bluuebunny/crossref_metadata_2025 huggingface dataset:
Preparation of molecularly imprinted polymers for vanillin via reversible addition‐fragmentation chain transfer suspension polymerization
Authors: Zhang Yan , Ding Junhong , Gong Shuwen
Published: September 2012

Molecularly imprinted polymers (MIPs) for vanillin were synthesized by suspension polymerization using ethylene glycol dimethacrylate as cross‐linker and methacrylic acid as functional monomer, respectively. The analysis of scanning electron microscopy and equilibrium binding experiments indicated that the MIPs can selectively separate the target analytes. Reversible addition‐fragmentation chain‐transfer (RAFT) technique was used to synthesize MIPs using benzyl dithiobenzoate as RAFT agent. The results showed smaller particle size, higher molecular adsorption, and considerable binding specificity toward vanillin than those prepared by suspension polymerization. © 2012 Wiley Periodicals, Inc. J. Appl. Polym. Sci., 2013
Commentary on ‘Antibiotics for prolonged moist cough in children’ with a response from the review authors
Authors: Rubin Bruce K. , Chang Anne B. , Marchant Julie M. , Morris Peter S.
Published: September 2012

This is a commentary on a Cochrane review, published in the issue of EBCH, first published as: Marchant JM, Morris PS, Gaffney J, Chang AB. Antibiotics for prolonged moist cough in children. Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD004822. DOI: 10.1002/14651858.CD004822.pub2.

Further information for this Cochrane review is available in this issue of EBCH in the accompanying Summary article. Copyright © 2012 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. The Cochrane Collaboration
Insulin Levels, Physical Activity, and Urinary Catecholamine Excretion of Obese and Non‐Obese Rhesus Monkeys
Authors: Wolden‐Hanson Tami , Davis Gary A. , Baum Scott T. , Kemnitz Joseph W.
Published: September 2012

The hypothesis that spontaneous obesity in rhesus monkeys is associated with abnormalities in energy expenditure was tested. Obese (n=7) and non‐obese (n=5) monkeys were described in terms of body size and composition, food intake, and physical activity. Additionally, the relationships among fasting and stimulated insulin levels in serum, C‐peptide levels in serum and urine, and urinary catecholamines were examined. Obese animals had primarily abdominal deposition of excess body fat, as indicated by markedly elevated abdominal circumferences and skin‐fold thicknesses. Food intake did not differ between groups. Physical activity was much lower in the obese group. Obese monkeys had markedly higher serum insulin and C‐peptide levels in the fasted state and in response to an intravenous glucose challenge. Urinary excretion of C‐peptide and catecholamines was measured during successive 2‐day periods of ad libitum feeding, food deprivation, and refeeding in order to examine potential differences between groups in sympathoadrenal activity and their relationship to insulin secretion. C‐peptide excretion was greater for obese and decreased for both groups during food deprivation. Urinary dopamine (DA), norepinephrine (NE), and epinephrine (E) levels were significantly greater for obese animals in all conditions. DA excretion was lowest during deprivation and E excretion was lowest during refeeding, whereas NE excretion was relatively unaffected by feeding condition. The overall patterns of C‐peptide and catecholamine excretion were qualitatively similar for both groups, and there were no reliable differences between obese and non‐obese in their responses to the feeding manipulation. The results suggest that hyperinsulinemia associated with obesity in rhesus monkeys is linked to increased catecholamine secretion and a resistance to cate‐cholaminergic action.
Mechanism of Free Fatty Acid Effects on Hepatocyte Insulin Receptor Binding and Processing
Authors: Hennes Magda M.I. , Shrago Earl , Kissebah Ahmed H.
Published: September 2012

We determined whether the paimitate effects on hepatocyte insulin receptor binding and post‐receptor trafficking were mediated by accelerated mitochondrial (β‐oxidation or accumulation of intracellular fatty acyl‐CoA derivatives and possibly protein acyiation. Preincubation of hepatocytes with moderate concentrations of paimitate (0.5 mM) resulted in a 23% decline in cell‐surface binding and proportional decreases in receptor‐mediated insulin internalization and degradation. Brief pretreatment of hepatocytes with the carnitine palmityltransferase‐I inhibitor, methyl paimoxirate (MP), prevented 70% of the paimitate effects. At higher paimitate concentrations (2.0 mM), cell‐surface binding was reduced by 34%, whereas internalization of the receptor complex was reduced by 78%. These effects were only partially prevented by MP pretreatment. Receptor‐mediated insulin degradation increased by 34% and was uninfluenced by MP pretreatment. Octanoate, which is rapidly shunted into mitochondrial oxidation, produced a dose‐dependent reduction in insulin binding, with proportional decreases in internalization and degradation. Similarly preincubation with 2.0 mM oleate, which, unlike palmitate, is not known to produce protein acylation, resulted in proportional decreases in insulin receptor binding and receptor‐mediated internalization and degradation. High concentrations of octanoate or oleate (2.0 mM) did not reproduce the additive postreceptor effects of palmitate. We conclude that the receptor and post‐receptor effects of moderate palmitate concentrations are closely linked to accelerated fatty acid oxidation. The post‐receptor effects observed at higher concentrations involve other mechanisms, possibly relating to intracellular levels of palmityl‐CoA derivatives.
Can Ethnic Differences in Men's Preferences for Women's Body Shapes Contribute to Ethnic Differences in Female Adiposity?
Authors: Allison David B. , Hoy M. Katherine , Fournier Angelique , Heymsfield Steven B.
Published: September 2012

