bluuebunny/crossref_metadata_2025 huggingface dataset:
Raised Interleukin‐6 Levels in Obese Patients
Authors: Roytblat Leonid , Rachinsky Maxim , Fisher Allan , Greemberg Lev , Shapira Yoram , Douvdevani Amos , Gelman Simon
Published: April 2008

Objective: Obese patients demonstrate a variety of biochemical, metabolic, and pulmonary abnormalities. Inflammatory mediators such as tumor necrosis factor‐α and interleukin‐6 (IL‐6) may have a direct effect on glucose and lipid metabolism. Hypoxemia in itself induces release of IL‐6. The aim of this study was to examine the relationship between IL‐6 levels in healthy volunteers (control group) and three different groups of obese patients: patients without obstructive sleep apnea syndrome (OSAS), patients with OSAS, and patients with obesity hypoventilation syndrome (OHS) (daytime baseline oxygen saturation of <93%).

Research Methods and Procedures: We measured serum IL‐6 levels in 25 obese patients (body mass index of >35 kg/m2) and 12 healthy women.

Results: The results demonstrate statistically significant differences in serum IL‐6 levels between the control group (1.28 ± 0.85 pg/mL) and obese patients without OSAS (7.69 ± 5.06 pg/mL, p < 0.05) and with OSAS (5.58 ± 0.37 pg/mL, p < 0.0005). In the patients with OHS, IL‐6 concentrations were highest (43.13 ± 24.27 pg/mL).

Discussion: We conclude that serum IL‐6 is increased in obese patients. The highest IL‐6 levels were found in the patients with OHS.
Lipoprotein Subpopulation Distributions in Lean, Obese, and Type 2 Diabetic Women: A Comparison of African and White Americans
Authors: MacLean Paul S. , Bower Joseph F. , Vadlamudi Satyaprasad , Green Thomas , Barakat Hisham A.
Published: April 2008

Objective: Abnormal subpopulation distributions of plasma lipoproteins have been reported in white American (WA) women with obesity and type 2 diabetes that explain part of the elevated rate of cardiovascular disease in these patients. This study examined if these perturbations also occur in obese and diabetic African American (AA) women and compared the lipoprotein profiles with WA counterparts.

Research Methods and Procedures: We determined the lipoprotein subpopulation distribution in the plasma of 51 lean women (29 WA, 22 AA, body mass index [BMI] < 30), 50 obese women (27 WA, 23 AA, BMI > 30), and 43 obese women with type 2 diabetes (27 WA, 16 AA), by nuclear magnetic resonance spectroscopy.

Results: AA diabetic women, like WA diabetic women, had a larger average very low density lipoprotein (VLDL) size, elevated levels of small low density lipoprotein cholesterol (LDL‐C), and lower levels of small high density lipoprotein cholesterol (HDL‐C), when compared to lean controls (p < 0.05). These differences were accompanied by higher VLDL‐triglycerides (TG) and LDL‐C in WA (p < 0.05), but not in AA. Although the effects of obesity and diabetes on lipoprotein subpopulation were fairly similar for AA and WA, some racial differences, particularly with respect to HDL, were observed.

Discussion: The atherogenic perturbations in lipoprotein profiles of obese AA women, particularly those with diabetes, were relatively similar to those found in WA women and may be contributing to the increased rate of cardiovascular disease (CVD) in AA with obesity and diabetes. The parameters of subpopulation distribution may provide better markers for CVD than lipid concentrations alone, particularly in AA women. Furthermore, subtle racial differences in lipoprotein profiles suggest that race‐specific criteria may be needed to screen patients for CVD.
Reference Growth Curves for Cypriot Children 6 to 17 Years of Age
Authors: Savva Savvas C. , Kourides Yiannis , Tornaritis Michael , Epiphaniou‐Savva Marina , Tafouna Panagiota , Kafatos Anthony
Published: April 2008

Objective: The purpose of the study was to present smoothed percentiles for body weight and height, waist circumference, and body mass index (BMI) in Cypriot children and to compare their BMI 85th and 95th percentiles with those of children in other countries.

Research Methods and Procedures: The study was a cross‐sectional study, including a representative sample of 2472 healthy children (49.1% boys) in Cyprus ages 6 to 17 years, who were evaluated during the 1999–2000 school year. Body weight and height and waist circumference were measured using standard procedures. BMI was calculated as weight in kilograms per height in square meters. Smoothed, sex‐specific percentiles for these variables were calculated using polynomial regression models. Crude weight, height, waist, and BMI percentile values are presented in sex‐specific tables and smoothed percentile curves are presented in charts. The 85th and 95th percentiles for BMI were compared with measurements from other countries, because of the concern of the upper limits of BMI in respect to the evaluation of obesity.

Results: The 85th and 95th BMI percentile values are higher in Cypriot boys than in Swedish and Iranian boys through all ages and in girls ages 6 to 15 years, whereas after the age of 15 years, both Swedish and Iranian girls’ percentiles are equalized with their Cypriot peers.

Discussion: Weight, height, waist circumference, and BMI values and charts are presented for the first time for Cypriot children and adolescents. Much concern should be addressed to the observation that for the majority of the Cypriot sample, the upper BMI limits are higher than the peers of developing and developed countries.
The Insulin Tolerance Test in Morbidly Obese Patients Undergoing Bariatric Surgery
Authors: Geloneze Bruno , Tambascia Marcos A. , Pareja José C. , Repetto Enrico M. , Magna Luis A.
Published: April 2008

Objective: To assess the effect of massive weight loss in relation to insulin resistance and its correlation to changes in glycemic homeostasis and lipid profile in severely obese patients.

