hormonal treatment, adipose tissues were removed for different studies.

Results: GH treatment increased both basal lipolysis and lipolytic sensitivity to dobutamine and CGP 12177 in adipocytes. The lipolytic sensitivity to terbutaline was not influenced by GH treatment. GH treatment increased the maximal lipolytic response to dobutamine and CGP 12177, but not to terbutaline as determined with absolute values of lipolysis. Forskolin‐induced lipolysis was increased by addition of GH to tissues. Moreover, GH treatment resulted in enhanced expression of hormone‐sensitive lipase. GH treatment in hypophysectomized rats influenced neither the expressions of Gαs protein and cholera toxin‐catalyzed adenosine diphosphate‐ribosylation of Gαs protein, nor cholera toxin‐induced 3′, 5′‐cyclic adenosine monophosphate accumulation. However, the expression of Gαi protein was decreased after GH treatment.

Discussion: These and previous results suggest that GH increases lipolysis in rat adipocytes partly through the β‐adrenergic system, including increases in both β1‐ and β3‐adrenergic receptor function, and partly through enhanced adenylate cyclase function, and expression of hormone‐sensitive lipase, perhaps via a decrease in Gαi protein expression.
Intestinal FABP2 A54T Polymorphism: Association with Insulin Resistance and Obesity in Women
Authors: Albala Cecilia , Santos José L. , Cifuentes Mariana , Villarroel Ana C. , Lera Lydia , Liberman Claudio , Angel Bárbara , Pérez‐Bravo Francisco
Published: April 2008

Objective: To assess the association between the Ala54Thr genetic polymorphism of the fatty acid‐binding protein 2 (FABP2) gene with insulin resistance and obesity.

Research Methods and Procedures: According to a sampling scheme based on BMI, 33 adult obese women (BMI ≥ 30) and 30 adult normal‐weight women (BMI > 18.5 and < 25 kg/m2) were recruited for this study. Women with chronic inflammatory diseases or acute pathology were excluded. Glucose, insulin, leptin, lipids, and tumor necrosis factor α (TNFα) were measured in fasting plasma samples. Insulin resistance was estimated through the homeostasis model assessment for insulin resistance method. The Ala54Thr allelic variant was determined by polymerase chain reaction, followed by restriction fragment‐length polymorphism analysis.

Results: The Thr54 allele was more frequent in obese than in nonobese women (47.0% vs. 31.7; p = 0.08). Among obese women, higher TNFα concentrations were found when comparing the Thr54/Thr54 genotype (30.0 ± 7.1 pg/mL) with either the Ala54/Thr54 genotype (21.2 ± 8.4 pg/mL) or the Ala54/Ala44 genotype (20.1 ± 7.0 pg/mL) (p < 0.05). In addition, higher fasting plasma insulin and leptin levels were found among Thr54/Thr54 homozygotes compared with the other genotypes (p < 0.05).

Discussion: Our results suggest that the Ala54Thr polymorphism of the FABP2 gene is associated with obesity and insulin resistance. The effect of this polymorphism might be mediated by elevated production of TNFα.
The Human Obesity Gene Map: The 2003 Update
Authors: Snyder Eric E. , Walts Brandon , Pérusse Louis , Chagnon Yvon C. , Weisnagel S. John , Rankinen Tuomo , Bouchard Claude
Published: April 2008

This is the tenth update of the human obesity gene map, incorporating published results up to the end of October 2003 and continuing the previous format. Evidence from single‐gene mutation obesity cases, Mendelian disorders exhibiting obesity as a clinical feature, quantitative trait loci (QTLs) from human genome‐wide scans and animal crossbreeding experiments, and association and linkage studies with candidate genes and other markers is reviewed. Transgenic and knockout murine models relevant to obesity are also incorporated (N = 55). As of October 2003, 41 Mendelian syndromes relevant to human obesity have been mapped to a genomic region, and causal genes or strong candidates have been identified for most of these syndromes. QTLs reported from animal models currently number 183. There are 208 human QTLs for obesity phenotypes from genome‐wide scans and candidate regions in targeted studies. A total of 35 genomic regions harbor QTLs replicated among two to five studies. Attempts to relate DNA sequence variation in specific genes to obesity phenotypes continue to grow, with 272 studies reporting positive associations with 90 candidate genes. Fifteen such candidate genes are supported by at least five positive studies. The obesity gene map shows putative loci on all chromosomes except Y. Overall, more than 430 genes, markers, and chromosomal regions have been associated or linked with human obesity phenotypes. The electronic version of the map with links to useful sites can be found at http:obesitygene.pbrc.edu.
Leptin Responsiveness to Energy Restriction: Genetic Variation in the Leptin Receptor Gene
Authors: Mars Monica , van Rossum Caroline T.M. , de Graaf Cees , Hoebee Barbara , de Groot Lisette C.P.G.M. , Kok Frans J.
Published: April 2008

