bluuebunny/crossref_metadata_2025 huggingface dataset:
Subcortical vascular cognitive impairment – the pathology and pathophysiology
Authors: Birns J , Kalra L
Published: January 2008

Vascular cognitive impairment (V.C.I.) encompasses all forms of cognitive loss associated with cerebrovascular disease and ischaemic brain injury. It includes cognitive impairment related to stroke, cortical and subcortical infarcts, silent infarcts and strategic infarcts, white matter lesions associated with small vessel disease, and specific arteriopathies such as CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leucoencephalopathy). Recent studies have demonstrated that VCI is most commonly of a subcortical aetiology with small vessel disease being the major cause. VCI plays an important part in patients with other forms of dementia, such as Alzheimer's disease, who have coexisting vascular lesions and it has been proposed that VCI may be the most common form of cognitive impairment in older people, with a prevalence of 5% in people over the age of 65. In view of the aging population and the growing magnitude of vascular disease in western society, the prevalence of subcortical VCI is likely to increase, with a greater impact on patients and health care providers. In this article, we will review the cerebrovascular pathology underlying subcortical VCI and its role in mediating the characteristic cognitive deficits.
Evaluierung von Interventionen aufgrund der Pflegediagnose «Soziale Isolation» und Anwendung der Methode Evidence-based Nursing
Authors: Burns Evelin , Haslinger-Baumann Elisabeth
Published: January 2008

In der häuslichen Krankenpflege, in der professionell agierende Krankenpflegepersonen weitgehend auf sich allein gestellt sind, sollen die Interventionen dem letzten wissenschaftlichen Stand entsprechen. Grundlage der gegenständlichen Untersuchung ist die Pflegediagnose «Soziale Isolation», wie sie beim Anbieter der Hauskrankenpflege Österreichisches Rotes Kreuz verwendet wird. Überprüft wurden die Interventionen der Pflegediagnose «Soziale Isolation» auf ihre wissenschaftliche Evidenz. Die Interventionen beziehen sich ausschließlich auf Personen, die in der Hauskrankenpflege betreut werden. Die wissenschaftliche Vorgehensweise basierte auf der Anwendung der Methode Evidence-based Nursing. Dabei wurden die einzelnen Interventionen der ausgewählten Pflegediagnose den Interventionen der Nursing Intervention Classifications (NIC) zugeordnet, um standardisierte englische Begriffe zu den deutschen Interventionen zu erhalten. Zehn ausgewählte Studien zeigten, dass soziale Isolation ein immer größer werdendes Problem für ältere Personen zu Hause ist. Die Hauskrankenpflegeperson soll zur ersten konkreten Einschätzung ein Assessmentinstrument verwenden. Besondere Empfehlungen können gemäß der Literatur bezüglich eines mehrdimensionalen Ansatzes zur Prophylaxe von sozialer Isolation gemacht werden. Das bedeutet die gleichzeitige Anwendung mehrerer unterschiedlicher Interventionen. Weiters sind auch auf besondere Bedürfnisse zugeschnittene Gruppenangebote hilfreich. Ein neuer Aspekt, der in der Literatur immer wieder beschrieben wird, ist die soziale Isolation der pflegenden Angehörigen. Diese hat starken Einfluss auf die zu betreuenden Personen selbst, sie darf deshalb von den Pflegepersonen nicht außer Acht gelassen werden und sollte in die Interventionen aufgenommen werden. Der Krankenpflegeperson die Menschen zuhause pflegt, kommt eine Schlüsselrolle im Erkennen von Sozialer Isolation zu und auch im Setzen der ersten Interventionen.
Validität der Waterlow-Skala zur Dekubitusrisikoeinschätzung auf der Intensivstation: eine prospektive Untersuchung an 698 Patienten
Authors: Compton Friederike , Strauß Matthias , Hortig Tino , Frey Judith , Hoffmann Falko , Zidek Walter , Schäfer Jürgen-Heiner
Published: January 2008

Patienten von Intensivstationen bilden eine besondere Risikogruppe für die Entwicklung von Dekubiti. Dennoch existieren für Intensivpatienten bislang keine ausreichend spezifischen, validierten Instrumente für die Dekubitusrisikoeinschätzung. In einer prospektiven Studie an 698 Patienten einer internistischen Intensivstation der Maximalversorgung wurde untersucht, inwieweit die Waterlow-Dekubitusrisikoskala für die Anwendung auf der Intensivstation geeignet ist. Es wurden ausschließlich Patienten eingeschlossen, bei denen zum Aufnahmezeitpunkt auf die Intensivstation keine Dekubiti bestanden. Die Waterlow-Skala wurde zur Einschätzung des Dekubitusrisikos bei Aufnahme auf die Intensivstation eingesetzt, und die auf der Skala erreichte Punktzahl in Hinblick auf im Verlauf der Intensivbehandlung aufgetretene Dekubiti (121 Patienten) ausgewertet. Die Ergebnisse zeigen, dass eine ausreichende Dekubitusrisikoeinschätzung mit der Waterlow-Skala zum Aufnahmezeitpunkt auf die Intensivstation nicht möglich ist. Sensitivität und Spezifität waren mit 64.4% bzw. 48.8% bei einer vergleichsweise hohen Waterlow-Punktzahl von 30 maximiert (positive und negative Likelihood Ratio von 1.26 bzw. 0.73). Die Fläche unter der Kurve (AUC) betrug in der Receiver-Operator-Characteristic-Kurve 0.59. Durch zusätzliche Verwendung intensivmedizinischer Parameter ließ sich die Risikoeinschätzung zwar verbessern (AUC 0.69), die Entwicklung und Validierung einer spezifisch intensivmedizinischen Dekubitusrisikoskala erscheint jedoch weiterhin erforderlich, um eine zuverlässige Dekubitusrisikostratifizierung auf der Intensivstation zu ermöglichen.
NMR relaxation measurements to quantify immiscible organic contaminants in sediments
Authors: Bryar Traci R. , Knight Rosemary J.
Published: January 2008

