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Mean BMI (mean + bmi)
Selected AbstractsCirculating leptin and body composition in chronic obstructive pulmonary diseaseINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 10 2005S. Karakas Summary Nutritional depletion and weight loss are two features of chronic obstructive pulmonary disease (COPD), and the association between low body mass index (BMI) and poor prognosis in patients with COPD is a common clinical observation. Mechanisms of weight loss are still unclear in COPD. Excessive energy expenditure partly due to increased work of breathing was shown, but other mechanisms have been searched for. Leptin is a hormone secreted by adipocytes that plays an important role in energy homeostasis and regulates body weight through control of appetite and energy expenditure. The aim of this study was to evaluate the association of circulating leptin levels and measures of body composition in COPD patients. Thirty male COPD outpatients (mean age 66.3 ± 8.4) and 20 controls (mean age 65.9 ± 10.8) were included in the study. After standard spirometry and body composition measurements, serum leptin concentration was measured by ELISA assay. COPD patients were grouped according to BMI. Mean BMI was 19.01 ± 2.26 kg/m2 in group 1 (COPD patients with low BMI), 26.85 ± 4.51 in group 2 COPD (COPD patients with normal/high BMI) and 27.64 ± 2.75 kg/m2 in healthy controls (group 3). Mean serum leptin concentration was 1.41 ± 1.86 ng/ml in group 1, 2.60 ± 1.38 ng/ml in group 2 and 2.82 ± 1.46 ng/ml in group 3 (p = 0.002). Leptin correlated to not only BMI but also body weight, waist circumference, triceps and biceps skinfold thickness and body fat percent (p < 0.05 for all). Results of this study suggest that the cause of weight loss is not increased circulating leptin in COPD. Instead, leptin remains regulated in COPD and further decreased in patients with low BMI, probably as a compensatory mechanism to preserve body fat content, which should be evaluated in further studies. [source] Exploring the nutrition and lifestyle knowledge, attitudes and behaviour of student home economics teachers: baseline findings from a 4-year longitudinal studyINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 4 2008Mary Isobelle Mullaney Abstract It is widely acknowledged that obesity linked with reduced exercise contributes to health problems, and that, conversely, individuals who embark on weight reducing diets may become deficient in key nutrients. It is often advocated that these problems, which can be grouped together as poor dietary practice, be tackled through education. This study attempts to examine the relationship between nutrition education and lifestyle behaviours in a select group of third level students. The Irish Home Economics curriculum aims to teach secondary school pupils about nutrition and lifestyle practices conducive to health. However, the attitudes and lifestyle practices of those teaching this subject have never been examined in Ireland. The purpose of the present 4-year longitudinal study, whose first year findings are presented here, is to investigate the nutrition and lifestyle knowledge, attitudes and behaviours of a cohort of Irish student home economics teachers over the 4 years of their Bachelor of Education (Home Economics) degree course. The study was designed to explore possible changes in knowledge, attitudes and practices over the course of their professional education. Nutritional knowledge was measured using a 220-question adapted version of the test devised by Parmenter and Wardle. Attitudes were measured using a questionnaire adapted from the Pan-EU Survey on Consumer Attitudes to Physical Activity, Body-weight and Health. Food, alcohol consumption and exercise were measured using a 7-day reported dietary/exercise diary. Nutrient intake data were determined using dietary analysis. Weight, height and waist circumference were measured and body mass index (BMI) calculated. When starting college, student home economics teachers have broadly similar anthropometric, dietary and lifestyle characteristics to those of their contemporaries. Mean BMI was identical [24.4 kg/m2 (SD 4.3)] to that reported in the North/South Ireland Food Consumption Survey (NSIFCS) for those aged 18,35 years, although energy intakes were significantly higher in the cohort of student teachers (P = 0.000). Thirty-eight per cent were overweight or obese vs. 33.6% in the NSIFCS. Only 17% (n = 6) of students achieved an intake of 300 µg/day of folate as recommended by the Food Safety Authority of Ireland and only one the recommended intake of non-starch polysaccharides (18 g/day). One in three students in this study smoke (16 of 48) and alcohol consumption was high. Only one student was very active. Students scored a mean of 55% (SD 8%) on the knowledge test, with similar scores attained for specific aspects of nutritional knowledge (i.e. food groups, constituents of foods, current dietary advice, nutrients, lifestyle practices). However, knowledge of nutrition definitions was weaker with a mean score of 31% (SD 8.6%). Students had a positive attitude towards food choice, the link between food and health and control over their own diet. Similar attitudes towards exercise, smoking and alcohol consumption were displayed despite students perceiving themselves as not having a balanced diet, having insufficient exercise and having regretted something done as a result of consuming alcohol. They appear to display optimistic bias in relation