bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in Serum Ghrelin Concentration following Biliopancreatic Diversion for Obesity
Authors: Adami Gian Franco , Cordera Renzo , Andraghetti Gabriella , Camerini Giovanni B. , Marinari Giuseppe M. , Scopinaro Nicola
Published: April 2008

Objective: Ghrelin is a recently discovered hormone that is produced mainly by the stomach and that increases food intake in rodents and humans. It has been postulated that the weight loss after gastric bypass surgery for obesity might be related to changes in serum ghrelin concentration.

Research Methods and Procedures: Serum leptin and ghrelin concentrations were measured in a group of obese patients before biliopancreatic diversion (BPD) and 2 and 12 months postoperatively. Insulin sensitivity was determined from serum glucose and insulin levels according to the homeostatic model of assessment for insulin resistance (HOMA IR).

Results: A sharp drop was observed in body weight, in BMI values, in HOMA IR data, and in serum leptin concentration at 2 and 12 months after BPD, whereas a significant increase of serum ghrelin level was observed at 12 months, when food intake had returned to preoperative levels. A negative correlation between the postoperative changes of serum ghrelin concentration and those of HOMA IR values was observed at 2 and 12 months after BPD.

Discussion: No evidence upholding a relationship between serum ghrelin concentration and food intake after BPD was seen; the postoperative changes likely reflected the achievement of a new state of energy balance. The negative relationship observed between post‐BPD changes in HOMA IR values and changes in serum ghrelin concentration supported the role of insulin in the modulation of ghrelin production.
Toward an Understanding of Health Services Use in Women with Binge Eating Disorder
Authors: Striegel‐Moore Ruth H. , Dohm Faith‐Anne , Wilfley Denise E. , Pike Kathleen M. , Bray Nancy L. , Kraemer Helena C. , Fairburn Christopher G.
Published: April 2008

Objectives: This study examined health services use in community samples of 102 white and 60 black women with binge eating disorder (BED), 164 white and 85 black healthy comparison women, and 86 white and 21 black women with a noneating Axis I psychiatric disorder.

Research Methods and Procedures: Participants were matched on age, ethnicity, and education and were asked about their use of emergency room visits, outpatient physician visits for medical care, outpatient psychotherapy visits, and days spent in the hospital over the previous 12 months. Total health services use was computed.

Results: There were no between‐group differences in outpatient physician visits or inpatient hospital days. Relative to healthy comparison women, women with BED and women with other Axis I disorders had increased total health services use, psychotherapy visits, and emergency department visits. Relative to women with noneating Axis I disorders, women with BED had less use of psychotherapy visits. Although obese white women were more likely to report emergency department visits than obese black women were, nonobese white women were less likely to report emergency department visits than nonobese black women were.

Discussion: That health services use by women with BED compared more with that of women with other Axis I disorders than with that of healthy women suggested that BED has clinical significance and is not benign in terms of its impact on the health care system. It appeared, however, that despite the availability of effective treatments, few women with BED received psychotherapy.
Is Dietary Fat Intake Related to Liking or Household Availability of High‐ and Low‐Fat Foods?
Authors: Raynor Hollie A. , Polley Betsy A. , Wing Rena R. , Jeffery Robert W.
Published: April 2008

Objectives: Despite the increasing availability of low‐ and reduced‐fat foods, Americans continue to consume more fat than recommended, which may be a contributing factor to the obesity epidemic. This investigation examined relationships between liking and household availability of high‐ and low‐fat foods and their association with dietary fat intake.

Research Methods and Procedures: A food frequency questionnaire assessed percent calories from fat consumed over the past year in 85 men and 80 women. Participants reported their degree of liking 22 “high‐fat foods” (>45% calories from fat) and 22 “low‐fat foods” (<18% calories from fat), and the number and percentage (number of high‐ or low‐fat foods/total number of foods × 100) of these high‐ and low‐fat foods in their homes.

Results: Hierarchical regression analyses examined the ability of liking and household availability of low‐ and high‐fat foods to predict percent dietary fat intake. After controlling for age, sex, and BMI, liking ratings for high‐ and low‐fat foods and the interaction of liking for low‐fat foods by the percentage of low‐fat foods in the household were significant predictors of percent dietary fat consumed. Greater liking of high‐fat foods and lower liking of low‐fat foods, both alone and combined with a lower percentage of low‐fat foods in the home, were predictive of higher dietary fat intake.

Discussion: Interventions designed to reduce dietary fat intake should target both decreasing liking for high‐fat foods and increasing liking for low‐fat foods, along with increasing the proportion of low‐fat foods in the household.
Associations among Active Transportation, Physical Activity, and Weight Status in Young Adults
Authors: Gordon‐Larsen Penny , Nelson Melissa C. , Beam Kristen
Published: April 2008

Objective: To describe prevalence of active, public, and car transit by overweight status and amount of leisure‐time physical activity in a nationally representative cohort of ethnically diverse young adults.

Research Methods and Procedures: Questionnaire data on patterns of transportation were collected from U.S. adolescents enrolled in Wave III (2001) of the National Longitudinal Study of Adolescent Health (N = 10, 771). Measured height and weight data were used to calculate BMI and classify adults by overweight status (BMI ≥ 25). Self‐reported physical activity data were used to classify adults into those who achieved ≥ 5 bouts of weekly moderate‐vigorous physical activity and those who did not. Results were stratified by overweight and physical activity status.

