bluuebunny/crossref_metadata_2025 huggingface dataset:
Early Obesity and Age‐Related Mimicry of Metabolic Syndrome in Female Mice with Sex Hormonal Imbalances
Authors: Sairam M Ram , Wang Min , Danilovich Natalia , Javeshghani Danesh , Maysinger Dusica
Published: April 2008

Objective: To investigate the relationship of early obesity to metabolic syndrome during sex hormonal imbalances in mutant female mice at different ages.

Research Methods and Procedures: Hormonal imbalances, accumulation and nature of adipose tissue, food intake, glucose tolerance, and expression of candidate genes and markers of inflammation were studied by comparing wild‐type, null, and haploinsufficient follitropin receptor knockout female mice at different ages.

Results: Follitropin receptor deletion in mice produced null females that are infertile and haploinsufficient mice that undergo accelerated biological aging. Both types of mutants with sex hormonal imbalances have central obesity without hyperphagia, but circulating leptin is elevated. Adipocyte hyperplasia and hypertrophy is attributed to elevated peroxisome proliferator‐activated receptor γ expression. Adiponectin protein levels increase in fat tissue and plasma. Only mutants but not controls acquire age‐dependent decline in glucose tolerance with high insulin and altered pancreatic β cells. Changes in inflammation markers, decreased muscle insulin receptor phosphorylation, and increase of the enzyme protein tyrosine phosphatase 1B indicate insulin resistance.

Discussion: In this animal model, the chronological appearance of early obesity induced by hormonal imbalances culminates in characteristics that are attributable to metabolic syndrome, including cardiovascular abnormalities. Dissection of the depot‐specific alterations and defining molecular interrelationships could help in developing targeted remedies and resolving complications and controversies related to health benefits and adversities of current hormone replacement therapy.
Visceral Obesity is Associated with High Levels of Serum Squalene
Authors: Peltola Paula , Pihlajamäki Jussi , Koutnikova Hana , Ruotsalainen Eija , Salmenniemi Urpu , Vauhkonen Ilkka , Kainulainen Sakari , Gylling Helena , Miettinen Tatu A. , Auwerx Johan , Laakso Markku
Published: April 2008

Objective: To investigate the impact of visceral obesity on cholesterol metabolism in normoglycemic offspring of patients with type 2 diabetes.

Research Methods and Procedures: The proportion of intra‐abdominal fat (IAF) was measured by abdominal computer tomography, and serum cholesterol synthesis and absorption markers were determined by gas‐liquid chromatography in 109 normoglycemic offspring of patients with type 2 diabetes. Insulin action was measured with the hyperinsulinemic euglycemic clamp. The gene encoding squalene synthase (farnesyl‐diphosphate farnesyltransferase 1) was screened with the single‐strand conformation polymorphism analysis and direct sequencing.

Results: Cholesterol synthesis markers correlated positively with IAF (r = 0.213 to 0.309, p ≤ 0.027) and negatively with the rates of insulin‐stimulated whole‐body glucose uptake (r = −0.372 to −0.248, p ≤ 0.010). However, serum squalene, the first measured precursor of cholesterol synthesis, showed a positive correlation with IAF (r = 0.309, p = 0.001) without any association with subcutaneous fat or insulin sensitivity. Variation in the farnesyl‐diphosphate farnesyltransferase 1 gene did not explain elevated serum squalene levels in viscerally obese subjects. From the cholesterol absorption markers, cholestanol was associated negatively with IAF and positively with whole‐body glucose uptake (p < 0.05).

Discussion: High serum squalene levels are associated with visceral obesity but not with subcutaneous obesity. Whether this finding is causally connected to visceral obesity remains to be established.
Comparison of Body Fat Composition and Serum Adiponectin Levels in Diabetic Obesity and Non‐diabetic Obesity
Authors: Kim Chulsik , Park Jina , Park Jongsuk , Kang Eunseok , Ahn Chulwoo , Cha Bongsoo , Lim Sungkil , Kim Kyungrae , Lee Hyunchul
Published: April 2008

Objective: Clinical aspects of diabetes and obesity are somewhat different, even at similar levels of insulin resistance. The purpose of this study was to determine differences in body fat distribution and serum adiponectin concentrations in diabetic and non‐diabetic obese participants. We were also interested in identifying the characteristics of insulin resistance in these two groups, particularly from the standpoint of adiponectin.

Research Methods and Procedures: Adiponectin concentrations of 112 type 2 diabetic obese participants and 124 non‐diabetic obese participants were determined. Abdominal adipose tissue areas and midthigh skeletal muscle areas were measured by computed tomography. A homeostasis model assessment of the insulin resistance score was calculated to assess insulin sensitivity. The relationships among serum adiponectin, body fat distribution, and clinical characteristics were also analyzed.

Results: Both abdominal subcutaneous and visceral fat areas were higher in the non‐diabetic obese group, whereas midthigh low‐density muscle area was higher in the diabetic obese group. The homeostasis model assessment of the insulin resistance score was similar between groups, whereas serum adiponectin was lower in the diabetic obese group. Abdominal visceral fat (β = −0.381, p = 0.012) was a more important predictor of adiponectin concentration than low‐density muscle (β = −0.218, p = 0.026) in cases of non‐diabetic obesity, whereas low‐density muscle (β = −0.413, p = 0.013) was a better predictor of adiponectin level than abdominal visceral fat (β = − 0.228, p = 0.044) in diabetic obese patients.