Laboratory NMR relaxation time (T2) measurements at 2 MHz were used to quantify the amount of toluene and bis(2‐ethylhexyl)phthalate (BEHP) in the presence of water in sand‐clay mixtures. NMR measurements were made on water, toluene, or BEHP in each sand‐clay mixture to understand the role of clay and iron content on the T2 of each fluid; we then made NMR measurements on mixtures of water and the contaminants in each sand‐clay mixture. Our ability to resolve the NMR response of the contaminant from that of water and to quantify the amount of the contaminant varied significantly with the clay and iron content of the sand‐clay mixtures. Detection limits as low as 3% contaminant (i.e., percent of the pore fluid, by weight) were observed in some sand‐clay mixtures. Our results suggest that NMR measurements could quantify toluene if some clay is present but are unlikely to be useful for quantifying BEHP.
Subdaily signals in GPS observations and their effect at semiannual and annual periods
Authors: King Matt A. , Watson Christopher S. , Penna Nigel T. , Clarke Peter J.
Published: January 2008

Estimates of seasonal geophysical loading from GPS may be biased by propagated unmodeled subdaily signals. Although the major geophysical signals at semidiurnal and diurnal frequencies are now routinely modeled in GPS analyses, the characteristics of unmodeled or mismodeled subdaily signals are not well known. Here, using site coordinates estimated every 5 minutes, we examine the subdaily coordinate spectral characteristics for ∼90 global GPS sites. Unmodeled signals with amplitudes at the 10 mm level are present at frequencies between ∼1/day and the Nyquist frequency. These are shown to propagate into 24 h solutions with (among other frequencies) annual and semiannual periods with amplitudes up to 5 mm, with a median amplitude in the height component of 0.8 mm (annual) and 0.6 mm (semiannual). They are shown to bias low‐degree spherical harmonics estimates of geophysical loading at the level of 5–10%, although the exact effect will be network dependent.
Temporal and spatial variations of the atmospheric CO2 concentration in China
Authors: Zhang Dongqi , Tang Jie , Shi Guangyu , Nakazawa Takakiyo , Aoki Shuji , Sugawara Satoshi , Wen Min , Morimoto Shinji , Patra Prabir K. , Hayasaka Tadahiro , Saeki Tazu
Published: January 2008

In order to understand the variations of atmospheric greenhouse gases over the Chinese mainland, an air sampling network was established in March 2003 that included one GAW global station, three GAW regional stations and three cooperative stations. Flask air samples were taken every week at the stations for 3 years. The secular increase and the seasonal variation in the CO2 concentration are clearly observable at all the stations, reflecting global as well as the regional terrestrial biospheric and human activities, as well as the local meteorological conditions. The average CO2 concentration depends on the station, with the lowest value observed at Mt. Waliguan and relatively high values observed at Fukang and Lin‐an stations, located in the westernmost and eastern parts of China, respectively. The observed CO2 concentration variations are also discussed within the context of forward transport model simulations using CO2 fluxes derived by time‐dependent inversion.
Interannual mode of sea level in the South China Sea and the roles of El Niño and El Niño Modoki
Authors: Chang C.‐W. June , Hsu Huang‐Hsiung , Wu Chau‐Ron , Sheu Woei‐Jen
Published: January 2008

ENSO‐scale variation of the summer ocean circulation in the South China Sea (SCS) is investigated. The interannual mode of SSH features a north‐south dipole pattern that modulates the cold jet off Vietnam. During the summers before and after the El Niño, the mode has opposite signs of extrema. Strengthened circulations couple with the cold SSTAs during the El Niño developing summers; weakened circulations accompany the warm SSTAs during the decaying summers. Heat advection by the basin circulation modulates the SST variation. The impact of the 1997 El Niño on the SCS circulation contrasting that of 1994 and 2002 El Niño Modoki is assessed. With moderate SST warming but further westward shift of the low‐level convergence of the atmosphere in the equatorial Pacific, the El Niño Modoki phenomenon enhanced the western North Pacific summer monsoon inside the SCS, driving stronger circulations in both the summers of 1994 and 2002.
Sources of edaphic cyanobacterial diversity in the Dry Valleys of Eastern Antarctica
Authors: Wood Susanna A , Rueckert Andreas , Cowan Donald A , Cary S Craig
Published: January 2008

