Overweight Adults (overweight + adult)

Distribution by Scientific Domains

Selected Abstracts

Original Paper: Telmisartan Effects on Insulin Resistance in Obese or Overweight Adults Without Diabetes or Hypertension

Willa Hsueh MD
J Clin Hypertens (Greenwich). 2010;12:746,752. 2010 Wiley Periodicals, Inc. Angiotensin receptor blockers (ARBs) are antihypertensive agents associated with reduced risk of new-onset diabetes mellitus. The ARB telmisartan is a partial agonist of peroxisome proliferator,activated receptor-gamma (PPAR-,). This study evaluated the effect of telmisartan on insulin resistance, a known target of PPAR-, agonism. Overweight/obese persons with body mass index ,28 kg/m2, waist circumference ,35 inches, and components of the metabolic syndrome without hypertension or diabetes who were not preselected for insulin resistance were enrolled. Patients were randomized to telmisartan or matching placebo for 16 weeks. The primary efficacy measure was changed from baseline in the insulin sensitivity index (SI), calculated from oral glucose tolerance testing. SI was also evaluated in a subset of patients using a hyperinsulinemic euglycemic clamp. Secondary end points included measures of insulin sensitivity and glucose and lipid metabolism. A total of 138 patients were randomized and received ,1 dose of study medication; 128 completed the study. At end point, no significant difference was found between telmisartan and placebo groups regarding change from baseline in SI or in glucose area under the curve. No significant between-group differences were found regarding glucose metabolism or lipoprotein levels. In the population with abdominal obesity and components of the metabolic syndrome, telmisartan did not increase insulin sensitivity. [source]

The addition of metformin in type 1 diabetes improves insulin sensitivity, diabetic control, body composition and patient well-being

R. J. Moon
Aim:, As many overweight people with T1DM are insulin resistant, adjuvant therapy with insulin sensitising agents, such as metformin, may be beneficial. This study evaluated the effect of adjuvant metformin in T1DM on insulin sensitivity, diabetic control, body composition, quality of life (QOL) and treatment satisfaction. Materials and Methods:, A 3-month prospective open-labelled pilot study of 16 patients aged 18-40 with T1DM and body mass index (BMI) >25 kg/m2 was performed. The patients received 500-850 mg metformin twice daily. Insulin sensitivity, assessed by a frequently sampled intravenous glucose tolerance test [n=5], body composition, HbA1c and quality of life (QOL) were measured before and after treatment. A retrospective review of 30 patients with T1DM treated with metformin for at least 4 months was also performed. BMI, HbA1c and insulin requirements during metformin treatment was compared to pre-metformin data, and to patients treated with insulin only. Results:, In the pilot study, insulin sensitivity increased significantly from 0.86 0.33 10,4/min/(U/ml) to 1.17 0.48 10,4/min/(U/ml) after 3 months adjuvant therapy (p = 0.043). This was associated with a decreased insulin requirement and mean daily blood glucose. There were no significant changes in HbA1c or body composition. QOL significantly improved (p < 0.002). The retrospective review revealed an initial reduction in HbA1c (0.8 1.4%, p = 0.001). This effect diminished with prolonged treatment. BMI decreased in patients remaining on metformin for a 2-year period (0.5 0.5kg/m2, p = 0.042). Conclusion:, Adjuvant metformin can improve QOL, insulin sensitivity and glycaemic control in overweight adults with T1DM. [source]

The association of physical activity and depression in Type 2 diabetes

Z. Lysy
Abstract Aims Physical inactivity and depressed mood are both associated with a higher likelihood of diabetes-related complications; the association between physical activity and depressed mood in Type 2 diabetes has not been reviewed previously. We have reviewed (i) the strength of this association and (ii) the impact of depression-specific management and physical activity interventions on mood and activity levels in overweight adults with Type 2 diabetes. Methods Studies published between January 1996 and September 2007 were identified (Ovid - medline, Psych- Info and embase) using pertinent search terms (keyword/title). Results Of the 12 studies included (10 cross-sectional, two trials), most employed a standardized questionnaire for depressed mood but only one item for physical activity. In adults with Type 2 diabetes, the inactive are 1.72 to 1.75 times more likely to be depressed than the more active; the depressed are 1.22 to 1.9 times more likely to be physically inactive than the non-depressed. Two randomized trials demonstrated that a depression management programme improved mood, but only one demonstrated increased physical activity. Conclusions Studies to date suggest an association between depressed mood and physical inactivity in adults with Type 2 diabetes, although objective measures of physical activity have not been employed. Depression-specific management may improve mood and possibly activity. A trial comparing the impact of depression-specific management compared with exercise intervention on depressed mood and activity in Type 2 diabetes is justified. [source]