Discussion: Therefore, factors involved in pathophysiology, including different serum adiponectin levels and body fat distributions, are believed to be responsible for differences in clinical characteristics, even at similar levels of insulin resistance in both diseases.
Skeletal Muscle Fat Oxidation Is Increased in African‐American and White Women after 10 days of Endurance Exercise Training
Authors: Cortright Ronald N. , Sandhoff Kimberly M. , Basilio Jessica L. , Berggren Jason R. , Hickner Robert C. , Hulver Matthew W. , Dohm G. Lynis , Houmard Joseph A.
Published: April 2008

Objective: Obesity is associated with lower rates of skeletal muscle fatty acid oxidation (FAO), which is linked to insulin resistance. FAO is reduced further in obese African‐American (AAW) vs. white women (CW) and may also be lower in lean AAW vs. CW. In lean CW, endurance exercise training (EET) elevates the oxidative capacity of skeletal muscle. Therefore, we determined whether EET would elevate skeletal muscle FAO similarly in AAW and CW with a lower lipid oxidative capacity.

Research Methods and Procedures: In vitro rates of FAO were assessed in rectus abdominus muscle strips using [1‐14C] palmitate (Pal) from lean AAW [BMI = 24.2 ± 0.9 (standard error) kg/m2] and CW (23.6 ± 0.8 kg/m2) undergoing voluntary abdominal surgery. Lean AAW (22 ± 0.9 kg/m2) and CW (24 ± 0.8 kg/m2) and obese AAW (36 ± 1.2 kg/m2) and CW (40 ± 1.3 kg/m2) underwent 10 consecutive days of EET on a cycle ergometer (60 min/d, 75% peak oxygen uptake). FAO was measured in vastus lateralis homogenates as captured 14CO2 using [1‐14C] Pal, palmitoyl‐CoA (Pal‐CoA), and palmityl‐carnitine (Pal‐Car).

Results: Muscle strip experiments showed suppressed rates of FAO (p = 0.03) in lean AAW vs. CW. EET increased the rates of skeletal muscle Pal oxidation (p = 0.05) in both lean AAW and CW. In obese subjects, Pre‐EET Pal (but not Pal‐CoA or Pal‐Car) oxidation was lower (p = 0.05) in AAW vs. CW. EET increased Pal oxidation 100% in obese AAW (p < 0.05) and 59% (p < 0.05) in obese CW. Similar increases (p < 0.05) in post‐EET FAO were observed for Pal‐CoA and Pal‐Car in both groups.

Discussion: Both lean and obese AAW possess a lower capacity for skeletal muscle FAO, but EET increases FAO similarly in both AAW and CW. These data suggest the use of EET for treatment against obesity and diabetes for both AAW and CW.
Intensive Weight Loss Program Improves Physical Function in Older Obese Adults with Knee Osteoarthritis
Authors: Miller Gary D. , Nicklas Barbara J. , Davis Cralen , Loeser Richard F. , Lenchik Leon , Messier Stephen P.
Published: April 2008

Objective: Physical function and body composition in older obese adults with knee osteoarthritis (OA) were examined after intensive weight loss.

Research Methods and Procedures: Older obese adults (n = 87; ≥60 years; BMI ≥ 30.0 kg/m2) with symptomatic knee OA and difficulty with daily activities were recruited for a 6‐month trial. Participants were randomized into either a weight stable (WS) or weight loss (WL) program. Participants in WL (10% weight loss goal) were prescribed a 1000 kcal/d energy deficit diet with exercise 3 d/wk. WS participants attended health information sessions. Body composition and physical function (Western Ontario and McMaster University Osteoarthritis Index, 6‐minute walking distance, and stair climb time) were assessed at baseline and 6 months. Statistical analysis included univariate analysis of covariance on 6‐month measurements using baseline values as covariates. Associations between physical function and body composition were performed.

Results: Body weight decreased 8.7 ± 0.8% in WL and 0.0 ± 0.7% in WS. Body fat and fat‐free mass were lower for WL than WS at 6 months (estimated means: fat = 38.1 ± 0.4% vs. 40.9 ± 0.4%, respectively; fat‐free mass = 56.7 ± 0.4 vs. 58.8 ± 0.4 kg, respectively). WL had better function than WS, with lower Western Ontario and McMaster University Osteoarthritis Index scores, greater 6‐minute walk distance, and faster stair climb time (p < 0.05). Changes in function were associated with weight loss in the entire cohort.

Discussion: An intensive weight loss intervention incorporating energy deficit diet and exercise training improves physical function in older obese adults with knee OA. Greater improvements in function were observed in those with the most weight loss.
Adult Obesity and Number of Years Lived with and without Cardiovascular Disease
Authors: Silva M. Carolina Pardo , De Laet Chris , Nusselder Wilma J. , Mamun Abdulah A. , Peeters Anna
Published: April 2008

Objective: To determine the differences in number of years lived free of cardiovascular disease (CVD) and number of years lived with CVD between men and women who were obese, pre‐obese, or normal weight at 45 years of age.

Research Methods and Procedures: We constructed multistate life tables for CVD, myocardial infarction, and stroke, using data from 2551 enrollees (1130 men) in the Framingham Heart Study who were 45 years of age.

Results: Obesity and pre‐obesity were associated with fewer number of years free of CVD, myocardial infarction, and stroke and an increase in the number of years lived with these diseases. Forty‐five‐year‐old obese men with no CVD survived 6.0 years [95% confidence interval (CI), 4.1; 8.1] fewer than their normal weight counterparts, whereas, for women, the difference between obese and normal weight subjects was 8.4 years (95% CI: 6.2; 10.8). Obese men and women lived with CVD 2.7 (95% CI: 1.0; 4.4) and 1.4 years (95% CI: −0.3; 3.2) longer, respectively, than normal weight individuals.