Cyanobacteria are major components of Antarctic Dry Valley ecosystems. Their occurrence in lakes and ponds is well documented, however, less is known about their distribution in edaphic environments. There has been considerable debate about the contribution of aquatic organic matter derived largely from cyanobacteria to terrestrial ecosystems. In this study, automated rRNA intergenic spacer analysis (ARISA) and 16S rRNA gene clone libraries were used to investigate cyanobacterial diversity in a range of soil environments within the Miers and Beacon Valleys. These data were used to elucidate the input of aquatic cyanobacteria to soil communities. Thirty-eight samples were collected from a variety of soil environments including dry and moist soils, hypoliths and lake and hydroterrestrial microbial mats. The results from the ARISA and 16S rRNA clone library analysis demonstrated that diverse cyanobacterial communities exist within the mineral soils of the Miers Valley. The soil samples from Beacon Valley were depauparate in cyanobacterial signals. Within Miers Valley, significant portions (29%–58%) of ARISA fragment lengths found in aquatic cyanobacterial mats were also present in soil and hypolith samples, indicating that lacustrine and hydroterrestrial cyanobacteria play a significant role in structuring soil communities. The influence of abiotic variables on the community structure of soil samples was assessed using BEST analysis. The results of BEST analysis of samples from within Miers Valley showed that total percentage of carbon content was the most important variable in explaining differences in cyanobacterial community structure. The BEST analyses indicated that four elements contributed significantly to species compositional differences between valleys. We suggest that the complete absence of lakes or ponds from Beacon Valley is a contributing factor to the low cyanobacterial component of these soils.
Grazing and Loss of Control Related to Eating: Two High‐risk Factors Following Bariatric Surgery
Authors: Colles Susan L. , Dixon John B. , O'Brien Paul E.
Published: January 2008

Background: Gastric restrictive surgery induces a marked change in eating behavior. However, the relationship between preoperative and postoperative eating behavior and weight loss outcome has received limited attention.

Objective: This study assessed a range of eating behaviors before and 1 year after laparoscopic adjustable gastric banding (LAGB) and explored the nature and extent of change in eating patterns, their clinical associates, and impact on weight loss.

Methods and Procedures: A 12‐month observational study assessed presurgical and postsurgical binge eating disorder (BED), uncontrolled eating, night eating syndrome (NES), grazing, nutrient intake and eating‐related behaviors, and markers of psychological distress. A total of 129 subjects (26 male and 103 female, mean age 45.2 ± 11.5 and BMI 44.3 ± 6.8) participated in this study.

Results: Presurgical BED, uncontrolled eating, and NES occurred in 14%, 31%, and 17.1% of subjects, which reduced after surgery to 3.1%, 22.5%, and 7.8%, respectively (P = 0.05 for all). Grazing was prevalent before (26.3%) and after surgery (38.0%). Preoperative BED most frequently became grazers (P = 0.029). The average percentage weight loss (%WL) was 20.8 ± 8.5%; range −0.67 to 50.0% and percentage of excess weight loss (%EWL) 50.0 ± 20.7%; range −1.44 to 106.9% (P < 0.001). Uncontrolled eating and grazing after surgery showed high overlap and were associated with poorer %WL (P = 0.008 and P < 0.001, respectively) and elevated psychological distress.

Discussion: Consistent with recent studies, uncontrolled eating and grazing were identified as two high‐risk eating patterns after surgery. Clearer characterization of favorable and unfavorable postsurgical eating behaviors, reliable methods to assess their presence, and empirically tested postsurgical intervention strategies are required to optimize weight loss outcomes and facilitate psychological well‐being in at‐risk groups.
Endocannabinoid Dysregulation in the Pancreas and Adipose Tissue of Mice Fed With a High‐fat Diet
Authors: Starowicz Katarzyna M. , Cristino Luigia , Matias Isabel , Capasso Raffaele , Racioppi Alessandro , Izzo Angelo A. , Di Marzo Vincenzo
Published: January 2008

Objective: In mice, endocannabinoids (ECs) modulate insulin release from pancreatic β‐cells and adipokine expression in adipocytes through cannabinoid receptors. Their pancreatic and adipose tissue levels are elevated during hyperglycemia and obesity, but the mechanisms underlying these alterations are not understood.

Methods and Procedures: We assessed in mice fed for up to 14 weeks with a standard or high‐fat diet (HFD): (i) the expression of cannabinoid receptors and EC biosynthesizing enzymes (N‐acyl‐phosphatidyl‐ethanolamine‐selective phospholipase D (NAPE‐PLD) and DAGLα) and degrading enzymes (fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL)) in pancreatic and adipose tissue sections by immunohistochemical staining; (ii) the amounts, measured by liquid chromatography–mass spectrometry, of the ECs, 2‐AG, and anandamide (AEA).

Results: Although CB1 receptors and biosynthetic enzymes were found mostly in α‐cells, degrading enzymes were identified in β‐cells. Following HFD, staining for biosynthetic enzymes in β‐cells and lower staining for FAAH were observed together with an increase of EC pancreatic levels. While we observed no diet‐induced change in the intensity of the staining of EC metabolic enzymes in the mesenteric visceral fat, a decrease in EC concentrations was accompanied by lower and higher staining of biosynthesizing enzymes and FAAH, respectively, in the subcutaneous fat. No change in cannabinoid receptor staining was observed following HFD in any of the analyzed tissues.

Discussion: We provide unprecedented information on the distribution of EC metabolic enzymes in the pancreas and adipose organ, where their aberrant expression during hyperglycemia and obesity contribute to dysregulated EC levels.
Regional Heterogeneity of Functional Changes in Conduit Arteries After High‐fat Diet
Authors: Bhattacharya Indranil , Mundy Alexa L. , Widmer Corinne C. , Kretz Martin , Barton Matthias
Published: January 2008

Objective: To determine effects of dietary fat content on vascular responses in different conduit arteries in mice.

Methods and Procedures: Vascular responses to reactive oxygen species (ROS)/hydroxyl radical (·OH), acetylcholine (ACh), endothelin‐1 (ET‐1), and angiotensin II (Ang II) were determined in carotid and femoral arteries of C57BL/6J mice fed with diets varying in fat content (low fat (LF), 12.3%; high fat (HF), 41%; and very high fat (VHF), 58% (kcal from fat)) for 15 weeks, beginning at 4 weeks of age.