In the United States, obesity is more common among black and Hispanic than white women. One putative cause of this difference is different cultural norms for attractiveness. Two studies assessed ethnic differences in men's perceptions of the attractiveness of females of varying sizes. In the fmst, 108 men recruited on the New York subway were shown sets of silhouettes depicting female bodies varying in fatness and were asked to pick the silhouette they found most attractive. They were also asked to indicate the thinnest and fattest figures they would consider dating. A measure of “latitude of acceptance” was computed as the difference between the thinnest and fattest figures considered. Results indicated no relationship between ethnicity and preference (F = 1.383, p =.257) or “latitude” (F =.102, p =.903). In Study 2, “personal advertisements” placed by 373 black, 1915 white, 110 Hispanic, and 30 Asian men from 35 newspapers and magazines were coded as: 1) thinness preferred; 2) no information on weight preference; 3) fatness preferred; or 4) states weight or looks unimportant. Results indicated a statistically significant but small association between ethnicity and preference (χ2 = 49.55, df=9, p<.00001). Relative to white and Asian men, black and Hispanic men more frequently requested fat women, Hispanic men less frequently requested thin women, and black men more frequently stated that looks or weight did not matter. Ethnicity explained only 2.1% of the variance in preference. Thus, it seems unlikely that ethnic differences in men's preferences for women's body shapes contribute substantially to ethnic differences in female adiposity.
Utility of a C‐Jun Microsatellite Marker in Determining Gene Dosage for fatty (fa)
Authors: Chua Streamson C. , Hansen Moritz H. , Truet Gary E. , Leibel Rudolph L.
Published: September 2012

The Zucker fatty (fa) mutation provides a genetic model for obesity and non‐insulin dependent diabetes mellitus. The molecular pathogenesis of the metabolic phenotype of these animals is not known. Detailed molecular maps of the region surrounding the fa locus on rat chromosome 5 can be used for positional cloning experiments as well as to permit genotyping of animals from appropriate crosses before the confounding metabolic effects of obesity have occurred.

We describe the development of a polymerase chain reaction (PCR) assay for a polymorphic simple sequence repeat (SSR) in the promoter region of the protooncogene c‐Jun. This assay was used to position cJun 4.5cM proximal to the fa locus in 111 F2 progeny of a 13MBN fa/+ F1 intercross.

Concurrent use of the cJun SSR with a previously described assay for a microsatellite in the glucose transporter, Glutl, permits rapid and accurate assessment of genotypes at the fa locus in animals of any age using minimal amounts of DNA. A strategy is described which minimizes the error rate in assigning genotype at the fatty locus for backcross and intercross progeny.
Exercise and Obesity
Authors: Bouchard Claude , Depres Jean‐Pierre , Tremblay Angelo
Published: September 2012

This paper reviews succinctly the evidence for a role of regular exercise in the prevention and the treatment of obesity and of its metabolic complications. Seventeen propositions relevant to an understanding of the topic are considered. The evidence suggests that regular exercise can be an important factor in the development of sustained negative energy balance conditions provided the volume of activity is high. This implies a program of low to moderate intensity exercise performed on an almost daily basis for at least one hour per session. To induce significant weight and fat losses and to treat overweight and obese patients, compliance to the program for several years becomes a necessity. Exercise increases lipid substrate oxidation and may favor carbohydrate intake for the same amount of energy intake. The acute effects of exercise on resting metabolic rate are well documented, but the long‐term influences of exercise training seem to be small and are rapidly suppressed with the cessation of training. The obese benefits also from a regular exercise regimen in terms of improved insulin sensitivity, lipid and lipoprotein profile, and blood pressure, as well as reduced risk of death. Regular exercise, such as walking, is a healthy course of action for the overweight or the obese patients.
Plasma Cortisol Levels Increase with Age in Obese Subjects
Authors: Chalew Stuart A. , Zadik Zvi , Lozano Rolando A. , Nelson Jerald C. , Kowarski A. Avinoam
Published: September 2012

In order to assess the influence of age, sex, and body mass on plasma cortisol concentrations, we measured the 24‐hour Integrated Concentration (IC) of cortisol (F) in 36 obese subjects (16 males, 20 females) aged 5.3–56.4 years, BMI=35.5 ± 7.3 kg/m2 and compared with 119 nonobese subjects, body mass indices (BMI) 21.2 ± 2.7 kg/m2, aged 8.8–66.2 years (55 males, 64 females). Subjects were nondiabetic, normotensive, without history of psychiatric illness, and otherwise in good health. IC studies were performed using a continuous blood withdrawal methodology, and IC‐F was assayed from the 24 hour pooled sample by a protein binding method. The effect of age and gender on IC‐F was analyzed by multivariate regression.

In the nonobese group there was no effect of age or sex on IC‐cortisol levels, the mean IC‐F= 173.8 ± 44.1 nmol/L. A statistically significant but weak negative effect of BMI on IC‐cortisol (r = ‐.18, p<0.05) was present.