Discussion: In addition to reducing life expectancy, obesity before middle age is associated with a reduction in the number of years lived free of CVD and an increase in the number of years lived with CVD. Such information is paramount for preventive and therapeutic decision‐making by individuals and practitioners alike.
Anthropometric Measures, Body Composition, Body Fat Distribution, and Knee Osteoarthritis in Women
Authors: Abbate Lauren M. , Stevens June , Schwartz Todd A. , Renner Jordan B. , Helmick Charles G. , Jordan Joanne M.
Published: April 2008

Objective: Increased BMI is a well‐recognized risk factor for radiographic knee osteoarthritis (rKOA); however, the contributions of the components of body composition, body fat distribution, and height to this association are not clear.

Research Methods and Procedures: We examined 779 women ≥45 years of age from the Johnston County Osteoarthritis Project. Body composition was assessed using DXA, and rKOA was defined as Kellgren‐Lawrence grade ≥2. Logistic regression models examined the association between rKOA and the fourth compared with the first quartiles of anthropometric, body composition, and fat distribution measures adjusting for age, ethnicity, and prior knee injury.

Results: The adjusted odds ratios and 95% confidence interval of BMI and weight were 5.27 (3.05, 9.13) and 5.28 (3.05, 9.16), respectively. In separate models, higher odds of rKOA were also found for fat mass [4.54 (2.68, 7.69)], percent fat mass [3.84 (2.26, 6.54)], lean mass [3.94 (2.22, 6.97)], and waist circumference [4.15 (2.45, 7.02)]. Waist‐to‐hip ratio was not associated with rKOA [1.45 (0.86, 2.43)], and percent lean mass was associated with lower odds [0.20 (0.11, 0.35)]. Taller women had higher odds of rKOA after adjustment for BMI [1.77 (1.05, 3.00)].

Discussion: This study confirms that BMI and weight are strongly associated with rKOA in women and suggests that precise measurements of body composition and measures of fat distribution may offer no advantage over the more simple measures of BMI or weight in assessment of risk of rKOA.
The Evolution of Very‐Low‐Calorie Diets: An Update and Meta‐analysis
Authors: Tsai Adam Gilden , Wadden Thomas A.
Published: April 2008

Objective: Very‐low‐calorie diets (VLCDs), providing <800 kcal/d, have been used since the 1970s to induce rapid weight loss. Previous reviews of the literature have disagreed concerning the relative efficacy of VLCDs vs. conventional low‐calorie diets (LCDs) for achieving long‐term weight loss.

Research Methods and Procedures: We sought to update findings on the clinical use, safety, and efficacy of VLCDs and to perform a meta‐analysis of randomized trials that compared the long‐term efficacy of LCDs and VLCDs. Original research articles were retrieved by a Medline search and from prior reviews of VLCDs. Trials were included only if they were randomized comparisons of LCDs and VLCDs and included a follow‐up assessment at least 1 year after maximum weight loss. Data were abstracted by both authors regarding: duration of VLCD, total length of treatment, attrition, short‐ and long‐term weight loss, changes in weight‐related comorbidities, and adverse effects.

Results: Six randomized trials were found that met inclusion criteria. VLCDs, compared with LCDs, induced significantly greater short‐term weight losses (16.1 ± 1.6% vs. 9.7 ± 2.4% of initial weight, respectively; p = 0.0001) but similar long‐term losses (6.3 ± 3.2% vs. 5.0 ± 4.0%, respectively; p > 0.2). Attrition was similar with VLCD and LCD regimens.

Discussion: VLCDs did not produce greater long‐term weight losses than LCDs. In the United States, the use of liquid meal replacements as part of a 1000 to 1500 kcal/d diet may provide an effective and less expensive alternative to VLCDs. In Europe, VLCDs are used with less intensive medical supervision than in the United States, which reduces the cost of this approach.
Central Leptin Gene Therapy Blocks Ovariectomy‐Induced Adiposity
Authors: Torto Rita , Boghossian Stéphane , Dube Michael G. , Kalra Pushpa S. , Kalra Satya P.
Published: April 2008

Objective: In this study, we tested the hypothesis that insufficiency of leptin restraint in the hypothalamus is responsible for promoting weight gain and adiposity after ovariectomy (ovx). Whether increasing leptin transgene expression can overcome the diminution in leptin restraint was evaluated in ovx rats.

Research Methods and Procedures: Enhanced leptin or green fluorescent protein (GFP; control) transgene expression was induced by a single intracerebroventricular injection of recombinant adeno‐associated viral vector encoding either leptin gene (rAAV‐lep) or GFP gene (rAAV‐GFP; control) in acutely and chronically ovx rats. Body weight and food intake responses were monitored weekly. White adipose tissue (WAT) mass and serum levels of WAT‐derived hormones, leptin, and adiponectin were analyzed at termination of the experiments.

Results and Discussion: An increase in leptin transgene expression in the hypothalamus initiated soon after ovx blocked hyperphagia and body weight gain and markedly suppressed WAT mass and adipokines, leptin, and adiponectin. Similar suppression of weight gain and adiposity and serum leptin and adiponectin levels after intracerebroventricular rAAV‐lep injection in chronically ovx rats were observed concomitant with unchanged daily food intake. These findings are consistent with the hypothesis that in the absence of ovarian steroids, the existent insufficiency of leptin restraint at the hypothalamic level can be overcome with ectopic leptin expression, thereby reinstating central control on weight and adiposity.
A Physiological Role of Breast Milk Leptin in Body Weight Control in Developing Infants
Authors: Miralles Olga , Sánchez Juana , Palou Andreu , Picó Catalina
Published: April 2008

Objective: Leptin, a hormone that regulates food intake and energy metabolism, is present in breast milk. The aim of this study was to determine whether milk leptin concentration is correlated with maternal circulating leptin and BMI and with body weight gain of infants.