Results: The vast majority of young adults used car transit (work, 90.4%; school, 74.7%). A small proportion of young adults used active means of transportation to work (8.1%) and school (26.7%), and fewer used public transportation to work or school (<10%). The proportion of individuals using active transportation was higher among the nonoverweight traveling to work (9.2%) and school (29.7%) and among the more active traveling to work (15.2%) and school (37.0%) relative to the overweight and less active young adults.

Discussion: The vast majority of young adults of all racial/ethnic backgrounds, particularly blacks and Hispanics, did not use active transportation to school and/or work. Active transportation was more common among nonoverweight and more active young adults, of high socioeconomic status, particularly full‐time students. Population‐level efforts (and environmental supports) to increase non‐leisure physical activity, particularly active transportation, are sorely needed as a means of supporting and promoting overall physical activity.
The Relationship of Health Outcomes to Improvement in BMI in Children and Adolescents
Authors: Kirk Shelley , Zeller Meg , Claytor Randal , Santangelo Megan , Khoury Philip R. , Daniels Stephen R.
Published: April 2008

Objective: To evaluate the clinical outcomes of patients participating in an outpatient program for managing childhood and adolescent obesity.

Research Methods and Procedures: Based on a retrospective chart review, 394 physician‐referred obese youth (BMI > 95th percentile), 5 to 19 years of age, were treated in an interdisciplinary, family‐centered, behavioral weight management program in a hospital‐based outpatient setting. Treatment included group exercise, parent education, and behavioral intervention therapies to improve diet and physical activity.

Results: A total of 177 (45%) completed the initial phase of treatment (mean duration = 5.6 months). For the completion group, there were significant improvements (all p < 0.001) in weight (−2.0 ± 4.9 kg), BMI (−1.7 ± 1.9 kg/m2), and BMI z score (−0.15 ± 0.15), without interfering with growth (height, 2.2 ± 1.3 cm; p < 0.001). Significant improvement was also found for blood pressure, total cholesterol, low‐density lipoprotein (LDL)‐cholesterol, triglycerides, insulin, and aerobic fitness. At onset of treatment, 134 (84%) patients had abnormal fasting insulin concentration, 88 (50%) had abnormal total cholesterol, 14 (8%) had abnormal diastolic blood pressure, and 69 (40%) had abnormal LDL‐cholesterol. At the end of treatment, a significant proportion of patients with baseline abnormal blood pressure, total cholesterol, and LDL‐cholesterol had normal values (p < 0.001). A decrease in BMI z score was associated with significant improvements in insulin and lipid values (all p < 0.05).

Discussion: We have demonstrated that a modest decrease in BMI in an ongoing clinical pediatric weight management program is accompanied by significant improvements in related health measures. These results may be helpful in counseling families with overweight children and adolescents.
Transtheoretical Model‐Chronic Disease Care for Obesity in Primary Care: A Randomized Trial
Authors: Logue Everett , Sutton Karen , Jarjoura David , Smucker William , Baughman Kristin , Capers Cynthia
Published: April 2008

Objective: To compare health benefits achieved in a transtheoretical model‐chronic disease (TM‐CD) minimal intervention for obesity vs. augmented usual care (AUC).

Research Method and Procedures: This was a 2‐year, randomized clinical trial with overweight or obese men and women from 15 primary care sites. AUC (n = 336) included dietary and exercise advice, prescriptions, and three 24‐hour dietary recalls every 6 months. TM‐CD care (n = 329) included AUC elements plus “stage of change” (SOC) assessments for five target behaviors every other month, mailed SOC and target behavior—matched workbooks, and monthly telephone calls from a weight‐loss advisor. Weight change was the primary outcome.

Results: Repeated measures models under the missing at random assumption yielded nonsignificant adjusted differences between the AUC and TM‐CD groups for weight change, waist circumference, energy intake or expenditure, blood pressure, and blood lipids. The pattern of change over time suggested that TM‐CD participants were trying harder to impact target behaviors during the first 6 to 12 months of the trial but relapsed afterward. Sixty percent of trial participants maintained their baseline weights for 18 to 24 months.

Discussion: A combination of mailed patient materials and monthly telephone calls based on the transtheoretical model and some elements of chronic disease care is not powerful enough, relative to AUC, to alter target behaviors among overweight primary care patients in an obesogenic environment. AUC may be sufficient to maintain weights among at‐risk primary care patients.
Racial Differences in the Tracking of Childhood BMI to Adulthood
Authors: Freedman David S. , Khan Laura Kettel , Serdula Mary K. , Dietz William H. , Srinivasan Sathanur R. , Berenson Gerald S.
Published: April 2008

Objective: The possibility that there are racial differences in the patterns of BMI (kilograms per meter squared) change throughout life has not been examined. For example, the high prevalence of obesity among black women could result from a higher prevalence of obesity among black girls or because normal‐weight black girls experience larger BMI increases in adolescence or adulthood than do their white counterparts. Therefore, we examined the tracking of childhood BMI into adulthood in a biracial (36% black) sample.

Research Methods and Procedures: Five‐ to 14‐year‐old children (2392) were followed for (mean) 17 years. Childhood overweight was defined as BMI ≥ 95th percentile, and adult obesity was defined as BMI ≥ 30 kg/m2.

