bluuebunny/crossref_metadata_2025 huggingface dataset:
Obesity Stigma in Sexual Relationships
Authors: Chen Eunice Y. , Brown Molly
Published: April 2008

Objective: Obese children are stigmatized in same‐sex relationships. This study examines whether, in adulthood, obesity stigma exists in adults when they are asked to rank order preferences for a sexual partner.

Research Methods and Procedures: Following the methods of Richardson et al. (Richardson SA, Goodman N, Hastorf AH, Dornbusch SM. Cultural uniformity in reaction to physical disabilities. Am Sociol Rev. 1961;26:241–247) and Latner and Stunkard (Latner J, Stunkard AJ, Wilson GT. Age, ethnic and gender differences in stigmatization of obesity. Orlando, FL: International Conference on Eating Disorders; 2004), 449 college students were asked to rank order six drawings of potential sexual partners. The drawings included an obese partner, partners with various other disabilities, and a healthy partner.

Results: The least‐preferred partners were obese. Men, compared with women, provided significantly lower ranks for obese partners (U = 20, 180.00, z = −2.84, p = 0.01).

Discussion: Despite the fact that the majority of adults in the U.S. are overweight, discrimination on the basis of weight occurs in making a choice of a sexual partner. Males particularly make choices of partner based on their weight. Obesity stigma may specifically affect women in sexual relationships. Weight‐related stigma needs to be addressed in the treatment of binge eating disorder or weight management. Finding ways to change attitudes and behavior toward the overweight is a goal for future research in the area.
Obesity and Weight Control Practices in 2000 Among Veterans Using VA Facilities
Authors: Wang Anthea , Kinsinger Linda S. , Kahwati Leila C. , Das Sandeep R. , Gizlice Ziya , Harvey Richard T. , Burdick Mary B. , Yevich Steven J.
Published: April 2008

Objective: To examine obesity prevalence and weight control practices among veterans who use Department of Veterans Affairs (VA) medical facilities (VA users).

Research Methods and Procedures: Data from the 2000 Behavioral Risk Factor Surveillance System, a telephone survey of 184, 450 adults, were analyzed. Outcome measures included BMI, weight control practices (the intent to manage weight, and diet and physical activity patterns), and receipt of professional weight control advice.

Results: Of VA users, 44% were overweight and 25% were obese. After controlling for demographic factors, VA users were somewhat less likely to be overweight (odds ratio, 0.86; 95% confidence interval, 0.74 to 1.00) but equally likely to be obese (odds ratio, 1.08; 95% confidence interval, 0.92 to 1.27), compared with non‐VA users. Among obese VA users, 75% reported trying to lose weight, and another 17% reported trying to maintain weight. Of these, only 40% decreased both calorie and fat intake. Only 27% of obese VA users who reported increasing exercise to lose weight followed recommendations for regular and sustained physical activity. Of obese VA users, 59% were inactive or irregularly active. Only 51% of obese VA users received professional advice to lose weight. Obese VA users were more likely than obese non‐VA users to report trying to lose weight, modifying diet to lose weight by decreasing both calories and fat intake, and receiving professional weight control advice.

Discussion: Interventions for weight management programs in VA facilities need to take into account the high prevalence of overweight/obesity among VA users and should emphasize effective weight control practices.
Cross‐Sectional and Longitudinal Associations of BMI with Socioeconomic Characteristics
Authors: Mujahid Mahasin S. , Diez Roux Ana V. , Borrell Luisa N. , Nieto F. Javier
Published: April 2008

Objective: To examine cross sectional and longitudinal associations of socioeconomic position and neighborhood environments with BMI in a middle‐aged and bi‐ethnic cohort.

Research Methods and Procedures: Analyses were based on 13, 167 subjects (45 to 64 years) who participated in the Atherosclerosis Risk in Communities Study, a population‐based study. Census block groups were used as proxies for neighborhoods and were characterized using a summary socioeconomic score. BMI was measured at baseline and at three follow‐up visits over a 9‐year period.

Results: Individual and neighborhood socioeconomic characteristics were independently and inversely associated with BMI at baseline in women [mean difference in kilograms per meter squared per unit increase in socioeconomic category (SE) for white and black women respectively; −1.56 (0.14), −1.59 (0.19) for education; −1.07 (0.10), −1.18 (0.18) for income; and −1.04 (0.09), −0.77 (0.18) for neighborhood characteristics]. Results for men were not as consistent. Baseline BMI was negatively associated with income in white men but was positively associated with education, income, and neighborhood characteristics in black men. BMI increased over time regardless of gender or race and in most age groups. In whites, there were no consistently patterned differences in longitudinal trends in BMI by individual or neighborhood socioeconomic characteristics. However, in blacks, there was some evidence of greater increases in the higher socioeconomic status groups.

Discussion: Socioeconomic factors are inversely associated with BMI in middle‐aged women, possibly reflecting socially patterned exposures occurring in childhood and adolescence. However, recent increases over time in BMI are either not clearly patterned by socioeconomic factors or are greater in the higher socioeconomic status groups.
Obesity Impacts on General Practice Appointments
Authors:   Counterweight Project Team
Published: April 2008

Objective: To quantify the impact of obesity on the number of visits to both primary and secondary care teams.

Research Methods and Procedures: The adult populations of 80 general practices throughout the United Kingdom were classified according to their BMI. We undertook a cross‐sectional survey of computer‐generated and handwritten records of 6150 obese people (BMI ≥ 30 kg/m2) and 1150 normal weight (BMI = 18.5 to 24.9 kg/m2) control subjects over an 18‐month retrospective period.