Results: In precontracted rings of carotid and femoral artery, ROS/·OH‐induced a rapid, transient vasodilation. In the carotid, but not in femoral artery, ROS/·OH‐induced dilation increased with increasing dietary fat intake (P < 0.05 vs. LF diet), while contractile responses to ROS/·OH remained unaffected. In femoral arteries, ROS/·OH‐induced contractions were reversed into relaxations after both HF and VHF diet (P < 0.05 vs. LF diet). Both ET‐1 and Ang II induced strong contractions in the femoral artery that were unaffected by dietary fat intake. In contrast, in the carotid artery Ang II–induced contraction was attenuated after HF and VHF diets (P < 0.005 vs. LF diet), whereas ET‐1‐induced vasoconstriction was significantly increased (P < 0.05 VHF vs. LF and HF). Treatment with VHF diet enhanced ACh‐mediated endothelium‐dependent relaxation only in the femoral artery (P < 0.05 vs. HF).

Discussion: These findings demonstrate that dietary fat content has regional and distinct effects on vascular function in different vascular beds. The data also suggest the possibility that in selected conduit arteries ROS‐dependent vasodilator mechanisms become activated in response to increased dietary fat intake.
Assessment of Diet‐induced Obese Rats as an Obesity Model by Comparative Functional Genomics
Authors: Li Shuyu , Zhang Hong‐Yan , Hu Charlie C. , Lawrence Frank , Gallagher Kelly E. , Surapaneni Anupama , Estrem Shawn T. , Calley John N. , Varga Gabor , Dow Ernst R. , Chen Yanyun
Published: January 2008

Objective: We applied a comparative functional genomics approach to evaluate whether diet‐induced obese (DIO) rats serve as an effective obesity model.

Methods and Procedures: Gene‐expression profiles of epididymal fat from DIO and lean rats were generated using microarrays and compared with the published array data of obese and non‐obese human subcutaneous adipocytes.

Results: Caloric intake and fuel efficiency were significantly higher in DIO rats, which resulted in increased body weight and adiposity. Circulating glucose, cholesterol, triglyceride, insulin, and leptin levels in DIO rats were significantly higher than those in the lean controls. DIO rats also exhibited impaired insulin sensitivity. A direct comparison of gene‐expression profiles from DIO and lean rats and those from obese and non‐obese humans revealed that global gene‐expression patterns in DIO rat fat resemble those of obese human adipocytes. Differentially expressed genes between obese and non‐obese subjects in both human and rat studies were identified and associated with biological pathways by mapping genes to Gene Ontology (GO) categories. Immune response–related genes and angiogenesis‐related genes exhibited significant upregulation in both obese humans and DIO rats when compared with non‐obese controls. However, genes in fatty acid metabolism and oxidation exhibited a broad downregulation only in obese human adipocytes but not in DIO rat epididymal fat.

Discussion: Our study based on gene‐expression profiling suggested that DIO rats in general represent an appropriate obesity model. However, the discrepancies in gene‐expression alterations between DIO rats and obese humans, particularly in the metabolic pathways, may explain the limitations of using DIO rodent models in obesity research and drug discovery.
Short Sleep Duration and Weight Gain: A Systematic Review
Authors: Patel Sanjay R. , Hu Frank B.
Published: January 2008

Objective: The recent obesity epidemic has been accompanied by a parallel growth in chronic sleep deprivation. Physiologic studies suggest sleep deprivation may influence weight through effects on appetite, physical activity, and/or thermoregulation. This work reviews the literature regarding short sleep duration as an independent risk factor for obesity and weight gain.

Methods and Procedures: A literature search was conducted for all articles published between 1966 and January 2007 using the search “sleep” and (“duration” or “hour” or “hours”) and (“obesity” or “weight”) in the MEDLINE database. Additional references were identified by reviewing bibliographies and contacting experts in the field. Studies reporting the association between sleep duration and at least one measure of weight were included.

Results: Thirty‐six publications (31 cross‐sectional, 5 prospective, and 0 experimental) were identified. Findings in both cross‐sectional and cohort studies of children suggested short sleep duration is strongly and consistently associated with concurrent and future obesity. Results from adult cross‐sectional analyses were more mixed with 17 of 23 studies supporting an independent association between short sleep duration and increased weight. In contrast, all three longitudinal studies in adults found a positive association between short sleep duration and future weight. This relationship appeared to wane with age.

Discussion: Short sleep duration appears independently associated with weight gain, particularly in younger age groups. However, major study design limitations preclude definitive conclusions. Further research with objective measures of sleep duration, repeated assessments of both sleep and weight, and experimental study designs that manipulate sleep are needed to better define the causal relationship of sleep deprivation on obesity.
Overweight and Obesity Doubled Over a 6‐year Period in Young Women Living in Poverty in Mexico
Authors: Neufeld Lynnette M. , Hernández‐Cordero Sonia , Fernald Lia C. , Ramakrishnan Usha
Published: January 2008

Objective: To document the changes in BMI and the prevalence of overweight and obesity in young women living in poverty in a semi‐urban community in Mexico.

Methods and Procedures: Women who had previously participated in a longitudinal research study (1997–2000) were re‐assessed in 2005. Anthropometric measurements were obtained using standard procedures, and socio‐demographic questionnaires were administered. Total and annual rate of change in BMI and change in the prevalence of overweight and obesity (BMI ≥ 25.0 and ≥30.0) were estimated.