Research Methods and Procedures: A group of 28 non‐obese women (BMI between 16.3 and 27.3 kg/m2) who breast‐fed their infants for at least 6 months and their infants were studied. Venous blood and milk samples were obtained from mothers at 1, 3, 6, and 9 months of lactation, and leptin concentration was determined. Infant body weight and height were followed until 2 years of age.

Results: During the whole lactation period, milk leptin concentration correlated positively with maternal plasma leptin concentration and with maternal BMI. In addition, milk leptin concentration at 1 month of lactation was negatively correlated with infant BMI at 18 and 24 months of age. A better negative correlation was also found between log milk leptin concentration at 1 and at 3 months of lactation and infant BMI from 12 to 24 months of age.

Discussion: We concluded that, in a group of non‐obese mothers, infant body weight during the first 2 years may be influenced by milk leptin concentration during the first stages of lactation. Thus, moderate milk‐borne maternal leptin appears to provide moderate protection to infants from an excess of weight gain. These results seem to point out that milk leptin is an important factor that could explain, at least partially, the major risk of obesity of formula‐fed infants with respect to breast‐fed infants.
A Family‐Based Approach to Preventing Excessive Weight Gain
Authors: Rodearmel Susan J. , Wyatt Holly R. , Barry Mary J. , Dong Fang , Pan Dongmei , Israel Richard G. , Cho Susan S. , McBurney Michael I. , Hill James O.
Published: April 2008

Objective: Preventing weight gain in adults and excessive weight gain in children is a high priority. We evaluated the ability of a family‐based program aimed at increasing steps and cereal consumption (for breakfast and snacks) to reduce weight gain in children and adults.

Research Methods and Procedures: Families (n = 105) with at least one 8‐ to 12‐year‐old child who was at‐risk‐for‐overweight or overweight (designated as the target child) were recruited for the study. Eighty‐two families were randomly assigned to receive the family‐based intervention and 23 families to the control condition. The 13‐week intervention consisted of specific increases in daily steps (an additional 2000 steps/d) and consumption of 2 servings/d of ready‐to‐eat cereal.

Results: The intervention was successful in increasing walking (steps) and cereal consumption. The intervention had positive, significant effects on percentage BMI‐for‐age and percentage body fat for target children and weight, BMI, and percentage body fat for parents. On further analysis, the positive effects of the intervention were seen largely in target girls and moms, rather than in target boys and dads.

Discussion: This family‐based weight gain prevention program based on small changes holds promise for reducing excessive weight gain in families and especially in growing overweight children.
Association between Obesity and Patient Satisfaction
Authors: Fong Ronald L. , Bertakis Klea D. , Franks Peter
Published: April 2008

Objective: To examine the relationship between BMI and patient satisfaction with health care providers using a nationally representative survey.

Research Methods and Procedures: This analysis examined the 9914 adult patients who completed the 2000 Medical Expenditure Panel Survey and had visited a health care provider within 12 months of the survey. Linear regression models were employed with patient satisfaction as the dependent variable. The patient satisfaction scale was based on ratings from five questions assessing the quality of provider interactions. The independent variable was BMI, with adjustments for the domains of demographics, social‐economic status, health attitudes and behavior, health status, and health care use. BMI (weight in kilograms/square of height in meters) was classified as normal weight (18.5 to 24.9), overweight (25.0 to 29.9), or obese (≥30.0). Hierarchical models were used to evaluate how each domain modified the BMI‐satisfaction association.

Results: Obese patients reported significantly greater satisfaction with their health care providers than their normal‐weight counterparts did (p < 0.05). There were no significant differences in satisfaction between normal‐weight and overweight patients or between overweight and obese patients. The health status domain produced the largest modification in the BMI‐satisfaction relationship. Examination of interaction effects revealed that the association between BMI and satisfaction was confined to older persons.

Discussion: In this nationally representative sample of individuals, obese persons were more satisfied than their normal‐weight counterparts. This finding counters those of previous studies. Incomplete adjustments for health care use and insurance status may have led to those conclusions.
A Primary Care Weight Management Intervention for Low‐Income African‐American Women
Authors: Martin Pamela Davis , Rhode Paula C. , Dutton Gareth R. , Redmann Stephen M. , Ryan Donna H. , Brantley Phillip J.
Published: April 2008

Objective: To determine whether a tailored weight management program, addressing the needs of obese, low‐income African‐American women, would produce greater weight loss than standard medical care.

Research Methods and Procedures: A randomized, controlled trial was conducted between 1999 and 2003 with 144 overweight or obese women (predominantly African‐American) enrolled at two primary care clinics. Four physicians at each clinic were randomly assigned to provide either tailored weight management interventions or standard care. The tailored condition consisted of six monthly outpatient visits lasting ∼15 minutes each, which included personalized materials and messages. The main outcome was body weight change.

Results: The intervention group lost more weight than the standard care group (p = 0.03). The tailored group lost a mean (standard deviation) of 2.0 (3.2) kg by Month 6. The standard care group gained 0.2 (2.9) kg. More participants in the tailored group lost weight (79% vs. 47%; p = 0.04).

