bluuebunny/crossref_metadata_2025 huggingface dataset:
Alcohol Intake and 8‐Year Weight Gain in Women: A Prospective Study
Authors: Wannamethee S. Goya , Field Alison E. , Colditz Graham A. , Rimm Eric B.
Published: April 2008

Objective: To examine prospectively the relationship between alcohol and 8‐year weight gain in women.

Research Methods and Procedures: A prospective study of 49, 324 women 27 to 44 years old who did not have a history of cardiovascular disease, cancer, or diabetes, who were not pregnant during the study period, and who reported weights in 1991 and 1999.

Results: In cross‐sectional analyses, there was a significant inverse relationship between alcohol and BMI even after adjustment for dietary factors and a wide range of confounders. In multivariate prospective analyses, a nonlinear relationship was seen between alcohol and weight gain (≥5 kg) in all women. Compared with nondrinkers, the adjusted relative odds [95% confidence interval (CI)] of weight gain according to grams per day were 0.94 (0.89, 0.99) for those consuming 0.1 to 4.9 g/d, 0.92 (0.85, 0.99) for 5 to 14.9 g/d, 0.86 (0.76, 0.78) for 15 to 29.9 g/d, and 1.07 (0.89, 1.28) for those consuming 30+ g/d (p< 0.0001 for quadratic trend). Women who continued to drink heavily and those who became heavy drinkers showed similar increased odds of weight gain. The increased odds of weight gain associated with heavy drinking (30+ g/d) were most marked in the younger women (<35 years) (odds ratio 1.64; 5% CI 1.03 to 2.61). In African‐American women, light drinking was associated with increased odds of weight gain compared with nondrinkers (odds ratio = 2.43; 95% CI 1.22 to 4.82)

Discussion: Our data suggest that light to moderate drinking (up to 30 g/d) is not associated with weight gain in women except possibly in African‐American women. Heavier drinking may promote weight gain in women.
The M16 Mouse: An Outbred Animal Model of Early Onset Polygenic Obesity and Diabesity
Authors: Allan Mark F. , Eisen Eugene J. , Pomp Daniel
Published: April 2008

Objective: To characterize the phenotypic consequences of long‐term selective breeding for rapid weight gain, with an emphasis on obesity and obesity‐induced diabetes (diabesity).

Research Methods and Procedures: M16 is the result of long‐term selection for 3‐ to 6‐week weight gain from an ICR base population. Experiment 1 characterized males from both lines for body weights (3, 6, and 8 weeks), feed (4 to 8 weeks) and H2O (6 to 8 weeks) consumption, and heat loss, body composition, and levels of several plasma proteins at 8 weeks of age. Experiment 2 characterized differences between lines for both sexes at three ages (6, 8, and 16 weeks) and fed two diets (high and normal fat). Body weight, composition, blood glucose, and plasma insulin and leptin levels were evaluated after an 8‐hour fast.

Results: At all ages measured, M16 mice were heavier, fatter, hyperphagic, hyperinsulinemic, and hyperleptinemic relative to ICR. M16 males and females were hyperglycemic relative to ICR, with 56% and 22% higher fasted blood glucose levels at 8 weeks of age.

Discussion: M16 mice represent an outbred animal model to facilitate gene discovery and pathway regulation controlling early onset polygenic obesity and type 2 diabetic phenotypes. Phenotypes prevalent in the M16 model, with obesity and diabesity exhibited at a young age, closely mirror current trends in human populations.
Production Rates of Cortisol in Obesity
Authors: Vierhapper Heinrich , Nowotny Peter , Waldhäusl Werner
Published: April 2008

Objective: To determine the metabolic clearance rates (MCRs) and endogenous production rates (PRs) of cortisol (F) in grades 2 and 3 obese men (n = 9) and women (n = 6).

Research Methods and Procedures: The MCRs and the endogenous PRs of cortisol (F) were determined in grades 2 and 3 obese men (n = 9) and women (n = 6) using the stable isotope dilution technique and mass spectrometry.

Results: In obese women, endogenous PRs of F (0.6 ± 0.4 mg/h) were similar to those of nonobese women, but MCRs of F were higher in obese women (9 ± 4 L/h) compared with nonobese women (5 + 2 L/h; p < 0.05). The MCR of F was correlated with the ratio of excreted cortisone to F metabolites. Furthermore, obese women were characterized by an increased ratio of androsterone to etiocholanolone (p < 0.01). In obese men, the MCRs (11 ± 6 L/h) and the endogenous PRs of F (0.6 ± 0.3 mg/h) were both similar to those of nonobese men, but the MCR of F was directly correlated with the ratio of excreted cortisone to F metabolites (r = 0.7833, p = 0.012).

Discussion: These data demonstrate sex‐specific differences in F metabolism in obesity. The rise in MCRs of F is more pronounced in obese women than in men. However, the increase in the MCR of F is moderate in both genders and exceeds the normal range only in a subgroup of obese individuals.
Sexual Dimorphism in the Response of Adipose Mass and Cellularity to Graded Caloric Restriction
Authors: Porter Marty H. , Fine Jacqueline B. , Cutchins Alexis G. , Bai Yaohui , DiGirolamo Mario
Published: April 2008

Objective: To investigate the effects of mild to moderate caloric restriction on parameters of body growth, fat mass, and adipose tissue cellularity in female and male Wistar rats.