Results: The tracking of childhood BMI differed between whites and blacks. Among overweight children, 65% of white girls vs. 84% of black girls became obese adults, and predictive values among boys were 71% (whites) vs. 82% (blacks). These racial differences reflected contrasting patterns in the rate of BMI change. Although the initial BMI of black children was not higher than that of white children, BMI increases with age were larger among black girls and overweight black boys than among their white counterparts. In contrast, relatively thin (BMI < 50th percentile) white boys were more likely to become overweight adults than were their black counterparts.

Discussion: These findings emphasize the black/white differences in BMI changes with age. Because of the adult health consequences of childhood‐onset obesity, early prevention should be given additional emphasis.
Novel Variants in the Putative Peroxisome Proliferator‐activated Receptor γ Promoter and Relationships with Obesity in Men
Authors: Larsen Thomas M. , Larsen Lesli H. , Torekov Signe K. , Ek Jakob , Black Eva , Toubro Søren , Astrup Arne , Sørensen Thorkild I. A. , Hansen Torben , Pedersen Oluf
Published: April 2008

Yet unidentified variants within the peroxisome proliferator‐activated receptor γ (PPARγ) 2 promoter may explain the inconsistent reports on associations between variants in the coding region and obesity or diabetes. Thus, we examined the putative PPARγ2 promoter (−3371 to +43 bp) for variants in 83 subjects with obesity or type 2 diabetes. We identified eight variants, seven of which were novel, including −792A>G, −816C>T, −882T>C, −1505G>A, −1881C>T, −1884T>A, −2604T>C, and −2953A>G. The variants −816C>T, −1505G>A, −1881C>T, and −2604T>C were in total linkage disequilibrium, and there was a high degree of linkage disequilibrium between several of the novel variants and Pro12Ala. The novel variants were, together with Pro12Ala and 1431C>T, examined for relationships with obesity among 234 men with early‐onset obesity with a BMI at age ∼20 years of 33.2 ± 2.5 kg/m2 and 323 nonobese men with a BMI of 21.7 ± 2.5 kg/m2, who were also reexamined after ∼29 years. The prevalence of the identified variants was not significantly different between the two groups, and the variants did not affect changes in BMI over time. In conclusion, the identified novel variants in the PPARγ2 promoter region do not explain the reported discrepancies in the association of previously identified variants with obesity and type 2 diabetes.
Angiotensin II Promotes Leptin Production in Cultured Human Fat Cells by an ERK1/2‐dependent Pathway
Authors: Skurk Thomas , van Harmelen Vanessa , Blum Werner F. , Hauner Hans
Published: April 2008

Objective: The fat cell hormone leptin is known to be implicated in the pathogenesis of hypertension and cardiovascular disease. Here we tested whether angiotensin (Ang) II is involved in the control of leptin release from human adipocytes.

Research Methods and Procedures: Leptin secretion was assessed from in vitro differentiated human adipocytes by radioimmunoassay. Western blot experiments were used to test for the signaling pathway activated by Ang II.

Results: Ang II increased leptin secretion into the culture medium in a dose‐ and time‐dependent fashion. At 10−5 M Ang II, the leptin concentration in the medium was increased at 24 hours by 500 ± 222% compared with control cultures (p < 0.05). This effect was also seen at the mRNA level. Similar effects were seen after exposure of fat cells to Ang III and Ang IV. Preincubation of fat cells with candesartan, an angiotensin II type 1 receptor antagonist, or the extracellular‐signal‐regulated kinases 1 and 2 inhibitor UO126 completely abolished the effect of Ang II on leptin production. The peroxisome proliferator‐activated receptor‐gamma agonist troglitazone modestly attenuated leptin release.

Discussion: In conclusion, Ang II and its metabolites stimulated leptin production in human adipocytes. This effect is mediated through an extracellular‐signal‐regulated kinases 1 and 2‐dependent pathway and includes the angiotensin II type 1 receptor subtype.
High‐fat Diet‐induced Ultradian Leptin and Insulin Hypersecretion are Absent in Obesity‐resistant Rats*
Authors: Otukonyong Effiong E. , Dube Michael G. , Torto Rita , Kalra Pushpa S. , Kalra Satya P.
Published: April 2008

Objective: Sprague‐Dawley rats fed a high‐fat diet (HFD) are either obesity prone (OP) or obesity resistant (OR). We tested the hypothesis that differences in the ultradian rhythmic patterns of insulin and ghrelin in OP vs. OR rats promote obesity in OP rats.

Research Methods and Procedures: Rats were fed regular chow or an HFD, and ultradian fluctuations in leptin, insulin, and ghrelin were analyzed in blood samples collected at 5‐minute intervals from intrajugular cannulae of freely moving rats.

Results: Regular chow feeding resulted in a slow weight gain accompanied by small increases in insulin and leptin and a decrease in ghrelin discharge, with only the pulse amplitude significantly altered. Similar changes were observed in OR rats, despite HFD consumption. In contrast, OP rats exhibited a high rate of weight gain and marked hyperinsulinemia, hyperleptinemia, and hypoghrelinemia; amplitude was altered, but frequency was stable. In a short‐term experiment, HFD elicited similar secretory patterns of smaller magnitude even in the absence of weight gain.