Research Methods and Procedures: A prospective clinical intervention study was carried out with 31 morbidly obese women (body mass index: 54.2 ± 8.8 kg/m2) divided into three groups according to their glucose tolerance test: 14 normal, 8 impaired glucose tolerance, and 9 type 2 diabetes. All subjects underwent an insulin tolerance test with intravenous bolus of 0.1 U insulin/kg body weight before silastic ring vertical gastroplasty Roux‐en‐Y gastric bypass surgery, and again at 2, 4, 6, and 12 months postoperatively. Fasting plasma glucose, hemoglobin A1c, and lipid profile were also evaluated.

Results: A reduction of 68 ± 15% in initial excess body weight was evident within 1 year. Along with weight loss, the following statistically significant changes were found: an increase in the insulin‐sensitivity index (Kitt) and a decrease in fasting plasma glucose and hemoglobin A1c, most notably in the type 2 diabetes group. An overall improvement in lipid profile was observed in all three groups.

Discussion: Bariatric surgery was an effective therapeutic approach for these obese patients because it reduced both weight and insulin resistance, along with improving metabolic parameters. Significant correlations were found between insulin resistance and metabolic improvements. Weight loss after bariatric surgery induced an improvement in metabolic fitness, related to the reduction in insulin resistance over a range of glucose tolerance statuses from normal to diabetic.
Childhood Obesity: The Health Issue
Authors: Deckelbaum Richard J. , Williams Christine L.
Published: April 2008

Overweight and obesity in children is epidemic in North America and internationally. Approximately 22 million children under 5 years of age are overweight across the world. In the United States, the number of overweight children and adolescents has doubled in the last two to three decades, and similar doubling rates are being observed worldwide, including in developing countries and regions where an increase in Westernization of behavioral and dietary lifestyles is evident. Comorbidities associated with obesity and overweight are similar in children as in the adult population. Elevated blood pressure, dyslipidemia, and a higher prevalence of factors associated with insulin resistance and type 2 diabetes appear as frequent comorbidities in the overweight and obese pediatric population. In some populations, type 2 diabetes is now the dominant form of diabetes in children and adolescents. Disturbingly, obesity in childhood, particularly in adolescence, is a key predictor for obesity in adulthood. Moreover, morbidity and mortality in the adult population is increased in individuals who were overweight in adolescence, even if they lose the extra weight during adulthood. Although the cause of obesity in children is similar to that of adults (i.e., more energy in vs. energy utilized), emerging data suggest associations between the influence of maternal and fetal factors during intrauterine growth and growth during the first year of life, on risk of later development of adult obesity and its comorbidities. In addition, recent data suggest that varying biological responses in different racial/ethnic groups differently contribute to overweight, obesity, and their comorbidities. Although differences in gene–nutrient interactions may contribute, the role of varying cultural and socioeconomic variables still needs to be determined to understand these disparities. Novel approaches in the prevention and treatment of childhood overweight and obesity are urgently required. With the strong evidence that a lifecycle perspective is important in obesity development and its consequences, consideration must be focused on prevention of obesity in women of child‐bearing age, excessive weight gain during pregnancy, and the role of breast‐feeding in reducing later obesity in children and adults. Consideration must be given to family behavior patterns, diet after weaning, and the use of new methods of information dissemination to help reduce the impact of childhood obesity worldwide.
Development of a Brief Measure to Assess Quality of Life in Obesity
Authors: Kolotkin Ronette L. , Crosby Ross D. , Kosloski Karl D. , Williams G. Rhys
Published: April 2008

Objective: Obesity researchers have a growing interest in measuring the impact of weight and weight reduction on quality of life. The Impact of Weight on Quality of Life questionnaire (IWQOL) was the first self‐report instrument specifically developed to assess the effect of obesity on quality of life. Although the IWQOL has demonstrated excellent psychometric properties, its length (74 items) makes it somewhat cumbersome as an outcome measure in clinical research. This report describes the development of a 31‐item version of the IWQOL (IWQOL‐Lite).

Research Methods and Procedures: IWQOLs from 996 obese patients and controls were used to develop the IWQOL‐Lite. Psychometric properties of the IWQOL‐Lite were examined in a separate cross‐validation sample of 991 patients and controls.

Results: Confirmatory factor analysis provided strong support for the adequacy of the scale structure. The five identified scales of the IWQOL‐Lite (Physical Function, Self‐Esteem, Sexual Life, Public Distress, and Work) and the total IWQOL‐Lite score demonstrated excellent psychometric properties. The reliability of the IWQOL‐Lite scales ranged from 0.90 to 0.94 and was 0.96 for the total score. Correlations between the IWQOL‐Lite and collateral measures supported the construct validity of the IWQOL‐Lite. Changes in IWQOL‐Lite scales over time correlated significantly with changes in weight, supporting its sensitivity to change. Significant differences in IWQOL‐Lite scale and total scores were found among groups differing in body mass index, supporting the utility of the IWQOL‐Lite across the body mass index spectrum.