In the obese subjects there was a significant increase in IC‐cortisol levels with age IC‐F(nmol/L)=2.76 x age(years) + 85.0 (r2=.36, p<0.0001). IC‐cortisol levels tended to be lower in obese males than females when controlled for age (p<0.05).

We conclude that in nonobese subjects IC‐F levels are independent of age and gender. However, there is a significant increase of IC‐cortisol levels with age in obese individuals. The observed increase of IC‐cortisol with age may contribute to metabolic complications of obesity.
Decreased Hepatic Insulin Extraction Precedes Overt Noninsulin Dependent (Type II) Diabetes in Obese Monkeys
Authors: Hansen Barbara C. , Strifler John S. , Bodkin Noni L.
Published: September 2012

Many obese middle‐aged rhesus monkeys (Macaca mulatta) spontaneously develop noninsulin dependent diabetes mellitus (NIDDM). Basal hyperinsulinemia and increased stimulated plasma insulin levels are associated with this obesity and precede the onset of overt diabetes. The present studies sought to determine the relative contributions of enhanced insulin secretion and of reduced insulin clearance to this early obesity‐associated hyperinsulinemia. Direct simultaneous measurement of portal and jugular vein insulin levels in two normal monkeys showed a constant rate of hepatic insulin extraction of 56±3% over the range of peripheral insulin levels from 351±113 to 625±118 pmol/L. In 33 additional monkeys ranging from normal to diabetic, basal C‐peptide levels were examined as an indicator of β‐cell secretion and the molar ratio of plasma C‐peptide to insulin (C/I ratio) under basal steady state conditions calculated as an index of hepatic insulin extraction. Well in advance of overt diabetes, there was a progressive decline of 67% in the apparent hepatic insulin extraction rate in association with increased obesity and plasma insulin levels. Basal insulin levels and hepatic insulin extraction returned toward normal in monkeys with impaired glucose tolerance and in those with overt diabetes. We conclude that reduced insulin disposal, probably due to reduced hepatic extraction of insulin, in addition to increased β‐cell activity, contributes to the development of basal hyperinsulinemia in obese rhesus monkeys progressing toward NIDDM. In addition, in overt diabetes, normal hepatic insulin extraction in the presence of limited β‐cell secretion may exacerbate the hypoinsulinemic state. (OBESITY RESEARCH 1993; 1:252–260)
Binge Eating Disorder: Current Knowledge and Future Directions
Authors: ZelitchYanovski Susan
Published: September 2012

Binge eating disorder (BED) is a newly characterized eating disorder that encompasses individuals who have severe distress and dysfunction due to binge eating, but who do not regularly engage in inappropriate compensatory behaviors. While relatively uncommon in the general community, BED becomes more prevalent with increasing severity of obesity. BED is associated with early onset of obesity, frequent weight cycling, body shape disparagement, and psychiatric disorders. These associations occur independent of the degree of obesity. Although many individuals with BED have good short‐term weight loss regardless of treatment modality, as a group they may be prone to greater attrition during weight‐loss treatment and more rapid regain of lost weight. Current treatments geared toward binge eating behaviors include antidepressant medications, cognitive behavioral psychotherapy, and interpersonal psychotherapy; however, these treatments have little efficacy in promoting weight loss, and only modest success in long‐term reduction of binge eating. As a significant proportion of obese individuals entering weight‐loss treatment and research programs are likely to meet criteria for BED, those conducting clinical research should be aware of this distinct subgroup and determine the contribution of BED to outcome measures. (OBESITY RESEARCH 1993; 1:306–324)
Vagal‐Central Nervous System Interactions Modulate the Feeding Response to Peripheral Enterostatin
Authors: Tian Qi , Nagase Hajime , York David A. , Bray George A.
Published: September 2012

Enterostatin selectively inhibits the intake of dietary fat after both peripheral and central administration. We have investigated the role of the hepatic vagus nerve in modulating the peripheral response to enterostatin in Sprague‐Dawley rats adapted to a high fat (HF) diet. Intraperitoneal (ip) enterostatin reduced intake of HF diet after overnight starvation. This response was abolished by selective vagal hepatic branch transection. Immunohistochemical techniques were used to identify the location of Fos protein in brain nuclei after ip enterostatin. Fos protein was evident in the nucleus tractus solitarius (NTS), parabrachial, paraventricular and supraoptic nuclei. The pattern of expression of Fos‐like immunoreactivity differed from that induced by the lipoprivic agent β‐mercaptoacetate. Transection of the hepatic vagus blocked the central Fos responses to ip enterostatin. We conclude that afferent hepatic vagal nerve activity is required for the feeding response to peripheral enterostatin.
Physical Activity and Long‐Term Maintenance of Weight Loss
Authors: Pronk Nicolaas P. , Wing Rena R.
Published: September 2012

To examine the effect of exercise on the long‐term maintenance of weight loss, two types of literature were reviewed ‐ correlational studies of predictors of long‐term weight loss, and randomized trials comparing diet, exercise, and the combination of diet plus exercise. Both literatures were striking in the consistency with which activity emerged as a determinant of long‐term maintenance of weight loss. The benefits of exercise for long‐term weight maintenance were observed with different types of populations, diets, and exercise interventions. Several possible explanations for these positive effects of diet plus exercise are presented, and suggestions made for future research on ways to maximize the benefit of this approach to weight control. Since adherence to exercise may ultimately prove to be the cornerstone for long‐term weight maintenance, studying ways to improve exercise adherence is recommended.
Body Size Perceptions and Eating Attitudes in Elderly Men
Authors: Stevens June , Kumnanyika Shiriki , Keil Julian E. , Seibert Lynne
Published: September 2012

The majority of studies on eating attitudes, dieting and body size perceptions have focused on young adults and women. This study examined these attitudes in 334 black and white men, ages 55 to 98 years, who were members of the Charleston Heart Study cohort. Associations of the eating attitude variable with race, education and weight status were examined.