Discussion: We showed that three hormonal signals of disparate origin involved in energy homeostasis were secreted in discrete episodes, and only the pulse amplitude component was vulnerable to age and HFD consumption. Increases in insulin and leptin and decreases in ghrelin pulse amplitude caused by HFD were exaggerated in OP rats relative to OR rats and preceded the weight increase. These findings show that a distinct genetic predisposition in the endocrine organs of OR rats confers protection against high‐fat intake‐induced ultradian hypersecretion of obesity‐promoting hormonal signals.
Cluster Analysis Methods Help to Clarify the Activity—BMI Relationship of Chinese Youth
Authors: Monda Keri L. , Popkin Barry M.
Published: April 2008

Objective: To use cluster analysis to create patterns of overall activity and inactivity in a diverse sample of Chinese youth and to evaluate their use in predicting overweight status.

Research Methods and Procedures: The study populations were drawn from the 1997 and 2000 years of the longitudinal China Health and Nutrition Survey, comprised of 2702 and 2641 schoolchildren in the 1997 and 2000 cross‐sectional samples, respectively, and 1175 children in the longitudinal cohort. Cluster analysis was used to group children into nonoverlapping activity/inactivity “clusters” that were subsequently used in models of prevalent and incident overweight. Results were compared with traditional models, with activity and inactivity coded separately, to assess whether further insight was gained with the cluster analysis methodology.

Results: Moderately and highly active youth were shown to have significantly decreased odds of overweight in both cross‐sectional and longitudinal analyses using cluster analysis. In incident longitudinal models, youth in the high activity/high inactivity cluster had the lowest odds of overweight [odds ratio = 0.12 (0.03, 0.44)]; in contrast, results from traditional models failed to show any significant relationship between overweight and activity or inactivity.

Discussion: Cluster analysis methods allow researchers to simultaneously capture activity and inactivity in new ways. In this comparative study, only with the clustering methodology did we find a significant effect of activity on incident overweight, furthering our ability to examine this complex relationship. Interestingly, no effect of increasing levels of inactivity was observed using either method, indicating that activity seems to be the more important determinant of overweight in this population.
The Relationship Between Parent and Child Self‐Reported Adherence and Weight Loss
Authors: Wrotniak Brian H. , Epstein Leonard H. , Paluch Rocco A. , Roemmich James N.
Published: April 2008

Objective: Better adherence to treatment strategies in family‐based behavioral weight control programs may lead to greater weight reduction and improved weight maintenance in youth. This study assessed the influence of child and parent self‐reported adherence to behavioral strategies on changes in 2‐year child and parent percentage overweight.

Research Methods and Procedures: Participants included 8‐ to 12‐year‐old children in ≥ 85th BMI percentile and their parents from 110 families taking part in two family‐based randomized controlled weight control studies. This study examined whether self‐reported adherence to behavioral strategies measured at 24 months increased prediction of child and parent percentage overweight change through 24‐month follow‐up after accounting for other factors that may influence weight change.

Results: Child adherence to weighing and to preplanning for celebrations where high‐fat foods are served and parent adherence to praising the child and modeling healthy eating habits predicted 24‐month child percentage overweight change (p < 0.001). Child adherence to recording food and calories and parent adherence to modeling healthy eating habits predicted 24‐month parent percentage overweight change (p < 0.001). In hierarchical regression models, child weighing and preplanning and parent modeling were significant (p < 0.01) incremental predictors (r2 of 24.8%) of 24‐month child percentage overweight. Child recording and parent modeling were significant (p < 0.01) incremental predictors (r2 of 14%) of parent 24‐month percentage overweight change.

Discussion: Child and parent adherence to specific components of family‐based behavioral weight control treatment are independent predictors of long‐term child and parent percentage overweight change.
Relationships of Psychiatric Disorders with Overweight and Obesity in an Adult General Population**
Authors: John Ulrich , Meyer Christian , Rumpf Hans‐Jürgen , Hapke Ulfert
Published: April 2008

Objective: To explore relationships of smoking and risk drinking status, nicotine and alcohol dependence, and anxiety, depressive, and somatoform disorders with overweight and obesity.

Research Methods and Procedures: A probability sample was drawn that was representative for the adult general population, 18 to 64 years of age, in one region of Germany; the participation rate was 70.2%. After excluding those who were pregnant or had a current eating disorder according to the DSM‐IV, 4063 individuals remained. Overweight and obesity were defined according to the BMI that was assessed in the face‐to‐face in‐home standardized interview (Composite International Diagnostic Interview) on psychiatric disorders.

Results: Men with a former nicotine dependence had higher odds of being overweight than men who never had a nicotine dependence (adjusted odds ratio, 1.5; confidence interval, 1.1 to 2.1). Men at current risk for drinking and current alcohol‐dependent or abusing men had lower odds of being overweight compared with men who never were alcohol dependent, abusing, or at risk for drinking (adjusted odds ratio, 0.3; confidence interval, 0.8 to 0.9). Effect sizes were small. No relationship of overweight with depressive, anxiety, or somatoform disorders was found in the multivariate analysis.