Results: Obese patients made significantly more visits to the general practitioner (GP), practice nurse (PN), and hospital outpatient units than normal weight patients (all p < 0.001), and they were admitted to the hospital more often (p = 0.034). For both GP and PN visits, the relationship remained after adjusting for age, sex, social deprivation category, country, and number of comorbidities. Among obese patients, there was an increasing relationship between frequent GP visits (at least four appointments) and greater BMI, which remained significant after adjustment had been made for age, sex, deprivation, country, and number of comorbidities.

Discussion: The human resource burden to general practice is significantly higher in the obese population than in the normal weight population, even when adjusted for confounding factors. The increase in prevalence of obesity will continue to put pressure on GP and PN time unless appropriate action is taken.
BMI, Physical Activity, and Health Care Utilization/Costs among Medicare Retirees
Authors: Wang Feifei , McDonald Tim , Reffitt Bonnie , Edington Dee W.
Published: April 2008

Objective: To examine the influence of physical activity (PA) and BMI on health care utilization and costs among Medicare retirees.

Research Methods and Procedures: This cross‐sectional study was based on 42, 520 Medicare retirees in a U.S.‐wide manufacturing corporation who participated in indemnity/perferred provider and one health risk appraisal during the years 2001 and 2002. Participants were assigned into one of the three weight groups: normal weight, overweight, and obese. PA behavior was classified into three levels: sedentary (0 time/wk), moderately active (1 to 3 times/wk), and very active (4+ times/wk).

Results: Generalized linear models revealed that the moderately active retirees had $1456, $1731, and $1177 lower total health care charges than their sedentary counterparts in the normal‐weight, overweight, and obese groups, respectively (p < 0.01). The very active retirees had $1823, $581, and $1379 lower costs than the moderately active retirees. Health care utilization and specific costs showed similar trends with PA levels for all BMI groups. The total health care charges were lower with higher PA level for all age groups (p < 0.01).

Discussion: Regular PA has strong dose‐response effects on both health care utilization and costs for overweight/obese as well as normal‐weight people. Promoting active lifestyle in this Medicare population, especially overweight and obese groups, could potentially improve their well‐being and save a substantial amount of health care expenditures. Because those Medicare retirees are hard to reach in general, more creative approaches should be launched to address their needs and interests as well as help reduce the usage of health care system.
Effort‐Related Calf Pain in the Obese and Long‐Term Changes after Surgical Obesity Treatment**
Authors: Karason Kristjan , Peltonen Markku , Lindroos Anna Karin , Sjöström Lars , Lönn Lars , Torgerson Jarl S.
Published: April 2008

Objective: To compare the prevalence of effort‐related calf pain in an obese and a general population and to analyze the incidence of and recovery from such pain after surgical and conventional obesity treatment.

Research Methods and Procedures: A random sample of 1135 subjects from a general population was compared with 6328 obese subjects in the Swedish Obese Subjects study. Obese subjects were followed longitudinally, and information about calf pain was obtained from surgically and conventionally treated patients for up to 6 years.

Results: In both sexes, self‐reported calf pain was more common in the obese than in the general population [odds ratios (ORs) 5.0 and 4.0 in men and women, respectively, p < 0.001]. Obese patients undergoing surgery had a lower 6‐year incidence of calf pain compared with the conventionally treated control group (ORs 0.39 and 0.61, p < 0.05). Among subjects reporting symptoms at baseline, the 6‐year recovery rate was higher in the surgical group compared with the control group (ORs 15.3 and 5.9, p < 0.001).

Discussion: Obese subjects have markedly more problems with effort‐related calf pain than the general population. Surgical obesity treatment reduces the long‐term risk of developing claudication symptoms and increases the likelihood of recovering from such symptoms.
Association of Proopiomelanocortin Gene Polymorphisms with Obesity in the IRAS Family Study
Authors: Sutton Beth S. , Langefeld Carl D. , Williams Adrienne H. , Norris Jill M. , Saad Mohammed F. , Haffner Steven M. , Bowden Donald W.
Published: April 2008

Proopiomelanocortin (POMC) has been found to be associated with rare Mendelian forms of obesity in children, and, in linkage studies, genomic regions containing the POMC locus have been linked to leptin levels, a predictor of obesity, in white, Mexican‐American, and African‐American families. POMC polymorphisms have not been investigated in detail for association with obesity in the general population. Five single nucleotide polymorphisms (SNPs) (G‐3460C, C17T, G3473A, C3755T, and A7069G) were genotyped on 811 Hispanic individuals in the Insulin Resistance Atherosclerosis Family Study and tested for association with multiple obesity quantitative traits. General and family‐based association analyses for each individual SNP and for haplotypes were performed using the generalized estimating equation and quantitative pedigree disequilibrium test (QPDT), respectively. Modest but consistent associations were observed for SNP C3755T, with p values ranging from 0.011 to 0.045 for association with BMI, waist, visceral adipose tissue, and subcutaneous adipose tissue. G‐3460C, G3473A, and A7069G were also found to be associated with additional obesity measurements (p value 0.025 to 0.04), with comparable levels of evidence observed for linkage disequilibrium between these traits and these SNPs. Results of the haplotype analyses were also consistent with the single SNP analysis, with haplotypes containing C3755T showing the greatest evidence of association (p values ranging 0.004 to 0.048). Monte Carlo simulations (gene dropping) that account for the number of comparisons and the correlation structure indicate that the multivariate significance for these obesity traits with these polymorphisms was p = 0.0091. Collectively, the POMC polymorphisms showed consistent evidence for association with obesity traits in Hispanic Americans across several analytical approaches using SNP and haplotype analysis. These results support the hypothesis that POMC contributes genetically to the development of obesity.
Body Mass Index Cutoffs for Underweight, Overweight, and Obesity in South Korean Schoolgirls
Authors: Kim Eunkyung , Hwang Ji‐Yun , Woo Eun‐Kyung , Kim Sung‐Soo , Jo Sangmee Ahn , Jo Inho
Published: April 2008

Objectives: To establish BMI percentiles and cutoffs for underweight, overweight, and obesity in South Korean schoolgirls.