Research Methods and Procedures: Three‐month‐old female and male Wistar rats were subjected to a chronic, mild to moderate caloric restriction paradigm (5%, 10%, or 20% reduction in caloric intake from ad libitum values) for 6 months. This was accomplished using a unique automated feeder system tailored to the food consumption levels of individual rats. Body weight and length, weight of lean organs, regional adipose mass, and adipose cellularity were measured before and after the diet restriction.

Results: Caloric restriction produced proportional decelerations in body weight increases in both genders, without significant changes in body length or lean organ mass. Marked and disproportional reductions in regional adipose tissue mass were produced at all levels of food restriction (even at 5% restriction). An unexpected finding was that in response to graded caloric restriction, female rats preserved adipose fat cell number at the expense of fat cell volume, whereas the converse was seen for male rats.

Discussion: These studies demonstrate a sexual dimorphism in the response to mild to moderate degrees of chronic caloric restriction. At low levels of caloric restriction, it is possible to affect regional adipose mass and cellularity while preserving lean organ mass.
Influence of Dietary Conjugated Linoleic Acid and Fat Source on Body Fat and Apoptosis in Mice*
Authors: Hargrave Kimberly M. , Meyer Brett J. , Li Changlong , Azain Michael J. , Baile Clifton A. , Miner Jess L.
Published: April 2008

Objective: To determine whether altered dietary essential fatty acid (linoleic and arachidonic acid) concentrations alter sensitivity to conjugated linoleic acid (CLA)‐induced body fat loss or DNA fragmentation.

Research Methods and Procedures: Mice were fed diets containing soy oil (control), coconut oil [essential fatty acid deficient (EFAD)], or fish oil (FO) for 42 days, and then diets were supplemented with a mixture of CLA isomers (0.5% of the diet) for 14 days. Body fat index, fat pad and liver weights, DNA fragmentation in adipose tissue, and fatty acid profiles of adipose tissue were determined.

Results: The EFAD diet decreased (p < 0.05) linoleic and arachidonic acid in mouse adipose tissue but did not affect body fat. Dietary CLA caused a reduction (p < 0.05) in body fat. Mice fed the EFAD diet and then supplemented with CLA exhibited a greater reduction (p < 0.001) in body fat (20.21% vs. 6.94% in EFAD and EFAD + CLA‐fed mice, respectively) compared with mice fed soy oil. Dietary FO decreased linoleic acid and increased arachidonic acid in mouse adipose tissue. Mice fed FO or CLA were leaner (p < 0.05) than control mice. FO + CLA‐fed mice did not differ in body fat compared with FO‐fed mice. Adipose tissue apoptosis was increased (p < 0.001) in CLA‐supplemented mice and was not affected by fat source.

Discussion: Reductions in linoleic acid concentration made mice more sensitive to CLA‐induced body fat loss only when arachidonic acid concentrations were also reduced. Dietary essential fatty acids did not affect CLA‐induced DNA fragmentation.
Psychiatric and Medical Symptoms in Binge Eating in the Absence of Compensatory Behaviors
Authors: Reichborn‐Kjennerud Ted , Bulik Cynthia M. , Sullivan Patrick F. , Tambs Kristian , Harris Jennifer R.
Published: April 2008

Objective: To explore the extent to which binge eating in the absence of compensatory behaviors (BE) is associated with psychiatric and medical symptoms in men and women and to control for the independent effects of BMI.

Research Methods and Procedures: A series of regression models was applied to questionnaire data on 8045 twins, 18 to 31 years old, from a population‐based Norwegian registry.

Results: BE was significantly associated with elevated obesity, overweight, symptoms of eating disorders, symptoms of anxiety and depression, panic attacks, depressive episodes, and reduced life satisfaction in both men and women. In women, BE was independently associated with insomnia and early menarche. In men, BE was independently associated with specific phobia, daily smoking, alcohol use, use of pain medication, impairment due to mental health, neck‐shoulder, lower back, and chronic muscular pain, and impairment due to physical health. Both men and women with BE reported higher rates of psychiatric treatment.

Discussion: Our results indicate that there is substantial comorbidity between BE and psychiatric symptoms independently of BMI for both men and women. Medical symptoms co‐occur less frequently than previously reported from treatment‐seeking populations in women. Across all domains, the array of symptoms exhibited by men with BE was broader than that observed in women with BE. This observation suggests the importance of considering gender differences in future studies of psychiatric and medical morbidity, binge eating, and obesity.
The Implications of Body Fat Mass and Fat Distribution for Cognitive Function in Elderly Women
Authors: Bagger Yu Z. , Tankó László B. , Alexandersen Peter , Qin Gerong , Christiansen Claus
Published: April 2008

Objective: To investigate how body fat mass, an established source of endogenous estrogen after menopause, influences cognitive impairment in elderly women.

Research Methods and Procedures: Study participants were 5607 generally healthy postmenopausal women with mean age of 63.8 years at baseline followed for an average of 7.3 years. Cognitive function assessed at follow‐up using the short Blessed test was related to baseline body weight, the yearly change in weight, and follow‐up measures of body fat depots assessed by DXA. Cognitive function was also related to various surrogates of lifetime estrogen exposure.

Results: Women with the worst cognitive performance (score ≥ 9) at follow‐up were the ones who lost the most body weight and revealed the lowest central fat mass (CFM). The association of weight loss with worse cognitive performance was apparent across all age groups except for those more than 80 years old. In the multivariate logistic model, the risk of cognitive impairment was 18% lower in women in the second quartile of CFM (p = 0.14), 32% lower in the third (p = 0.01), and 48% lower in the fourth (p < 0.001) compared with those in the first quartile. CFM showed significant correlation with the simultaneously measured serum estradiol (r = 0.25; p < 0.001). Cognitive score showed an inverse linear relationship with the duration of reproductive period and bone mineral density assessed at follow‐up.