Discussion: The IWQOL‐Lite appears to be a psychometrically sound and clinically sensitive brief measure of quality of life in obese persons.
Low‐Calorie Diets and Sustained Weight Loss
Authors: Finer Nicholas
Published: April 2008

The principles of weight management in overweight and obesity are primarily to achieve clinically significant weight loss and secondarily (but perhaps more importantly) to maintain weight loss. The traditional approach to weight reduction has been the prescription of diets that provide an energy intake below that of energy expenditure, usually to provide a balanced ratio of protein, carbohydrate, and fat in reduced quantities to provide an energy intake of 800 to 1500 kcal/d. Evaluation of the efficacy of such interventions is difficult despite a wealth of publications, because few randomized trials have been conducted and various adjunctive therapies confound interpretation. Systematic reviews of low‐calorie diets have been unable to come to any firm conclusions about the value of different ways of achieving energy restriction, but one meta‐analysis of low‐fat diets produced a mean weight loss of 10 kg of weight loss that was greater in those with a higher initial body weight. Greater weight loss was achieved by subjects prescribed a 600‐kcal deficit diet, compared with a conventional low‐calorie (1200 kcal/d) diet. This study has been influential for clinical dietetic practice, particularly with UK dietitians, but also in the design of dietetic support in clinical trials of pharmacotherapy. Low‐calorie diets can be effective treatment, but the optimum way of delivering such diets remains unclear.
Obesity and Disease Management: Effects of Weight Loss on Comorbid Conditions
Authors: Anderson James W. , Konz Elizabeth C.
Published: April 2008

Objective: This review is designed to quantitate the effects of obesity and weight gain on risk for coronary heart disease (CHD) and to review the effects of weight loss on CHD risk factors.

Research Methods and Procedures: After a comprehensive review of the literature related to body weight and weight gain on CHD risk, the relative risks (RRs) were tabulated. Values were averaged and meta‐analysis techniques were used to estimate the variance‐adjusted RR.

Results: Young persons with higher body mass index values have a significantly higher risk for CHD than do slender young people. For every 1% above a desirable body mass index, the risk for CHD increases by 3.3% for women and by 3.6% or men. Every kilogram of weight gain after high school increases risk for CHD by 5.7% for women and 3.1% for men. Weight loss significantly decreases major CHD risk factors. For every kilogram of weight loss the following favorable changes occur: fasting serum cholesterol, −1.0%; low‐density lipoprotein cholesterol, −0.7%; triglycerides, −1.9%; high‐density lipoprotein cholesterol, +0.2%; systolic blood pressure, −0.5%; diastolic blood pressure, −0.4%; and blood glucose, −0.2 mM.

Discussion: Obesity and/or weight gain are associated with major risk for CHD. Weight loss significantly improves serum lipid parameters, blood pressure, and fasting blood glucose values. Effective treatment approaches are available for most overweight or obese individuals but a major challenge is to enable these individuals to engage in these programs. Professional and consumer education is essential for advancing effective intervention strategies for overweight individuals.
The Adipose Tissue Phenotype of Hormone‐Sensitive Lipase Deficiency in Mice
Authors: Wang Shu Pei , Laurin Nancy , Himms‐Hagen Jean , Rudnicki Michael A. , Levy Emile , Robert Marie‐France , Pan Linghe , Oligny Luc , Mitchell Grant A.
Published: April 2008

Objective: To directly ascertain the physiological roles in adipocytes of hormone‐sensitive lipase (HSL; E.C. 3.1.1.3), a multifunctional hydrolase that can mediate triacylglycerol cleavage in adipocytes.

Research Methods and Procedures: We performed constitutive gene targeting of the mouse HSL gene (Lipe), subsequently studied the adipose tissue phenotype clinically and histologically, and measured lipolysis in isolated adipocytes.

Results: Homozygous HSL−/− mice have no detectable HSL peptide or cholesteryl esterase activity in adipose tissue, and heterozygous mice have intermediate levels with respect to wild‐type and deficient littermates. HSL‐deficient mice have normal body weight but reduced abdominal fat mass compared with normal littermates. Histologically, both white and brown adipose tissues in HSL−/− mice show marked heterogeneity in cell size, with markedly enlarged adipocytes juxtaposed to cells of normal morphology. In isolated HSL−/− adipocytes, lipolysis is not significantly increased by β3‐adrenergic stimulation, but under basal conditions in the absence of added catecholamines, the lipolytic rate of isolated HSL−/− adipocytes is at least as high as that of cells from normal controls. Cold tolerance during a 48‐hour period at 4 °C was similar in HSL−/− mice and controls. Overnight fasting was well‐tolerated clinically by HSL−/− mice, but after fasting, liver triglyceride content was significantly lower in HSL−/− mice compared with wild‐type controls.