Research Methods and Procedures: A total of 1229 South Korean schoolgirls aged 8 to 18 years were randomly selected to complete a self‐administered questionnaire. BMI charts and cutoffs were constructed after analyzing data from 1107 subjects. Percentile curves were established by the modified LMS method.

Results: The percentiles for underweight, overweight, and obesity corresponding to BMI of 18.5, 23.0, and 25.0 kg/m2 at age 18 were the 13.0th percentile, the 77.8th percentile, and the 91.2nd percentile, respectively. The corresponding prevalences of underweight, overweight, and obesity were 12.1, 12.5, and 9.8%, respectively.

Discussion: We established for the first time, to our knowledge, new BMI cutoffs for ages 8 to 18 that corresponded to BMIs of 18.5, 23.0, and 25.0 kg/m2 for Asian adults designated by the International Obesity Task Force. These newly established BMI cutoffs might help to estimate the prevalence of overweight and obesity in Asian children.
Anthropometric Indices and the Incidence of Hypertension: A Comparative Analysis
Authors: Fuchs Flávio D. , Gus Miguel , Moreira Leila B. , Moraes Renan S. , Wiehe Mário , Pereira Gérson M. , Fuchs Sandra C.
Published: April 2008

Objective: To investigate the association between several anthropometric measurements of obesity with the incidence of hypertension.

Research Methods and Procedures: Participants were 592 individuals free of hypertension, selected at random from the community. In the baseline evaluation, they were submitted to completed measures of demographics, anthropometrics, blood pressure, and other risk factors for hypertension. Incident hypertension was defined by blood pressure equal or higher than 140/90 mm Hg or use of blood pressure‐lowering drugs.

Results: During a mean follow‐up time of 5.6 ± 1.1 years, 127 developed hypertension. The hazard ratios for the development of hypertension, adjusted for age, baseline blood pressure, gender, and alcohol consumption, were 1.042 (p = 0.091) for BMI, 1.023 (p = 0.028) for waist circumference, 1.042 (p = 0.013) for waist‐to‐height ratio, 1.061 (p = 0.014) for waist‐to‐height2 index, 1.079 (p = 0.022) for waist‐to‐height3 index, and 1.033 (p = 0.006) for the waist‐to‐hip ratio.

Discussion: The correction of the circumference of waist for stature or hip circumference improves its performance in the prediction of the incidence of hypertension.
Adiponectin Levels during Low‐ and High‐Fat Eucaloric Diets in Lean and Obese Women
Authors: Berk Evan S. , Kovera Albert J. , Boozer Carol N. , Pi‐Sunyer F.X. , Johnson Julia A. , Albu Jeanine B.
Published: April 2008

Objective: Adiponectin influences insulin sensitivity (SI) and fat oxidation. Little is known about changes in adiponectin with changes in the fat content of eucaloric diets. We hypothesized that dietary fat content may influence adiponectin according to an individual's SI.

Research Methods and Procedures: We measured changes in adiponectin, insulin, glucose, and leptin in response to high‐fat (HF) and low‐fat (LF) eucaloric diets in lean (n = 10) and obese (n = 11) subjects. Obese subjects were further subdivided in relation to a priori SI.

Results: We found significantly higher insulin, glucose, and leptin and lower adiponectin in obese vs. lean subjects during both HF and LF. The mean group values of these measurements, including adiponectin (lean, HF 21.9 ± 9.8; LF, 20.8 ± 6.6; obese, HF 10.0 ± 3.3; LF, 9.5 ± 2.3 ng/mL; mean ± SD), did not significantly change between HF and LF diets. However, within the obese group, the insulin‐sensitive subjects had significantly higher adiponectin during HF than did the insulin‐resistant subjects. Additionally, the change in adiponectin from LF to HF diet correlated positively with the obese subjects’ baseline SI.

Discussion: Although in lean and obese women, group mean values for adiponectin did not change significantly with a change in fat content of a eucaloric diet, a priori measured SI in obese subjects predicted an increase in adiponectin during the HF diet; this may be a mechanism that preserves SI in an already obese group.
Cariporide Counteracts Atherosclerosis‐related Functions in Monocytes from Obese and Normal Individuals
Authors: Kaloyianni Martha , Zolota Zacharoula , Paletas Konstantinos , Tsapas Apostolos , Koliakos George
Published: April 2008

Objective: This study aimed to show the effect of high glucose concentrations in combination with a pharmaceutical analog of the Na+/H+ antiport inhibitor, cariporide, on scavenger receptor CD36 expression, cell adhesion, and cell migration of human monocytes derived from obese and normal individuals.

Research Methods and Procedures: Monocytes were isolated from six healthy obese individuals and six healthy age‐ and sex‐matched controls by use of whole blood Percoll sedimentation and plastic surface monocyte binding. The density of CD36 scavenger receptors on the surface of monocytes was assessed by the use of a fluorescent fluorescein isothiocyanate (FITC)‐linked monoclonal antibody. Transmigration of monocytes through laminin‐1–coated filters was performed on 5‐μm pore Transwell culture inserts. Monocyte attachment to laminin was estimated by a solid phase assay.