Discussion: These findings argue for a protective association of body fat mass with cognitive impairment in elderly women. This association seems to involve a more prominent exposure to endogenous estrogens.
Restrained Eating Behavior and the Metabolic Response to Dietary Energy Restriction in Women
Authors: Keim Nancy L. , Horn William F.
Published: April 2008

Objective: To determine whether prior eating behavior characterized by dietary restraint alters responses in energy expenditure and substrate oxidation associated with a short‐term, energy‐restricted diet.

Research Methods and Procedures: A repeated‐measures, 3‐day diet‐intervention study of adequate (125 kJ/kg of body weight) or restricted (62.5 kJ/kg) energy intake was conducted with 30 women, 20 to 46 years, BMI 25 to 45 kg/m2, whose prior eating behavior was “restrained” or “unrestrained.” The Eating Inventory (cognitive restraint subscale) was used to measure restrained eating behavior. Energy expenditure and substrate oxidation were measured after a 12‐hour fast and during the first and fourth hours after a standard meal. Plasma glucose, nonesterified fatty acids, and insulin were measured at corresponding times. Body composition was determined by total body electrical conductivity.

Results: Resting energy expenditure was not affected by 3 days of energy restriction. Short‐term energy restriction resulted in lower respiratory‐exchange ratios, higher rates of fat oxidation, and lower rates of carbohydrate oxidation. Subjects classified as restrained eaters had higher postprandial respiratory‐exchange ratios and carbohydrate‐oxidation rates compared with unrestrained eaters. Fasting insulin concentrations were lower in restrained eaters. These effects associated with prior eating behavior were independent of the diet intervention.

Discussion: Metabolic outcomes associated with a 3‐day energy‐restricted diet (i.e., increased fat oxidation and decreased carbohydrate oxidation) were not affected by prior restrained eating behavior. However, restrained eating behavior was associated with increased carbohydrate oxidation after a mixed meal. This effect of restrained eating behavior may be attributable to increased insulin sensitivity.
Preventing and Treating Obesity in Girls and Young Women to Curb the Epidemic
Authors: Kral John G.
Published: April 2008

Obesity and its serious comorbidities, type 2 diabetes, coronary heart disease, hypertension, and dyslipidemia, have reached epidemic proportions in adults and children. Female obesity is more prevalent and, thus, has greater epidemiological importance: Mothers transmit the disease epigenetically and genetically. Maternal obesity affects maternal health, pregnancy outcome, and fetal, neonatal, childhood, and ultimately adult morbidity and mortality. Obesity is easy to diagnose, as are most of its risk factors, yet very little progress has been made in preventing the disease.

During a brief period of rapid early growth, there is imprinting of antecedents of adult obesity and obesity‐related disease. Because of the rapidity of this early growth and the relative brevity of the critical period, early recognition and prompt intervention are necessary and possibly sufficient to prevent the development of obesity. Identification of inappropriate rapid weight gain through frequent weighing should trigger immediate adjustment of energy intake, a simple intervention in bottle‐fed infants, the ones at greatest risk for becoming obese.

This review presents a step‐care strategy with fail‐safe action levels starting with maternal education and diet, exercise, and behavior modification for mother and child and progressing to drug treatment and, in selected cases, laparoscopic surgery for young women of childbearing age in whom other measures have failed. This approach is predicated on the assumption that careful monitoring and responsive supplementation of potential deficiencies is easier to achieve, more cost‐effective, and safer than effectively treating manifest obesity and its comorbidities in adults.
Obesity Research in Canada: Literature Overview of the Last 3 Decades
Authors: Sokar‐Todd Hanan B. , Sharma Arya M.
Published: April 2008

Objective: To identify research published on obesity in Canada, to explore the range of areas studied, and to identify gaps and areas that merit future research attention.

Research Methods and Procedures: Medline and International Pharmaceutical Abstracts databases were searched from 1970 onwards. Original articles were identified and categorized by areas of interest.

Results: A total of 1186 relevant articles were identified: 17, 136, 687, and 346 articles during the 1970s, 1980s, 1990s, and 2000 to 2003, respectively. Of the articles, 816 were considered original studies and accepted for this analysis. Twelve research areas were identified: basic science involving animal experiments (29%), human experiments (16%), populations surveys (14%), obesity‐related comorbidities (13%), diagnostic/surgical issues (11%), nonpharmacological approaches (7%), drug‐related issues (4%), anthropometrics (2%), impact of weight loss (2%), cost/healthcare use (1%), attitudes/perceptions (0.9%), and models/procedures (0.5%). Two‐thirds of all research was conducted in Quebec (34%) and Ontario (33%).

Discussion: Given the multifactorial nature of obesity, Canadian obesity research covers a broad range of areas with a predominance of basic science but lesser emphasis on community and primary care studies. Furthermore, there was a paucity of research on either clinical management of medical conditions in obese patients or clinical aspects that go beyond weight loss. Thus, although Canada appears well represented in basic research, more attention to exploration of clinical issues and healthcare delivery for obese patients appears warranted.
Bariatric Surgery Patients’ Views of Their Physicians’ Weight‐Related Attitudes and Practices
Authors: Anderson Drew A. , Wadden Thomas A.
Published: April 2008

Objective: A prior study found that nearly 80% of bariatric surgery patients felt that they were treated disrespectfully by members of the medical profession. This study assessed patient‐physician interactions in a group of bariatric surgery patients and in a group of less obese patients who sought weight loss by other means.