to health risks. These findings provide baseline data for the longitudinal study and indicate that those choosing to pursue a career as a home economics teacher in Ireland have similar nutritional and lifestyle characteristics to those of their contemporaries. [source] Obesity As a Risk Factor for Sustained Ventricular Tachyarrhythmias in MADIT II PatientsJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 2 2007GRZEGORZ PIETRASIK M.D. Background: Obesity, as defined by body mass index ,30 kg/m2, has been shown to be a risk factor for cardiovascular disease. However, data on the relationship between body mass index (BMI) and the risk of ventricular arrhythmias and sudden cardiac death are limited. The aim of this study was to evaluate the risk of ventricular tachyarrhythmias and sudden death by BMI in patients after myocardial infarction with severe left ventricular dysfunction. Methods: The risk of appropriate defibrillator therapy for ventricular tachycardia or ventricular fibrillation (VT/VF) by BMI status was analyzed in 476 nondiabetic patients with left ventricular dysfunction who received an implantable cardioverter defibrillator (ICD) in the Multicenter Automatic Defibrillator Implantation Trial-II (MADIT II). Results: Mean BMI was 27 ± 5 kg/m2. Obese patients comprised 25% of the study population. After 2 years of follow-up, the cumulative rates of appropriate ICD therapy for VT/VF were 39% in obese and 24% in nonobese patients, respectively (P = 0.014). In multivariate analysis, there was a significant 64% increase in the risk for appropriate ICD therapy among obese patients as compared with nonobese patients, which was attributed mainly to an 86% increase in the risk of appropriate ICD shocks (P = 0.006). Consistent with these results, the risk of the combined endpoint of appropriate VT/VF therapy or sudden cardiac death (SCD) was also significantly increased among obese patients (Hazard Ratio 1.59; P = 0.01). Conclusions: Our findings suggest that in nondiabetic patients with ischemic left ventricular dysfunction, a BMI ,30 kg/m2 is an independent risk factor for ventricular tachyarrhythmias. [source] Prevalence of overweight and obesity in young Greek menOBESITY REVIEWS, Issue 2 2008A. Papadimitriou Summary We determined the prevalence of overweight and obesity in young Greek men in 2006 and examined variations related to their place of residence and educational level. Body height and weight were measured in 2568 conscripts of the Greek army, aged 19,26 years. The calculated body mass index (BMI, kg m,2) was correlated to their socio-demographic characteristics, i.e. level of education and place of residence (urban or rural). Overweight and obesity were defined according to the World Health Organization classification. Mean BMI (standard deviation) of the conscripts was 24.7 (4.2). The prevalence of overweight (30 > BMI , 25 kg m,2) was 28.5% and correlated positively with a higher educational level, whereas the prevalence of obesity (BMI , 30 kg m,2) was 10.4% and correlated positively with a lower educational level. Our data were compared with those of similar studies performed in the years 1969: BMI 23.8 (1.4) (P < 0.0001) and 1990: BMI 23.8 (2.9) (P < 0.0001), showing a positive secular trend for BMI in Greek conscripts in the last 16 years. In conclusion, we documented an alarmingly high prevalence of overweight and obesity among young Greek men. [source] BT03 SILASTIC RING MINI GASTRIC BYPASS FOR MORBID OBESITY: THE NEW ZEALAND EXPERIENCEANZ JOURNAL OF SURGERY, Issue 2009K. C. Wong Purpose: , The laparoscopic mini gastric bypass (LMGB) is purportedly a technically simpler, yet equally effective operation to the laparoscopic Roux-en-Y gastric bypass as treatment for morbid obesity. This study reports the early results of LMGB in a major New Zealand bariatric centre. Methodology: , Clinical data was prospectively collected on all patients undergoing LMGB over a two year period. Results: , 142 patients were studied. 77% were females. Mean age was 43.8. Pre-operative mean body weight and body mass index (BMI) were 121.3 kg and 45.4 kg/m2 respectively. Mean BMI at one and two years follow up had decreased to 27.35 and 25.72 kg/m2 respectively. 83% of patients reported obesity associated co-morbidities pre-operatively. Post-operatively, 78% of patients reported a reduction in medication requirement. All surgery was performed laparoscopically. There were no anastomotic leaks and zero mortality. 8% of patients required further operations for complications or revision to a Roux-en-Y gastric bypass. 20% of patients required subsequent endoscopic interventions, the majority for investigation of vomiting and/or pain. 22% of patients required re-admission. 