Serum leptin concentrations are an important afferent signal in energy balance homeostasis. It has been speculated that the leptin responsiveness to energy restriction is affected by the functionality of the leptin receptor. The purpose of this analysis was to explore the effect of polymorphisms in the LEPR gene on the acute decline in leptin after 4 days of 65% energy restriction. Leptin concentrations of the study group (n = 44; all men) declined by 2.3 ± 1.5 μg/L [–39.4% (95% confidence interval: −43.6 to −34.9)]. Leptin responses did not statistically differ between noncarriers and carriers of three mutant variants of the polymorphisms: Lys109/Lys109 (−41.4%) vs. Arg109/+ (−37.0%) (p = 0.33); Gln223/Gln223 (−41.5%) vs. Arg223/+ (−37.8%) (p = 0.40); Lys656/Lys656 (−39.5%) vs. Asn656/+ (−39.3%) (p = 0.96). No effect of the assessed polymorphisms in the LEPR gene on the acute decline in leptin after energy restriction was observed. Power calculations are provided for future studies on the leptin responsiveness to energy restriction.
Insulin Action on Expression of Novel Adipose Genes in Healthy and Type 2 Diabetic Subjects
Authors: Koistinen Heikki A. , Forsgren Margareta , Wallberg‐Henriksson Harriet , Zierath Juleen R.
Published: April 2008

Objective: Adipose tissue secretes several molecules that may participate in metabolic cross‐talk to other insulin‐sensitive tissues. Thus, adipose tissue is a key endocrine organ that regulates insulin sensitivity in other peripheral insulin target tissues. We have studied the expression and acute insulin regulation of novel genes expressed in adipose tissue that are implicated in the control of whole body insulin sensitivity.

Research Methods and Procedures: Expression of adiponectin, c‐Cbl—associated protein (CAP), 11‐β hydroxysteroid dehydrogenase type 1 (11β‐HSD‐1), and sterol regulatory element binding protein (SREBP)‐1c was determined in subcutaneous adipose tissue from type 2 diabetic and age‐ and BMI‐matched healthy men by real‐time polymerase chain reaction analysis.

Results: Expression of adiponectin, CAP, 11β‐HSD‐1, and SREBP‐1c was similar between healthy and type 2 diabetic subjects. Insulin infusion for 3 hours did not affect expression of CAP, 11β‐HSD‐1, or adiponectin mRNA in either group. However, insulin infusion increased SREBP‐1c expression by 80% in healthy, but not in type 2 diabetic, subjects.

Discussion: Our results provide evidence that insulin action on SREBP‐1c is dysregulated in adipose tissue from type 2 diabetic subjects. Impaired insulin regulation on gene expression of select targets in adipose tissue may contribute to the pathogenesis of type 2 diabetes.
High Local Concentrations and Effects on Differentiation Implicate Interleukin‐6 as a Paracrine Regulator
Authors: Sopasakis Victoria Rotter , Sandqvist Madeléne , Gustafson Birgit , Hammarstedt Ann , Schmelz Martin , Yang Xiaolin , Jansson Per‐Anders , Smith Ulf
Published: April 2008

Objective: To examine the possibility that interleukin‐6 (IL‐6) can act as a paracrine regulator in adipose tissue by examining effects on adipogenic genes and measuring interstitial IL‐6 concentrations in situ.

Research Methods and Procedures: Circulating and interstitial IL‐6 concentrations in abdominal and femoral adipose tissue were measured using the calibrated microdialysis technique in 20 healthy male subjects. The effects of adipose cell enlargement on gene expression and IL‐6 secretion were examined, as well as the effect of IL‐6 in vitro on gene expression of adiponectin and other markers of adipocyte differentiation.

Results: The IL‐6 concentration in the interstitial fluid was ∼100‐fold higher than that in plasma, suggesting that IL‐6 may be a paracrine regulator of adipose tissue. This was further supported by the finding that adding IL‐6 in vitro at similar concentrations down‐regulated the expression of adiponectin, aP2, and PPARγ‐2 in cultured human adipose tissue. In addition, gene expression and release of IL‐6, both in vivo and in vitro, correlated with adipose cell size.

Discussion: These data suggest that IL‐6 may be a paracrine regulator of adipose tissue. Furthermore, increased adipose tissue production of IL‐6 after hypertrophic enlargement of the adipose cells may detrimentally affect systemic insulin action by inducing adipose tissue dysfunction with impaired differentiation of the pre‐adipocytes and/or adipocytes and lower adiponectin.
Preadipocyte Number in Omental and Subcutaneous Adipose Tissue of Obese Individuals
Authors: Bakker Arjen H.F. , van Dielen Francois M.H. , Greve Jan Willem M. , Adam Judit A. , Buurman Wim A.
Published: April 2008

Objective: To determine the variation in preadipocyte isolation procedure and to assess the number and function of preadipocytes from subcutaneous and omental adipose tissue of obese individuals.