Research Methods and Procedures: A total of 105 bariatric surgery candidates (mean BMI, 54.8 kg/m2) and 214 applicants to a randomized controlled trial of the effects of behavior modification and sibutramine (mean BMI, 37.8 kg/m2) completed a questionnaire that assessed patient‐physician interactions concerning weight.

Results: Only 13% of bariatric surgery patients reported that they were usually or always treated disrespectfully by members of the medical profession, a percentage substantially lower than that found in the previous study. Surprisingly, surgery patients were significantly more satisfied than nonsurgery patients with the care they received for their obesity. Surgery patients also reported significantly more interactions with physicians concerning obesity and weight loss compared with nonsurgery patients. A substantial percentage of both groups, however, reported that their physician did not discuss weight control with them.

Discussion: These and other findings suggest that doctor‐patient interactions concerning weight may have improved in the past decade; however, there is still much room for improvement. Increased efforts are needed to help physicians discuss, assess, and potentially treat obesity in primary care practice.
Assessing Body Composition among 3‐ to 8‐Year‐Old Children: Anthropometry, BIA, and DXA
Authors: Eisenmann Joey C. , Heelan Kate A. , Welk Gregory J.
Published: April 2008

Objective: To examine the inter‐relationships of body composition variables derived from simple anthropometry [BMI and skinfolds (SFs)], bioelectrical impedance analysis (BIA), and dual energy x‐ray (DXA) in young children.

Research Methods and Procedures: Seventy‐five children (41 girls, 34 boys) 3 to 8 years of age were assessed for body composition by the following methods: BMI, SF thickness, BIA, and DXA. DXA served as the criterion measure. Predicted percentage body fat (%BF), fat‐free mass (FFM; kilograms), and fat mass (FM; kilograms) were derived from SF equations [Slaughter (SL)1 and SL2, Deurenberg (D) and Dezenberg] and BIA. Indices of truncal fatness were also determined from anthropometry.

Results: Repeated measures ANOVA showed significant differences among the methods for %BF, FFM, and FM. All methods, except the D equation (p = 0.08), significantly underestimated measured %BF (p < 0.05). In general, correlations between the BMI and estimated %BF were moderate (r = 0.61 to 0.75). Estimated %BF from the SL2 also showed a high correlation with DXA %BF (r = 0.82). In contrast, estimated %BF derived from SFs showed a low correlation with estimated %BF derived from BIA (r = 0.38); likewise, the correlation between DXA %BF and BIA %BF was low (r = 0.30). Correlations among indicators of truncal fatness ranged from 0.43 to 0.98.

Discussion: The results suggest that BIA has limited utility in estimating body composition, whereas BMI and SFs seem to be more useful in estimating body composition during the adiposity rebound. However, all methods significantly underestimated body fatness as determined by DXA, and, overall, the various methods and prediction equations are not interchangeable.
Obesity and Awareness of Obesity as Risk Factors for Breast Cancer in Six Ethnic Groups
Authors: Consedine Nathan S. , Magai Carol , Conway Francine , Neugut Alfred I.
Published: April 2008

Objective: To document BMI and knowledge regarding obesity as a risk factor for breast cancer among subpopulations of African‐, Caribbean‐, and European‐American women and to consider the variables predicting obesity in these diverse groups.

Research Methods and Procedures: A stratified cluster‐sampling plan was used to recruit 1364 older women from Brooklyn, NY, during 2000–2002. Two groups were born in the United States (African Americans and European Americans), whereas others were from the English‐speaking Caribbean, Haiti, the Dominican Republic, and Eastern Europe. Participants provided demographics, height and weight measures, and estimates of the risk obesity posed for breast cancer.

Results: Women from all groups were significantly overweight (BMI > 25 kg/m2), although European Americans were lowest, followed by Dominicans and Haitians; African‐American and English‐speaking Caribbean women fell into the obese range, even when background variables were controlled. Knowledge of obesity as a breast cancer risk factor was also poor across groups, but Dominicans and Haitians had the lowest scores on knowledge. Importantly, knowledge was not associated with BMI in the overall sample, even when controlling for demographics and ethnicity, although logistic regressions comparing normal weight women with overweight and obese groupings suggested some knowledge of breast cancer risk in the overweight, but not the obese, group.

Discussion: The findings remind health professionals of the need to consider more specific ethnic groupings than has hitherto been the case, as well as consider how ethnic and cultural variables may influence perceptions of obesity and its relation to cancer risk.
Weight Counseling Patterns of U.S. Pediatricians
Authors: Rattay Karyl Thomas , Fulton Janet E. , Galuska Deborah A.
Published: April 2008

Objective: To estimate the proportion and characteristics of U.S. pediatricians who reportedly counsel their patients about maintaining a healthy weight.

Research Methods and Procedures: Beginning in October 1998, information was collected from 813 primary care pediatricians randomly selected from a nationally representative sample. Pediatricians were asked how frequently they counseled about maintaining a healthy weight during the well‐care visits of patients in three age groups. Multivariable logistic regression determined which physician characteristics were associated with counseling.

Results: Approximately fifty percent of pediatricians reportedly always counseled about maintaining a healthy weight. Those who always counseled were more likely to be women, to spend more time with patients during well‐care visits, and to conduct more well‐care visits per week from patients in one particular age group. Most pediatricians who responded that they always counseled about healthy weight reported that they counseled about physical activity and nutrition, but not about balancing caloric intake with expenditure.