Results: Mean age in 2005 was 30.0 ± 5.7 years (n = 683) and time between recruitment and follow‐up was 6.4 ± 1.0 years. Mean change in BMI was +3.6 ± 2.7 (range −8.2 to +14.6). In 2005, 500 (73.2%) women were overweight, up from 263 (38.5%) in the original assessment. The prevalence of obesity tripled over the follow‐up period (from 9.8% to 30.3%). The mean annual rate of change in BMI was +0.6 (±0.4). After adjustment for age and parity at baseline, an annual rate of change of BMI above the sample median (>0.5) was associated with lower levels of formal education.

Discussion: The annual increase in the prevalence of overweight and obesity in this sample is double that which was reported at a national level in Mexico. An understanding of the determinants of this rapid increase among the women living in poverty in Mexico is urgently needed.
Intake of Fruits and Vegetables in Relation to 10‐year Weight Gain Among Spanish Adults
Authors: Vioque Jesus , Weinbrenner Tanja , Castelló Adela , Asensio Laura , de la Hera Manoli Garcia
Published: January 2008

Objective: Despite the alarming increase in the prevalence of obesity, epidemiologic studies that prospectively examine the fruit and vegetable consumption and other lifestyle factors in relation to weight gain (WG) are still insufficient. We explored the associations between fruit and vegetable intake and WG over a 10‐year period in an adult Mediterranean population.

Methods and Procedures: We performed a 10‐year follow‐up study with healthy participants (n = 206) aged 15–80 years at baseline in 1994, who participated in a nutrition survey in Valencia, Spain. Data on diet, lifestyle factors, and body weight were obtained in 1994 and 2004 using a food frequency questionnaire (FFQ) and direct measurements.

Results: The average WG over the study period was 3.41 (s.d. 6.9) kg. In multivariate analyses, participants in the third quartile of fruit intake at baseline in 1994 had lower risk of WG≥3.41 kg compared to those in the lowest quartile (oddsratio (OR) = 0.31, 95% confidence interval (CI), 0.11–0.85; P trend = 0.044). Regarding vegetable intake, the risk of WG was lowest in participants of the fourth quartile (>333 g/day), which had an 84% reduced risk of gaining 3.41 kg weight (OR = 0.18, 95% CI, 0.05–0.66; P trend = 0.017). When the intake of fruits and vegetables was combined, the risk of WG decreased across quartiles, with the lowest risk among those in the fourth quartile (OR = 0.22, 95% CI, 0.06–0.81; P trend = 0.022). Further adjustment for an increased intake of fruits and vegetables over the past 10 years reported by participants in 2004 did not appreciably alter the observed ORs.

Discussion: Dietary patterns associated with a high intake of fruits and vegetables in Mediterranean populations may reduce long‐term risk of subsequent WG and obesity among adults.
Lack of Association of Ghrelin Precursor Gene Variants and Percentage Body Fat or Serum Lipid Profiles
Authors: Martin Glynn R. , Loredo J.C. , Sun Guang
Published: January 2008

Ghrelin has been recognized for its involvement in food intake, control of energy homeostasis, and lipid metabolism. However, the roles of genetic variations in the ghrelin precursor gene (GHRL) on body compositions and serum lipids are not clear in humans. Our study investigated five single‐nucleotide polymorphisms (SNPs) within GHRL to determine their relationship with body fat percentage (BF), trunk fat percentage (TF), lower body (legs) fat percentage (LF), and serum lipids in 1,464 subjects, which were recruited from the genetically homogeneous population of Newfoundland and Labrador (NL), Canada. Serum glucose, insulin, total cholesterol, high‐density lipoprotein‐cholesterol, low‐density lipoprotein‐cholesterol, and triglycerides were determined. Five SNPs are rs35684 (A/G: a transition substitution in exon 1), rs4684677 (A/T: a missense mutation), rs2075356 (C/T: intron), rs26802 (G/T: intron), and rs26311 (A/G: near the 3′ untranslated region) of GHRL were genotyped using TaqMan validated or functionally tested SNP genotyping assays. Our study found no significant evidence of an allele or genotype association between any of the variant sites and body compositions or serum lipids. Furthermore, haplotype frequencies were not found to be significantly different between lean and obese subjects. In summary, the results of our study do not support a significant role for genetic variations in GHRL in the differences of body fat and serum lipid profiles in the NL population.
Impact of Obesity on Health‐related Quality of Life in Schizophrenia and Bipolar Disorder
Authors: Kolotkin Ronette L. , Corey‐Lisle Patricia K. , Crosby Ross D. , Swanson Jodi M. , Tuomari Anne V. , L'Italien Gilbert J. , Mitchell James E.
Published: January 2008

Objective: Studies have reported that up to 60% of individuals with schizophrenia and 68% of those with bipolar disorder are overweight/obese. This paper explores the health‐related quality of life (HRQOL) of individuals with schizophrenia or bipolar disorder as a function of obesity status.

Methods and Procedures: Two hundred and eleven participants were recruited from four psychiatric programs (outpatient, day treatment, case management, and psychosocial rehabilitation). HRQOL was assessed using both a general measure (Medical Outcomes Study Short‐Form‐36 (SF‐36)) and a weight‐related measure (Impact of Weight on Quality of Life‐Lite (IWQOL‐Lite)). To interpret HRQOL scores obtained by the obese group, we compared scores to those obtained by reference groups from the weight‐loss literature.