Research Methods and Procedures: The preadipocyte number per gram of adipose tissue in the abdominal‐subcutaneous and abdominal‐omental adipose stores of 27 obese subjects with a BMI of 44 ± 10 kg/m2 and an age of 40 ± 9 years was determined.

Results: The assessment of the preadipocyte number was found to be labor intensive and error prone. Our data indicated that the number of stromal vascular cells (SVCs), isolated from the adipose tissue by collagenase digestion, was dependent on the duration of collagenase treatment and the size and the origin of the biopsy. In addition, the fat accumulation and leptin production by differentiated SVCs were dependent on the number of adherent SVCs (aSVCs) in the culture plate and the presence of proteins derived from serum and peroxisome proliferator‐activated receptor ligands.

Discussion: Using our standardized isolation and differentiation protocol, we found that the number of SVCs, aSVCs, leptin production, and fat accumulation still varied considerably among individuals. Interestingly, within individuals, the number of SVCs, aSVCs, and the leptin production by differentiating aSVCs from both the subcutaneous and the omental fat depots were associated, whereas fat accumulation was not. In obese to severely obese subjects, differences in BMI and age could not explain differences in SVCs, aSVCs, leptin production, and fat accumulation.
Oxygen Uptakes Adjusted for Body Composition in Normal‐Weight and Obese Adolescents
Authors: Ekelund Ulf , Franks Paul W. , Wareham Nicolas J. , Åman Jan
Published: April 2008

Objective: To test whether resting oxygen uptake (Vo2), submaximal Vo2, and maximal Vo2 (Vo2max) differs between obese adolescents (n = 18; BMI > 30) and a matched normal‐weight control group after adjustment for differences in fat‐free mass (FFM) and fat mass (FM).

Research Methods and Procedures: FFM and FM were assessed by DXA. Resting Vo2, submaximal Vo2, and Vo2max were measured by indirect calorimetry.

Results: There was no difference in resting Vo2 between groups after adjusting for FFM and FM. Submaximal Vo2 did not differ between groups after adjusting for body weight. Percentage Vo2max and NET Vo2 (Vo2max − resting Vo2) were significantly higher in the obese group during submaximal exercise, however not after adjusting for body weight. Vo2max was not significantly different between groups after adjusting for FFM.

Discussion: When body compositions are appropriately controlled for, resting Vo2, submaximal Vo2, and Vo2max do not differ between obese and normal‐weight adolescents. These data suggested that the higher relative Vo2 observed in obese adolescent subjects is due to their higher FM and not to an impaired Vo2max even though they may be less physically active.
Adipose Angiotensinogen Secretion, Blood Pressure, and AGT M235T Polymorphism in Obese Patients
Authors: Prat‐Larquemin Lydie , Oppert Jean‐Michel , Clément Karine , Hainault Isabelle , Basdevant Arnaud , Guy‐Grand Bernard , Quignard‐Boulangé Annie
Published: April 2008

Objective: To investigate AGT secretion in cultured adipocytes from obese patients and its relationship with obesity‐related phenotypes, blood pressure, and the M235T polymorphism in the AGT gene.

Research Methods and Procedures: Measurements, including anthropometry, body composition (DXA), and blood pressure, were performed in 61 overweight or obese women (BMI: 28 to 68 kg/m2). A subcutaneous abdominal adipose tissue biopsy was used for adipocyte size determination and quantification of AGT secretion in the medium of cultured adipocytes. AGT M235T genotype was determined using polymerase chain reaction‐restriction fragment length polymorphism.

Results: Adipose secretion of the AGT protein (range, 140 to 2575 ng/106 cells/24 h) was not significantly correlated with BMI, body fat, or blood pressure and did not vary according to the M235T polymorphism in the AGT gene. However, the AGT M235T polymorphism was associated with adipocyte size (111.6 ± 2.8, 108.8 ± 1.9, 118.2 ± 2.6 μm in MM, MT, and TT genotypes, respectively; p < 0.01) after adjustment for age and fat mass. An association between the AGT M235T polymorphism and adipocyte size (p < 0.02 adjusted for sex, age, and BMI) was found in another independent sample of 106 obese subjects (sex ratio, M/F 16/90; BMI, 29 to 70 kg/m2).

Discussion: In cultured adipocytes from obese subjects, AGT secretion was not associated with body fat phenotypes, blood pressure, or fat cell size. However, results from two independent studies suggest an association between the AGT M235T polymorphism and adipocyte size.
Sex‐Specific Fat Distribution Is Not Linear Across Pubertal Groups in a Multiethnic Study
Authors: He Qing , Horlick Mary , Thornton John , Wang Jack , Pierson Richard N. , Heshka Stanley , Gallagher Dympna
Published: April 2008

Objective: To investigate sexual dimorphism and race differences in fat distribution (android/gynoid) before and during puberty.