Discussion: Although many pediatricians report counseling about healthy weight, the frequency of counseling might be further increased by increasing the amount of time the patient spends during office visits with the pediatrician or with other professional staff, such as nurses or dieticians.
Preventing Overestimation of Pixels in Computed Tomography Assessment of Visceral Fat
Authors: Potretzke Aaron M. , Schmitz Kathryn H. , Jensen Michael D.
Published: April 2008

Objective: Computed tomography (CT) is a common research procedure for measuring abdominal fat distribution, but little is written about the software used to analyze images. Our objective was to compare in‐house and commercially available software for quantitative measurement of abdominal fat distribution. In the process, we encountered some unexpected problems.

Research Methods and Procedures: A total of 123 volunteers had single‐slice abdominal CT images taken that were used to evaluate various aspects of the commercial image analysis program.

Results: The agreement between the commercial and in‐house programs was excellent (r = 0.996, p < 0.00, 001) for both total and intraabdominal fat, and we were able to reduce between‐observer variability in measured fat areas through the use of statistical handling of region of interest information. We also noted that intracolonic contents sometimes had the same Hounsfield units as adipose tissue. We analyzed single‐slice CT images from 50 volunteers to determine the potential impact of this effect on visceral fat area; the overestimate of visceral fat area was 19 ± 22% (maximum, 112% overestimate). The commercial program could prevent this error, whereas our in‐house program could not.

Discussion: We concluded that a readily available commercial image analysis program compares well with a previously validated in‐house program and that it offers some advantages with respect to preventing overestimation of pixels as visceral fat.
Alterations of Gastrointestinal Motility in Obesity
Authors: Xing Jinhong , Chen Jiande D.Z.
Published: April 2008

All nutrients are absorbed in the gastrointestinal (GI) system, and GI motility plays a very critical role in the consumption of foods, digestion, and absorption of nutrients. Various segments of the GI tract (esophagus, stomach, and intestines) coordinate in a complex yet precise way to control the process of food consumption, digestion, and absorption of nutrients. GI motility not only regulates the rates at which nutrients are processed and absorbed in the gut but also participates in the control of appetite and satiety. Altered GI motility has been associated with various disease conditions (gastroparesis, etc.) and has been frequently observed in obese patients. The significance of these GI motility alterations in obesity is not fully understood, but they have been considered as potential contributing factors in the development and maintenance of obesity and changed eating behavior. Therapies aimed at regulating GI motility are being actively explored and applied clinically for the management of obese patients. To better understand the pathophysiology of obesity, we systematically reviewed GI motility changes observed in obese conditions. The relationship and pathological significance of these findings, as well as the potential therapies by modification of GI motility, are also discussed.
Polymorphisms in PLIN and Hypertension Combined with Obesity and Lipid Profiles in Han Chinese
Authors: Yan Weili , Chen Shufeng , Huang Jianfeng , Shen Yan , Qiang Boqin , Gu Dongfeng
Published: April 2008

The current study investigated the association between PLIN polymorphisms and the combination of hypertension and obesity (HO) and the related clinical features. The polymorphisms 1237 (T/C), 1243 (C/T), and 1323 (C/G) were genotyped in 503 cases with HO and 511 unrelated controls. No associations between polymorphism 1237 (T/C) or 1243 (C/T) and HO were found. However, total cholesterol (TC) levels were significantly different among genotypes of polymorphism 1243 (p = 0.023, power = 0.55). In male cases, 1243T carriers (TT + CT) had higher TC, high‐density lipoprotein‐cholesterol, and low‐density lipoprotein‐cholesterol levels compared with CC homozygote carriers (5.23 ± 0.88 vs. 4.98 ± 0.90, p = 0.024; 1.13 ± 0.23 vs. 1.07 ± 0.22 mM, p = 0.034; 3.3 ± 0.78 vs. 3.11 ± 0.80, p = 0.03, respectively). Additionally, 1243T allele carriers were more prevalent among the subjects with both HO and elevated TC levels (≥5.2 mM) than those with HO and optimal TC levels (<5.2 mM) (χ2 = 8.53; p < 0.003; odds ratio, 1.69; 95% confidence interval, 1.19∼2.42). Multiple logistic regression analysis suggested a significant contribution of polymorphism 1243 to the elevated TC levels after controlling for conventional risk factors (odds ratio, 1.48; 95% confidence interval, 1.14∼1.91; p = 0.003). Polymorphism 1243 in the PLIN gene did not seem to be associated with HO but with TC levels in Chinese. The PLIN gene may be involved in human lipid metabolism.
The FOXC2 C‐512T Polymorphism Is Associated with Obesity and Dyslipidemia
Authors: Carlsson Emma , Almgren Peter , Hoffstedt Johan , Groop Leif , Ridderstråle Martin
Published: April 2008

The transcription factor FOXC2 has been implicated in resistance to diet‐induced obesity and insulin resistance. To investigate the possible role for FOXC2 in obesity and related phenotypes, we performed two association studies for obesity using unrelated case‐control materials by genotyping the FOXC2 C‐512T polymorphism. In the first study (127 obese and 127 normal‐weight nondiabetic subjects matched for age and sex), the C‐allele showed association with obesity, odds ratio 1.74 (1.12 to 2.73; p < 0.01) for the C‐ vs. T‐allele and 1.81 (1.04 to 3.25; p < 0.05) for the C/C and C/T vs. T/T genotype. BMI was higher in carriers of the C/C and C/T genotype in normal weight [adjusted p value (padj) = 0.02] but not in obese subjects (padj = 0.1). In the replication study (223 obese and 231 nonobese subjects), subjects with the C/C genotype exhibited an increased risk for obesity, odds ratio 2.01 (1.15 to 3.52; p = 0.01). Obese carriers of the C‐allele had lower high‐density lipoprotein‐cholesterol [1.1 (0.9 to 1.3) vs. 1.2 (1.0 to 1.4) mM, padj = 0.006] and increased triglyceride levels (1.95 [1.30 to 2.68] vs. 1.60 [1.10 to 2.40] mM, padj = 0.02) compared with obese carriers of the T/T genotype. Our data suggest that FOXC2 is a weak but consistent candidate gene for obesity and dyslipidemia.
n‐3 Fatty Acids Modulate T‐Cell Calcium Signaling in Obese Macrosomic Rats
Authors: Guermouche Baya , Yessoufou Akadiri , Soulimane Nassima , Merzouk Hafida , Moutairou Kabirou , Hichami Aziz , Khan Naim Akhtar
Published: April 2008