Eighty‐two percent of the overweight white men studied had dieted to lose weight, whereas only 49% of slimmer white men had dieted. In contrast, overweight black men did not diet more than slimmer black men. Overall black men dieted less than white men (37% reported dieting). Black men who were high school graduates were 1.3 times more likely to have dieted than were less educated black men. Overweight white men were over twice as likely as slimmer white men to feel guilty after overeating. This difference was not found in overweight versus slimmer black men.

Education was not associated with measured body mass index (BMI) or perceived or ideal body size. However, there were some racial differences in these variables. White men preferred to be slightly thinner than black men (ideal BMI 25.6 vs. 26.1 kg/m2), and the difference between actual and desired BMI was 0.6 kg/m2 greater in white than in black men.

These results indicate that effects of race and weight status on eating restraint and body size perceptions seen in younger subjects and in women are also present, at least to some degree, in elderly men.
Dieting Status and Its Relationship to Weight, Dietary Intake, and Physical Activity Changes Over Two Years in a Working Population
Authors: French Simone A. , Jeffery Robert W , Forster Jean L.
Published: September 2012

The present study prospectively examined changes in dietary intake, physical activity and weight associated with self‐reported efforts to lose weight in a cohort of 3671 men and women sampled from the general population. Dieting efforts, dietary intake, physical activity and weight were measured at two points in time, 24 months apart.

At baseline, current dieters reported consuming fewer dairy products, sweets, meat, soft drinks and fried potatoes (all p's < .0001), and engaging more frequently in high‐intensity physical activity (p < .0001) than those not currently dieting. At follow‐up, current dieters reported consuming fewer sweets (p < .0001) and fried potatoes (p < .0008), and engaging more frequently in moderate‐intensity physical activity (p < .02) than those not currently dieting. Prospectively, those who initiated weight‐loss diets showed the largest decrease in consumption of sweets (p < .0001), soft drinks (p < .0001), and fried potatoes (p < .01), and increase in frequency of high‐intensity physical activity (p < .0001) and moderate‐intensity physical activity (p < .007). Those initiating weight‐loss diets were the only group to lose weight (1 lb.). Those dieting at baseline but not at follow‐up gained the most weight (4 lbs.).

Self‐reports of current dieting correspond to reported changes in dietary intake and physical activity, and to measured changes in weight over the same time period. Individuals who report dieting to lose weight have healthier eating and exercise patterns than those who do not report dieting.
Fibrinogen in Obesity Before and After Weight Reduction
Authors: Ditschuneit Herwig H. , Flechtner‐Mors Marion , Adler Guido
Published: September 2012

Several studies have shown that obesity is associated with atherosclerosis. The reason may be that there is often a gathering together of risk factors for cardiovascular disease in obesity. Recently plasma fibrinogen level has been identified as an important cardiovascular risk factor. The aim of the study was to investigate fibrinogen levels in obesity before and after weight reduction.

Obese but otherwise healthy patients with overweight problems were studied. 448 female patients (39.1 ± 13.2 years, body mass index 38.7 kg/m2) and 136 male patients (39.4 ± 12.8 years, body mass index 40.7 kg/m2) were examined after overnight fasting.

Sixty patients (44 female, 16 male) were studied after 9.5 ± 6.2 month of dieting (1200 kcal/day: 20% protein, 30% fat and 50% carbohydrates). The weight loss was 16.7 ± 11.0 kg in the female and 16.2 ± 6.7 kg in the male patients, and blood pressure, triglycerides, blood glucose and uric acid had declined.

The fibrinogen level correlated with the body mass index, the waist circumference, the hip circumference and the waist to hip ratio. The fibrinogen level also correlated with insulin. A partial correlation of fibrinogen and insulin continued to exist after removing the linear effects of the other variables measured. After weight reduction, the level of fibrinogen was lower. In patients with extreme overweight and high fibrinogen levels, who reduced their BMI by 7.4 ± 1.24 kg/m2, the weight loss correlated with the decrease in fibrinogen.

The results suggest that fibrinogen is associated with the degree of obesity and with the fasting insulin level. Fibrinogen concentration is lowered by weight reduction. However decrease of fibrinogen was observed only in patients with considerable weight loss.
Assessing Impact of Weight on Quality of Life
Authors: Kolotkin Ronette L. , Head Susan , Hamilton Michael , Tse Chiu‐Kit J.
Published: September 2012