Research Methods and Procedures: Fat distribution was measured by skinfold thickness and DXA in healthy African‐American, Asian, and white subjects (n = 920), divided into pre‐, early, and late pubertal groups.

Results: Gynoid fat masses adjusted for covariates were lower in late pubertal compared with prepubertal boys, but were not consistently greater in late pubertal compared with prepubertal girls. Progression of sex‐specific fat distribution with increasing maturation was present in Asians only. Among African‐American and white subjects, early pubertal boys had greater gynoid fat mass compared with the prepubertal group, whereas early pubertal girls had less gynoid fat mass compared with the prepubertal group. Sexual dimorphism in fat distribution was present in all pubertal groups, except among whites at early puberty. Among girls, Asians had lower gynoid fat than whites and African Americans in all pubertal groups. Among boys, Asians had less gynoid fat by DXA in early puberty and late puberty.

Discussion: Comparison among races demonstrated differences in sexual dimorphism and sex‐specific fat distribution with progression in pubertal group. However, in all race groups, the fat distribution of late pubertal boys was more “male” or “android” than prepubertal boys, but late pubertal girls did not differ consistently from prepubertal girls. These findings suggested that the greater sexual dimorphism of fat distribution in late puberty compared with prepuberty may be attributable to larger changes in boys with smaller changes in girls.
Lowered Tumor Necrosis Factor Receptors, but Not Increased Insulin Sensitivity, with Infliximab
Authors: Di Rocco Paola , Manco Melania , Rosa Giuseppina , Greco Aldo V. , Mingrone Geltrude
Published: April 2008

Objectives: To verify whether Infliximab could modify insulin sensitivity and TNF‐α and GLUT4 mRNA expression in muscle and adipose tissue of morbidly obese subjects. Soluble TNF receptors I and II (TNFR‐I and TNFR‐II) were also assayed.

Research Methods and Procedures: Six obese subjects were investigated before and 2 weeks after a single intravenous administration of 5 mg/kg Infliximab; insulin sensitivity was evaluated by euglycemic hyperinsulinemic clamp, and TNF‐α and GLUT4 mRNA expression were assessed by reverse‐transcriptase polymerase chain reaction on muscle and adipose tissue. TNF‐α, TNFR‐I, and TNFR‐II were determined using the ELISA technique.

Results: Infliximab infusion did not affect fasting plasma insulin or fasting plasma glucose levels; whole body glucose uptake did not change significantly. TNF‐α and GLUT4 mRNA did not show any significant change in muscle or adipose tissue. Serum TNF‐α was undetectable before and after treatment, whereas TNFR‐I and TNFR‐II concentrations significantly decreased (p < 0.01).

Discussion: An explanation for the absence of effect of Infliximab on insulin resistance in morbidly obese subjects may be the paracrine way of action of this cytokine. Because Infliximab is predominantly distributed within the vascular compartment, its effectiveness in penetrating muscle and adipose tissue is potentially low. The significant decrease of TNFR‐I and TNFR‐II might be ascribed to a targeted effect of Infliximab on the immune system.
Melanin‐Concentrating Hormone Receptor Mutations and Human Obesity: Functional Analysis
Authors: Gibson William T. , Pissios Pavlos , Trombly Daniel J. , Luan Jian'An , Keogh Julia , Wareham Nicholas J. , Maratos‐Flier Eleftheria , O'Rahilly Stephen , Farooqi I. Sadaf
Published: April 2008

Melanin‐concentrating hormone (MCH), a neuropeptide highly expressed in the lateral hypothalamus, has an important role in the regulation of energy balance and body weight in rodents. We examined whether mutations in the two known MCH receptors might be associated with obesity‐related phenotypes in humans. Among 106 subjects with severe early onset obesity and a history of hyperphagia, we found two missense variants in MCHR1: Y181H and R248Q. Neither of these was found in 192 normal weight controls. R248Q cosegregated with obesity across two generations; family data were unavailable for Y181H. When expressed in HEK293 cells, R248Q showed no evidence of constitutive activation or ligand hypersensitivity for extracellular signal‐regulated kinase phosphorylation. In addition, R248Q showed no enhanced suppression of cAMP generation. Two common single‐nucleotide polymorphisms were found to be in linkage disequilibrium: g.‐114A>G and c.39C>T. No association between either of these single‐nucleotide polymorphisms and obesity‐related phenotypes was found among a population cohort of 541 whites. Only two rare noncoding variants were found in MCHR2. In conclusion, mutations in the MCH receptors are not commonly found in humans with severe early onset obesity. Clarification of the relationship of these variants to obesity must await study in other populations and/or in genetically modified mice.
Exercise‐Induced Reduction in Obesity and Insulin Resistance in Women: a Randomized Controlled Trial
Authors: Ross Robert , Janssen Ian , Dawson Jody , Kungl Ann‐Marie , Kuk Jennifer L. , Wong Suzy L. , Nguyen‐Duy Thanh‐Binh , Lee SoJung , Kilpatrick Katherine , Hudson Robert
Published: April 2008

Objectives: To determine the effects of equivalent diet‐ or exercise‐induced weight loss and exercise without weight loss on subcutaneous fat, visceral fat, and insulin sensitivity in obese women.