Discussion: There is a relationship between being overweight and nicotine and alcohol dependence or abuse among men but not among women. Even though one reason for women to refrain from quitting smoking is the fear of weight gain, these results do not support this. This information could help convince women to try to quit smoking.
Prevalence of Uncomplicated Obesity in an Italian Obese Population
Authors: Iacobellis Gianluca , Ribaudo Maria Cristina , Zappaterreno Alessandra , Iannucci Concetta Valeria , Leonetti Frida
Published: April 2008

Objective: The existence of healthy obese subjects has been suggested but not clearly reported. We sought to address the prevalence of uncomplicated obesity and adverse risk factors in a large Italian obese population.

Research Methods and Procedures: This was a cross‐sectional study of a population of consecutive Italian obese subjects. We studied 681 obese subjects (514 women and 167 men), with a mean age of 41.1 ± 13.9 years (range, 16 to 77 years), mean BMI of 40.2 ± 7.6 kg/m2 (range, 30 to 89.8 kg/m2), and a history of obesity for 20.5 ± 7 years (range, 10.5 to 30 years). Anthropometric, metabolic, cardiac, and obesity‐related risk factors were evaluated.

Results: The prevalence of uncomplicated subjects was 27.5%, independent of BMI and duration of obesity. The youngest group of obese subjects showed a higher, but not statistically significantly higher, prevalence of uncomplicated obesity. No statistical difference for the prevalence of impaired fasting glucose, glucose intolerance, high triglycerides, high total cholesterol, low‐density lipoprotein cholesterol, and high‐density lipoprotein cholesterol among BMI categories (from mild to extremely severe obesity degree) was found. Obese subjects with BMI >50 kg/m2 showed a higher prevalence of high blood pressure only when they were compared with the group with a BMI of 30 to 35 kg/m2 (p < 0.01). Obese subjects with BMI >40 kg/m2 showed a higher prevalence of hyperinsulinemia than subjects with BMI 30 to 35 kg/m2 (p < 0.01).

Discussion: This study shows that a substantial part of an Italian obese population has uncomplicated obesity, and the prevalence of adverse risk factors in this sample is unexpectedly low and partially independent of obesity degree. Uncomplicated obesity could represent a well‐defined clinical entity.
Weight and Height Growth Rate and the Timing of Adiposity Rebound
Authors: Williams Sheila M.
Published: April 2008

Objective: Adiposity rebound occurs when the ratio of the velocities of log(weight) to log(height) changes from <2 to >2. This study examined the timing of adiposity rebound in the context of the velocities of weight and height in early childhood because it is not known whether faster weight gain or slower gain in stature is the more important determinant.

Research Methods and Procedures: This was a longitudinal study of 406 boys and 397 girls born in Dunedin, New Zealand, in 1972 and 1973. Each child's height and weight were measured at 3 years of age and at least twice more as part of their two yearly assessments until 11 years of age.

Results: The mean age of adiposity rebound was 6.6 ± 1.10 years (SD) for boys and 6.0 ± 1.21 years for girls. After adjusting for sex, the correlations between the timing of rebound and z‐scores for BMI, weight, and height at rebound were −0.35, −0.30, and −0.14, respectively. Correlations between the timing of rebound and estimated values of weight and height velocities at 3 years were −0.48 and −0.00. The correlations with BMI and waist girth at 26 years were −0.39 and −0.35.

Discussion: Children with an earlier adiposity rebound were heavier and had above average BMIs. Early rebound is the result of higher rates of weight gain, measured in percentage terms, rather than slower than average accrual of stature. This suggests that restraining weight gain could delay adiposity rebound and prevent obesity in early adulthood.
Changes in Prevalence of Overweight and in Body Image among Fijian Women between 1989 and 1998**
Authors: Becker Anne E. , Gilman Stephen E. , Burwell Rebecca A.
Published: April 2008

Objective: To investigate changes in prevalence of overweight and obesity and in body image among ethnic Fijian women in Fiji during a period of rapid social change and the relationship between changes in body image and BMI.

Research Methods and Procedures: The study design was a multiwave cohort study of BMI in a traditional Fijian village over a 9.5‐year period from 1989 to 1998. Cohorts were identified in 1989 (n = 53) and in 1998 (n = 50). Selection criteria included Fijian ethnicity, female gender, age of at least 18 years, and residence in a specific coastal Fijian village in 1989 and 1998, respectively. Assessments consisted of measurement of height and weight, collection of demographic data by written survey, and administration of the Nadroga Language Body Image Questionnaire.

Results: The prevalence of overweight and obesity was significantly different between the cohorts, increasing from 60% in 1989 to 84% in 1998 (p = 0.014). In addition, the age‐adjusted mean BMI was significantly higher in 1998 compared with 1989 (p = 0.011). Finally, there were significant between‐cohort differences in multiple measures of body image, which were mostly independent of BMI.

Discussion: At 84%, the prevalence of overweight and obesity in this community sample of Fijian women is among the highest in the world. The dramatically increased prevalence over the 9.5‐year period studied corresponds with rapid social change in Fiji and significant shifts in prevailing traditional attitudes toward body shape.
Body Weight Loss and Weight Maintenance in Relation to Habitual Caffeine Intake and Green Tea Supplementation
Authors: Westerterp‐Plantenga Margriet S. , Lejeune Manuela P.G.M. , Kovacs Eva M. R.
Published: April 2008

Objective: Investigation of the effect of a green tea‐caffeine mixture on weight maintenance after body weight loss in moderately obese subjects in relation to habitual caffeine intake.