This paper is a preliminary report on the development of a new instrument, the Impact of Weight on Quality of Life (IWQOL) questionnaire, that assesses the effects of weight on various areas of life. We conducted two studies utilizing subjects in treatment for obesity at Duke University Diet and Fitness Center. The first study describes item development, assesses reliability, and compares pre‐ and post‐treatment scores on the IWQOL. In the second study we examined the effects of body mass index (BMI), gender, and age on subjects' perceptions of impact of weight on quality of life. Results indicate adequate psychometric properties with test‐retest reliabilities averaging .75 for single items, and .89 for scales. Scale internal consistency averaged .87. Post‐treatment scores differed significantly from pre‐treatment scores on all scales, indicating that treatment produced positive changes in impact of weight on quality of life. The results of the second study indicate that the impact of weight generally worsened as the patients' size increased. However for women there was no association between BMI and impact of weight on Self‐Esteem and Sexual Life. Even at the lowest BMI tertile studied, women reported that weight had a substantial impact in these areas. There were also significant gender differences, with women showing greater impact of weight on Self‐Esteem and Sexual Life compared with men. The impact of age was a bit surprising, with some areas showing positive changes and others showing no change.
Life Insurance and Overweight
Authors: Bray George A.
Published: September 2012

Two items were selected for this month's Classics in Obesity. The first is an extract from the Report of the Joint Committee on the Medico Actuarial Mortality Investigation published in 1913 (1). The second is an extract from DeLamar Lectures by Louis Dublin from 1927 (3). It is selected because Dublin and the insurance industry played a major role in the focus on the increased risk of death among the overweight. In his lecture in 1926 Dublin says, “The conviction that body build affects longevity has been general for a long time.” But when was this concept first identified and how long did it take to impact research in obesity? The idea was clearly enunciated in the material published by the Association of Life Insurance Medical Directors and the Actuarial Society of America in 1913 that increased mortality was associated with increased deviations in body weight. I have plotted the 1913 data below (Figure 1). The increase in mortality with increasing upward deviation is readily apparent. But there is little evident impact of deviations below average.
Fatness and Physical Fitness of Girls 7 to 17 Years
Authors: Malina Robert M. , Beunen Gaston P. , Claessens Albrecht L. , Lefevre Johan , Eynde Bart Vanden , Renson Roland , Vanreusel Bart , Simons Jan
Published: September 2012

A two‐fold approach was used to investigate the association between fatness and fitness of girls 7 to 17 years of age: first, age‐specific correlations between fatness and measures of health‐related and motor fitness, and second, comparisons of fitness levels of girls classified as fat and lean. A representative sample of 6700 between 7 to 17 years was surveyed. Adiposity (fatness) was estimated as the sum of five skinfolds (biceps, triceps, subscapular, suprailiac, medial calf). Physical fitness included health‐related items (step test, PWC170the sit and reach, sit‐ups and leg lifts, flexed arm hang) and motor performance items (standing long jump, vertical jump, arm pull strength, flamingo stand, shuttle run, plate tapping). Age‐specific partial correlations between fatness and each fitness item, controlling for stature and weight, were calculated. In addition, in each age group the fattest 5% (presumably the obese) and the leanest 5% were compared on each fitness test. After controlling for stature and weight, subcutaneous fatness accounts for variable percentages of the variance in each fitness item. Estimates for health‐related fitness items are: cardiorespiratory endurance ‐ step test (3% to 5%) and PWC170(0% to 16%), flexibility ‐ sit and reach (3% to 8%), functional strength ‐ flexed arm hang (6% to 17%) and abdominal strength ‐ sit‐ups/leg lifts (1% to 8%). Corresponding estimates for motor fitness items are more variable: speed of limb movement ‐plate tapping (0% to 3%), balance ‐ flamingo stand (0% to 5%), speed and agility ‐ shuttle run (2% to 12 %), static strength ‐ arm pull (4% to 12%), explosive strength ‐ standing long jump/vertical jump (11% to 18%). At the extremes, the fattest girls have generally poorer levels of health‐related and motor fitness.
Maintenance of Weight Loss: A Needs Assessment
Authors: DePue Judith D. , Clark Matthew M. , Ruggiero Laurie , Medeiros Meredith L , Pera Vincent
Published: September 2012

This study identified facilitators and obstacles to maintenance of weight loss following a very‐low‐calorie‐diet and behavior modification program. A survey was mailed to a random sample of 178 program completers and received a 61% response rate; the most frequent follow‐up period was more than 2 years. Twenty‐nine percent reported weighing the same (within 10 lbs) or less than the end of their participation in the treatment program (maintainers), while 71% reported their present weight was a mean of 65% higher than their initial weight loss (regainers). Maintainers were significantly more likely to report engaging in regular aerobic exercise, attending a maintenance support group, and confidence in their ability to manage their weight in the future, while regainers were more likely to report stress and motivation as frequent weight management obstacles. Respondents consistently identified the need for low/no cost ongoing support. Maintainers and relapsers reported similar challenges in managing their weight, yet with different results, suggesting the need to identify subgroups for which different post‐treatment support options could be applied.
Evaluation of Drugs for Treating Obesity
Authors: Bray George A.
Published: September 2012