Research Methods and Procedures: Fifty‐four premenopausal women with abdominal obesity [waist circumference 110.1 ± 5.8 cm (mean ± SD)] (BMI 31.3 ± 2.0 kg/m2) were randomly assigned to one of four groups: diet weight loss (n = 15), exercise weight loss (n = 17), exercise without weight loss (n = 12), and a weight‐stable control group (n = 10). All groups underwent a 14‐week intervention.

Results: Body weight decreased by ∼6.5% within both weight loss groups and was unchanged in the exercise without weight loss and control groups. In comparison with controls, cardiorespiratory fitness improved within the exercise groups only (p < 0.01). Reduction in total, abdominal, and abdominal subcutaneous fat within the exercise weight loss group was greater (p < 0.001) than within all other groups. The reduction in total and abdominal fat within the diet weight loss and exercise without weight loss groups was greater than within controls (p < 0.001) but not different from each other (p > 0.05). Visceral fat decreased within all treatment groups (p < 0.008), and these changes were not different from each other. In comparison with the control group, insulin sensitivity improved within the exercise weight loss group alone (p < 0.001).

Discussion: Daily exercise without caloric restriction was associated with substantial reductions in total fat, abdominal fat, visceral fat, and insulin resistance in women. Exercise without weight loss was also associated with a substantial reduction in total and abdominal obesity.
Prevalence of the Metabolic Syndrome across Cardiorespiratory Fitness Levels in Women
Authors: Farrell Stephen W. , Cheng Yiling J. , Blair Steven N.
Published: April 2008

Objectives: To determine the prevalence of the metabolic syndrome across age strata and cardiorespiratory fitness (CRF) levels in women.

Research Methods and Procedures: 7104 women underwent a physical examination, including a maximal treadmill exercise test. Participants were divided into CRF quintiles according to age. The metabolic syndrome was identified using Adult Treatment Panel‐III Guidelines. Tests for trend were performed on demographic variables across CRF quintiles, as well as prevalence of the metabolic syndrome across CRF quintiles, age strata, and maximal workload achieved [maximal metabolic equivalent (MET) level].

Results: The overall prevalence of the metabolic syndrome was 6.5%. Age‐ and smoking‐adjusted prevalence was lower across quintiles of CRF (19.0%, 6.7%, 6.0%, 3.6%, and 2.3% for quintiles I to V, respectively, p for trend = 0.001). Smoking‐adjusted prevalence of the metabolic syndrome was higher across age strata (2.4%, 2.7%, 6.4%, 8.7%, 15.3%, and 16.1% for ages 20 to 29, 30 to 39, 40 to 49, 50 to 59, 60 to 69, and 70 to 80, respectively, p for trend = 0.001). Prevalence of the metabolic syndrome in the different age groups for women who achieved a maximal MET level of 11 or higher was one‐third to one‐fourth that of women who achieved lower maximal MET levels.

Discussion: Prevalence of the metabolic syndrome was markedly lower across progressively higher levels of CRF in women of different age strata. Because regular physical activity improves components of the metabolic syndrome, modest increases in CRF among low fit women may ameliorate the metabolic syndrome in some instances.
Percentage Fat in Overweight and Obese Children: Comparison of DXA and Air Displacement Plethysmography**
Authors: Radley Duncan , Gately Paul J. , Cooke Carlton B. , Carroll Sean , Oldroyd Brian , Truscott John G.
Published: April 2008

Objective: To compare percentage body fat (percentage fat) estimates from DXA and air displacement plethysmography (ADP) in overweight and obese children.

Research Methods and Procedures: Sixty‐nine children (49 boys and 20 girls) 14.0 ± 1.65 years of age, with a BMI of 31.3 ± 5.6 kg/m2 and a percentage fat (DXA) of 42.5 ± 8.4%, participated in the study. ADP body fat content was estimated from body density (Db) using equations devised by Siri (ADPSiri) and Lohman (ADPLoh).

Results: ADP estimates of percentage fat were highly correlated with those of DXA in both male and female subjects (r = 0.90 to 0.93, all p < 0.001; standard error of estimate = 2.50% to 3.39%). Compared with DXA estimates, ADPSiri and ADPLoh produced significantly (p < 0.01) lower estimates of mean body fat content in boys (−2.85% and −4.64%, respectively) and girls (−2.95% and −5.15%, respectively). Agreement between ADP and DXA methods was further examined using the total error and methods of Bland and Altman. Total error ranged from 4.46% to 6.38% in both male and female subjects. The 95% limits of agreement were relatively similar for all percentage fat estimates, ranging from ±6.73% to ±7.94%.