14% of patients reported new onset reflux or worsening of pre-existing reflux after LMGB. 82% of patients reported increased exercise capability post LMGB. 54% of patients required vitamin supplementation. Conclusion: , LMGB achieves significant weight loss and resolution of obesity related co-morbidities with a low short term complication rate. LMGB should be considered as a safe and simple surgical option for morbid obesity. [source] Posttraumatic stress disorder as a risk factor for obesity among male military veteransACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2007W. V. R. Vieweg Objective:, Obesity is a significant public health problem in the United States, particularly among military veterans with multiple risk factors. Heretofore, posttraumatic stress disorder (PTSD) has not clearly been identified as a risk factor for this condition. Method:, We accessed both a national and local database of PTSD veterans. Results:, Body mass index (BMI) was greater (P < 0.0001) among male military veterans (n = 1819) with PTSD (29.28 ± 6.09 kg/m2) than those veterans (n = 44 959) without PTSD (27.61 ± 5.99 kg/m2) in a sample of randomly selected veterans from the national database. In the local database of male military veterans with PTSD, mean BMI was in the obese range (30.00 ± 5.65) and did not vary by decade of life (P = 0.242). Conclusion:, Posttraumatic stress disorder may be a risk factor for overweight and obesity among male military veterans. [source] Growth and Lipid Metabolism in Girls and Young Women with Epilepsy during Pubertal MaturationEPILEPSIA, Issue 7 2005Kirsi Mikkonen Summary:,Purpose: To assess growth and the serum lipid profile in girls with epilepsy receiving monotherapy at a mean age of 12.6 years and approximately 6 years later. Methods: A population-based cohort of 77 girls with epilepsy and 49 healthy controls participated in this follow-up study including two cross-sectional evaluations (age range, 8,18.5 years on the first evaluation, and 12.5,25.8 years on the second evaluation). Forty of the patients were initially taking valproate (VPA), 19, carbamazepine (CBZ), and 18, oxcarbazepine (OXC). Growth data were compiled, body mass index (BMI) was calculated, and serum total (TC), and high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) cholesterol and triglyceride concentrations were analyzed. Results: Linear growth and final height did not differ between the patients and the controls. At follow-up, the mean BMI of the patients who were off medication (61%) was similar to that of the controls, whereas the patients initially treated with VPA who were still taking any medication had a higher BMI. On the first evaluation, the patients taking VPA had low serum HDL-C, and those taking CBZ or OXC had high serum TC and LDL-C concentrations. At follow-up, serum lipid levels were similar in the patients off medication and the controls. Conclusions: Neither epilepsy nor antiepileptic therapy affects linear growth or final height, but they may have unfavorable effects on body weight and serum lipid concentrations. Lipid-profile impairment seems to be transient if the medication is discontinued. Overweight is common in patients treated with VPA during puberty if epilepsy and medication continue into adulthood. [source] Does ecological momentary assessment improve cognitive behavioural therapy for binge eating disorder?EUROPEAN EATING DISORDERS REVIEW, Issue 5 2002A pilot study Abstract The purpose of this pilot study was to test whether self-monitoring in CBT could be enhanced in order to improve the identification of proximal antecedents of binge eating in binge eating disorder (BED). CBT was modified by asking participants to monitor all eating intensively through ecological momentary assessment (EMA). A total of 41 females (mean BMI,=,37.9; SD,=,8.2) meeting DSM-IV criteria for BED were randomly assigned to one of two group treatments; CBT (n,=,22) or CBT with EMA (n,=,19). CBT with EMA differed from CBT in that for the first 2 weeks of treatment, participants completed detailed pocket diaries about mood, events, etc., when signalled at random by programmable wristwatches, as well as at all times when eating. All participants completed measures of eating (EDE-Q, TFEQ, EES) and general psychopathology (BDI, RSE) before treatment, at the end of treatment, and at 1-year follow-up. While both treatment groups showed improvement on the outcome variables of interest, the individual data gained via EMA did not significantly enhance standard CBT. Therefore, it is unlikely that further research incorporating EMA as a therapeutic technique within CBT for BED will be compelling. Copyright © 2002 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Influence of angiotensin-converting enzyme I/D gene polymorphism on clinical and histological correlates of chronic hepatitis CHEPATOLOGY RESEARCH, Issue 8 2009Carlo Fabris Aim:, This study aimed to verify the relationship between the insertion,deletion (I/D) polymorphism of angiotensin-converting enzyme (ACE) and clinical and histological correlates of chronic hepatitis C. Methods:, Two-hundred and fifty-eight, treatment naive, unselected hepatitis C virus (HCV) RNA-positive patients and 210 controls were studied. ACE allelic variants were determined by polymerase chain reaction. Results:, Mean staging scores adjusted for age, body mass index (BMI) and alcohol consumption were: men, D/* = 2.283; men, I/I = 2.092; women, D/* = 2.241; and women, I/I = 3.283 (P = 0.028). Age-adjusted mean BMI were: men, D/* = 25.01; men, I/I = 24.87; women, D/* = 23.73; and women, I/I = 22.50 (P = 0.006). Age and BMI-adjusted mean low-density lipoprotein (LDL)/ high-density lipoprotein (HDL) cholesterol ratios were: men, D/* = 2.344; men, I/I = 2.283; women, D/* = 1.916; and women, I/I = 1.903 (P = 0.004). Histological grading correlated positively with triglycerides and negatively with HDL and LDL cholesterol (P < 0.0001). Conclusion:, Female ACE I/I homozygotes have higher liver fibrosis scores in comparison to D/* women and to men; moreover, they are leaner and have a lower LDL/HDL cholesterol ratio. These observations suggest a possible mutual influence between ACE polymorphism, serum lipid concentrations and outcome of chronic HCV infection. [source] Gender-dependent effect of ageing on peripheral insulin actionINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 4 2005A-M. Borissova Summary The aim of the present study was to investigate the effect of both gender and age on insulin secretion, peripheral insulin effectiveness and insulin-receptor binding. Eighty healthy volunteers, 40 females of mean age 38.47 ± 11.37 years and mean BMI 21.99 ± 2.06 kg/m2 and 40 males of mean age 34.87 ± 11.22 years and mean BMI 22.65 ± 2.31 kg/m2, with normal glucose tolerance participated in the study. Peripheral insulin effectiveness was measured by the artificial endocrine pancreas, using the euglycaemic hyperinsulinaemic clamp technique and insulin-receptor binding on circulating mononuclear blood cells. Peripheral insulin sensitivity was significantly higher in females as compared to males (p < 0.001), while males demonstrated higher total number of insulin receptors (p < 0.0001) and number of high-affinity receptors (p < 0.01). Peripheral insulin sensitivity decreased with ageing in both males and females, the reduction in females being more pronounced (p < 0.05). In the group under 40 years, the females demonstrated significantly higher insulin sensitivity as compared to males (p < 0.001) and lower insulin-receptor binding. Over 40 years, females presented higher peripheral insulin sensitivity and higher insulin-receptor binding. The percentage of specifically bound insulin increased significantly with ageing in females and decreased in males. We consider that probably the higher androgen level in males affects the post-receptor processes in insulin action and despite the higher insulin-receptor binding, males have lower insulin sensitivity. The androgen levels in females increase with ageing, which could probably affect peripheral insulin sensitivity at the post-receptor level. In conclusion, our results demonstrate that when analysing peripheral insulin effectiveness and insulin-receptor binding, one should always consider both gender and age. [source] Obesity in adults with Down syndrome: a case,control studyJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 2 2005C. A. Melville Abstract Background Obesity has a negative impact upon mortality and morbidity. Studies report that obesity is more prevalent in individuals with Down syndrome than individuals with intellectual disabilities (ID) not associated with Down syndrome. However, there have been no studies using a methodology of matched comparison groups and findings from previous studies are contradictory. Methods A detailed method was used to identify all adults with ID in Leicestershire. Individuals were invited to participate in a medical examination , that included measurement of their height and weight, from which body mass index (BMI) was calculated. For each person with Down syndrome, an individual matched for gender, age and accommodation type was identified, from the Leicestershire ID database. Results The data for 247 matched pairs is reported. Women with Down syndrome had lower mean height and weight, but greater mean BMI than the matched pairs. Men with Down syndrome had a lower mean height and weight but there was no statistical difference in BMI compared to the matched pairs. Using World Health Organization categories of BMI, women with Down syndrome were more likely to be overweight or obese than their matched pairs (odds ratio = 2.17). Men with Down syndrome were more likely to be in the overweight category than their matched pairs but were less likely to be obese (odds ratio = 0.85). Conclusions This study demonstrates that, compared to a matched sample, there is a greater prevalence of obesity amongst women with Down syndrome but not men. As the impact on the health of people with Down syndrome of being overweight or obese is uncertain, this is an area that requires further study. [source] Meeting American Diabetes Association Guidelines In Endocrinologist PracticeJOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 2 2000C.D. Miller OBJECTIVE,To determine whether American Diabetes Association (ADA) guidelines can be met in the context of routine endocrinology practice. RESEARCH DESIGN AND METHODS,Charts were reviewed for a group of patients who were examined in 1998, followed for greater than or equal to 1 year, and had two or more visits during that year. Process measures and metabolic outcomes were studied for patients with type 2 diabetes, and glycemic control was assessed for patients with type 1 diabetes. RESULTS,A total of 1.21 patients with type 2 diabetes had a mean age of 63 years, a mean BMI of 31 kg/m(2), and a mean duration of diabetes of 12 years. Many had comorbidities or complications: 80% had hypertension, 64% had hyperlipidemia, 78% had neuropathy, 22% had retinopathy, and 21% had albuminuria. Management of type 2 diabetic patients was complex: 38% used oral hypoglycemic agents alone (54% of these were using two or more agents), 31% used oral hypoglycemic agents and insulin, and 26% used insulin alone, 42% of patients taking insulin therapy injected insulin three or more times per day. Within 12 months, 74% of patients had dilated eye examinations, 70% had lipid profiles, and 55% had urine albumin screening. Of the patients, 87% had a foot examination at their last visit. Blood pressure levels averaged 133/72 mmHg, cholesterol levels averaged 4.63 mmol/l, triglyceride levels averaged 1.99 mmol/l. HDL cholesterol levels averaged 1.24 mmol/l, and LDL cholesterol levels averaged 2.61. mmol/l. Random blood glucose levels averaged 8.0 mmol/l, and HbA(1c) levels averaged 6.9 +/, 0.1%. A total