Results: High glucose concentrations caused an increase in monocytes from normal and obese individuals in the expression of CD36 receptors and positively influenced monocyte migration and adhesion to laminin. Cariporide together with glucose counteracted these effects. The effects of migration and adhesion of monocytes to laminin were specific to glucose, because the effect was significantly higher when monocytes were incubated in the presence of 20 mM of glucose than in the presence of 20 mM of fructose. Monocytes from obese subjects showed greater response than in normal to all of the studied effects, with the highest response in laminin attachment.

Discussion: The data of this study suggest that cariporide counteracts atherosclerosis‐related functions through Na+/H+ antiport inhibition in monocytes from both normal and obese individuals.
Familial Resemblance in Eating Behaviors in Men and Women from the Quebec Family Study
Authors: Provencher Véronique , Pérusse Louis , Bouchard Luigi , Drapeau Vicky , Bouchard Claude , Rice Treva , Rao D.C. , Tremblay Angelo , Després Jean‐Pierre , Lemieux Simone
Published: April 2008

Objective: It is commonly recognized that genetic, environmental, behavioral, and social factors are involved in the development of obesity. The family environment may play a key role in shaping children's eating behaviors. The purpose of this study was to estimate the degree of familial resemblance in eating behavioral traits (cognitive dietary restraint, disinhibition, and susceptibility to hunger).

Research Methods and Procedures: Eating behavioral traits were assessed with the Three‐Factor Eating Questionnaire in 282 men and 402 women (202 families) from the Quebec Family Study. Familial resemblance for each trait (adjusted for age, sex, and BMI) was investigated using a familial correlation model.

Results: The pattern of familial correlation showed significant spouse correlation for the three eating behavior phenotypes, as well as significant parent‐offspring and sibling correlations for disinhibition and susceptibility to hunger. According to the most parsimonious model, generalized heritability estimates (including genetic and shared familial environmental effects) reached 6%, 18%, and 28% for cognitive dietary restraint, disinhibition, and susceptibility to hunger, respectively.

Discussion: These results suggest that there is a significant familial component to eating behavioral traits but that the additive genetic component appears to be small, with generalized heritability estimates ranging from 6% to 28%. Thus, non‐familial environmental factors and gene‐gene and gene‐environmental interactions seem to be the major determinants of the eating/behavioral traits.
Dietary Patterns and the Metabolic Syndrome in Obese and Non‐obese Framingham Women**
Authors: Sonnenberg Lillian , Pencina Michael , Kimokoti Ruth , Quatromoni Paula , Nam Byung‐Ho , D'Agostino Ralph , Meigs James B. , Ordovas Jose , Cobain Mark , Millen Barbara
Published: April 2008

Objectives: To examine the relationship between habitual dietary patterns and the metabolic syndrome (MetS) in women and to identify foci for preventive nutrition interventions.

Research Methods and Procedures: Dietary patterns, nutrient intake, cardiovascular disease (CVD), and MetS risk factors were characterized in 1615 Framingham Offspring‐Spouse Study (FOS) women. Dietary pattern subgroups were compared for MetS prevalence and CVD risk factor status using logistic regression and analysis of covariance. Analyses were performed overall in women and stratified on obesity status; multivariate models controlled for age, apolipoprotein E (APOE) genotypes, and CVD risk factors.

Results: Food and nutrient profiles and overall nutritional risk of five non‐overlapping habitual dietary patterns of women were identified including Heart Healthier, Lighter Eating, Wine and Moderate Eating, Higher Fat, and Empty Calories. Rates of hypertension and low high‐density lipoprotein levels were high in non‐obese women, but individual MetS risk factor levels were substantially increased in obese women. Overall MetS risk varied by dietary pattern and obesity status, independently of APOE and CVD risk factors. Compared with obese or non‐obese women and women overall with other dietary patterns, MetS was highest in those with the Empty Calorie pattern (contrast p value: p < 0.05).

Discussion: This research shows the independent relationship between habitual dietary patterns and MetS risk in FOS women and the influence of obesity status. High overall MetS risk and the varying prevalence of individual MetS risk factors in female subgroups emphasize the importance of preventive nutrition interventions and suggest potential benefits of targeted behavior change in both obese and non‐obese women by dietary pattern.
Dietary Fat Intake and Insulin Resistance in Black and White Children
Authors: Weigensberg Marc J. , Ball Geoff D.C. , Shaibi Gabriel Q. , Cruz Martha L. , Gower Barbara A. , Goran Michael I.
Published: April 2008

Objective: The purpose of this study was to determine whether dietary fat intake above current Acceptable Macronutrient Distribution Range (AMDR) guidelines was associated with greater insulin resistance in black and white children.

Research Methods and Procedures: We studied 142 healthy children (n = 81 whites, n = 61 blacks), 6.5 to 14 years old. Dietary composition was determined by repeated 24‐hour dietary recall, body composition by DXA, visceral fat by computed tomography, and insulin sensitivity (SI) and acute insulin response to glucose (AIRg) by frequently sampled intravenous glucose tolerance test. Subjects were categorized by ethnicity (white/black) and dietary fat intake (above‐AMDR/within‐AMDR guidelines), and differences were analyzed by 2 × 2 analysis of covariance, adjusting for covariates.

Results: After adjusting for total body fat, gender, and Tanner stage, subjects consuming dietary fat above AMDR intake guidelines had lower SI and higher AIRg. This effect was specific to black children (32% lower SI and 62% higher AIRg in above‐AMDR compared with within‐AMDR blacks) and was not seen in whites.