Objective: We investigated the effects of a diet containing EPAX‐7010, rich in PUFAs such as eicosapentaenoic acid [20:5(n‐3)] and docosahexaenoic acid [22:6(n‐3)], i.e., a PUFA/EPAX regimen, on T‐cell activation in diabetic pregnant rats and their obese pups.

Research Methods and Procedures: Mild hyperglycemia in pregnant rats was induced by intraperitoneal injection of streptozotocin on Day 5 of gestation. T‐cell blastogenesis was assayed by using 3H‐thymidine, whereas intracellular free calcium concentrations ([Ca2+]i) were measured by using Fura‐2 in diabetic pregnant rats and their obese offspring.

Results: Concavalin‐A‐stimulated T‐cell proliferation was decreased in both pregnant diabetic rats and their obese pups as compared with control animals. Feeding the PUFA/EPAX diet restored T‐cell proliferation in both groups of animals. We also employed ionomycin, which at 50 nM opens calcium channels, and thapsigargin (TG), which recruits [Ca2+]i from endoplasmic reticulum pool. We observed that ionomycin‐induced increases in [Ca2+]i in T‐cells of diabetic mothers and obese offspring were greater than in those of control rats. Furthermore, feeding PUFA/EPAX diet diminished significantly the ionomycin‐evoked rise in [Ca2+]i in diabetic and obese animals. TG‐induced increases in [Ca2+]i in T‐cells of diabetic pregnant rats and their obese offspring were greater than in those of control rats. The feeding of the experimental diet significantly curtailed the TG‐evoked increases in [Ca2+]i in both diabetic and obese rats.

Discussion: Together, these observations provide evidence that T‐cell activation and T‐cell calcium signaling are altered during gestational diabetes and macrosomia. Hence, dietary fish oils, particularly eicosapentaenoic acid and docosahexaenoic acid, may restore these T‐cell abnormalities.
Pleiotropic Effects of Genes for Insulin Resistance on Adiposity in Baboons
Authors: Cai Guowen , Cole Shelley A. , Tejero M. Elizabeth , Proffitt John M. , Freeland‐Graves Jeanne H. , Blangero John , Comuzzie Anthony G.
Published: April 2008

Objective: Previous research has suggested a genetic contribution to the development of insulin resistance and obesity. We hypothesized that the same genes influencing insulin resistance might also contribute to the variation in adiposity.

Research Methods and Procedures: A total of 601 (200 male, 401 female) adult baboons (Papio hamadryas) from nine families with pedigrees ranging in size from 43 to 121 were used in this study. Plasma insulin, glucose, C‐peptide, and adiponectin were analyzed, and homeostasis model assessment of insulin resistance (HOMA IR) was calculated. Fat biopsies were collected from omental fat tissue, and triglyceride concentration per gram of fat tissue was determined. Body weight and length were measured, and BMI was derived. Univariate and bivariate quantitative genetic analyses were performed using SOLAR.

Results: Insulin, glucose, C‐peptide, and adiponectin levels, HOMA IR, triglyceride concentration of fat tissue, body weight, and BMI were all found to be significantly heritable, with heritabilities ranging from 0.15 to 0.80. Positive genetic correlations (rGs) were observed for HOMA IR with C‐peptide (rG = 0.88 ± 0.10, p = 0.01), triglyceride concentration in fat tissue (rG = 0.86 ± 0.33, p = 0.02), weight (rG = 0.50 ± 0.20, p = 0.03), and BMI (rG = 0.64 ± 0.22, p = 0.02).

Discussion: These results suggest that a set of genes contributing to insulin resistance also influence general and central adiposity phenotypes. Further genetic research in a larger sample size is needed to identify the common genes that constitute the genetic basis for the development of insulin resistance and obesity.
Circadian Eating and Sleeping Patterns in the Night Eating Syndrome
Authors: O'Reardon John P. , Ringel Brenda L. , Dinges David F. , Allison Kelly Costello , Rogers Naomi L. , Martino Nicole S. , Stunkard Albert J.
Published: April 2008

Objective: To compare the eating and sleep‐wake patterns of persons with the night eating syndrome (NES) with those of matched control subjects.

Research Methods and Procedures: Forty‐six overweight/obese NES subjects (mean age 43.3 ± 9.8 years; 32 women) and 43 similar controls (mean age 39.0 ± 11.0 years; 28 women) wore wrist actigraphs for 7 days and completed sleep and food diaries at home.