Discussion: Obese, low‐income, African‐American women provided with 90 minutes of physician‐delivered, tailored weight management instruction over 6 months achieved greater weight loss than those receiving standard medical care. The primary care physician can be effective in delivering weight loss interventions, and the primary care clinic may be a useful setting to implement weight management interventions.
Construct Validity of the Short Form‐36 Health Survey and Its Relationship with BMI in Obese Outpatients
Authors: Corica Francesco , Corsonello Andrea , Apolone Giovanni , Lucchetti Maria , Melchionda Nazario , Marchesini Giulio ,   The QUOVADIS Study Group
Published: April 2008

Objective: To investigate the construct validity of the Short Form‐36 (SF‐36) Health Survey questionnaire in obese patients.

Research Methods and Procedures: Our series consisted of 1735 obese patients (age, 44.7 ± 11.0 years; 1346 women) consecutively enrolled in the QUOVADIS study, an observational multicenter study of obese treatment‐seeking outpatients. The construct validity of the SF‐36 was assessed by main component analysis. Age‐, gender‐, and education‐adjusted general linear models were used to investigate the relationship between BMI and SF‐36 domains or factors identified by main component analysis.

Results: BMI was significantly associated with poor health‐related quality of life in all eight SF‐36 domains, and the strongest association was observed with physical activity. Main components analysis generated a six‐factor solution explaining 59% of the observed variance. BMI was strongly associated with factors based on the loading of items regarding the physical activity domain and factors based on role‐physical and role‐emotional items or general health and bodily pain items. In contrast, mental health‐, vitality‐, and social functioning‐based factors were not related to BMI.

Discussion: In obese treatment‐seeking outpatients, the clustering of SF‐36 items in main components is not significantly different from the domain‐based approach generally used, thus confirming the robustness of such a generic questionnaire in this specific condition. However, the peculiar clustering of some SF‐36 items and their relationship with BMI suggest that the health‐related quality of life profile of subjects belonging to that population may be better described with alternative aggregations of the SF‐36 items or with disease‐tailored questionnaires.
Dietary Patterns and Changes in Body Weight in Women
Authors: Schulze Matthias B. , Fung Teresa T. , Manson JoAnn E. , Willett Walter C. , Hu Frank B.
Published: April 2008

Objective: Our objective was to examine the association between adherence to dietary patterns and weight change in women.

Research Methods and Procedures: Women (51,670, 26 to 46 years old) in the Nurses’ Health Study II were followed from 1991 to 1999. Dietary intake and body weight were ascertained in 1991, 1995, and 1999. A Western pattern, characterized by high intakes of red and processed meats, refined grains, sweets and desserts, and potatoes, and a prudent pattern, characterized by high intakes of fruits, vegetables, whole grains, fish, poultry, and salad dressing, were identified with principal component analysis, and associations between patterns and change in body weight were estimated.

Results: Women who increased their Western pattern score had greater weight gain (multivariate adjusted means, 4.55 kg for 1991 to 1995 and 2.86 kg for 1995 to 1999) than women who decreased their Western pattern score (2.70 and 1.37 kg for the two time periods), adjusting for baseline lifestyle and dietary confounders and changes in confounders over time (p < 0.001 for both time periods). Furthermore, among women who increased their prudent pattern score, weight gain was smaller (multivariate‐adjusted means, 1.93 kg for 1991 to 1995 and 0.66 kg for 1995 to 1999) than among women who decreased their prudent pattern score (4.83 and 3.35 kg for the two time periods) (p < 0.001). The largest weight gain between 1991 and 1995 and between 1995 and 1999 was observed among women who decreased their prudent pattern score while increasing their Western pattern score (multivariate adjusted means, 6.80 and 4.99 kg), whereas it was smallest for the opposite change in patterns (0.87 and −0.64 kg) (p < 0.001).

Discussion: Adoption of a Western dietary pattern is associated with larger weight gain in women, whereas a prudent dietary pattern may facilitate weight maintenance.
High‐Molecular Weight Adiponectin Isoforms Increase after Biliopancreatic Diversion in Obese Subjects
Authors: Salani Barbara , Briatore Lucia , Andraghetti Gabriella , Adami Gian Franco , Maggi Davide , Cordera Renzo
Published: April 2008

Objective: Our objective was to test the effect of biliopancreatic diversion (BDP) in adiponectin multimerization. Adiponectin, the major protein secreted by adipose tissue, circulates in plasma in different isoforms. The most clinically relevant oligomers are high‐molecular weight (HMW) multimers and low‐molecular weight (LMW) trimers. Contrasting data on the effect of weight loss on adiponectin isoforms have been reported.

Research Methods and Procedures: We measured total plasma adiponectin and HMW and LMW adiponectin oligomers (by Western blot analysis) before and 1 month after BPD, in 18 severely obese subjects.

Results: One month after BPD, body weight decreased ∼11%. Total adiponectin showed significant increase after BPD. In addition, we found a significant increase in HMW (percentage) adiponectin oligomers. We found a significant inverse correlation between HMW (percentage) and BMI before and after BPD. Homeostasis model of assessment‐insulin resistance decreased significantly after the BPD, without any significant correlation with total serum adiponectin and adiponectin oligomers.

Discussion: A moderate weight loss after BPD increases total and HMW adiponectin oligomers. The significant correlation between BMI and HMW (percentage) adiponectin oligomers but not between BMI and total adiponectin might indicate a role of body fat mass in regulation of adiponectin multimerization. These data suggest that HMW oligomers represent a very sensitive parameter to short‐term BMI changes after BPD.
Decreased Expression of Adipogenic Genes in Obese Subjects with Type 2 Diabetes
Authors: Dubois Severine G. , Heilbronn Leonie K. , Smith Steven R. , Albu Jeanine B. , Kelley David E. , Ravussin Eric ,   The Look AHEAD Adipose Research Group
Published: April 2008

Objective: Our objective was to delineate the potential role of adipogenesis in insulin resistance and type 2 diabetes. Obesity is characterized by an increase in adipose tissue mass resulting from enlargement of existing fat cells (hypertrophy) and/or from increased number of adipocytes (hyperplasia). The inability of the adipose tissue to recruit new fat cells may cause ectopic fat deposition and insulin resistance.