Discussion: In black, but not white, children, those with dietary fat intake above current AMDR guidelines had lower SI and higher AIRg than those who met AMDR guidelines. These findings support current AMDR guidelines for dietary fat in black children and adolescents. The mechanism(s) underlying the ethnic differences in the relationship between dietary fat intake and SI in children require further investigation.
Urinary F2‐Isoprostanes Are Not Associated with Increased Risk of Type 2 Diabetes
Authors: Il'yasova Dora , Morrow Jason D. , Wagenknecht Lynne E.
Published: April 2008

Objective: Free radicals have been implicated in the etiology of type 2 diabetes. Cross‐sectional studies have demonstrated associations between oxidative damage and type 2 diabetes. However, no prospective data on this association are available.

Research Methods and Procedures: A case control study was conducted within the prospective cohort of the Insulin Resistance Atherosclerosis Study: 26 cases who developed type 2 diabetes in the follow‐up period and 26 controls who remained free of type 2 diabetes were randomly selected. Oxidative status was assessed by measuring 2, 3‐dinor‐5, 6‐dihydro‐15‐F2t‐isoprostane (F2‐IsoPM) in baseline urine samples using gas chromatography/mass spectroscopy. Type 2 diabetes was defined by serial oral glucose tolerance tests and World Health Organization criteria.

Results: Urinary F2‐IsoPM varied between 0.18 and 2.60 ng/mg creatinine; 25th/50th/75th percentiles were 0.42, 0.60, and 0.89, respectively. A trend toward higher levels were observed in women and in persons with impaired glucose tolerance at baseline (p= 0.1). F2‐IsoPM increased with BMI (r= 0.36,p= 0.01). After adjustment for age, gender, baseline impaired glucose tolerance status, and BMI, F2‐IsoPM levels were inversely associated with development of type 2 diabetes: odds ratio = 0.32 (95% confidence interval, 0.12 to 0.81) for the difference between the 75th and 25th percentiles.

Discussion: These results suggest that oxidative damage is not a cause of type 2 diabetes. Positive cross‐sectional associations of F2‐IsoPM with the risk factors for diabetes, BMI, and impaired glucose tolerance and inverse associations with development of type 2 diabetes indicate that F2‐IsoPM might reflect a compensatory mechanism.
Low‐ and High‐Carbohydrate Diets: Body Composition Differences in Rats
Authors: McNeel Ronald L. , Mersmann Harry J.
Published: April 2008

Objective: To determine differences in adipose tissue mass, cell size, and lipid metabolism transcripts and differences in composition of body weight loss and energy expenditure (EE) after isoenergetic, energy‐restricted intake of low‐carbohydrate/high‐fat/high‐protein (LC) and high‐carbohydrate/low‐fat/moderate‐protein (HC) diets.

Research Methods and Procedures: Ten‐week old female Sprague‐Dawley rats were fed a high‐fat diet ad libitum for 8 weeks to induce weight gain and fat deposition. Weight‐matched rats were then assigned to isoenergetic LC (Atkins) and HC (American Dietary Association Exchange) diets for 10 weeks at 65% of ad libitum energy intake.

Results: There was no significant difference in the serum lipid profiles or amount of body weight lost between the HC and LC groups, whereas a higher insulin sensitivity index (p < 0.01) resulted from the HC compared with the LC diet. Compared with the post‐restriction LC group, the HC group demonstrated (p < 0.05) higher EE during active hours, lower mRNA levels for the lipogenic genes peroxisome proliferator‐activated receptor γ2, lipoprotein lipase, and, adipocyte fatty acid binding protein, decreased adipocyte cell volume, and decreased fat mass.

Discussion: Results indicated down‐regulation of lipogenic genes, decreased fat mass, and, therefore, improved body composition in the post‐restriction HC compared with the LC group. The small mean differences between the two diet groups (p = 0.11) in 24‐hour EE over the 10 weeks of diet intervention would account for the majority of the lower mean body weights in the post‐restriction HC group. These data suggest that macronutrient composition of the diet influences body composition and indicate a distinction between HC and LC diets.
Hyperphagia and Obesity in Na,K‐ATPase α2 Subunit‐Defective Mice
Authors: Kawakami Kiyoshi , Onaka Tatsushi , Iwase Michiko , Homma Ikuo , Ikeda Keiko
Published: April 2008

Objective: The Na,K‐ATPase α2 subunit gene (Atp1a2) is expressed in the brain, skeletal muscles, heart, and adipocytes. Specific function of the α2 subunit, such as involvement in differentiation and function of adipocytes, has not been addressed. The aim of this study was to examine whether Atp1a2‐defective heterozygous mice show obesity and reveal the mechanisms underlying the obesity.

Research Methods and Procedures: We measured the differentiation and glucose uptake function of in vitro‐differentiated adipocytes derived from embryonic fibroblasts of Atp1a2‐defective mice. Food intake, body temperature, metabolic rate, and spontaneous activity and mRNA levels of neuropeptide genes were compared between the heterozygous and wild‐type adult mice.

Results: Atp1a2 heterozygous female mice developed obesity after middle age. The time course of in vitro adipocyte differentiation of embryonic fibroblasts isolated from wild type, heterozygous, and homozygous mice was not different, glucose and Rb uptake activities of the in vitro‐differentiated adipocytes were not altered, and the effects of insulin on glucose uptake and those of monensin and ouabain on Rb uptake were similar among the genotypes. However, food intake in the light phase was significantly greater in the heterozygous mice than the wild type in the 24‐hour dark‐light cycle, whereas it was similar under constant‐light condition. Body temperature, metabolic rate at rest, and spontaneous motor activity of the heterozygous mice were similar to those of the wild type. Orexin mRNA level was lower in heterozygous than wild‐type mice.