Conclusions: In isolated fat cells, the lipolytic rate after β‐adrenergic stimulation is mainly dependent on HSL. However, the observation of a normal rate of lipolysis in unstimulated HSL−/− adipocytes suggests that HSL‐independent lipolytic pathway(s) exist in fat. Physiologically, HSL deficiency in mice has a modest effect under normal fed conditions and is compatible with normal maintenance of core body temperature during cold stress. However, the lipolytic response to overnight fasting is subnormal.
The Human Obesity Gene Map: The 2000 Update
Authors: Pérusse Louis , Chagnon Yvon C. , Weisnagel S. John , Rankinen Tuomo , Snyder Eric , Sands John , Bouchard Claude
Published: April 2008

This report constitutes the seventh update of the human obesity gene map incorporating published results up to the end of October 2000. Evidence from the rodent and human obesity cases caused by single‐gene mutations, Mendelian disorders exhibiting obesity as a clinical feature, quantitative trait loci uncovered in human genome‐wide scans and in cross‐breeding experiments in various animal models, and association and linkage studies with candidate genes and other markers are reviewed. Forty‐seven human cases of obesity caused by single‐gene mutations in six different genes have been reported in the literature to date. Twenty‐four Mendelian disorders exhibiting obesity as one of their clinical manifestations have now been mapped. The number of different quantitative trait loci reported from animal models currently reaches 115. Attempts to relate DNA sequence variation in specific genes to obesity phenotypes continue to grow, with 130 studies reporting positive associations with 48 candidate genes. Finally, 59 loci have been linked to obesity indicators in genomic scans and other linkage study designs. The obesity gene map reveals that putative loci affecting obesity‐related phenotypes can be found on all chromosomes except chromosome Y. A total of 54 new loci have been added to the map in the past 12 months and the number of genes, markers, and chromosomal regions that have been associated or linked with human obesity phenotypes is now above 250. Likewise, the number of negative studies, which are only partially reviewed here, is also on the rise.
Body Mass Index and Future Healthcare Costs: A Retrospective Cohort Study
Authors: Thompson David , Brown Jonathan B. , Nichols Gregory A. , Elmer Patricia J. , Oster Gerry
Published: April 2008

Objective:To assess the relationship between body mass index (BMI) and future healthcare costs.

Research Methods and Procedures:We undertook a retrospective cohort study of the relationship between obesity and future healthcare costs at Kaiser Permanente Northwest Division, a large health maintenance organization in Portland, Oregon. Study subjects (n= 1286) consisted of persons who responded to a 1990 health survey that was mailed to a random sample of adult Kaiser Permanente Northwest Division members who were 35 to 64 years of age; had a BMI ≥ 20 kg/m2(based on self‐reported height and weight); did not smoke cigarettes; and did not have a history of coronary heart disease, stroke, human immunodeficiency virus, or cancer. Subjects were stratified according to their BMI in 1990 (20 to 24.9, 25 to 29.9, and ≥30 kg/m2;n= 545, 474, and 367, respectively). We then tallied their costs (in 1998 US dollars) for all inpatient care, outpatient services, and prescription drugs over a 9‐year period (1990 through 1998).

Results:For persons with BMIs of 20 to 24.9 kg/m2, mean (±SE) annual costs of prescription drugs, outpatient services, inpatient care, and all medical care averaged $261 (±18), $848 (±59), $532 (±85), and $1631 (±120), respectively, over the study period. Cost ratios (95% confidence intervals) for persons with BMIs of 25 to 29.9 kg/m2and ≥30 kg/m2, respectively, were 1.37 (1.12 to 1.66) and 2.05 (1.62 to 2.55) for prescription drugs, 0.96 (0.83 to 1.13) and 1.14 (0.97 to 1.37) for outpatient services, 1.20 (0.81 to 1.86) and 1.38 (0.91 to 2.14) for inpatient care, and 1.10 (0.91 to 1.35) and 1.36 (1.11 to 1.68) for all medical care.

Discussion:Future healthcare costs are higher for persons who are overweight, especially those with BMIs ≥ 30 kg/m2.
Defining the Relationship between Obesity and Total Joint Arthroplasty
Authors: Stickles Beverly , Phillips Leslie , Brox William Timothy , Owens Brett , Lanzer William L.
Published: April 2008

Objective: The purpose of this study was to examine the relationship between obesity and patient‐administered outcome measures after total joint arthroplasty.

Research Methods and Procedures: A voluntary questionnaire‐based registry contained 592 primary total hip arthroplasty patients and 1011 primary total knee arthroplasty patients with preoperative and 1‐year data. Using logistic regression, the relationships between body mass index and the several outcome measures, including Short Form‐36 and Western Ontario and McMaster Universities Osteoarthritis Index, were examined.

Results: There was no difference between obese and non‐obese patients regarding satisfaction, decision to repeat surgery, and Δphysical component summary, Δmental component summary, and ΔWestern Ontario and McMaster Universities Osteoarthritis Index scores (p > 0.05 for all). Body mass index was associated with an increased risk of having difficulty descending or ascending stairs at 1 year (odds ratio, 1.2 to 1.3).

Discussion: Obese patients enjoy as much improvement and satisfaction as other patients from total joint arthroplasty.
Defining Health‐Related Obesity in Prepubertal Children
Authors: Higgins Paul B. , Gower Barbara A. , Hunter Gary R. , Goran Michael I.
Published: April 2008

Objective: The purpose of this study was to develop percentage of fat and waist circumference cut‐points in prepubertal children with the intention of defining obesity associated with cardiovascular disease (CVD) risk.

Research Methods and Procedures: A cross‐sectional analysis of 87 prepubertal children aged 4 to 11 years was used. Percentage of body fat was determined by DXA. Waist circumference was measured to the nearest millimeter. Receiver Operating Characteristic analyses of percentage of fat and waist circumference were used to develop cut‐points for individuals with adverse levels of CVD risk factors.