Criteria for the evaluation of new drugs to treat obesity are important as guides for designing clinical trials to test these agents. These criteria must be developed in relation to the realities of obesity, which is a chronic disease associated with morbidity and mortality that is increased by visceral fat deposits. The observation that patients regain weight after stopping drug treatment for obesity argues for the proposition that drugs work only when taken and NOT that the drugs are ineffective. The analogy between the development of treatments for obesity to those for the treatment of hypertension is used to highlight potential areas for new developments. Several features of an ideal drug for the treatment of obesity are suggested. Criteria for evaluating new drugs include both primary and secondary endpoints. The primary endpoint for an anti‐obesity drug should be weight loss, possibly by category of success. Losses of total body fat or visceral fat might be alternative primary endpoints. Secondary endpoints include reduction in risk factors for associated diseases and improvement in the quality of life. In trials where vigorous placebo designs including highly aggressive behavior modification or very‐low‐calorie diets were used, it may be difficult or impossible to detect a response to a drug.
Drugs That Cause Weight Gain
Authors: Fernstrom Madelyn H.
Published: September 2012

Among drugs which cause weight gain, the tricyclic antidepressant medications are a drug class producing persistent and problematic body weight gain in many treated patients. Major depressive illness is often associated with reductions in appetite and body weight, and treatment with antidepressants effectively restores mood, appetite and weight. However, a frequent complaint of patients treated with tricyclic drugs is of excessive and unwanted weight gain, oftentimes resulting in medication noncompliance. The incidence of weight gain during acute and chronic treatment with different, frequently prescribed antidepressant drugs will be reviewed, as will the possible mechanisms by which such drugs alter caloric intake and expenditure, contributing to drug‐induced weight gain.
Topical Fat Reduction
Authors: Greenway Frank L. , Bray George A. , Heber David
Published: September 2012

The fat on women's thighs is more difficult to mobilize due to increased α‐2 adrenergic receptor activity induced by estrogen. Lipolysis can be initiated through adipocyte receptor stimulation (β adrenergic) or inhibition (adenosine or α‐2 adrenergic) or by inhibition of phosphodiesterase. Since many women desire regional thigh fat loss, a series of clinical trials were initiated using one thigh as a double‐blinded control. Trial #1: Five overweight women had injections of isoproterenol at intervals around the thigh three times a week for 4 weeks with diet and walking. Trial #2: Five overweight woman had ointment containing forskolin, yohimbine and aminophylline applied to the thigh five times a week for 4 weeks after hypertonic warm soaks with a diet and walking. Trial #3: Eighteen overweight women were divided into three groups of six and trial #2 was repeated with each agent alone vs. placebo using forskolin, yohimbine or aminophylline in separate ointments. Trial #4: Thirty overweight women had 10% aminophylline ointment applied to the thigh five times a week for 6 weeks with diet and walking. Chemistry panel, theophylline level and patch testing wereperformed. Trial#5: Twelve women had trial #4 repeated with 2% aminophylline cream without a diet or walking. Trial #6: Trial #5 was repeated with 0.5% aminophylline cream. All trials except yohimbine ointment gave significantly more girth loss from the treated thigh (p < 0.05 to p < 0.001). Chemistry panel showed no toxicity. Theophylline was undetectable and patch testing was negative. We conclude that topical fat reduction for women's thighs can be achieved without diet or exercise.
Brain Peptides and Obesity: Pharmacologic Treatment
Authors: Leibowitz Sarah F.
Published: September 2012

Obesity results from an imbalance between nutrient ingestion and metabolism, with more calories being ingested than utilized. The brain plays an important role in coordinating these complex behavioral and physiological functions, operating through multiple neurochemical systems with distinct properties. This review focuses on two hypothalamic peptide systems, neuropeptide Y (NPY) and galanin (GAL), that illustrate how the brain operates through different mechanisms to control the body's nutrient stores, in different states or conditions. These peptides have different behavioral and physiological effects and are, themselves, differentially responsive to feedback signals from circulating steroids, peptides, and nutrients. They can be distinguished by their relation to natural feeding patterns and endogenous hormones and by their specificity of action in relation to natural biological rhythms.

The neuroanatomical substrates involved in these actions of NPY and GAL are also distinct. The neurocircuit mediating NPY's actions originates in the arcuate nucleus and terminates in the medial portion of the paraventricular nucleus; the GAL‐containing neurons, in contrast, are concentrated in the lateral portion of the paraventricular nucleus, in addition to the medial preoptic area, which contribute to local GAL innervation as well as projections to the median eminence. Regarding their distinct functions, the evidence suggests that the NPY system is more closely related to patterns of carbohydrate ingestion and carbohydrate utilization, channeling nutrients towards the synthesis of fat. It is most strongly activated at the start of the active feeding cycle or after weaning, in close association with the adrenal steroid, corticosterone. The GAL system, in contrast, is more closely associated with patterns of fat consumption and signals related to fat oxidation. This peptide system is most active during the middle of the feeding cycle or immediately after puberty, in close association with the gonadal steroids. The gene expression and synthesis of these peptides in their respective neuronal cell groups is inhibited by circulating insulin and altered by dietary nutrients. Disturbances in sensitivity to insulin and steroid feedback regulation in the brain are believed to be involved in producing abnormal patterns of peptide function that result in overeating and body weight gain.
Effects of D‐Chiroinositol Added to a Meal on Plasma Glucose and Insulin in Hyperinsulinemic Rhesus Monkeys
Authors: Ortmeyer Heidi K. , Larner Joseph , Hansen Barbara C.
Published: September 2012