Research Methods and Procedures: We examined the expression of candidate genes involved in adipocyte proliferation and/or differentiation [CCAAT/enhancer‐binding protein (C/EBP) α, C/EBPδ, GATA domain‐binding protein 3 (GATA3), C/EBPβ, peroxisome proliferator‐activated receptor (PPAR) γ2, signal transducer and activator of transcription 5A (STAT5A), Wnt‐10b, tumor necrosis factor α, sterol regulatory element‐binding protein 1c (SREBP1c), 11 beta‐hydroxysteroid dehydrogenase, PPARG angiopoietin‐related protein (PGAR), insulin‐like growth factor 1, PPARγ coactivator 1α, PPARγ coactivator 1β, and PPARδ] in subcutaneous adipose tissue from 42 obese individuals with type 2 diabetes and 25 non‐diabetic subjects matched for age and obesity.

Results: Insulin sensitivity was measured by a 3‐hour 80 mU/m2 per minute hyperinsulinemic glucose clamp (100 mg/dL). As expected, subjects with type 2 diabetes had lower glucose disposal (4.9 ± 1.9 vs. 7.5 ± 2.8 mg/min per kilogram fat‐free mass; p < 0.001) and larger fat cells (0.90 ± 0.26 vs. 0.78 ± 0.17 μm; p = 0.04) as compared with obese control subjects. Three genes (SREBP1c, p < 0.01; STAT5A, p = 0.02; and PPARγ2, p = 0.02) had significantly lower expression in obese type 2 diabetics, whereas C/EBPβ only tended to be lower (p = 0.07).

Discussion: This cross‐sectional study supports the hypothesis that impaired expression of adipogenic genes may result in impaired adipogenesis, potentially leading to larger fat cells in subcutaneous adipose tissue and insulin resistance.
Differential Effects of Gastric Bypass and Banding on Circulating Gut Hormone and Leptin Levels
Authors: Korner Judith , Inabnet William , Conwell Irene M. , Taveras Carmen , Daud Amna , Olivero‐Rivera Lorraine , Restuccia Nancy L. , Bessler Marc
Published: April 2008

Objective: To quantify plasma concentrations of hormones that regulate energy homeostasis in order to establish possible mechanisms for greater weight loss after Roux‐en‐Y gastric bypass (RYGBP) compared with gastric banding (BND).

Research Methods and Procedures: Four groups of women were studied: lean (n = 8; mean BMI, 21.6 kg/m2); BND (n = 9; BMI, 35.8; 25% weight loss), RYGBP (n = 9; BMI, 34.2; 36% weight loss), and controls matched for BMI to the surgical groups (n = 11; BMI, 34.4).

Results: Fasting total peptide YY (PYY) and PYY(3–36) immunoreactivity were similar among all groups, but the postprandial response in the RYGBP group was exaggerated, such that 30 minutes after the meal, total and PYY(3–36) levels were 2‐ to 4‐fold greater compared with all other groups. Maximal postprandial suppression of total ghrelin was blunted in the BND group (13%) compared with RYGBP (27%). Postprandial suppression of octanoylated ghrelin was also less in BND (29%) compared with RYGBP (56%). Fasting insulin was lower in RYGBP (6.6 μU/mL) compared with BND (10.0 μU/mL). Compared with lean controls, leptin concentrations were significantly higher in BND but not in RYGBP. There was a greater increase in post‐meal satiety in the RYGBP group compared with BND and overweight controls.

Discussion: The differences between RYGBP and BND subjects in postprandial concentrations of PYY and ghrelin would be expected to promote increased satiety and earlier meal termination in RYGBP and may aid in greater weight loss. The differences in insulin and leptin concentrations associated with these procedures may also reflect differences in insulin sensitivity and energy partitioning.
Patient Characteristics as Predictors of Weight Loss after an Obesity Treatment for Children
Authors: Braet Caroline
Published: April 2008

Objective: To examine pretreatment patient characteristics as predictors of treatment outcome 2 years after completion of an inpatient treatment for children with obesity.

Research Methods and Procedures: Children (N = 122) ranging in age from 7 to 17 years [mean, 12.7 ± 2.3 (SD) years] with a mean adjusted BMI of 179.5 ± 28.6% participated in an inpatient obesity treatment program. Children (90.2% response rate) participated in the 2‐year follow‐up. Eight predictors, administered at baseline, were entered in separate regression analyses, with weight loss and changes on three psychological health measures as the outcome measures.

Results: Analyses revealed that baseline degree of overweight, age, and initial weight loss were significant positive predictors of weight loss 2 years after treatment, whereas eating disorder characteristics were a negative predictor. Sex, socioeconomic status, global self‐esteem, and symptoms of psychopathology did not predict weight loss. With regard to the psychological outcome measures, baseline symptomatology emerged as the most important predictor of treatment changes.

Discussion: Long‐lasting weight loss is associated with severity of pretreatment characteristics. Identification of the clinical markers for long‐term response to treatment is useful to set realistic weight loss goals for clients and to tailor treatment programs to patient characteristics.
Associations between Aortic Calcification and Components of Body Composition in Elderly Men
Authors: Alexandersen Peter , Tankó László B. , Bagger Yu Z. , Jespersen Jørgen , Skouby Sven O. , Christiansen Claus
Published: April 2008

Objective: To investigate associations among body composition, cardiovascular risk factors, and atherosclerosis in middle‐aged and elderly men for the identification of potential pathogenic links.