Results: The risk factors selected for analyses (i.e., fasting insulin, high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol, triglycerides, and total cholesterol/high‐density lipoprotein cholesterol) were significantly related to percentage of body fat and waist circumference. Likelihood ratios were used to identify percentage of fat and waist circumference cut‐points associated with adverse cardiovascular risk profiles. Two cut‐points, an upper cut‐point of 33% body fat and a lower cut‐point of 20% body fat, were derived. Waist circumference cut‐points indicative of adverse and normal risk‐factor profiles were 71 cm and 61 cm, respectively.

Discussion: The data indicate that children with ≥33% body fat and children with a waist circumference ≥71 cm were more likely to possess an adverse CVD risk‐factor profile than a normal risk‐factor profile. The likelihood of children with <20% body fat or a waist circumference <61 cm possessing an adverse CVD risk‐factor profile as opposed to a normal risk‐factor profile was small. The cut‐points describe an adequate health‐related definition of childhood obesity.
Influence of Sibutramine on Energy Expenditure in African American Women
Authors: Starling Raymond D. , Liu Xiaolan , Sullivan Dennis H.
Published: April 2008

Objective: African American women have a high prevalence of obesity, which partially may be explained by their lower rates of resting energy expenditure (REE). The aim of this study was to examine the influence of acute sibutramine administration on REE and post‐exercise energy expenditure in African American women.

Research Methods and Procedures: A total of 15 premenopausal, African American women (age, 29 ± 5 years; body fat, 38 ± 7%) completed a randomized, double‐blind cross‐over design with a 30‐mg ingestion of sibutramine or a placebo. Each trial was completed a month apart in the follicular phase and included a 30‐minute measurement of REE 2.5 hours after sibutramine or placebo administration. This was followed by 40 minutes of cycling at ∼70% of peak aerobic capacity and a subsequent 2‐hour measurement of post‐cycling energy expenditure.

Results: There was no difference (p > 0.05) in REE (23.70 ± 2.81 vs. 23.69 ± 2.95 kcal/30 min), exercise oxygen consumption (1.22 ± 0.15 vs. 1.25 ± 0.15 liter/min), and post‐cycling energy expenditure (104.2 ± 12.7 vs. 104.9 ± 11.4 kcal/120 min) between the sibutramine and placebo trials, respectively. Cycling heart rate was significantly higher (p = 0.01) during the sibutramine (158 ± 14 beats/min) vs. placebo (150 ± 12 beats/min) trials.

Discussion: These data demonstrate that acute sibutramine ingestion does not increase REE or post‐exercise energy expenditures but does increase exercising heart rate in overweight African American women. Sibutramine may, therefore, impact weight loss through energy intake and not energy expenditure mechanisms.
Is Body Mass Index a Measure of Adiposity in Elderly Women?
Authors: Bedogni Giorgio , Pietrobelli Angelo , Heymsfield Steven B. , Borghi Athos , Manzieri Anna Maria , Morini Pietro , Battistini Nino , Salvioli Gianfranco
Published: April 2008

Objective: To evaluate the accuracy of body mass index (BMI) as a predictor of body fat in elderly women.

Research Methods and Procedures: A total of 1423 women aged 67 ± 5 (mean ± SD, range: 60 to 88) years were consecutively enrolled into the study. Fat mass (FM) was measured using DXA.

Results: BMI explained 72.9% of FM variance (p < 0.0001), with a root mean square error of estimate (RMSE) of 3.5 kg. After standardization of RMSE on the dependent variable as RMSE%, the prediction error equaled 15%. BMI explained 54.8% of FM% variance (p < 0.0001), with an RMSE of 4.1%, corresponding to an RMSE% of 11%.

Discussion: The relatively high RMSE% of the FM and FM%‐BMI associations caution against the use of BMI as an adiposity index in individual elderly women. However, an error corresponding to 11% of FM% may be accepted for population studies of body fat in elderly women.
Weight Loss and Gender: An Examination of Physician Attitudes
Authors: Anderson Caitlin , Peterson Carol B. , Fletcher Linda , Mitchell James E. , Thuras Paul , Crow Scott J.
Published: April 2008

Objective: The purpose of this study was to investigate physician attitudes toward the treatment of overweight and obese individuals and to evaluate potential gender differences in treatment recommendations.

Research Methods and Procedures: A survey describing several hypothetical patients was sent to 700 randomly selected physicians; 209 (29.9%) returned the survey. Two versions of the questionnaire (one for men and one for women) described three hypothetical patients at three levels of body mass index (BMI) (32, 28, and 25 kg/m2). One‐half of the physicians received a version of the questionnaire describing the patients as women, and one‐half received a version describing the patients as men. Respondents answered questions about attitudes toward treatment and specific interventions and referrals they would view as appropriate.

Results: Physicians were more likely to encourage women with a BMI of 25 kg/m2 to lose weight than men with the same BMI, and indicated that they would suggest more treatment referrals for women than men. Men with a BMI of 32 kg/m2 were more likely to be encouraged to lose weight than women with the identical BMI. Physicians were more likely to encourage weight loss and see treatment referrals as appropriate for patients with higher BMIs.

Discussion: This study indicates that physicians treat male and female patients differently, with physicians more likely to encourage weight loss and provide referrals for women with a BMI of 25 kg/m2 than for men with an identical BMI and less likely to encourage weight loss for women than men with a BMI of 32 kg/m2.
Night Eating Syndrome Is Associated with Depression, Low Self‐Esteem, Reduced Daytime Hunger, and Less Weight Loss in Obese Outpatients
Authors: Gluck Marci E. , Geliebter Allan , Satov Tracy
Published: April 2008

Objective: The objective of this study was to assess the relationship between the night eating syndrome (NES), measures of depression and self‐esteem, test meal intake, and weight loss in obese participants.