We have previously demonstrated that D‐chiroinositol, administered intravenously to insulin‐resistant monkeys, increases the rate of disappearance of plasma glucose and insulin. The purpose of the present study was to determine whether orally administered D‐chiroinositol might also similarly improve the postprandial plasma glucose profile of hyperinsulinemic insulin‐resistant monkeys. A complete liquid diet meal (15 ml/kg body weight) was ingested by each of six monkeys on two occasions separated by 10 days, with conditions identical except D‐chiroinositol (500 mg/kg body weight) was added to the second meal. At 110 minutes following each meal, the monkeys were anesthetized and blood samples obtained at 120, 150, 180, 210, 240, 270 and 300 minutes. Plasma glucose and insulin concentrations were determined. The mean plasma glucose concentration (120 − 300 minutes) was significantly lower after the meal containing D‐chiroinositol compared to the control meal (7.1 ± 1.2 vs. 7.8 ± 1.2 mM) (p<0.05). Plasma insulin concentrations tended to be lower after the meal containing D‐chiroinositol compared to the control meal (3930 ± 1068 vs. 4518 ± 1200 pM) (p<0.15, ns). We conclude that in hyperinsulinemic monkeys, D‐chiroinositol added to a meal lowers postprandial plasma glucose without an increase in plasma insulin, and therefore may be a useful agent for reducing meal‐induced hyperglycemia without inducing hyperinsulinemia.
Distribution of Anthropometric Variables and the Prevalence of Obesity in Populations of West African Origin: The International Collaborative Study on Hypertension in Blacks (ICSHIB)
Authors: Rotimi Charles N. , Cooper Richard S. , Ataman Susan L. , Osotimehin Babatunde , Kadiri Solomon , Muna Walinjom , Kingue Samuel , Fraser Henry , McGee Daniel
Published: September 2012

A survey of the prevalence of hypertension and associated risk factors including obesity was carried out among persons of West African heritage currently living in societies at different stages of social, economic and technological development. We present here the distribution of several anthropometric variables and the prevalence of obesity in these populations. Using a standard protocol with centralized training of field staff, 7 439 men and women aged 24 to 75 from six multinational sites were recruited and examined. Although men were taller, women were more obese across sites. Body mass index (BMI) and consequently the prevalence of overweight and obesity increased with westernization from rural African subsistence farming communities to suburban Chicago. Average BMI increased with age until about age 54, and then began to decline or at least level off. The mean BMI for African‐American men and women was 27.1 kg/m2 and 30.8 kg/m2, respectively. Men displayed high levels of centripetal fatness, measured as the waist‐to‐hip ratio (WHR), compared to the women across site. Based on the US Department of Agriculture guidelines, 22.6% and 56.9% of the African‐American men and women had elevated WHR. Although account must be taken of the important contribution of an individual's genetic background, this multinational study of persons with similar heritage clearly shows the potent impact of current environmental factors on the distribution and level of obesity.
Abnormalities of Energy Expenditure and the Development of Obesity
Authors: Roberts Susan B.
Published: September 2012

The role of energy expenditure in the development of obesity remains unclear. This issue is examined using data from prospective studies of energy expenditure and obesity, the effects of overfeeding and diet composition on energy expenditure, and studies of the relationship between energy expenditure for physical activity and body composition. The combined results from these investigations strongly support the view that low energy expenditure can facilitate rapid weight gain in susceptible individuals. It is speculated that, in susceptible individuals, low energy expenditure for resting energy expenditure as well as physical activity are part of a range of mechanisms available for providing surplus energy for rapid weight gain. In addition, both cross‐sectional and intervention studies indicate that there is an equilibration between the level of energy expenditure for physical activity and body fat content. While genetic and other factors clearly play an important role in this relationship, it appears that a modest reduction in body fat content can be achieved by increasing energy expenditure for physical activity in physical exercise programs.
Relationship of Co‐Morbidities of Obesity to Weight Loss and Four‐Year Weight Maintenance/Rebound
Authors: Hensrud Donald D. , Weinsier Roland L. , Darnell Betty E. , Hunter Gary R.
Published: September 2012

This study examined the effect of weight loss (separate from energy restriction) and weight maintenance/rebound over time on blood pressure, serum lipids, and body composition in 24 obese (mean 137% ideal body weight (IEW)) females with mild to moderate hypertension. Weight loss was induced under tightly controlled General Clinical Research Center conditions until each subject had lost at least 10 kg (mean 13 kg) and attained normal body weight (<120% IBW). After 4 years subjects returned for repeat evaluation. Weight changes were compared with 24 pair‐matched normal weight controls who were also followed for 4 years. With weight loss, significant improvements were seen in standing mean arterial pressure (MAP), serum total cholesterol, low‐density lipoprotein cholesterol, and triglycerides. Subjects regained 11 kg (87% of the weight lost) over the 4 year follow‐up period while control subjects gained only 2 kg. Subjects who chose self‐selected exercise gained less weight than nonexercisers (6 kg vs. 13 kg, P<0.05). With weight regain there were significant increases in standing and supine MAP, total cholesterol, and high‐density lipoprotein (HDL) cholesterol. The amount of weight regained was significantly correlated with standing MAP (r=0.73), triglycerides (r=0.43), and HDL cholesterol (r=‐0.47). The percentage fat of the weight regained was no greater than that of the weight previously lost. Weight loss, distinct from energy restriction, was associated with improvements in blood pressure and serum lipid levels. The ability to sustain these improvements in the co‐morbidities of obesity was directly related to the persistence and magnitude of weight loss maintenance.
Altered Functions of Ion Channels in Diabetic β Cells
Authors: Kato Seika , Ishida Hitoshi , Tsuura Yoshiyuki , Seino Yutaka
Published: September 2012