Research Methods and Procedures: The study included 168 white men 44 to 86 years old. Severity of aortic calcification (AC) was graded on lateral radiographs, and body fat and lean mass were measured by DXA. Information on demographic and lifestyle characteristics also was gathered.

Results: A strong and independent inverse association was found between AC and peripheral lean mass (PLM), even after adjusting for age and BMI (p < 0.05). Independently of the influence of PLM, AC was directly correlated with truncal fat mass (p < 0.05). Furthermore, AC was inversely associated with tertiles of the free androgen index (p < 0.05). In a multiple regression model, age and serum cholesterol (p < 0.01) contributed directly, and truncal fat mass tended also to contribute directly (p = 0.09), whereas PLM contributed borderline inversely (p = 0.06) to the variation of AC (R = 0.635, p < 0.0001).

Discussion: Severity of AC is strongly dependent on age and further modulated by an array of traditional cardiovascular risk factors. Sarcopenia and truncal fat mass are reciprocal correlates of atherosclerosis of borderline statistical significance in multivariate models. To clarify whether sarcopenia is an atherogenic risk factor or rather a parallel consequence of low‐grade inflammation also promoting atherogenic trends, further longitudinal studies in larger sample sizes of men and women are needed.
Cardiorespiratory Fitness in Youth: Relationship to Insulin Sensitivity and β‐Cell Function
Authors: Lee SoJung , Bacha Fida , Gungor Neslihan , Arslanian Silva A.
Published: April 2008

Objective: We examined whether the relationship between cardiorespiratory fitness (CRF) and insulin sensitivity (IS)/secretion is independent of adiposity in healthy African‐American (n = 65) and white (n = 57) youth.

Research Methods and Procedures: IS and β‐cell function were evaluated by a 3‐hour hyperinsulinemic‐euglycemic and a 2‐hour hyperglycemic (12.5 mM) clamp, respectively. Total fat was measured by DXA and abdominal fat with computed tomography. CRF (peak volume of oxygen) was measured using a graded maximal treadmill test.

Results: Independent of race, CRF was inversely (p < 0.05) related to total and abdominal fat, fasting insulin and first phase insulin secretion, and positively (p < 0.05) related to IS. When subjects were categorized into low (≤50th) and high (>50th) CRF groups, IS was significantly (p < 0.05) higher in the high compared with the low CRF group independently of race. Furthermore, first and second phase insulin secretion were lower (p < 0.05) in the high CRF group in comparison with the low CRF group in both races. However, in multiple regression analyses CRF was not (p > 0.05) an independent predictor of IS and acute insulin secretion after accounting for total adiposity.

Discussion: Our findings demonstrate that low CRF is associated with decreased IS compensated by higher insulin secretion in both African‐American and white youth. However, this relationship disappears after adjusting for differences in adiposity, suggesting that the association between fitness and IS is mediated, at least in part, through fatness.
Esculetin Induces Apoptosis and Inhibits Adipogenesis in 3T3‐L1 Cells
Authors: Yang Jeong‐Yeh , Della‐Fera Mary Anne , Hartzell Diane L. , Nelson‐Dooley Cass , Hausman Dorothy B. , Baile Clifton A.
Published: April 2008

Objective: To determine the effects of esculetin, a plant phenolic compound with apoptotic activity in cancer cells, on 3T3‐L1 adipocyte apoptosis and adipogenesis.

Research Methods and Procedures: 3T3‐L1 pre‐confluent preadipocytes and lipid‐filled adipocytes were incubated with esculetin (0 to 800 μM) for up to 48 hours. Viability was determined using the Cell Titer 96 Aqueous One Solution cell proliferation assay; apoptosis was quantified by measurement of single‐stranded DNA. Post‐confluent preadipocytes were incubated with esculetin for up to 6 days during maturation. Adipogenesis was quantified by measuring lipid content using Nile Red dye; cells were also stained with Oil Red O for visual confirmation of effects on lipid accumulation.

Results: In mature adipocytes, esculetin caused a time‐ and dose‐related increase in adipocyte apoptosis and a decrease in viability. Apoptosis was increased after only 6 hours by 400 and 800 μM esculetin (p < 0.05), and after 48 hours, as little as 50 μM esculetin increased apoptosis (p < 0.05). In preadipocytes, apoptosis was detectable only after 48 hours (p < 0.05) with 200 μM esculetin and higher concentrations. However, results of the cell viability assay indicated a reduction in preadipocyte number in a time‐ and dose‐related manner, beginning as early as 6 hours with 400 and 800 μM esculetin (p < 0.05). Esculetin also inhibited adipogenesis of 3T3‐L1 preadipocytes. Esculetin‐mediated inhibition of adipocyte differentiation occurred during the early, intermediate, and late stages of the differentiation process. In addition, esculetin induced apoptosis during the late stage of differentiation.

Discussion: These findings suggest that esculetin can alter fat cell number by direct effects on cell viability, adipogenesis, and apoptosis in 3T3‐L1 cells.
Active Transportation to School Over 2 Years in Relation to Weight Status and Physical Activity
Authors: Rosenberg Dori E. , Sallis James F. , Conway Terry L. , Cain Kelli L. , McKenzie Thomas L.
Published: April 2008

Objective: To prospectively examine potential benefits of active commuting to school on measures of weight status and physical activity in a sample of youth.