Research Methods and Procedures: A randomized placebo‐controlled double blind parallel trial in 76 overweight and moderately obese subjects, (BMI, 27.5 ± 2.7 kg/m2) matched for sex, age, BMI, height, body mass, and habitual caffeine intake was conducted. A very low energy diet intervention during 4 weeks was followed by 3 months of weight maintenance (WM); during the WM period, the subjects received a green tea‐caffeine mixture (270 mg epigallocatechin gallate + 150 mg caffeine per day) or placebo.

Results: Subjects lost 5.9 ±1.8 (SD) kg (7.0 ± 2.1%) of body weight (p < 0.001). At baseline, satiety was positively, and in women, leptin was inversely, related to subjects’ habitual caffeine consumption (p < 0.01). High caffeine consumers reduced weight, fat mass, and waist circumference more than low caffeine consumers; resting energy expenditure was reduced less and respiratory quotient was reduced more during weight loss (p < 0.01). In the low caffeine consumers, during WM, green tea still reduced body weight, waist, respiratory quotient and body fat, whereas resting energy expenditure was increased compared with a restoration of these variables with placebo (p < 0.01). In the high caffeine consumers, no effects of the green tea‐caffeine mixture were observed during WM.

Discussion: High caffeine intake was associated with weight loss through thermogenesis and fat oxidation and with suppressed leptin in women. In habitual low caffeine consumers, the green tea‐caffeine mixture improved WM, partly through thermogenesis and fat oxidation.
Effects of Calcium and Dairy on Body Composition and Weight Loss in African‐American Adults
Authors: Zemel Michael B. , Richards Joanna , Milstead Anita , Campbell Peter
Published: April 2008

Objective: Our objective was to determine the effects of dairy consumption on adiposity and body composition in obese African Americans.

Research Methods and Procedures: We performed two randomized trials in obese African‐American adults. In the first (weight maintenance), 34 subjects were maintained on a low calcium (500 mg/d)/low dairy (<1 serving/d) or high dairy (1200 mg Ca/d diet including 3 servings of dairy) diet with no change in energy or macronutrient intake for 24 weeks. In the second trial (weight loss), 29 subjects were similarly randomized to the low or high dairy diets and placed on a caloric restriction regimen (−500 kcal/d).

Results: In the first trial, body weight remained stable for both groups throughout the maintenance study. The high dairy diet resulted in decreases in total body fat (2.16 kg, p < 0.01), trunk fat (1.03 kg, p < 0.01), insulin (18.7 pM, p < 0.04), and blood pressure (6.8 mm Hg systolic, p < 0.01; 4.25 mm Hg diastolic, p < 0.01) and an increase in lean mass (1.08 kg, p < 0.04), whereas there were no significant changes in the low dairy group. In the second trial, although both diets produced significant weight and fat loss, weight and fat loss on the high dairy diet were ∼2‐fold higher (p < 0.01), and loss of lean body mass was markedly reduced (p < 0.001) compared with the low dairy diet.

Discussion: Substitution of calcium‐rich foods in isocaloric diets reduced adiposity and improved metabolic profiles in obese African Americans without energy restriction or weight loss and augmented weight and fat loss secondary to energy restriction.
Air Displacement Plethysmography: Validation in Overweight and Obese Subjects
Authors: Ginde Samir R. , Geliebter Allan , Rubiano Frederick , Silva Analiza M. , Wang Jack , Heshka Stanley , Heymsfield Steven B.
Published: April 2008

Objective: Patients with moderate and severe obesity, because of their physical size, often cannot be evaluated with conventional body composition measurement systems. The BOD POD air displacement plethysmography (ADP) system can accommodate a large body volume and may provide an opportunity for measuring body density (Db) in obese subjects. Db can be used in two‐ or three‐compartment body composition models for estimating total body fat in patients with severe obesity. The purpose of this study was to compare Db measured by ADP to Db measured by underwater weighing (UWW) in subjects ranging from normal weight to severely obese.

Research Methods and Procedures: Db was measured with UWW and BOD POD in 123 subjects (89 men and 34 women; age, 46.5 ± 16.9 years; BMI, 31.5 ± 7.3 kg/m2); 15, 70, and 10 subjects were overweight (25 ≤ BMI < 30 kg/m2), obese (30 ≤ BMI < 40 kg/m2), and severely obese (BMI ≥ 40 kg/m2), respectively.

Results: There was a strong correlation between Db(kilograms per liter) measured by UWW and ADP (r = 0.94, standard error of the estimate = 0.0073 kg/L, p < 0.001). Similarly, percent fat estimates from UWW and ADP using the two‐compartment Siri equation were highly correlated (r = 0.94, standard error of the estimate = 3.58%, p < 0.001). Bland‐Altman analysis showed no significant bias between Db measured by UWW and ADP. After controlling for Db measured by ADP, no additional between‐subject variation in Db by UWW was accounted for by subject age, sex, or BMI.

Discussion: Body density, an important physical property used in human body composition models, can be accurately measured by ADP in overweight and obese subjects.
Geographic Variation in the Prevalence of Obesity, Diabetes, and Obesity‐Related Behaviors**
Authors: Ford Earl S. , Mokdad Ali H. , Giles Wayne H. , Galuska Deborah A. , Serdula Mary K.
Published: April 2008

Objective: To examine the variation in the prevalences of obesity and type 2 diabetes in weight loss counseling by health providers and in other potential obesity‐related determinants in 100 metropolitan statistical areas in the United States.