Discussion: The Na,K‐ATPase α2 subunit is not involved in the differentiation or in glucose and Rb uptake function of in vitro‐differentiated adipocytes. Hyperphagia is the likely primary cause of obesity in Atp1a2 heterozygous mice.
Altered Hypothalamic Signaling and Responses to Food Deprivation in Rats Fed a Low‐Carbohydrate Diet
Authors: Kinzig Kimberly P. , Scott Karen A. , Hyun Jayson , Bi Sheng , Moran Timothy H.
Published: April 2008

Objective: To model how consuming a low‐carbohydrate (LC) diet influences food intake and body weight.

Research Methods and Procedures: Food intake and body weight were monitored in rats with access to chow (CH), LC‐high‐fat (HF), or HF diets. After 8 weeks, rats received intracerebroventricular injections of a melanocortin agonist (melanotan‐II) and antagonist (SHU9119), and feeding responses were measured. At sacrifice, plasma hormones and hypothalamic expression of mRNA for proopiomelanocortin (POMC), melanocortin‐4 receptor, neuropeptide Y (NPY), and agouti related protein (AgRP) were assessed. A second set of rats had access to diet (chow or LC‐HF) for 4 weeks followed by 24 h food deprivation on two occasions, after which food intake and hypothalamic POMC, NPY, and AgRP mRNA expression were measured.

Results: HF rats consumed more food and gained more weight than rats on CH or LC‐HF diets. Despite similar intakes and weight gains, LC‐HF rats had increased adiposity relative to CH rats. LC‐HF rats were more sensitive to melanotan‐II and less sensitive to SHU9119. LC‐HF rats had increased plasma leptin and ghrelin levels and decreased insulin levels, and patterns of NPY and POMC mRNA expression were consistent with those of food‐deprived rats. LC‐HF rats did not show rebound hyperphagia after food deprivation, and levels NPY, POMC, and AgRP mRNA expression were not affected by deprivation.

Discussion: Our results demonstrate that an LC diet influences multiple systems involved in the controls of food intake and body weight. These data also suggest that maintenance on an LC‐HF diet affects food intake by reducing compensatory responses to food deprivation.
The Association between Plasma Adiponectin and Insulin Sensitivity in Humans Depends on Obesity
Authors: Kantartzis Konstantinos , Fritsche Andreas , Tschritter Otto , Thamer Claus , Haap Michael , Schäfer Silke , Stumvoll Michael , Häring Hans‐Ulrich , Stefan Norbert
Published: April 2008

Objective: In humans, low plasma adiponectin concentrations precede a decrease in insulin sensitivity and predict type 2 diabetes independently of obesity. However, it is possible that the contribution of adiponectin to insulin sensitivity is not equally strong over the whole range of obesity.

Research Methods and Procedures: We investigated the cross‐sectional association between plasma adiponectin levels and insulin sensitivity in different ranges of body fat content [expressed as percentage of body fat (PFAT)] in a large cohort of normal glucose‐tolerant subjects (n = 900). All individuals underwent an oral glucose tolerance test (OGTT), and 299 subjects additionally a euglycemic hyperinsulinemic clamp. In longitudinal analyses, the association of adiponectin at baseline with change in insulin sensitivity was investigated in a subgroup of 108 subjects.

Results: In cross‐sectional analyses, the association between plasma adiponectin and insulin sensitivity, adjusted for age, gender, and PFAT, depended on whether subjects were lean or obese [p for interaction adiponectin × PFAT = <0.001 (OGTT) and 0.002 (clamp)]. Stratified by quartiles of PFAT, adiponectin did not correlate significantly with insulin sensitivity in subjects in the lowest PFAT quartile (R2 = 0.10, p = 0.13, OGTT; and R2 = 0.10, p = 0.57, clamp), whereas the association in the upper PFAT quartile was rather strong (R2 = 0.36, p < 0.0001, OGTT; and R2 = 0.48, p = 0.003, clamp). In longitudinal analyses, plasma adiponectin at baseline preceded change in insulin sensitivity in obese (n = 54, p = 0.03) but not in lean (n = 54, p = 0.68) individuals.

Discussion: These data suggest that adiponectin is especially critical in sustaining insulin sensitivity in obese subjects. Thus, interventions to reduce insulin resistance by increasing adiponectin concentrations may be effective particularly in obese, insulin‐resistant individuals.
Low 25‐Hydroxyvitamin D Does Not Affect Insulin Sensitivity in Obesity after Bariatric Surgery
Authors: Manco Melania , Calvani Menotti , Nanni Giuseppe , Greco Aldo V. , Iaconelli Amerigo , Gasbarrini Giovanni , Castagneto Marco , Mingrone Geltrude
Published: April 2008

Objective: A positive correlation between levels of 25‐hydroxyvitamin D [25(OH)D] and insulin sensitivity has been shown in healthy subjects. We aimed to test the hypothesis that concentration of 25(OH)D influences insulin sensitivity in obesity before and after weight loss.

Research Methods and Procedures: We investigated the relation between serum 25(OH)D and insulin sensitivity (estimated by euglycemic‐hyperinsulinemic clamp) in 116 obese women (BMI ≥ 40 kg/m2) evaluated before and 5 and 10 years after biliopancreatic diversion (BPD). Body composition was estimated by the isotope dilution method.