Results: Sixty‐three percent of participants with schizophrenia and 68% of those with bipolar disorder were obese. Obese participants were more likely to be women, on mood stabilizers, taking a greater number of psychiatric medications, and to have poorer weight‐related and general HRQOL. Weight‐related HRQOL in the obese psychiatric sample was more impaired than in outpatient and day treatment samples seeking weight loss but less impaired than in gastric‐bypass patients. Several of the physical domains of general HRQOL were more impaired for the obese psychiatric sample than for the outpatient weight‐loss sample. However, physical functioning was less impaired for the obese psychiatric sample than for gastric‐bypass patients.

Discussion: The presence of obesity among individuals with schizophrenia or bipolar disorder is associated with decreased HRQOL. These results have implications for prevention and management of weight gain in individuals with schizophrenia or bipolar disorder.
Anthropometric Risk Factors for Colorectal Polyps in African‐American Women
Authors: Wise Lauren A. , Rosenberg Lynn , Palmer Julie R. , Adams‐Campbell Lucile L.
Published: January 2008

Objective: Colorectal adenomas are thought to be precursor lesions to colorectal cancer, a leading cause of cancer incidence and mortality in African‐American women. Studies suggest that obesity is associated with risk of adenomas in white women, but little is known about the relation in African‐American women. We prospectively examined the association between selected anthropometric factors and colorectal polyps in African‐American women.

Methods and Procedures: Data were obtained from the Black Women's Health Study (BWHS), a prospective cohort study of African‐American women. From 1997 to 2003, we followed 33,403 women aged ≥30 years with no prior diagnosis of cancer or polyps. Cox regression was used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for risk of polyps, with adjustment for potential confounders.

Results: After 211,797 person‐years of follow‐up, 1,189 cases of colorectal polyps were reported. The IRR comparing women with a current BMI ≥35 to <25 kg/m2 was 1.35 (95% CI = 1.12–1.62), after adjustment for covariates including waist‐to‐hip ratio (WHR). Women who gained ≥30 kg since age 18 were 1.76 times as likely as those who gained <5 kg to report polyps (95% CI = 1.33–2.33). The IRR comparing the highest (≥0.87) to lowest (<0.71) quintiles of WHR was 1.26 (95% CI = 1.04–1.54), after adjustment for covariates including BMI. BMI at age 18, adult height, and waist circumference (BMI‐adjusted) were not materially associated with risk. Results were similar among women with a recent endoscopy.

Discussion: Weight gain and obesity in adulthood may increase the risk of colorectal polyps in African‐American women.
Effect of Obesity on Short‐ and Long‐term Mortality Postcoronary Revascularization: A Meta‐analysis
Authors: Oreopoulos Antigone , Padwal Raj , Norris Colleen M. , Mullen John C. , Pretorius Victor , Kalantar‐Zadeh Kamyar
Published: January 2008

Objective: Overweight and obesity are often assumed to be risk factors for postprocedural mortality in patients with coronary artery disease (CAD). However, recent studies have described an “obesity paradox”—a neutral or beneficial association between obesity and mortality postcoronary revascularization. We reviewed the effect of overweight and obesity systematically on short‐ and long‐term all‐cause mortality post‐coronary artery bypass grafting (CABG) and post‐percutaneous coronary intervention (PCI).

Methods: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Scopus, and Web of Science to identify cohort, case control, and randomized controlled studies evaluating the effect of obesity on in‐hospital/short‐term (within 30 days) and long‐term (up to 5 years) mortality. Full‐text, published articles reporting all‐cause mortality between individuals with and without elevated BMI were included. Two reviewers independently assessed studies for inclusion and performed data extraction.

Results: Twenty‐two cohort publications were identified, reporting results in ten post‐PCI and twelve post‐CABG populations. Compared to individuals with non‐elevated BMI levels, obese patients undergoing PCI had lower short‐ (odds ratio (OR) 0.63; 95% confidence interval (CI) 0.54–0.73) and long‐term mortality (OR 0.65; 95% CI 0.51–0.83). Post‐CABG, obese patients had lower short‐term (OR 0.63; 95% CI 0.56–0.71) and similar long‐term (OR 0.88; 95% CI 0.60–1.29) mortality risk compared to normal weight individuals. Results were similar in overweight patients for both procedures.

Conclusions: Compared to non‐obese individuals, overweight and obese patients have similar or lower short‐ and long‐term mortality rates postcoronary revascularization. Further research is needed to confirm the validity of these findings and delineate potential underlying mechanisms.
Disordered Eating Attitudes and Behaviors in Overweight Youth
Authors: Goldschmidt Andrea B. , Aspen Vandana Passi , Sinton Meghan M. , Tanofsky‐Kraff Marian , Wilfley Denise E.
Published: January 2008