of 87% of patients had HbA(1c) levels less than or equal to 8.0%. A total of 30 patients with type 1 diabetes had mean age of 44 years, a mean BMI of 26 kg/m(2), and a mean duration of diabetes of 20 years. All type 1 diabetic patients used insulin and averaged 3.4 injections a day, their average HbA(1c) level was 7.1 +/, 0.2%, and 80% had HbA(1c) levels less than or equal to 8.0%. CONCLUSIONS,Although endocrinologists must manage patients with multifaceted problems, complex treatment regimens yield glycemic control levels comparable with the Diabetes Control and Complications Trial and allow ADA guidelines to be met in a routine practice setting. [source] 11 Gastric myoelectric activity while viewing and eating food in obese participantsNEUROGASTROENTEROLOGY & MOTILITY, Issue 6 2006JY WANG Purpose:, This study observed the reactions of the stomach to food viewing and food eating in obese people. Method:, The participants were 20 obese (mean BMI of 32) and 20 normal-weighted (mean BMI of 21) undergraduate students, who were required to fast for at least 4 hours preceding the experiment. They viewed a video clip of food for 6 minutes; consumed food till full; and viewed the same video clip of food 30 minutes after the meal. Cutaneous electrogastrograms (EGGs) were recorded during the entire procedure. Questionnaires concerning the participants' perception of somatic and affective changes during the tasks were completed. Results:, The percentages of bradygastric, normal and tachygastric EGG activity were very similar between obese group and normal-weighted group during the baseline period. During the first food image viewing, an increase in normal 3 cpm activity and a decreased in bradygastric activity occurred in both groups, but obese participants showed less of an increase in 3 cpm activity than normal-weighted participants and the percentage of bradygastric activity was higher in obese group than in the normal-weighted group. During the 30 min. period following the meal, a higher percentage of bradygastric activity and a lower percentage of 3 cpm activity were observed in obese participants than in normal-weighted participants. Furthermore, obese participants showed a different pattern of change in 3 cpm and bradygastric activity than normal-weighed participants during the 30 min. The whole 30-min period was divided into five 6-min periods. In the obese group, the percentage of 3 cpm activity decreased in the third and forth 6-min periods and increased to the highest level in the last 6-min period, while in the normal-weighted group, the 3 cpm percentage was the greatest in the first 6-min period. Obese participants and normal-weighted participants reacted similarly to the second food image exposure, except that a higher increase in 3 cpm activity was observed in the normal-weighted group in the period after the termination of viewing the food images. Conclusions:, These data suggest that obese people react to food images and to food eating differently from normal-weighted people. EGG activity in obese participants needs further investigation. [source] Prevalence of overweight in the Seychelles: 15 year trends and association with socio-economic statusOBESITY REVIEWS, Issue 6 2008P. Bovet Summary We assessed the 15-year trends in the distribution of body mass index (BMI) and the prevalence of overweight in the Seychelles (Indian Ocean, African Region) and the relationship with socio-economic status (SES). Three population-based examination surveys were conducted in 1989, 1994 and 2004. Occupation was categorized as ,labourer', ,intermediate' or ,professional'. Education was also assessed in 1994 and 2004. Between 1989 and 2004, mean BMI increased markedly in all sex and age categories (overall: 0.16 kg m,2 per calendar year, which corresponds to 0.46 kg per calendar year). The prevalence of overweight (including obesity, BMI , 25 kg m,2) increased from 29% to 52% in men and from 50% to 67% in women. The prevalence of obesity (BMI , 30 kg m,2) increased from 4% to 15% in men and from 23% to 34% in women. Overweight was associated inversely with occupation in women and directly in men in all surveys. In multivariate analysis, overweight was associated similarly (direction and magnitude) to occupation and education. In conclusion, the increasing prevalence of overweight and obesity over time in all age, sex and SES categories suggests large-scale changes in societal obesogenic factors. The sex-specific association of SES with overweight suggests that prevention measures should be tailored accordingly. [source] Prevalence of obesity in Kuwait and its relation to sociocultural variablesOBESITY REVIEWS, Issue 2 2006Y. Y. Al-Kandari Summary This study ascertains the prevalence of obesity and its relationship with some sociocultural characteristics in Kuwaiti society. The sample involved 212 men and 212 women, most of whom are overweight and obese. Grades 1 (body mass index [BMI] > 25,30 kg m,2), 2 (BMI > 30,40) and 3 (BMI > 40) of obesity characterize 71.2% of the sample. Most individuals are in grade 2 obesity, 37.2%. Grade 1 obesity is seen in 31.4% of the sample. Obesity increases with age, especially in women. The heaviest women are aged 60 years or older (mean BMI of 33.8), about the same mean as in the 50,59-year-old age group. The highest frequency of grades 1 and 2 obesity occur in women 30,39 years old. Fifty per cent of the underweight women are 20,29 years old or are over 60 years old. Most women of normal weight are 20,29 years old. For the men, 60% of the