Results: Prevalence of hypovitaminosis D was 76% in the obese status and 91% and 89% at 5 and 10 years after BPD, respectively, despite ergocalciferol supplementation. 25(OH)D concentration decreased from 39.2 ± 22.3 in obesity (p = 0.0001) to 27.4 ± 16.4 and 25.1 ± 13.9 nM 5 and 10 years after BPD, respectively. Whole‐body glucose uptake increased from 24.27 ± 4.44 at the baseline to 57.29 ± 11.56 and 57.71 ± 8.41 μmol/kgfat free mass per minute 5 and 10 years after BPD, respectively (p = 0.0001). Predictor of 25(OH)D was fat mass (R2 = 0.26, p = 0.0001 in obesity; R2 = 0.20, p = 0.02 after BPD). Parathormone correlated with fat mass (R2 = 0.19; p = 0.0001) and BMI (R2 = 0.053; p = 0.01) and inversely with M value (R2 = 0.16; p = 0.0001), but only in obese subjects.

Discussion: A high prevalence of hypovitaminosis D was observed in morbid obesity both before and after BPD. Low 25(OH)D did not necessarily imply increased insulin resistance after BPD, a condition where, probably, more powerful determinants of insulin sensitivity overcome the low circulating 25(OH)D levels. However, the present data cannot exclude some kind of influence of vitamin D status on glucose and insulin metabolism.
Meta‐Analysis of the Association of the Trp64Arg Polymorphism in the β3 Adrenergic Receptor with Insulin Resistance
Authors: Zhan Siyan , Ho Suzanne C.
Published: April 2008

Objective: To clarify the possible association between the Trp64Arg polymorphism and insulin resistance (IR).

Research Methods and Procedures: Articles evaluating the effect of the Trp64Arg polymorphism on IR were identified on the MEDLINE and PubMed databases from 1995 to February, 2004. After extraction of relevant data, main and subgroup meta‐analyses were performed to assess the differences in IR indices between Trp/Trp and Trp/Arg genotypes.

Results: Forty eligible papers containing 56 subgroups were included in this meta‐analysis. Among a total of 12, 805 subjects, 21.9% had Trp64Arg mutation: 20.8%, heterozygotes and 1.1%, homozygotes. Significant associations were found between this mutation and some indices of IR. The weighted mean difference in fasting insulin, 120‐minute insulin level after oral glucose tolerance test, and homeostasis model assessment between Arg64 and Trp64 was 0.23 [95% confidence interval (CI), 0.05 to 0.42] pM, 0.89 (95% CI, 0.30 to 1.48) pM, and 0.55 (95% CI, 0.14 to 0.96), respectively. Subgroup analysis further indicated that this significant association existed only in the Asian population (p < 0.01) and in the obese (p = 0.02) and diabetes subgroups (p = 0.03).

Discussion: Numerous studies have been conducted to examine the relationship between the β3‐adrenergic receptor Trp64Arg polymorphism and components of IR syndrome. However, the results have been inconsistent and have led to controversy about whether this polymorphism is associated with these clinical features. The current meta‐analysis demonstrated the moderate effects of the Trp64Arg polymorphism on IR in the Asian population and in obese and diabetic subgroups.
The Impact of Calcium and Dairy Product Consumption on Weight Loss
Authors: Harvey‐Berino Jean , Gold Beth Casey , Lauber Renee , Starinski Amy
Published: April 2008

Objective: Recent evidence suggests that diets high in calcium and dairy products are associated with lower body weight, particularly lower body fat levels. The purpose of this study was to compare weight and body fat loss on a calorie‐restricted, low‐dairy (CR) vs. high‐dairy (CR+D) diet.

Research Methods and Procedures: Fifty‐four subjects (BMI 30 ± 2.5 kg/m2, 45 ± 6.6 years, 4 men) were randomly assigned to calorie‐restricted (−500 kcal/d) low‐dairy calcium (n = 29; ∼1 serving dairy/d, 500 mg/d calcium) or high‐dairy calcium (n = 25; 3 to 4 servings dairy/d, 1200 to 1400 mg/d calcium) diets for 12 months. Main outcome measures included change in weight (kilograms) and body fat (percentage).

Results: There were no significant differences between groups at baseline. At 12 months, weight and body fat loss were not significantly different. Subjects in the CR vs. CR+D conditions lost 9.6 ± 6.5 vs. 10.8 ± 5.9 kg (p = 0.56) and 9.0 ± 3.8 vs. 10.1 ± 3.6 kg body fat (p = 0.37).

Discussion: These findings suggest that a high‐dairy calcium diet does not substantially improve weight loss beyond what can be achieved in a behavioral intervention.
Results of Go Girls: A Weight Control Program for Overweight African‐American Adolescent Females
Authors: Resnicow Ken , Taylor Ricia , Baskin Monica , McCarty Frances
Published: April 2008

Objective: Go Girls was a church‐based nutrition and physical activity program designed for overweight African‐American (AA) adolescent females.

Research Methods and Procedures: Ten predominantly middle‐socioeconomic churches were randomized to either a high‐intensity (20 to 26 sessions) or moderate‐intensity (six sessions) culturally tailored behavioral group intervention delivered over 6 months. Each session included an experiential behavioral activity, ∼30 minutes of physical activity, and preparation and tasting of healthy foods. In the high‐intensity group, girls also received four to six telephone counseling calls. From the 10 churches, 123 girls completed baseline and 6‐month post‐test assessments. The primary outcome was BMI; secondary outcomes included waist and hip circumferences, percentage body fat estimated by bioimpedance, serum insulin, glucose, and lipids, and cardiovascular fitness at 6‐month follow‐up. Selected measures were also collected at 1‐year follow‐up.