Results: There was no difference between the total energy intake of the NES and the control subjects, but the pattern of energy intake differed greatly. Relative to control subjects, the temporal pattern of food intake of night eaters was delayed. Food intake after the evening meal, as a proportion of the 24‐hour intake, was more than 3‐fold greater in NES subjects than in controls (34.6 ± 10.1% vs. 10.0 ± 6.9%, p = 0.001). NES subjects had sleep onset, offset, and total sleep duration times comparable with those of controls. NES subjects reported more nocturnal awakenings than did controls (1.5 ± 1.0 per night vs. 0.5 ± 0.5; p < 0.001), and their actigraphically monitored arousals occurred earlier during sleep (at 128 minutes after sleep onset vs. 193 minutes, p = 0.01). NES subjects consumed food on 74% of the awakenings vs. 0% for the controls.

Discussion: The pattern of cumulative energy intake of the night eaters suggests a phase delay in energy consumption relative to sleep‐wake times. NES may involve a dissociation of the circadian control of eating relative to sleep.
Impact of Obesity and Body Fat Distribution on Cardiovascular Risk Factors in Hong Kong Chinese
Authors: Thomas G. Neil , Ho Sai‐Yin , Lam Karen S.L. , Janus Edward D. , Hedley Anthony J. , Lam Tai Hing ,   Hong Kong Cardiovascular Risk Factor Prevalence Study Steering Committee
Published: April 2008

Objective: Body fat distribution has been reported to differentially contribute to the development of cardiovascular risk. We report the relative associations between general and central obesity and risk factors in 2893 Chinese subjects recruited from the Hong Kong population.

Research Methods and Procedures: Anthropometric parameters [waist circumference (WC) and BMI], surrogate measures of insulin resistance (fasting plasma glucose and insulin, oral glucose tolerance test, 2 hours glucose and insulin), fasting lipids (total, low‐density lipoprotein‐cholesterol, high‐density lipoprotein‐cholesterol, and triglycerides) and systolic and diastolic blood pressure were measured. General obesity was classified as BMI ≥25.0 kg/m2 and central obesity as a WC ≥80 or ≥90 cm in women and men, respectively.

Results: A total of 39.2% of the population was found to be obese. Obesity per se increased the levels of the risk factors, but central adiposity contributed to a greater extent to adverse high‐density lipoprotein‐cholesterol, triglyceride, and insulin resistance levels. There was a continuous relationship between increasing obesity, both general and central, and cardiovascular risk, with lowest risk associated with the lowest indices of obesity. In the 1759 nonobese subjects divided into quartiles of BMI or WC, the levels of the cardiovascular risk factors still significantly increased with increasing quartiles of adiposity.

Discussion: Central adiposity appears to contribute to a greater extent than general adiposity to the development of cardiovascular risk in this population. The relationship between obesity parameters and risk is a continuum, with risk factors significantly increasing even at levels usually considered nonobese. These observations support the proposed redefinition of overweight and obesity in Asian populations using lower cut‐off points.
Weight Loss Intervention for Obese Older Women: Improvements in Performance and Function
Authors: Jensen Gordon L. , Roy Marie‐Andrée , Buchanan Alice E. , Berg Melanie B.
Published: April 2008

Objectives: To determine the feasibility of a 3‐month weight loss program for obese older women with short‐term laboratory, performance, functional, and life quality outcomes.

Research Methods and Procedures: This was a pre‐ and postintervention design. Community‐dwelling women (n = 26) ≥60 years old with BMI ≥30 were enrolled in a 3‐month weight loss program promoting prudent diet, behavior modification, and physical activity. The primary emphasis of the program was on health, function, and quality of life. The approach was specifically tailored to older subjects through use of large‐font instructional materials, supplementation of calcium and vitamin D, and moderate weight loss and physical activity goals. An initial assessment by a bariatric physician was followed by eight visits with a dietitian and a follow‐up physician visit. Measurements included anthropometrics, body composition, laboratories, pedometer, physical performance, Short‐Form 36 Health Status Survey (SF‐36), Life Space Assessment, and dietary assessment.

Results: Eighteen participants completed the program. There was a significant decrease in mean body weight (100 ± 15 vs. 96 ± 18 kg, p = 0.006), with a mean weight loss of 4.3 ± 5.5 kg (range −15.5 to +7.20 kg). Significant improvements were observed for diastolic blood pressure, total cholesterol, triglycerides, physical performance, pedometer‐measured step counts, and step climb and descent. Self‐rated physical functioning (SF‐36 subscore) and vitality (SF‐36 subscore) were also significantly improved.

Discussion: It is feasible for self‐selected obese older women to achieve a moderate weight loss and increase in physical activity resulting in short‐term improvements in laboratory, physical performance, self‐reported function, vitality, and life quality outcomes.
The Long‐Term Management of Obesity with Continuing Pharmacotherapy
Authors: Frank Arthur
Published: April 2008

Objective: Long‐term, possibly lifetime, use of medications for the management of obesity may be thought to be similar to the use of pharmacotherapy for other chronic diseases such as hypertension or diabetes. Because there have been no systematic studies of this extended use, the experience of eight patients who have used obesity medications in a sustaining manner was studied.

Research Methods and Procedures: The clinical characteristics of eight adult patients, each of whom has experience with long‐term (more than 10 years) use of medications for weight loss and weight maintenance, were studied.

Results: The clinical experience of these eight patients was analyzed. Each chose to sustain the use of weight management medications for more than 10 years because of perceived benefit, comfort, and the absence of significant side effects. There has been no evidence of the development of tolerance, addiction, or misuse and no adverse events related to the medication. The beneficial effects of the medication have not diminished with time.