Discussion: In this study, conversion of Db using the Siri equation led to mean percentage fat estimates that agreed better with those determined by DXA compared with the Lohman equations. However, relatively high limits of agreement using either equation resulted in percentage fat estimates that were not interchangeable with percentage fat determined by DXA.
Amount of Food Group Variety Consumed in the Diet and Long‐Term Weight Loss Maintenance
Authors: Raynor Hollie A. , Jeffery Robert W. , Phelan Suzanne , Hill James O. , Wing Rena R.
Published: April 2008

Objective: Decreases in variety of foods consumed within high‐fat‐dense food groups and increases in variety of foods consumed within low‐fat‐dense food groups are associated with lower energy intake and greater weight loss during obesity treatment and may assist with weight loss maintenance. This study examined food group variety in 2237 weight loss maintainers in the National Weight Control Registry, who had lost 32.2 ± 18.0 kg (70.9 ± 39.5 lbs) and maintained a weight loss of at least 13.6 kg (30 lbs) for 6.1 ± 7.7 years.

Research Methods and Procedures: At entry into the registry, registry members completed a food frequency questionnaire from which amount of variety consumed from different food groups was assessed. To provide a context for interpreting the level of variety occurring in the diet of registry participants, food group variety was compared between registry participants and 96 individuals who had recently participated in a behavioral weight loss program and had lost at least 7% of initial body weight.

Results: Registry members reported consuming a diet with very low variety in all food groups, especially in those food groups higher in fat density. Registry participants consumed significantly (p < 0.001) less variety within all food groups, except fruit and combination foods, than recent weight losers after 6 months of weight loss treatment.

Discussion: These results suggest that successful weight loss maintainers consume a diet with limited variety in all food groups. Restricting variety within all food groups may help with consuming a low‐energy diet and maintaining long‐term weight loss.
Does Prior Authorization of Sibutramine Improve Medication Compliance or Weight Loss?
Authors: Risser Joseph A. , Vash Peter D. , Nieto Lurline
Published: April 2008

Objective: This study was designed to examine whether prior authorization for insurer reimbursement of weight loss medication affects compliance with taking sibutramine or adherence to a medical weight control program. The underlying hypothesis is that physician advocacy through prior authorization increases patient compliance and treatment outcomes.

Research Methods and Procedures: A retrospective review was conducted of 22 subjects who had received a prescription for sibutramine that was reimbursed through their health insurer by prior authorization (PAR) and compared them with 47 randomly selected subjects who were also prescribed sibutramine but did not receive reimbursement (non‐PAR). Outcome measures included the percentage weight lost, visits to the clinic, and number of prescriptions received at 3, 6, 9, and 12 months.

Results: The proportion of subjects remaining in the clinic program, the number of clinic visits made, the number of prescriptions received, and the amount of weight lost were all significantly greater among PAR subjects than among non‐PAR subjects. PAR subjects used the medication 37% longer by month 6 (2.43 vs. 1.52 prescriptions; p < 0.02), visited the clinic 44% more often (72.5 vs. 40.5 visits in 12 months; p < 0.0006), and achieved 38% better maximal weight loss (16% vs. 9.9% at 6 months; p < 0.49) than non‐PAR subjects.

Discussion: This study suggests that, when those medications are not included on a health insurer's formulary, the use of the prior authorization process may improve both medication and behavioral compliance.
Obesity and Overweight Prevalence in Polish 7‐ to 9‐Year‐Old Children
Authors: Małecka‐Tendera Ewa , Klimek Katarzyna , Matusik Paweł , Olszanecka‐Glinianowicz Magdalena , Lehingue Yves ,   Behalf of the Polish Childhood Obesity Study Group
Published: April 2008

Objective: Secular trend in childhood obesity is a well‐known phenomenon, and it is important to monitor it in cross‐sectional studies. The study aim was to estimate prevalence of obesity and overweight in Polish 7‐ to 9‐year‐old children and to compare the results with a French study based on the same protocol.

Research Methods and Procedures: The study was conducted in 2001 according to the protocol of the European Childhood Obesity Group. Height and weight were measured, and BMI was calculated to define nutritional status in a randomly selected group of 2916 (1445 girls and 1471 boys) primary school children. Obesity and overweight were estimated according to International Obesity Task Force references with curve for obesity and overweight passing through 30 and 25 kg/m2 at age 18, respectively.

Results: Overweight (including obesity) was found in 15.4% of Polish children (in 15.8% of girls and 15.0% of boys) and obesity in 3.6% (3.7% of girls and 3.6% of boys) compared with 18.1% of overweight and 3.8% of obese children in French study. There was no significant difference in nutrition status between Polish and French children except for higher frequency of overweight in French 9‐year‐old boys. The same trend of decreasing overweight through age classes was observed in both populations.