Disordered eating attitudes and behaviors appear to be quite common in youth, and overweight youth have been identified as a subset of the population at particularly high risk for endorsing such symptoms. Overweight and eating disorder (ED) symptomatology independently confer significant threats to one's physical and psychosocial health, showing strong links with body weight gain and risk for ED development. When concurrent, the risk for negative health outcomes may be compounded. The purpose of this article is to review the current state of the literature as it concerns disordered eating and its correlates in overweight children and adolescents. Extant literature on the prevalence, distribution, correlates, and etiology of disordered eating attitudes and behaviors (i.e., negative attitudes toward shape and weight, unhealthy weight control behaviors, and binge eating) in overweight youth is reviewed and consolidated in order to make assessment and treatment recommendations for healthcare providers. The current literature suggests that early detection of disordered eating in overweight youth should be a priority to provide appropriate intervention, thereby helping to slow the trajectory of weight gain and prevent or reduce the long‐term negative consequences associated with both conditions. Future research should focus on explicating developmental pathways, and on developing novel prevention and treatment interventions for overweight youth exhibiting disordered eating patterns.
Effects of Breastfeeding on Trajectories of Body Fat and BMI throughout Childhood
Authors: Buyken Anette E. , Karaolis‐Danckert Nadina , Remer Thomas , Bolzenius Katja , Landsberg Beate , Kroke Anja
Published: January 2008

Objective: To investigate the effect of breastfeeding in healthy boys and girls on their trajectories of percent body fat (%BF) and BMI standard deviation scores (BMI–SDS) throughout childhood.

Methods and Procedures: Analyses of the DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study included data from 219 male and 215 female term participants, born between 1984 and 1999, with repeated anthropometric measurements between 0.5 and 7 years and prospective data on duration of breastfeeding.

Results: Among boys with an overweight mother (OW‐M), analyses adjusted for potential confounders revealed that not or shortly breastfed (≤17 weeks) boys did not experience the age‐dependent decrease in %BF seen in all children with normal weight mothers (NW‐Ms). In contrast, boys fully breastfed for >17 weeks were protected against the adverse effect of maternal overweight (effect of long breastfeeding vs. no/short breastfeeding among boys with OW‐Ms: 0.46%/year; s.e. 0.18; P = 0.01). There was also a suggestion of an interaction between maternal overweight and breastfeeding for the BMI–SDS trajectory (0.08 SDS/year; s.e. 0.04; P = 0.07). Among boys with NW‐Ms mothers and the corresponding subgroups of girls, breastfeeding had little effect on the development of %BF or BMI–SDS throughout childhood.

Discussion: Our study suggests that breastfeeding could offset a potential programming effect for childhood adiposity among boys with OW‐Ms, to whom advice to breast‐feed should thus be specifically targeted.
Protein‐leverage in Mice: The Geometry of Macronutrient Balancing and Consequences for Fat Deposition
Authors: Sørensen Allan , Mayntz David , Raubenheimer David , Simpson Stephen J.
Published: January 2008

Objective: The Protein‐Leverage Hypothesis proposes that humans regulate their intake of macronutrients and that protein intake is prioritized over fat and carbohydrate intake, causing excess energy ingestion when diets contain low %protein. Here we test in a model animal, the mouse: (i) the extent to which intakes of protein and carbohydrate are regulated; (ii) if protein intake has priority over carbohydrates so that unbalanced foods low in %protein leads to increased energy intake; and (iii) how such variations in energy intake are converted into growth and storage.

Methods and Procedures: We fed mice one of five isocaloric foods having different protein to carbohydrate composition, or a combination of two of these foods (N = 15). Nutrient intake and corresponding growth in lean body mass and lipid mass were measured. Data were analyzed using a geometric approach for analyzing intake of multiple nutrients.

Results: (i) Mice fed different combinations of complementary foods regulated their intake of protein and carbohydrate toward a relatively well‐defined intake target. (ii) When mice were offered diets with fixed protein to carbohydrate ratio, they regulated the intake of protein more strongly than carbohydrate. This protein‐leverage resulted in higher energy consumption when diets had lower %protein and led to increased lipid storage in mice fed the diet containing the lowest %protein.

Discussion: Although the protein‐leverage in mice was less than what has been proposed for humans, energy intakes were clearly higher on diets containing low %protein. This result indicates that tight protein regulation can be responsible for excess energy ingestion and higher fat deposition when the diet contains low %protein.
Overweight and Obesity in an Ethnically Diverse Rural School District: The Healthy Kids Project
Authors: Eichner June E. , Moore William E. , Perveen Ghazala , Kobza Cee E. , Abbott Kathryn E. , Stephens Aietah L.
Published: January 2008

Objective: Data on Native American children and adolescents are rarely reported along with other racial and ethnic groups. The Healthy Kids Project is part of an effort to describe the prevalence of overweight and obesity in a racially mixed rural area where Native American, Hispanic, African American, and white children reside.

Methods and Procedures: We measured height and weight of students in Anadarko, Oklahoma public schools (n = 1,980) in 2002–2003. All available students (95.7%) whose parents had not opted out of school health assessments were included. From these data, we calculated BMI (weight (kg) / height (m2)) and used the International Obesity Task Force reference to classify children into BMI categories.

Results: Native American, Hispanic, African American, and white children who live and attend school in the same surroundings are at risk of overweight and obesity. White children had the lowest combined prevalence of overweight and obesity (37.6%), and Native American children had the highest (53.8%) followed closely by African American (51.7%) and Hispanic children (50.5%).

Discussion: The childhood obesity epidemic includes all racial and ethnic groups to different degrees. In a rural public school, Native American, Hispanic, and African children had higher rates of overweight/obesity than white children.
Increasing Healthy Eating vs. Reducing High Energy‐dense Foods to Treat Pediatric Obesity
Authors: Epstein Leonard H. , Paluch Rocco A. , Beecher Meghan D. , Roemmich James N.
Published: January 2008

Objective: The objective was to compare targeting increased eating of healthy foods vs. reducing intake of high energy‐dense foods within the context of a family‐based behavioral weight control program.