Discussion: The clinical characteristics of eight patients, each of whom has used obesity pharmacotherapy for more than 10 years, are described. The experience of these eight individuals cannot be generalized to the entire population of overweight or obese patients. It does suggest, however, that some patients respond successfully to this form of therapy and that they will derive value from it for the management of this disease. Efforts should be made to identify these patients, and consideration should be given to the use of chronic medications for the continuing management of obesity.
Economics and Obesity: Costing the Problem or Evaluating Solutions?
Authors: Roux Larissa , Donaldson Cam
Published: April 2008

There is no doubt that obesity is a major public health problem. However, what is the contribution of economics to solving it? In this report, we make the case that the role of economics is not in measuring the economic burden of obesity, through so‐called cost‐of‐illness studies. Such studies merely confirm that obesity is a serious societal issue; adding a monetary figure to this does not add much. The economic foundations of such estimates can also be questioned, thus lessening their policy relevance. The real value of economics in the arena of obesity care is in evaluating, through formal economic evaluation, the use of our scarce health care resources in different strategies to prevent and treat obesity.
The Association between Weight Perception and BMI among High School Students
Authors: Brener Nancy D. , Eaton Danice K. , Lowry Richard , McManus Tim
Published: April 2008

Objective: To assess the association between weight perception and BMI among a large, diverse sample of adolescents. This study used both measured and self‐reported height and weight to calculate BMI.

Research Methods and Procedures: A convenience sample of students (n = 2032) in grades 9 through 12 completed a questionnaire assessing demographic characteristics, self‐reported height and weight, and body weight perception. These students were then weighed and had their height measured using a standard protocol.

Results: Using BMI calculated from measured height and weight, 1.5% of students were classified as underweight or at risk for underweight, 51.2% of students were normal weight, and 47.4% were overweight or at risk for overweight. Among this same sample of students, however, 34.8% perceived themselves as underweight, 42.9% perceived themselves as about the right weight, and 22.3% perceived themselves as overweight. Even when using BMI calculated from self‐reported height and weight, >20% of students who were overweight or at risk for overweight perceived themselves as underweight.

Discussion: Because perception of overweight is a key determinant of adolescent nutritional habits and weight management, many students who are overweight or at risk for overweight but who do not perceive themselves as such are unlikely to engage in weight control practices. Increasing awareness of medical definitions of overweight might improve accuracy of weight perceptions and lead to healthier eating and increased physical activity.
Energy Intake and Meal Portions: Associations with BMI Percentile in U.S. Children
Authors: Huang Terry T‐K , Howarth Nancy C. , Lin Biing‐Hwan , Roberts Susan B. , McCrory Megan A.
Published: April 2008

Objective: We examined relationships of eating patterns and reported energy intake (rEI) with BMI percentile in U.S. children.

Research Methods and Procedures: Two 24‐hour dietary recalls from the Continuing Surveys of Food Intakes by Individuals 1994 to 1996 and 1998 (1005 boys, 990 girls) were averaged, and children were categorized into three age groups: 3 to 5 years (n = 1077), 6 to 11 years (n = 537), and 12 to 19 years (n = 381). Physiologically implausible reports due to reporting bias or abnormal intake (rEI outside ±18% to 23% of predicted energy requirements; pER) were identified.

Results: rEI averaged 109 ± 34% and 100 ± 10% of pER in the total and plausible samples, respectively. EI was overreported more in younger children and underreported more in overweight older children. Children with plausible rEI (45.3% of sample) averaged 4.7 eating occasions/d, 589 kcal/meal, 223 kcal/snack, and 2038 kcal/d. rEI was not associated with BMI percentile in the total sample. In the plausible sample, rEI, meal portion size, and meal energy were positively associated with BMI percentile in boys 6 to 11 years and in children 12 to 19 years. No relationships were found in children 3 to 5 years and girls 6 to 11 years. Relationships were more consistent and stronger in the plausible compared with the total sample.

Discussion: Excluding implausible dietary reports may be necessary for discerning dietary associations with BMI percentile. EI and meal, but not snack, patterns may play a quantitatively greater role in weight regulation as children age.
Sustained Weight Loss in Obese Subjects Has Benefits That Are Independent of Attained Weight
Authors: Dixon John B. , Anderson Margaret , Cameron‐Smith David , O'Brien Paul E.
Published: April 2008

Objective: To explore the hypothesis that sustained weight loss in severely obese patients may have benefits that are independent of their attained BMI.

Research Methods and Procedures: We conducted a comparison of two weight‐stable groups with BMI in the 30 to 35 kg/m2 range. Subjects (n = 79) were selected obese patients 3 years after laparoscopic adjustable gastric band surgery, and controls (n = 79) were obese patients seeking weight loss therapy. Subjects were selected in a de‐identified manner from our database to best match the control group. A range of clinical, biochemical, and questionnaire measures were obtained to assess obesity‐related health status

Results: Subjects maintained a mean weight loss of 32.8 ± 18 kg after surgery. The weight loss subjects had significantly lower fasting plasma glucose, insulin, and triglyceride concentrations, along with higher high‐density lipoprotein‐cholesterol levels and better indirect measures of insulin sensitivity when compared with controls (p < 0.05 for all). In addition, aminotransferase levels, neutrophil counts, and globulin levels were also significantly lower in weight loss subjects. All differences in laboratory variables remained significant after controlling for BMI. The subjects also reported better health‐related quality of life, fewer symptoms of depression, and greater satisfaction with their appearance than controls.

Discussion: These findings suggest that the post‐weight loss state conveys benefits that are greater than predicted by the attained BMI. These findings may have important implications regarding the expectations of weight loss therapy, and mechanisms for this effect should be carefully sought.