Research Methods and Procedures: We performed a cross‐sectional study using data from the 2000 Behavioral Risk Factor Surveillance System, the largest telephone survey of health behaviors in the United States, of age‐adjusted prevalence of obesity, type 2 diabetes, intake of ≥five servings of fruits and vegetables per day, participation in 150 minutes of leisure‐time physical activity per week, receipt of weight management advice, and reports of trying to lose or maintain weight among men and women more than 18 years old.

Results: The age‐adjusted prevalence of obesity ranged from 13.1% to 30.0% and that of type 2 diabetes from 3.3% to 9.2%. Among participants who had visited a physician for a routine checkup in the previous 12 months, 13.1% to 27.1% of all participants recalled receiving advice from a health professional about their weight, and 11.7% to 34.6% of overweight or obese participants recalled receiving advice to maintain or lose weight.

Discussion: Significant differences in the prevalence of obesity and self‐reported type 2 diabetes and in medical practice patterns regarding weight management advice exist among metropolitan statistical areas. These results suggest important opportunities to investigate reasons for these variations that could potentially be used to mitigate the current epidemic of obesity and to identify areas where obesity and diabetes prevention efforts may need to be targeted.
BMI and Cervical Cancer Screening among White, African‐American, and Hispanic Women in the United States
Authors: Wee Christina C. , Phillips Russell S. , McCarthy Ellen P.
Published: April 2008

Objectives: We examined cervical cancer screening by BMI in white, African‐American, and Hispanic women and explored women's reasons for not undergoing screening.

Research Methods and Procedures: We used logistic regression to examine Pap testing in the preceding 3 years across BMI groups for white (n = 6419), African‐American (n = 1715), and Hispanic women (n = 1859) age 18 to 75 years who responded to the 2000 National Health Interview Survey. We used bivariable analyses to describe women's reasons for not undergoing testing and examined whether unscreened women received physician recommendations for screening.

Results: Of 12, 170 women, 50% were normal weight, 26% were overweight, and 21% were obese. The proportion who reported Pap testing in the last 3 years was 86% in whites, 88% in African Americans, and 78% in Hispanics. After adjustment for sociodemographics, health care access, and illness burden, severely obese white women (BMI = 40+ kg/m2) were significantly less likely to undergo Pap testing (relative risk, 0.92; 95% CI, 0.83 to 0.99) compared with normal weight women. BMI was not associated with screening in African Americans or Hispanics. A higher proportion of obese white women than normal weight women cited putting off the test or embarrassment or discomfort as the primary reason for not undergoing screening. Among the unscreened, obese women were as likely as normal weight women to receive a physician recommendation to undergo screening.

Discussion: Disparities in cervical cancer screening by body weight persist for white women with severe obesity. Disparities were not explained by differences in the rate of physician recommendations for screening, but obese white women may be more likely to delay screening or to find screening painful, uncomfortable, or embarrassing than normal weight white women. Efforts to increase screening among obese women should address women's reservations about screening.
Obesity and Receipt of Personal Care Assistance for People with Mobility Impairments
Authors: Resnik Linda , Lapane Kate L. , Allen Susan M.
Published: April 2008

Objective: The purpose of this study was to evaluate the extent to which level of obesity was associated with hours of personal care among people with mobility impairments.

Research Methods and Procedures: The analytic sample consisted of 9496 respondents to the Adult Disability Follow‐Back Survey (NHIS‐D Phase II) who had mobility difficulty and difficulty with at least one activity of daily living or instrumental activity of daily living. Logistic regression analyses determined the relationship between level of obesity and receipt of any paid or unpaid help, controlling for potential confounders. In addition, differences in hours of help by level of obesity were evaluated using multiple regression.

Results: In the crude analysis, obese respondents were significantly less likely to receive any paid help than normal weight respondents (average odds ratio 0.75) and received significantly fewer hours of both paid and unpaid help. The difference in prevalence of receipt of any unpaid and any paid help by level of obesity was explained by adjustment for age and other demographic characteristics. Adjusted hours of paid and unpaid help were equivalent for those with and without obesity.

Discussion: Obese people with mobility impairments received less help with personal care than those of normal weight, although these findings are explained by demographics. Nevertheless, these findings raise public health concerns given the growing obesity epidemic in the United States and lack of available resources to support younger persons with disabilities.
Diet Induction of Monocyte Chemoattractant Protein‐1 and its Impact on Obesity
Authors: Chen Airu , Mumick Sheena , Zhang Chunsheng , Lamb John , Dai Hongyue , Weingarth Drew , Mudgett John , Chen Howard , MacNeil Douglas J. , Reitman Marc L. , Qian Su
Published: April 2008

Objective: To examine the effect of a high‐fat diet on gene expression in adipose tissues and to determine induction kinetics of adipose monocyte chemoattractant protein‐1 and −3 (MCP‐1 and MCP‐3) in diet‐induced obesity (DIO) and the effect of a lack of MCP‐1 signaling on DIO susceptibility and macrophage recruitment into adipose tissue.