Methods and Procedures: Forty‐one 8–12 year‐old children >85th BMI percentile were randomly assigned to a 24‐month family‐based behavioral treatment that targeted increasing fruits and vegetables and low‐fat dairy vs. reducing intake of high energy‐dense foods.

Results: Children in the increase healthy food group showed greater reduction in zBMI compared to children in the reduce high energy‐dense food group at 12‐ (−0.30 zBMI units vs. −0.15 zBMI units, P = 0.01) and 24‐ (−0.36 zBMI units vs −0.13 zBMI units, P = 0.04) month follow‐up. Parents in the increase healthy food group showed greater reductions in concern about child weight (P = 0.007), and these changes were associated with child zBMI change (P = 0.008). Children in the reduce high energy‐dense group showed larger sustained reductions in high energy‐dense foods (P < 0.05). Baseline levels of high energy‐dense foods (P < 0.05), parent food restraint (P = 0.01), parent concern over parent weight (P = 0.01) and parent acceptance of the child (P < 0.05) moderated child zBMI change, with greater sustained reductions in zBMI for children in the increase healthy food group for each measure. Parent zBMI change followed the same pattern as child changes, and parent and child zBMI changes were correlated (P < 0.001).

Discussion: Focusing on healthy food choices within an energy restricted diet may be useful in family‐based weight control programs.
Age‐variability in Body Shape Associated With Excess Weight: The UK National Sizing Survey
Authors: Wells Jonathan C.K. , Cole Tim J. , Treleaven Philip
Published: January 2008

Background: The health risks of obesity are disproportionately due to central abdominal adiposity; however, the extent to which age is associated with the body shape of obese adults is not known.

Objective: Three‐dimensional (3D) data on body shape from the UK National Sizing Survey were analyzed to investigate age‐associated changes in body shape within the BMI bands <20, 20–24.99, 25–29.99 and ≥30 kg/m2.

Methods: Measurements of anthropometry (weight and height) and a 3D body scan were obtained in 4,344 men and 5,266 women recruited from eight British cities.

Results: The body shape of men showed high consistency within BMI bands between early adulthood and old age. In contrast, the body shape of women altered within each BMI band with increasing age. In obese, overweight, and normal weight women, age was associated with decreased thigh girth, increased waist, and bust girth. Whereas young obese women maintained an hourglass shape, in old age the body shape of obese women converged on that of obese men.

Discussion: The association of age with body shape is markedly different between the sexes, with the impact of obesity on shape strongly age‐dependent in women but not in men. The age delay in the association between obesity and high waist girth in women may contribute to the sex‐difference in life expectancy. The relationship between body shape change and cardiovascular risk merits longitudinal investigation within individuals.
Genes Implicated in Serotonergic and Dopaminergic Functioning Predict BMI Categories
Authors: Fuemmeler Bernard F. , Agurs‐Collins Tanya D. , McClernon F. Joseph , Kollins Scott H. , Kail Melanie E. , Bergen Andrew W. , Ashley‐Koch Allison E.
Published: January 2008

Objective: This study addressed the hypothesis that variation in genes associated with dopamine function (SLC6A3, DRD2, DRD4), serotonin function (SLC6A4, and regulation of monoamine levels (MAOA) may be predictive of BMI categories (obese and overweight + obese) in young adulthood and of changes in BMI as adolescents transition into young adulthood. Interactions with gender and race/ethnicity were also examined.

Methods and Procedures: Participants were a subsample of individuals from the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative sample of adolescents followed from 1995 to 2002. The sample analyzed included a subset of 1,584 unrelated individuals with genotype data. Multiple logistic regressions were conducted to evaluate the associations between genotypes and obesity (BMI > 29.9) or overweight + obese combined (BMI ≥ 25) with normal weight (BMI = 18.5–24.9) as a referent. Linear regression models were used to examine change in BMI from adolescence to young adulthood.

Results: Significant associations were found between SLC6A4 5HTTLPR and categories of BMI, and between MAOA promoter variable number tandem repeat (VNTR) among men and categories of BMI. Stratified analyses revealed that the association between these two genes and excess BMI was significant for men overall and for white and Hispanic men specifically. Linear regression models indicated a significant effect of SLC6A4 5HTTLPR on change in BMI from adolescence to young adulthood.

Discussion: Our findings lend further support to the involvement of genes implicated in dopamine and serotonin regulation on energy balance.
Does Clinical Depression Affect the Accuracy of Self‐reported Height and Weight in Obese Women?
Authors: Jeffery Robert W. , Finch Emily A. , Linde Jennifer A. , Simon Gregory E. , Ludman Evette J. , Operskalski Belinda H. , Rohde Paul , Ichikawa Laura E.
Published: January 2008

Objective: Recent research from a self‐report survey showed a strong association between obesity and clinical depression in women. The present analysis assessed whether differential bias in self‐reports of height and weight as a function of depression influences the apparent strength of the association.

Methods: Accuracy of self‐reported height and weight was assessed in 250 obese (mean BMI=38.7 kg/m2) women, 135 of whom met the American Psychiatric Association DSM‐IV diagnostic criteria for clinical depression.

Results: Depressed and non‐depressed women underreported their weight by 1.5 and 1.2 kg, respectively. They underreported their height by 0.002 and 0.003 m, respectively.

Discussion: Bias in self‐reports of body weight and height is similar in depressed and non‐depressed obese women. The underreporting of weight in both groups is similar in magnitude to that seen in normal weight women. Thus, using self‐reports of height and weight seems unlikely to bias estimates of the association between obesity and clinical depression in women.