Research Methods and Procedures: The study included 76 overweight (body mass index = 36.7 ± 6.5 SD) outpatients (53 women and 23 men; aged 43.5 ± 9.5 years) entering a weight loss program. They completed a Night Eating Questionnaire, the Zung Depression Inventory, and the Rosenberg Self‐Esteem Scale. Based on criteria by Stunkard et al. (Stunkard A, Berkowitz R, Wadden T, Tanrikut C, Reiss E, Young L. Binge eating disorder and the night eating syndrome. Int J Obes Relat Metab Disord. 1996;20:1–6), participants had NES if they reported: (1) skipping breakfast ≥4 d/wk, interpreted as morning anorexia; (2) consuming more than 50% of total daily calories after 7 pm; and (3) difficulty falling asleep or staying asleep ≥4 d/wk. Eleven (14%) participants met the criteria for NES. After an 8‐hour fast, all participants ingested a nutritionally complete liquid meal through a straw from a large opaque cooler until extremely full. They also completed ratings of hunger and fullness before and after this meal.

Results: Night eaters had higher depression (p = 0.04), lower self‐esteem (p = 0.003), and less hunger (p = 0.005), and a trend for more fullness (p = 0.06) before the daytime test meal than the others. However, there were no significant differences in test‐meal intake between groups. Nevertheless, test‐meal intake was greater later in the day only for the night eaters (p = 0.01). Over a 1‐month period, the night eaters lost less weight (4.4 ± 3.2 kg) than the others (7.3 ± 3.2 kg; p = 0.04), after controlling for body mass index.

Discussion: NES is a syndrome with distinct psychopathology and increased food intake later in the day, both of which may contribute to poorer weight loss outcome. NES criteria need to be better quantified and NES deserves consideration as a diagnostic eating disorder.
Growth of Visceral Fat, Subcutaneous Abdominal Fat, and Total Body Fat in Children
Authors: Huang Terry T.‐K. , Johnson Maria S. , Figueroa‐Colon Reinaldo , Dwyer James H. , Goran Michael I.
Published: April 2008

Objective: To examine the patterns of growth of visceral fat, subcutaneous abdominal fat, and total body fat over a 3‐ to 5‐year period in white and African American children.

Research Methods and Procedures: Children (mean age: 8.1 ± 1.6 years at baseline) were recruited from Birmingham, Alabama, and those with three or more repeated annual measurements were included in the analysis (N = 138 children and 601 observations). Abdominal adipose tissue (visceral and subcutaneous) was measured using computed tomography. Total body fat and lean tissue mass were measured by DXA. Random growth curve modeling was performed to estimate growth rates of the different body fat compartments.

Results: Visceral fat and total body fat both exhibited significant growth effects before and after adjusting for subcutaneous abdominal fat and lean tissue mass, respectively, and for gender, race, and baseline age (5.2 ± 2.2 cm2/yr and 1.9 ± 0.8 kg/yr, respectively). After adjusting for total body fat, the growth of subcutaneous abdominal fat was not significant. Whites showed a higher visceral fat growth than did African Americans (difference: 1.9 ± 0.8 cm2/yr), but there was no ethnic difference for growth of subcutaneous abdominal fat or total body fat. There were no gender differences found for any of the growth rates.

Discussion: Growth of visceral fat remained significant after adjusting for growth of subcutaneous abdominal fat, implying that the acquisition of the two abdominal fat compartments may involve different physiologic mechanisms. In contrast, growth of subcutaneous abdominal fat was explained by growth in total body fat, suggesting that subcutaneous fat may not be preferentially deposited in the abdominal area during this phase of growth. Finally, significantly higher growth of visceral fat in white compared with African American children is consistent with cross‐sectional findings.
Effect of Scalp and Facial Hair on Air Displacement Plethysmography Estimates of Percentage of Body Fat
Authors: Higgins Paul B. , Fields David A. , Hunter Gary R. , Gower Barbara A.
Published: April 2008

Objective: The objective of this study was to determine the effect of body hair (scalp and facial) on air displacement plethysmography (BOD POD) estimates of percentage of body fat.

Research Methods and Procedures: A total of 25 men (31.4 ± 8.0 years, 83.4 ± 12.2 kg, 181.8 ± 6.9 cm) agreed to grow a beard for 3 weeks to participate in the study. Total body density (g/cm3) and percentage of body fat were evaluated by BOD POD. To observe the effect of trapped isothermal air in body hair, BOD POD measures were performed in four conditions: criterion method (the beard was shaven and a swimcap was worn), facial hair and swimcap, facial hair and no swimcap, and no facial hair and no swimcap.

Results: The presence of only a beard (facial hair and swimcap) resulted in a significant underestimation of percentage of body fat (16.2%, 1.0618 g/cm3) vs. the criterion method (17.1%, 1.0597 g/cm3, p < 0.001). The effect of scalp hair (no swim cap worn) resulted in a significant underestimation in percentage of body fat relative to the criterion method, either with facial hair (facial hair and no swimcap; 14.8%, 1.0649 g/cm3) or without facial hair (no facial hair and no swimcap; 14.8%, 1.0650 g/cm3, p < 0.001 for both).