Research Methods and Procedures: Obese and lean adipose tissues were profiled for expression changes. The time‐course of MCP‐1 and MCP‐3 expression was examined by reverse transcriptase‐polymerase chain reaction. Plasma MCP‐1 levels were determined by enzyme‐linked immunosorbent assay (ELISA). Chemokine receptor‐2 (CCR2) knockout mice were placed on the high‐fat diet to determine DIO susceptibility. Macrophage infiltration in adipose tissue was examined by immunohistochemistry with F4/80 antibody.

Results: DIO elevated adipose expression of many inflammatory genes, including MCP‐1 and MCP‐3. Adipose MCP‐1 and MCP‐3 mRNA levels increased within 7 days of starting a high‐fat diet, with elevation of plasma MCP‐1 detected after 4 weeks on the diet. The induction of MCP‐1 and MCP‐3 expression preceded that of tumor necrosis factor‐α. The elevated plasma MCP‐1 concentration in obese mice was partially reversed by treatment with AM251. No change in DIO susceptibility and macrophage accumulation in adipose tissue were observed in CCR2 knockout mice, which lack the MCP‐1 receptor CCR2.

Discussion: A high‐fat diet elevated adipose expression of inflammatory genes, including early induction of MCP‐1 and MCP‐3, supporting the view that obese adipose tissues contribute to systemic inflammation. However, despite increased MCP‐1 in obesity, disruption of MCP‐1 signaling did not confer resistance to DIO in mice or reduce adipose tissue macrophage infiltration.
Weight Change in Monozygotic Twins Treated with Valproate
Authors: Klein Karl Martin , Hamer Hajo M. , Reis Janine , Schmidtke Jörg , Oertel Wolfgang H. , Theisen Frank M. , Hebebrand Johannes , Rosenow Felix
Published: April 2008

Objective: To evaluate whether genetic factors contribute to weight gain associated with valproate (VPA) therapy.

Research Methods and Procedures: We retrospectively and prospectively evaluated five pairs of monozygotic twins concordant for epilepsy and treated with VPA regarding weight course.

Results: In all twin pairs, both twins showed similar weight courses under therapy with VPA.

Discussion: These results suggest that genetic factors may have an influence on the weight change induced by VPA. Further studies are necessary to obtain heritability estimates regarding this effect of VPA therapy and to identify the relevant genes.
Effect of Energy‐Reduced Diets High in Dairy Products and Fiber on Weight Loss in Obese Adults
Authors: Thompson Warren G. , Holdman Nicole Rostad , Janzow Denise J. , Slezak Jeffrey M. , Morris Kristin L. , Zemel Michael B.
Published: April 2008

Objective: Studies suggest that high‐dairy and high‐fiber/low‐glycemic index diets may facilitate weight loss, but data are conflicting. The effects on weight loss and body fat of a high‐dairy diet and a diet high in dairy and fiber and low in glycemic index were compared with a standard diet.

Research Methods and Procedures: Ninety obese subjects were recruited into a randomized trial of three diets designed to provide a calorie deficit of 500 calories/d over a 48‐week period. The study compared a moderate (not low)‐calcium diet with a high‐calcium diet.

Results: Seventy‐two subjects completed the study. Significant weight and fat loss occurred with all three diets. A diet with 1400 mg of calcium did not result in greater weight (11.8 ± 6.1 kg) or fat (9.0 ± 6.0 kg) loss than a diet with 800 mg of calcium (10.0 ± 6.8 and 7.5 ± 6.6 kg, respectively). A diet with 1400 mg of calcium, increased fiber content, and fewer high‐glycemic index foods did not result in greater weight (10.6 ± 6.8 kg) or fat (8.5 ± 7.8 kg) loss than the standard diet with 800 mg of calcium. Lipid profile, high‐sensitivity C‐reactive protein, leptin, fasting glucose, and insulin improved significantly, but there were no significant differences between the experimental diets and the control diet.

Discussion: We found no evidence that diets higher than 800 mg of calcium in dairy products or higher in fiber and lower in glycemic index enhance weight reduction beyond what is seen with calorie restriction alone.
Stunting at 2 Years in Relation to Body Composition at 9 Years in African Urban Children**
Authors: Cameron Noël , Wright Melanie M. , Griffiths Paula L. , Norris Shane A. , Pettifor John M.
Published: April 2008

Objective: To determine whether African urban children who were stunted at 2 years of age demonstrated an altered body composition by the end of childhood, before entering puberty, at 9 years of age.

Research Methods and Procedures: This was a mixed‐longitudinal study of 330 prepubertal African children (182 boys) from Soweto‐Johannesburg, South Africa. Anthropometric data at 2 years of age were compared with anthropometric, DXA‐determined body composition and fat patterning in late childhood (7 to 9 years).

Results: Children who had been stunted at 2 years were significantly shorter and lighter than non‐stunted children at 7 to 9 years, but there were no differences in their BMI or centralization of body fat. Previously stunted status significantly predicted reduced weight and height at 7 to 9 years but did not predict BMI, body composition, or fat patterning after controlling for potential confounding factors. The odds ratio for stunting at 2 years as a predictor of overweight at 7 to 9 years was not significant at 1.09 (95% confidence limits: 0.30, 3.98).

Discussion: Greater BMI in stunted infants does not demonstrate a tendency toward overweight or obesity but is a reflection of the greater reduction in height rather than weight in stunted children. Stunted children may be programmed to accumulate greater body fat at central sites during adolescence, but we have been unable to show that these changes are evident before the initiation of pubertal development.