Childhood body mass index gain during the summer versus during the school year

Douglas B. Downey
The nationwide increase in obesity affects all population sectors, but the impact on children is of special concern because overweight children are prone to becoming overweight adults. Contrary to the opinion of experts, research suggests that schools may be more part of the solution than the problem. Recent seasonal comparison research (comparing children's outcomes during the summer and during school year) reports that children gain body mass index (BMI) nearly twice as fast during the summer as during the school year. Whereas most children experience healthier BMI gain during the school year than the summer, this is especially the case for black and Hispanic children and for children already overweight. [source]

Trends in overweight and obese adults in Malaysia (1996,2009): a systematic review

A. Z. Khambalia
Summary Like other nations experiencing rapid industrialization, urbanization and a nutrition transition, there is concern in Malaysia of a possible escalation in the prevalence of overweight and obesity. In 1996, the National Health and Morbidity Survey reported a 16.6% and 4.4% prevalence of overweight and obesity, respectively. In the following decade, there have been several national and community surveys on overweight and obesity in Malaysia. The objective of this systematic review is to describe the trend from 1996 to 2009 in the prevalence of overweight and obesity in adults in Malaysia nationally and by gender, age and race. Results indicate that there has been a small rise in overweight adults in the years 1996, 2003 and 2006 (20.7%, 26.7% and 29.1%) and a much more dramatic increase in obesity in 1996, 2003, 2004 and 2006 (5.5%, 12.2%, 12.3% and 14.0%). Evidence showed a greater risk for overweight and obesity among women compared with men. Based on the highest-quality studies, overweight and obesity levels were highest among adults 40,59 years old. Overweight levels were highest among Indians, followed by Malays, Chinese and Aboriginals, with less consistency across studies on the order of risk or obesity by ethnicity. [source]

Relationship between costs of lifestyle interventions and weight loss in overweight adults

R. P. Bogers
Summary Lifestyle interventions in a healthcare setting are effective for weight loss, but it is unclear whether more expensive interventions result in more weight loss. Our objective was to explore the relationship between intervention costs and effectiveness in a systematic review of randomized trials. Intervention studies were selected from 14 reviews and from a systematic MEDLINE-search. Studies had to contain a dietary and a physical activity component and report data on measured weight loss in healthy Caucasian overweight adults. Intervention costs were calculated in a standardized way. The association between costs and percentage weight loss after 1 year was assessed using regression analysis. Nineteen original studies describing 31 interventions were selected. The relationship between weight loss and intervention costs was best described by an asymptotic regression model, which explained 47% of the variance in weight loss. A clinically relevant weight loss of 5% was already observed in interventions of approximately ,110. Results were similar in an intention-to-treat analysis. In conclusion, lifestyle interventions in health care for overweight adults are relatively cheap and higher intervention costs are associated with more weight loss, although the effect of costs on weight loss levels off with growing costs. [source]

Long-term effectiveness of diet-plus-exercise interventions vs. diet-only interventions for weight loss: a meta-analysis

T. Wu
Summary Diet and exercise are two of the commonest strategies to reduce weight. Whether a diet-plus-exercise intervention is more effective for weight loss than a diet-only intervention in the long-term has not been conclusively established. The objective of this study was to systemically review the effect of diet-plus-exercise interventions vs. diet-only interventions on both long-term and short-term weight loss. Studies were retrieved by searching MEDLINE and Cochrane Library (1966 , June 2008). Studies were included if they were randomized controlled trials comparing the effect of diet-plus-exercise interventions vs. diet-only interventions on weight loss for a minimum of 6 months among obese or overweight adults. Eighteen studies met our inclusion criteria. Data were independently extracted by two investigators using a standardized protocol. We found that the overall standardized mean differences between diet-plus-exercise interventions and diet-only interventions at the end of follow-up were ,0.25 (95% confidence interval [CI],0.36 to ,0.14), with a P -value for heterogeneity of 0.4. Because there were two outcome measurements, weight (kg) and body mass index (kg m,2), we also stratified the results by weight and body mass index outcome. The pooled weight loss was 1.14 kg (95% CI 0.21 to 2.07) or 0.50 kg m,2 (95% CI 0.21 to 0.79) greater for the diet-plus-exercise group than the diet-only group. We did not detect significant heterogeneity in either stratum. Even in studies lasting 2 years or longer, diet-plus-exercise interventions provided significantly greater weight loss than diet-only interventions. In summary, a combined diet-plus-exercise programme provided greater long-term weight loss than a diet-only programme. However, both diet-only and diet-plus-exercise programmes are associated with partial weight regain, and future studies should explore better strategies to limit weight regain and achieve greater long-term weight loss. [source]