Discussion: A significant underestimation of percentage of body fat was observed with the presence of facial hair (∼1%) and scalp hair (∼2.3%). This underestimation in percentage of body fat may be caused by the effect of trapped isothermal air in body hair on body‐volume estimates. Thus, excess facial hair should be kept to a minimum and a swimcap should be worn at all times to ensure accurate estimates of body fat when using the BOD POD.
The Trp64Arg Polymorphism of the β3‐Adrenergic Receptor Gene Is Not Associated with Training‐Induced Changes in Body Composition: The HERITAGE Family Study
Authors: Garenc Christophe , Pérusse Louis , Rankinen Tuomo , Gagnon Jacques , Leon Arthur S. , Skinner James S. , Wilmore Jack H. , Rao D. C. , Bouchard Claude
Published: April 2008

Objective: To investigate the association between the Trp64Arg polymorphism of the β3‐adrenergic receptor gene and changes in body composition in response to endurance training.

Research Methods and Procedures: Adult sedentary white and black subjects participating in the HERITAGE Family Study were measured before and after 20 weeks on endurance training for the body mass index, fat mass, percentage of body fat, fat‐free mass, sum of eight skinfolds, and subcutaneous, visceral, and total abdominal fat areas. The association between the Trp64Arg polymorphism and the response phenotypes, computed as the difference between pre‐ and post‐training values, was tested by analysis of covariance separately in men and women. The gene by race interaction term was also tested.

Results: No race differences were observed for allelic and genotype frequencies. Training resulted in significant reduction of body fat in both men and women. No association of the Trp64Arg polymorphism was observed with training‐induced changes for any of the body composition phenotypes in both men and women.

Discussion: These results suggest that the Trp64Arg polymorphism of the β3‐adrenergic receptor gene is not related to changes in body composition in response to exercise training.
Treatment of Morbid Obesity in Inner‐City Women
Authors: Raghuwanshi Maya , Kirschner Marvin , Xenachis Cristina , Ediale Kola , Amir Judy
Published: April 2008

Objective:To explore the use of the very‐low‐calorie formula diet (VLCD) in the indigent population of Newark, NJ, with the goal of achieving 10% weight loss within a relatively short period of 10 weeks.

Research Methods and Procedures:We accepted 131 morbidly obese indigent women into our study program. The study was limited to women only and the average starting weight was 292.3 ± 5.9 lbs (± SE; 50.3 ± 0.9 body mass index [kg/m2]). We used three treatment paradigms: total cost‐free program for 10 weeks; cost‐free, but compliance requirements; and a weekly charge of $25. The results obtained were compared with two control populations: women enrolled during the same recruitment period in a comparable suburban VLCD program and a historical control population of suburban women treated from 1985 through 1995.

Results:In group A (total cost‐free), 79% of patients completed the 10‐week program, but only 18% of patients achieved the goal of 10% weight loss. In group B when attendance and weight loss requirements were imposed, the dropout rate accelerated such that only 37% of patients completed the 10‐week course, and 16% of the women were successful with their weight loss. In group C, imposing $25/wk financial outlay also accelerated dropouts but had little effect on weight loss success, which was 10% of the starting group. By comparison, the suburban patients and the historical control group exhibited 67% and 76% attendance rates after 10 weeks, and 33% and 55% success rates, respectively, in achieving the weight loss goal.

Discussion:We conclude that inner‐city patients exhibit great interest in weight loss when financial barriers are removed. Successful weight loss was achieved in 10% to 18% of patients using the VLCD approach, approximately one‐half of that obtained in affluent suburban women. Imposing financial or compliance restrictions to the inner‐city patients served only to enhance dropouts.
Circulating Interleukin‐6 in Relation to Adiposity, Insulin Action, and Insulin Secretion
Authors: Vozarova Barbora , Weyer Christian , Hanson Kristin , Tataranni P. Antonio , Bogardus Clifton , Pratley Richard E.
Published: April 2008

Objective: Plasma concentrations of interleukin‐6 (IL‐6), a proinflammatory cytokine produced and released in part by adipose tissue, are elevated in people with obesity and type 2 diabetes. Because recent studies suggest that markers of inflammation predict the development of type 2 diabetes, we examined whether circulating plasma IL‐6 concentrations were related to direct measures of insulin resistance and insulin secretory dysfunction in Pima Indians, a population with high rates of obesity and type 2 diabetes.

Research Methods and Procedures: Fasting plasma IL‐6 concentrations (enzyme‐linked immunosorbent assay), body composition (DXA), insulin action (M; hyperinsulinemic euglycemic clamp), and acute insulin secretory responses to glucose (25 g intravenous glucose tolerance test) were measured in 58 Pima Indians without diabetes (24 women, 34 men).

Results: Fasting plasma IL‐6 concentrations were positively correlated with percentage of body fat (r = 0.26, p = 0.049) and negatively correlated with M (r = −0.28, p = 0.031), but were not related to acute insulin response (r = 0.13, p = 0.339). After adjusting for percentage of body fat, plasma IL‐6 was not related to M (partial r = −0.23, p = 0.089).