underweight sample are 50,60 years old. Male respondents between 30 and 39 years old are the heaviest; 42.7% of the sample are within grade 1 obesity and 40.7% of the sample within grade 2 obesity. The smallest percentage of men in grades 1 and 2 obesity are those 50,59 years old. An association was found between some sociocultural variables and obesity. Data show an increasing prevalence of obesity in Kuwait compared with some previous studies. [source] Comparison of characteristics from White- and Black-Americans with venous thromboembolism: A cross-sectional study,,AMERICAN JOURNAL OF HEMATOLOGY, Issue 7 2010John A. Heit When compared with Whites, Black-Americans may have a 40% higher incidence venous thromboembolism (VTE) incidence. However, whether other VTE characteristics and risk factors vary by race is uncertain. To compare demographic and baseline characteristics among White- and Black-Americans with VTE, we used data prospectively collected from consecutive consenting adults enrolled in seven Centers for Disease Control (CDC) Thrombosis and Hemostasis Centers from August 2003 to March 2009. These characteristics were compared among Whites (n = 2002) and Blacks (n = 395) with objectively diagnosed VTE, both overall, and by age and gender. When compared with Whites, Blacks had a significantly higher proportion with pulmonary embolism (PE), including idiopathic PE among Black women, and a significantly higher proportion of Blacks were women. Blacks had a significantly higher mean BMI and a significantly lower proportion with recent surgery, trauma or infection, family history of VTE, and documented thrombophilia (solely from reduced factor V Leiden and prothrombin G20210A prevalence). Conversely, Blacks had a significantly higher proportion with hypertension, diabetes mellitus, chronic renal disease and dialysis, HIV, and sickle cell disease. When compared with White women, Black women had a significantly lower proportion with recent oral contraceptive use or hormone therapy. We conclude that Whites and Blacks differ significantly regarding demographic and baseline characteristics that may be risk factors for VTE. The prevalence of transient VTE risk factors and idiopathic VTE among Blacks appears to be lower and higher, respectively, suggesting that heritability may be important in the etiology of VTE among Black-Americans. Am. J. Hematol. 85:467,471, 2010 © 2010 Wiley-Liss, Inc. [source] Living related small bowel transplantation in children: 3-dimensional computed tomography donor evaluationPEDIATRIC TRANSPLANTATION, Issue 1 2004Fabrizio Panaro Abstract:, The evaluation of the small bowel vascular anatomy of living small bowel donors (LSBD) is usually performed with conventional angiography (CA). Recently, angio computed tomography (CT) has become a valid study of the vascular anatomy for kidney and liver living donors. We studied the applicability of angio CT with 3-D reconstruction (3-D-ACT) in the evaluation of LSBD. Potential LSBDs for pediatric transplant underwent both CA and 3-D-ACT to evaluate the anatomy of the distal branches of the superior mesenteric artery and vein. Angio-CT was performed with General Electric Lightspeed Scanner. The 3-D reconstruction was performed on the TeraRecon workstation. Adverse reactions, contrast dosage, test duration, invasiveness, hospital-stay, patient discomforts and accuracy were evaluated. Four potential donors (four female; mean age: 30.5 yr; mean BMI: 28.4) underwent both tests. Adverse reactions correlated to contrast agent used (90 mL CA, 150 mL 3-D-ACT) were not reported. CA required a hospitalization of 6 h as opposed to immediate discharge after the 3-D-ACT. The CA required the placement of transfemoral catheter and therefore greater patient discomfort than with 3-D-ACT. The 3-D-ACT arterial images were rated as equivalent to CA, however, 3-D-ACT venous images were rated better than the CA in all cases. CT-angiography with 3-D reconstruction is an acceptable method for vascular evaluation. When compared with routine angiography, it is less invasive, better tolerated and faster, but does require a significantly greater volume of venous contrast. 3-D-ACT also offers a better evaluation of the venous phase, and thus may become the test of choice to evaluate the vascular anatomies of LSBD candidates. [source] Effects of ethnicity and socioeconomic status on body composition in an admixed, multiethnic population in HawaiiAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 3 2009Daniel E. Brown This study determined ethnic differences in anthropometric measures of a sample of adults in Hawaii, examining the effects of differing degrees of ethnic admixing and socioeconomic status (SES) on the measures. Adults who had attended elementary school in Hawaii underwent anthropometric measurements and answered questionnaires about their educational attainment, income, age, cultural identity, ethnic ancestry, and health. Individuals reporting Asian American cultural identity had significantly lower mean body mass index (BMI) and waist circumference (WC) than others, whereas those with Hawaiian/Pacific Islander cultural identity had significantly higher BMI and WC. Educational attainment, but not reported family income and age, was significantly related to BMI and WC, and differences in educational attainment accounted for the increased mean BMI and WC in Hawaiian/Pacific Islanders, but did not account for the lower mean BMI and WC among Asian Americans. Higher percentage of Asian ancestry was significantly correlated