Discussion: The prevalence of obesity and overweight (including obesity) in prepubertal children estimated in two European countries according to the same protocol and using the same references showed little differences between the two populations despite higher prevalence of obesity in Polish than French adults.
High‐density Lipoprotein Apolipoprotein A‐I Kinetics in Obesity
Authors: Ooi Esther M. M. , Watts Gerald F. , Farvid Maryam S. , Chan Dick C. , Allen Michael C. , Zilko Simon R. , Barrett P. Hugh R.
Published: April 2008

Objective: Low plasma concentrations of high‐density lipoprotein (HDL)‐cholesterol and apolipoprotein A‐I (apoA‐I) are independent predictors of coronary artery disease and are often associated with obesity and the metabolic syndrome. However, the underlying kinetic determinants of HDL metabolism are not well understood.

Research Methods and Procedures: We pooled data from 13 stable isotope studies to investigate the kinetic determinants of apoA‐I concentrations in lean and overweight—obese individuals. We also examined the associations of HDL kinetics with age, sex, BMI, fasting plasma glucose, fasting insulin, Homeostasis Model Assessment score, and concentrations of apoA‐I, triglycerides, HDL‐cholesterol and low‐density lipoprotein‐cholesterol.

Results: Compared with lean individuals, overweight—obese individuals had significantly higher HDL apoA‐I fractional catabolic rate (0.21 ± 0.01 vs. 0.33 ± 0.01 pools/d; p < 0.001) and production rate (PR; 11.3 ± 4.4 vs. 15.8 ± 2.77 mg/kg per day; p = 0.001). In the lean group, HDL apoA‐I PR was significantly associated with apoA‐I concentration (r = 0.455, p = 0.004), whereas in the overweight—obese group, both HDL apoA‐I fractional catabolic rate (r = −0.396, p = 0.050) and HDL apoA‐I PR (r = 0.399, p = 0.048) were significantly associated with apoA‐I concentration. After adjustment for fasting insulin or Homeostasis Model Assessment score, HDL apoA‐I PR was an independent predictor of apoA‐I concentration.

Discussion: In overweight—obese subjects, hypercatabolism of apoA‐I is paralleled by an increased production of apoA‐I, with HDL apoA‐I PR being the stronger determinant of apoA‐I concentration. This could have therapeutic implications for the management of dyslipidemia in individuals with low plasma HDL‐cholesterol.
Adiposity in Middle‐aged Women is Associated with Genetic Taste Blindness to 6‐n‐Propylthiouracil
Authors: Goldstein Gretchen L. , Daun Henryk , Tepper Beverly J.
Published: April 2008

Objective: Taste blindness to the bitterness of 6‐n‐propylthiouracil (PROP) may be a genetic marker for food preferences and dietary choices that ultimately influence body weight. A previous study in middle‐aged women showed that those who were taste blind to PROP (i.e., nontasters) had higher BMIs than those with the greatest sensitivity to PROP (i.e., supertasters). This study tested the hypothesis that the nontaster phenotype was associated with greater adiposity in middle‐aged women.

Research Methods and Procedures: Forty women with a mean BMI of 26.6 ± 1.3 kg/m2 and a mean age of 41.8 ± 1.8 years were recruited from the local community. They were classified as nontasters (n = 8), medium tasters (n = 18), or supertasters (n = 14) of PROP using a filter paper screening procedure. Anthropometric measures included height, weight, body fatness, triceps skinfold thickness, and waist circumference. Dietary restraint and disinhibition were also measured to assess cognitions associated with body weight.

Results: BMI was 6.2 units higher in nontaster women compared with supertaster women (29.7 ± 0.9 vs. 23.5 ± 0.9, respectively; p < 0.05). Body fatness (p < 0.01) and triceps skinfold thickness (p < 0.05) were also higher in these women. Waist circumference showed a trend in the appropriate direction. Although disinhibition was associated with greater adiposity, the relation between PROP status and adiposity was not altered after controlling for disinhibition.

Discussion: The PROP nontaster phenotype was strongly associated with several measures of adiposity in middle‐aged women. These data confirm our previous findings and suggest that the PROP polymorphism may be a reliable indicator of weight gain susceptibility.
Adipose Gene Expression Patterns of Weight Gain Suggest Counteracting Steroid Hormone Synthesis
Authors: van Schothorst Evert M. , Franssen‐van Hal Nicole , Schaap Mirjam M. , Pennings Jeroen , Hoebee Barbara , Keijer Jaap
Published: April 2008

Objective: To identify early molecular changes in weight gain, using analysis of gene expression changes in adipose tissue of mice fed well‐defined humanized (Western) high‐fat and low‐fat (control) diets during a short (3‐ to 5‐week) time interval.