Research Methods and Procedures: A cohort of students from seven elementary schools was measured four times—in the fall and spring of fourth grade (N = 1083) and fifth grade (N = 924). Participants were classified as active (walking, biking, or skateboarding to school almost every day for baseline analyses or at least 2 d/wk for analyses of consistent active commuting) or non‐active commuters to school. Accelerometers were used to measure physical activity. Height, weight, and skinfolds were objectively assessed.

Results: Boys who actively commuted to school had lower BMI (p < 0.01) and skinfolds (p < 0.05) than non‐active commuters to school in the fourth grade. Active commuting to school over 2 years was not associated with BMI change or overweight status.

Discussion: Walking and cycling to school may contribute to preventing excessive weight gain, or leaner children may walk or cycle to school.
Weight Loss Strategies for Obese Adults: Personalized Weight Management Program vs. Standard Care
Authors: Byrne Nuala M. , Meerkin Jarrod D. , Laukkanen Raija , Ross Robert , Fogelholm Mikael , Hills Andrew P.
Published: April 2008

Objective: The objective of this study was to evaluate the effect of a 32‐week personalized Polar weight management program (PWMP) compared with standard care (SC) on body weight, body composition, waist circumference, and cardiorespiratory fitness in overweight or obese adults.

Research Methods and Procedures: Overweight or obese (29 ± 2 kg/m2) men and women (n = 74) 38 ± 5 years of age were randomly assigned into either PWMP (men = 20, women = 21) or SC (men = 15, women = 18). Both groups managed their own diet and exercise program after receiving the same standardized nutrition and physical activity advice. PWMP also received a weight management system with literature to enable the design of a personalized diet and exercise weight loss program. Body weight and body composition, waist circumference, and cardiorespiratory fitness were measured at weeks 0, 16, and 32.

Results: Eighty percent of participants completed the 32‐week intervention, with a greater proportion of the dropouts being women (PWMP: 2 men vs. 7 women; SC: 2 men vs. 4 women). At 32 weeks, PWMP completers had significantly (p < 0.001) greater losses in body weight [6.2 ± 3.4 vs. 2.6 ± 3.6 (standard deviation) kg], fat mass (5.9 ± 3.4 vs. 2.2 ± 3.6 kg), and waist circumference (4.4 ± 4.5 vs. 1.0 ± 3.6 cm). Weight loss and fat loss were explained by the exercise energy expenditure completed and not by weekly exercise duration.

Discussion: More effective weight loss was achieved after treatment with the PWMP compared with SC. The results suggest that the PWMP enables effective weight loss through tools that support self‐monitoring without the requirement of more costly approaches to program supervision.
Television Viewing and Long‐Term Weight Maintenance: Results from the National Weight Control Registry
Authors: Raynor Douglas A. , Phelan Suzanne , Hill James O. , Wing Rena R.
Published: April 2008

Objective: To examine the role of television (TV) viewing in long‐term maintenance of weight loss.

Research Methods and Procedures: All subjects (N = 1422) were enrolled in the National Weight Control Registry (NWCR), a national sample of adults who have maintained a minimum weight loss of 13.6 kg for at least 1 year. Participants self‐reported the average number of hours of weekly TV viewing at entry into the NWCR and at a 1‐year follow‐up. Cross‐sectional and prospective analyses were performed to determine the frequency of TV viewing and the extent to which TV viewing was independently associated with weight regain over the 1‐year of follow‐up.

Results: A relatively high proportion (62.3%) of participants reported watching 10 or fewer hours of TV per week on entry in the NWCR. More than one third of the sample (36.1%) reported watching <5 h/wk, whereas only 12.4% watched ≥21 h/wk, which contrasts markedly from the national average of 28 hours of TV viewing per week reported by American adults. Both baseline TV viewing (p ≤ 0.02) and increases in TV viewing (p ≤ 0.001) over the follow‐up were significant predictors of 1‐year weight regain, independent of physical activity and dietary behaviors.

Discussion: Individuals who are successful at maintaining weight loss over the long term are likely to spend a relatively minimal amount of time watching TV.
Perceived Psychological Stress and Serum Leptin Concentrations in Japanese Men
Authors: Otsuka Rei , Yatsuya Hiroshi , Tamakoshi Koji , Matsushita Kunihiro , Wada Keiko , Toyoshima Hideaki
Published: April 2008

Objective: To examine epidemiologically whether subjects with higher stress perception levels have higher leptin concentrations.

Research Methods and Procedures: In this cross‐sectional study, the study population comprised 1062 male workers at local government offices in central Japan. Self‐administered questionnaires were distributed in 1997. Awareness of stress was assessed by the question: “Do you have much stress in your life?” and participants were asked to select from four possible responses: “very much,” “much,” “ordinary,” or “little.” Blood samples were also collected after fasting 12 hours overnight to determine serum leptin concentrations.

Results: The mean (standard deviation) age and BMI were 50.2 (6.4) years and 23.3 (2.6) kg/m2, respectively. Crude leptin concentrations according to stress categories were 2.86, 3.26, 3.32, and 3.54 ng/mL, respectively, and leptin concentrations adjusted for age, BMI, physical activity, drinking and smoking habits, overtime work, shift work, sleep duration, and availability of confidants were 2.96, 3.24, 3.34, and 3.43 ng/mL for “little,” “ordinary,” “much,” and “very much,” respectively (p = 0.03 by one‐way analysis of covariance; p < 0.01 by test of linear trend). Significant associations were also observed among the level of perceived psychological stress and work‐related stressors, variables related to sleep, and other psychological variables.

Discussion: This study showed that subjects who perceived psychological stress had high leptin levels, which provides epidemiological evidence that psychological stress may have the potential effect of increasing blood levels of the pleiotropic peptide, leptin.