with lower BMI and WC, whereas higher percentage of Hawaiian/Pacific Islander ancestry was significantly correlated with increased BMI and WC. Differences in education accounted for the significantly increased BMI in participants with a higher percentage of Hawaiian/Pacific Islander ancestry, but did not entirely account for the lower BMI in individuals with a higher percentage of Asian American ancestry. These results suggest that the high rate of obesity and its sequelae seen in Pacific Islanders may be more a result of socioeconomic status and lifestyle than of genetic propensity, whereas the lower rates of obesity observed in Asian American populations are less directly influenced by socioeconomic factors. Am. J. Hum. Biol., 2009. © 2009 Wiley-Liss, Inc. [source] Growth status and obesity of Hopi childrenAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 6 2003Joey C. Eisenmann The purpose of this study was to examine the growth status and prevalence of underweight, overweight, and obesity in Hopi children. Subjects were 263 (117 males, 146 females) Hopi children 6,12 years of age. Stature and mass were measured and the body mass index (BMI) was calculated. Body size variables were plotted relative to age- and sex-specific reference data and the prevalence rates for underweight, overweight, and obesity were estimated using the BMI as the criterion. Age-specific sex differences were compared using independent samples t -tests. In both sexes, mean age-specific stature appeared to be relatively stable around the 50th percentile of reference values. Mean age-specific mass appeared to be relatively stable between the 50th and 90th percentiles of the reference values, while the mean BMI tended to fluctuate about the 85th percentile. Approximately 23% of Hopi children were classified as overweight and an additional 24% were classified as obese. Only two subjects were categorized as underweight. The results are consistent with other reports that childhood obesity is a serious public health concern among Native Americans. Further study is warranted to examine the causes of the high prevalence rates of pediatric obesity among Native Americans and the effectiveness of prevention and intervention programs. Am. J. Hum. Biol. 15:741,745, 2003. © 2003 Wiley-Liss, Inc. [source] The six-minute walk test in outpatients with obesity: reproducibility and known group validityPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 2 2008Ulla Evers Larsson Abstract Background and Purpose.,To assess the reproducibility and validity of the six-minute walk test (6MWT) in men and women with obesity in order to facilitate evaluation of treatment outcome.,Method.,A test,retest design was used to test reproducibility and a comparative design to test known group validity. Forty-three obese outpatients (16 male), mean age 47 (21,62) years, mean body mass index (BMI) 40 (3,62)kg-m,2 performed the 6MWT twice within one week. Intraclass correlation (ICC1.1) and measurement error (Sw) were calculated from the mean square values derived from a one-way repeated-measures ANOVA (fixed effect model). The reproducibility was also analysed by means of coefficient of variation (CV) and the Bland Altman method including 95% limits of agreement. The variance of the distance walked was analysed by means of regressions. The known group validity of the 6MWT (distance walked and the work of walking) in obese participants was shown by comparisons with 41 lean participants (18 male), mean age 47 (24,65) years, mean BMI 22.7kg-m,2 (19,25).,Results.,The obese group walked 534,m (confidence interval [CI] 508,560 the first and 552,m (CI 523,580) the second walk (p < 0.001). Sw was 25,m, CV 4.7%, ICC1.1 was 0.96. The limits of agreement were ,46,m+80,m. The validity tests showed that they walked 162,m shorter (p < 0.001) and performed much heavier work (p < 0.001) than the lean group. In the obese group, BMI alone explained 38% of the variance of the distance walked.,Conclusions.,The 6MWT showed good reproducibility and known group validity and can be recommended for evaluating walking ability in subjects with obesity. For individual evaluation, however, an improved walking distance of at least 80,m was required to make the difference clinically significant. Despite shorter walking distance the obese participants performed heavier work than the lean. Copyright © 2008 John Wiley & Sons, Ltd. [source] Latest news and product developmentsPRESCRIBER, Issue 17 2008Article first published online: 15 SEP 200 Small AED suicide risk Antiepileptic drugs (AEDs) are associated with a small increase in the risk of suicidal thoughts, the MHRA has warned. In the latest Drug Safety Update (2008;2:Issue 1) the MHRA says that, compared with placebo, AEDs are associated with an additional two cases of suicidal thoughts and behaviour per 1000 patients (0.43 vs 0.22 per cent). This may occur as early as one week after starting treatment. It is unclear whether the risk varies among AEDs. Also in this issue, the MHRA warns of an increased risk of tumour progression and reduced survival in patients with cancer treated with recombinant erythropoietin. Other topics include the use of lenalidomide (Revlimid) and thalidomide for multiple myeloma; new restrictions on the use of moxifloxacin (Avelox) due to adverse effects; and a reminder that metronidazole should be administered orally, not by intravenous injection, for the treatment of C. difficile -associated diarrhoea. Low-fat diet least effective option? A low-fat diet is associated with less