Results: At 6‐month follow‐up, the net difference between the high‐ and moderate‐intensity groups was 0.5 BMI units. This difference was not statistically significant (p = 0.20). There were no significant group differences in secondary outcomes. Girls in the high‐intensity condition, however, who attended more than three‐quarters of the sessions had significantly lower BMI and percentage body fat relative to girls in the high‐intensity group who attended fewer sessions. Findings at 1‐year follow‐up mirrored those at 6 months.

Discussion: We concluded that the intervention was not effective in reducing adiposity, although there were some positive findings among high attenders. Despite the null result, the intervention was generally well received by participants. Future interventions may require greater dose and a more structured dietary change program.
The Influence of Parenting Change on Pediatric Weight Control
Authors: Stein Richard I. , Epstein Leonard H. , Raynor Hollie A. , Kilanowski Colleen K. , Paluch Rocco A.
Published: April 2008

Objective: Parenting style was examined as a predictor of weight loss maintenance in behavioral family‐based pediatric obesity treatment.

Research Methods and Procedures: Fifty obese children who participated in a behavioral family‐based pediatric obesity treatment were studied. Hierarchical regression tested the incremental effect of baseline parenting and parenting during treatment on children's percentage overweight change over 12 months, beyond demographics and adherence to targeted behaviors.

Results: Children's percentage overweight significantly decreased at 6 (−16.3) and 12 (−11.1) months. Adherence to program goals significantly increased variance accounted for in the regression model by 10.8%, whereas adding baseline father acceptance and change in father acceptance accounted for another 20.5%. The overall model accounted for 40.6% of the variance in pediatric weight control. ANOVA showed significantly greater percentage overweight decrease from baseline for youth with fathers who increased their acceptance vs. those who decreased acceptance at 6 (−19.8 vs. −14.6) and 12 (−17.4 vs. −8.1) months.

Discussion: Youth who perceive an increase in father acceptance after treatment had better changes in percentage overweight over 12 months than youth with lower ratings of father acceptance. Future directions include examining how other parenting dimensions impact pediatric obesity treatment outcome and how parental acceptance can be enhanced to improve child weight control.
Obesity and Cardiovascular Disease Risk Factors in Firefighters: A Prospective Cohort Study
Authors: Soteriades Elpidoforos S. , Hauser Russ , Kawachi Ichiro , Liarokapis Dimitrios , Christiani David C. , Kales Stefanos N.
Published: April 2008

Objective: Obesity, despite being a significant determinant of fitness for duty, is reaching epidemic levels in the workplace. Firefighters’ fitness is important to their health and to public safety.

Research Methods and Procedures: We examined the distribution of BMI and its association with major cardiovascular disease (CVD) risk factors in Massachusetts firefighters who underwent baseline (1996) and annual medical examinations through a statewide medical surveillance program over 5 years of follow‐up. We also evaluated firefighters’ weight change over time.

Results: The mean BMI among 332 firefighters increased from 29 at baseline to 30 at the follow‐up examination (2001), and the prevalence of obesity increased from 35% to 40%, respectively (p < 0.0001). In addition, the proportion of firefighters with extreme obesity increased 4‐fold at follow‐up (from 0.6% to 2.4%, p < 0.0001). Obese firefighters were more likely to have hypertension (p = 0.03) and low high‐density lipoprotein‐cholesterol (p = 0.01) at follow‐up. Firefighters with extreme obesity had an average of 2.1 CVD risk factors (excluding obesity) in contrast to 1.5 CVD risk factors for normal‐weight firefighters (p = 0.02). Finally, on average, normal‐weight firefighters gained 1.1 pounds, whereas firefighters with BMI ≥ 35 gained 1.9 pounds per year of active duty over 5 years of follow‐up.

Discussion: Obesity is a major concern among firefighters and shows worsening trends over time. Periodic medical evaluations coupled with exercise and dietary guidelines are needed to address this problem, which threatens firefighters’ health and may jeopardize public safety.
Weight Change in Adult Life and Health Outcomes
Authors: Elliott Alison M. , Aucott Lorna S. , Hannaford Philip C. , Smith W. Cairns
Published: April 2008

Objective: To investigate the relationship between weight change in adult life and subsequent mortality and cancer incidence in women.

Research Methods and Procedures: In 1994 to 1995, all women (age range, 42 to 81) still under general practitioner observation in the United Kingdom's Royal College of General Practitioners Oral Contraception Study (n = 12 303) were sent a health survey asking about health and lifestyle issues, including current weight and weight at age 30. The main outcome measures were 6‐year all‐cause mortality and cancer incidence among different weight change deciles. Cox regression was used to calculate hazard ratios that were adjusted for: social class at recruitment, BMI at age 30, and age group, parity, smoking status, and hormone replacement therapy status in 1995.

Results: Women who had been obese at age 30 were more likely to die and significantly more likely to develop cancer in the 6 years after the health survey than non‐obese respondents. Women reporting weight gains between age 30 and 1995 were significantly less likely to die during the 6 years after the health survey than those with a stable weight, whereas those with weight loss did not fare any better than those in the stable‐weight group.

Discussion: Although obesity at young age was associated with subsequent mortality and cancer incidence, weight gain over a time period of 12 to 51 years appeared to be beneficial when compared with women with stable weight over the same time period. Further research is needed to confirm or refute our findings and to allow detailed examination of potential explanations for them.