Research Methods and Procedures: An adipose‐enriched cDNA microarray was constructed and used for the expression analyses of visceral adipose tissues of wildtype young adult C57BL/6J male mice on different diets.

Results: Mice on a high‐fat diet had significantly higher body weight (at most, 9.6% greater) and adipose tissue weights compared with mice on a control diet. Gene expression analyses revealed 31 transcripts significantly differentially expressed in visceral adipose tissue between the diet groups. Most of these genes were expressed more on the high‐fat diet. They mainly encode proteins involved in cellular structure (e.g., myosin, procollagen, vimentin) and lipid metabolism (e.g., leptin, lipoprotein lipase, carbonic anhydrase 3). This increase in gene expression was accompanied by a decrease in oxidative phosphorylation and carbohydrate metabolism (ATP citrate lyase). Importantly, genes belonging to steroid hormone biosynthesis (3β‐hydroxysteroid dehydrogenase‐1, cholesterol side‐chain cleavage cytochrome P450, and steroid‐11β‐hydroxylase) were all expressed less in mice on a high‐fat diet.

Discussion: A short time period of 3 to 5 weeks of high‐fat feeding altered gene expression patterns in visceral adipose tissue in male mice. Gene expression changes indicate initiation of adipose tissue enlargement and the down‐regulation of adipose steroid hormone biosynthesis. The latter suggests a mechanism by which initial progression toward weight gain is counteracted.
Cognitive Behavioral Therapy and Fluoxetine as Adjuncts to Group Behavioral Therapy for Binge Eating Disorder
Authors: Devlin Michael J. , Goldfein Juli A. , Petkova Eva , Jiang Huiping , Raizman Pamela S. , Wolk Sara , Mayer Laurel , Carino Janel , Bellace Dara , Kamenetz Claudia , Dobrow Ilyse , Walsh B. Timothy
Published: April 2008

Objective: Although binge eating disorder is a common and distressing concomitant of obesity, it has not yet been established whether affected individuals presenting to behavioral weight control programs should receive specialized treatments to supplement standard treatment. This study was designed to examine the added benefit of two adjunctive interventions, individual cognitive behavioral therapy (CBT) and fluoxetine, offered in the context of group behavioral weight control treatment.

Research Methods and Procedures: One hundred sixteen overweight/obese women and men with binge eating disorder were all assigned to receive a 16‐session group behavioral weight control treatment over 20 weeks. Simultaneously, subjects were randomly assigned to receive CBT + fluoxetine, CBT + placebo, fluoxetine, or placebo in a two‐by‐two factorial design. Outcome measures, assessed at the end of the 16‐session acute treatment phase, included binge frequency, weight, and measures of eating‐related and general psychopathology.

Results: Overall, subjects showed substantial improvement in binge eating and both general and eating‐related psychopathology, but little weight loss. Subjects who received individual CBT improved more in binge frequency than did those not receiving CBT (p< 0.001), and binge abstinence was significantly more common in subjects receiving CBT vs. those who did not (62% vs. 33%,p< 0.001). Fluoxetine treatment was associated with greater reduction in depressive symptoms (p< 0.05). The 54 subjects who achieved binge abstinence improved more on all measures than the 62 subjects who did not. In particular, these subjects lost, on average, 6.2 kg compared with a gain of 0.7 kg among non‐abstainers.

Discussion: Adjunctive individual CBT results in significant additional binge reduction in obese binge eaters receiving standard behavioral weight control treatment.
Metabolic Syndrome in Overweight and Obese Japanese Children
Authors: Yoshinaga Masao , Tanaka Satoru , Shimago Atsushi , Sameshima Koji , Nishi Junichiro , Nomura Yuichi , Kawano Yoshifumi , Hashiguchi Jun , Ichiki Takeo , Shimizu Shinichiro
Published: April 2008

Objective: To determine the prevalence of and sex differences related to the metabolic syndrome among obese and overweight elementary school children.

Research Methods and Procedures: Subjects were 471 overweight or obese Japanese children. Children meeting at least three of the following five criteria qualified as having the metabolic syndrome: abdominal obesity, elevated blood pressure, low high‐density lipoprotein‐cholesterol levels, high triglyceride levels, and high fasting glucose levels. Fasting insulin levels were also examined.

Results: Japanese obese children were found to have a significantly lower prevalence (17.7%) of the metabolic syndrome than U.S. obese adolescents (28.7%, p = 0.0014). However, Japanese overweight children had a similar incidence (8.7%) of the metabolic syndrome compared with U.S. overweight adolescents (6.8%). Hyperinsulinemia in girls and abdominal obesity in boys are characteristic features of individual metabolic syndrome factors in Japanese children.

Discussion: The prevalence of the metabolic syndrome is not lower in preteen Japanese overweight children than in U.S. overweight adolescents, although it is significantly lower in Japanese obese preteen children than in U.S. obese adolescents. Primary and secondary interventions are needed for overweight preteen children in Japan.