Discussion: Fasting plasma IL‐6 concentrations are positively related to adiposity and negatively related to insulin action in Pima Indians. The relationship between IL‐6 and insulin action seems to be mediated through adiposity.
Influence of Total vs. Visceral Fat on Insulin Action and Secretion in African American and White Children
Authors: Goran Michael I. , Bergman Richard N. , Gower Barbara A.
Published: April 2008

Objective: To examine whether total body fat (FAT) in general or visceral fat (VFAT) in particular is associated with greater metabolic risk in white and African American children.

Research Methods and Procedures: A total of 68 white and 51 African American children had measures of insulin sensitivity (Si) and acute insulin response (AIR) by a frequently sampled intravenous glucose tolerance test, total body fat by DXA and abdominal fat distribution (visceral vs. subcutaneous) by computed tomography. The influence of FAT and VFAT on insulin parameters were examined by comparing subgroups of children with high or low FAT vs. high or low VFAT and by multiple regression analysis.

Results: In whites, fasting insulin, Si, and AIR were significantly influenced by FAT, but not VFAT (e.g., for Si, 9.8 ± 0.8 in low FAT vs. 4.6 ± 0.7 × 10−4/min/[μIU/mL] in high FAT, p < 0.05; 6.8 ± 0.7 in low VFAT vs. 7.5 ± 0.8 × 10−4/min/[μIU/mL] in high VFAT, p > 0.1). In African Americans, fasting insulin and Si were also primarily influenced by FAT (e.g., for Si, 4.9 ± 0.4 in low FAT vs. 2.8 ± 0.5 × 10−4/min/[μIU/mL] in high FAT, p < 0.05) but not by VFAT, and there were no significant effects of either fat compartment on AIR. In multiple regression analysis, Si was significantly influenced by FAT (negative effect), ethnicity (lower in African Americans), and gender (lower in females), whereas fasting insulin was significantly influenced by VFAT (positive effect), ethnicity (higher in African Americans), and fat free mass (positive effect).

Discussion: Body fat in general is the predominant factor influencing Si, but VFAT may have additional effects on fasting insulin. The lack of major effects of VFAT on Si in children may be explained by lower levels of VFAT or because VFAT affects aspects of whole body insulin action that are not measured by the minimal model.
Total and Central Obesity among Elderly Hispanics and the Association with Type 2 Diabetes
Authors: Bermudez Odilia I. , Tucker Katherine L.
Published: April 2008

Objective: To report the prevalence of total and central obesity in a representative sample of Puerto Rican and Dominican elders in Massachusetts, to compare them with a neighborhood‐based group of non‐Hispanic white elders, and to examine associations of obesity indices with the presence of type 2 diabetes.

Research Methods and Procedures: We examined the prevalence of overweight, obesity, and central obesity in 596 Hispanics of Caribbean origin, ages 60 to 92 years, and 239 non‐Hispanic whites, and tested linear and logistic regression models to determine associations among body mass index (BMI), waist circumference (WC), and diabetes.

Results: Obesity (BMI ≥ 30 kg/m2) was prevalent among all ethnic groups, ranging from 17% to 29% for Dominican and Puerto Rican men, respectively, and from 29% to 40% for non‐Hispanic white and Dominican women, respectively. These differences were not statistically significant. Among Hispanic men and women, diabetes was prevalent across all BMI and WC categories but tended to be greatest among those with BMI of 25 to 29 kg/m2 (41% to 43%). In contrast, diabetes was most prevalent in the obese group (36% to 45%) of non‐Hispanic whites. Both BMI and WC were associated with the presence of diabetes, but the coefficients were greater for non‐Hispanic whites than for Hispanics.

Discussion: Caribbean Hispanics and non‐Hispanic whites living in the same Massachusetts localities had high prevalences of overweight and obesity. Total and central obesity exerted a differential effect on the presence of diabetes among ethnic groups; for Hispanics, diabetes was prevalent even among non‐obese individuals, whereas for non‐Hispanic white women, the prevalence of diabetes was strongly associated with total and central obesity. Additional research is needed to investigate the factors associated with the differential effect of obesity on the prevalence of type 2 diabetes among Hispanic and non‐Hispanic white elders.
Ability of Young Women to Recall Past Body Size and Age at Menarche
Authors: Koprowski Carol , Coates Ralph J. , Bernstein Leslie
Published: April 2008

Objective: The ability of young women (n = 132, average age 17 years) to recall body size and age at menarche was examined. The use of body silhouettes to assist women in recalling their body size at menarche and to represent their current body size was also evaluated.

Research Methods and Procedures: Subjects, who previously participated in a cohort study, were asked to recall height and weight at the time of menarche, to select body silhouettes that best reflected their body shape at the time of menarche and their current body shape, and to recall age at menarche. Two sets of body silhouettes were developed, one representative of an adult body shape and another representative of an adolescent body shape.

Results: Pearson correlation coefficients between the adult and adolescent body figures and actual body mass index (BMI; kg/m2) at the time of menarche were not significantly different (r = 0.82 for adult figures vs. r = 0.72 for adolescent figures, p > 0.05). The correlation between actual BMI at the time of menarche and body silhouette (r = 0.77, all subjects) was similar to the correlation between actual and recalled BMI at the time of menarche (r = 0.83) as well as the correlation between current BMI and current body silhouette (r = 0.75). Recalled and actual ages at menarche were highly correlated (r = 0.83).

Discussion: The recall of body shape was considered to be a less precise measure of body size than asking about height and weight, but use of body silhouettes may offer advantages in certain situations.