Selective impairment of glucose‐induced insulin secretion and hyper‐responsiveness to arginine are known features of GK rats, a genetic model of NIDDM. We focus on the ionic mechanism underlying these phenomena using patch‐clamp techniques. Pancreatic islets were isolated from male GK rats and age‐matched control Wistar rats and were subjected to dispersion and culture. Single channel recordings of KATP cnannels were performed using either on‐cell mode or inside‐out patch mode. Ca2+ channel currents were recorded under conventional whole‐cell mode. In GK β cells, ATP sensitivity of KATP channels itself was not altered, although glucose‐induced closure of KATP channels was severely impaired. Among substrates for fuel metabolism, only dehy‐droxyacetone (DHA) reproduced this anomaly. On the other hand, current densities of L‐type Ca2+ channels were increased in GK β cells. Since DHA is a known substrate for glycerol phosphate shuttle, current data suggest that major metabolic deficit of GK β cells resides in this shuttle. On the other hand, increased L‐type Ca2+ channel activities might be an ionic basis for augmented insulin response to non‐glucose depolarizing stimuli in GK β cells.
Hypothalamic Monoamines and Insulin in Relation to Feeding in the Genetically Obese Zucker Rat as Revealed by Microdialysis
Authors: Orosco Martine , Gerozissis Kyriaki , Rouch Claude , Meile Marie‐José , Nicolaidïs Stylianos
Published: September 2012

Dynamic changes in VMH and PVN monoamines and immunoreactive insulin (IRI) were investigated by microdialysis in freely‐moving genetically obese Zucker rats in order to relate possible disturbances to the impaired regulation of food intake of this model. Serotonin (5‐HT), 5‐HIAA and dopamine (DA) increased at the beginning of spontaneous meals while DOPAC decreased. Although similar in normal and obese rats, these changes were much more dramatic in the latter, as if more “signal” for satiety were necessary at the VMH‐PVN level. Glucoprivic feeding or satiety are induced in normal rats by intravenous infusions of insulin or insulin+glucose respectively. The Zucker rat is resistant to these treatments. The monoaminergic changes brought about by these infusions were similar in obese and normal rats (decreases in 5‐HT and DA and increases in 5‐HIAA and DOPAC), but the occurrence of meals, in the obese, showed a superim‐position of monoaminergic changes resembling those related to spontaneous feeding. The monoaminergic effects of insulin must therefore be dissociated from its effects on feeding. Hypothalamic insulin itself might be the brain signal. At the beginning of meals presented for the first time, VMH‐PVN IRI increased earlier and with a smaller magnitude in the obese. When the rats were accustomed to scheduled meals, a similar anticipatory increase in IRI was found in both obese and lean rats. This suggests that brain insulin is more than a satiety signal. In addition, in response to an i.v. insulin infusion, IRI increased twice as much in obese rats despite lower basal levels. Whatever the origin of hypothalamic insulin, the larger response of the obese Zucker rat, known to be insulin resistant, may reflect the inefficiency of the peptide in reducing feeding and body weight in this pathological model.
Usefulness of Fluoxetine in Obese Non‐Insulin‐Dependent Diabetics: A Multicenter Study
Authors: Daubresse Jean‐Claude , Kolanowski Jaroslaw , Krzentowski Georges , Kutnowski Maximilien , Scheen Andre , Van Gaal Luc
Published: September 2012

Weight reduction is essential in the management of most noninsulin‐dependent diabetics, but this therapeutical goal is difficult to obtain.

In this double‐blind parallel study, 82 noninsulin‐dependent diabetics, moderately obese (BMI = 30–39 kg/nr2), were given for an 8‐week period either placebo (P) or fluoxetine (F), a specific serotonin reuptake inhibitor, in addition to their usual antidiabetic treatment. Thirty‐nine of them received 60 mg fluoxetine a day and 43 were given the placebo.

At admission, both groups had similar weight excess, metabolic control and serum lipid values. In comparison with the P‐treated subjects, those treated with fluoxetine (F) lost more weight after 3 weeks (‐1.9 vs. −0.7 kg, p<0.0009) and after 8 weeks (‐3.1 vs. −0.9 kg, p<0.0007). Fasting blood glucose decreased in group F after 3 weeks (‐ 1.5 vs. −0.4 mmol/L, p<0.003) and after 8 weeks (‐1.7 vs. −0.02 mmol/L, p<0.0004). HbAlc decreased from 8.5% to 7.7% in group F and from 8.6% to 8.3% in group P (p=0.057). Mean triglyceride level was also reduced in group F after 8 weeks (p=0.042). Fasting C‐pep‐tide did not change in either group, but fasting insulin values decreased in group F after 3 weeks (p<0.02) and after 8 weeks (p<0.05).

The insulin/C‐peptide molar ratio decreased significantly in group F after 3 weeks (p<0.04) and after 8 weeks (p<0.05) in comparison with group P. The drug was generally well tolerated and no major side effects were reported.

In conclusion, the addition of fluoxetine to the usual oral hypoglycemic agent therapy might be beneficial in obese non‐insulin‐dependent diabetics, at least on a short‐term basis.