weight loss and less favourable metabolic changes over two years than a low-carbohydrate (Watkins) diet or a Mediterranean diet in 322 moderately obese patients (mean BMI 30kg per m2; N Eng J Med 2008;359:229,41). Estimated energy intake was similar for all diets. Mean weight loss in all randomised patients was 2.9kg for the low fat diet, 4.4kg for the Mediterranean diet and 4.7kg for the low-carbohydrate diet. The low-carbohydrate diet was associated with greater increases in HDL-cholesterol and greater reductions in triglycerides and total cholesterol/HDL-C ratio compared with the low-fat diet. Among people with diabetes, fasting plasma glucose and insulin resistance were decreased only in those assigned to the Mediterranean diet, and only the low carbohydrate diet significantly decreased HbA1c. Stopping post-MI statins Patients who stop taking a statin first prescribed after an acute MI almost double their risk of death compared with nonusers, a new study shows (Eur Heart J; published online 29 July 2008; doi: 10.1093/eurheartj/ehn346). The analysis of 9939 MI survivors in the General Practice Research Database showed that, compared with patients who had never used a statin, the risk of death was unchanged for those previously taking a statin who continued treatment after MI. The risk was reduced by 28 per cent for those who started a statin post-MI and continued it but, in those who started a statin but then stopped it, the hazard ratio for death was 1.88 (CI 95% 1.13-3.07). Stopping control medication (aspirin, beta-blockers or proton pump inhibitors) did not alter the risk of death. Smoking quit rates with NRT and varenicline Differences in quit rates between nicotine replacement therapy (NRT) and varenicline (Champix) are small, according to a multinational study (Thorax 2008;63:717,24). The trial compared transdermal NRT (21mg to 7mg per day over 10 weeks) with varenicline (1mg twice daily for 12 weeks). Over the final four weeks of treatment, the abstinence rate was significantly higher with varenicline (56 vs 43 per cent). After one year, the four-week abstinence rates were 26 and 20 per cent respectively (p = 0.056) and seven-day point prevalence abstinence rates at 6 or 12 months were not significantly different. Varenicline reduced craving, withdrawal symptoms and smoking satisfaction compared with NRT but at the cost of a higher incidence of nausea (37 vs 10 per cent). Azithromycin goes OTC The MHRA has announced that azithromycin will be available without prescription for the treatment of Chlamydia infection. Under the brand Clamelle, azithromycin will be supplied from pharmacies to over-16s who have tested positive for infection but have no symptoms; their partners may also be treated. A urine testing kit will be marketed to pharmacists. Product news Sodium valproate (Epilim Chronosphere) is now available as modified-release granules to be taken with food or a drink; 30 sachets, in five strengths from 50750mg, cost £30. Boehringer Ingelheim has introduced a higher strength of its telmisartan/hydrochlorothiazide combination (Micardis Plus) for hypertension; 80mg/25mg costs £14.18 for a month's supply. Copyright © 2008 Wiley Interface Ltd [source] Analysis of Lipoproteins and Body Mass Index in Professional Football PlayersPREVENTIVE CARDIOLOGY, Issue 3 2001Joseph P. Garry MD Exercise is known to improve lipoprotein levels, whereas an elevated body mass index (BMI) is associated with less favorable lipoprotein levels. To date, there have been no reports of lipid analyses in elite athletes who also have BMIs in ranges considered unhealthful. The purpose of this study was to evaluate the lipid-lipoprotein profiles in a group of professional football players and to determine what association exists between these profiles and the players' BMIs. An observational study was conducted of 70 professional football players from one National Football League team. Measurements included BMI (kg·m,2), and fasting serum lipid analysis. BMI and position played were found to correlate (p<0.001), with linemen having the highest mean BMI, 38.1 kg·m,2. Comparing mean lipid values among BMI categories demonstrated lower high-density lipoprotein cholesterol levels (p<0.01), higher triglycerides (p<0.05), and higher total cholesterol/high-density lipoprotein cholesterol ratios (p<0.001) with an increasing BMI. Among the professional football players studied, a lower BMI was associated with a more favorable lipid-lipoprotein profile. Among the elite athletes in this study with the highest BMIs, exercise may not confer the same protective benefits on cardiovascular risk as it does in those athletes with normal BMIs. [source] Maxillomandibular Advancement for Persistent Obstructive Sleep Apnea After Phase I Surgery in Patients Without Maxillomandibular DeficiencyTHE LARYNGOSCOPE, Issue 10 2000Kasey K. Li DDS Abstract Objective To assess the outcomes of maxillomandibular advancement (MMA) for the treatment of persistent obstructive sleep apnea syndrome (OSA) after phase I reconstruction in patients who do not have maxillomandibular deficiency. Methods From January 1997 to September 1998, 25 patients previously treated with phase I reconstruction (uvulopalatoplasty, genioglossus advancement, and/or hyoid suspension) who did not have maxillary and mandibular deficiencies underwent MMA for persistent OSA. Variables examined include age, sex, body mass index (BMI), respiratory disturbance index (RDI), lowest oxygen saturation (LSAT), and cephalometric data. In addition, a minimum of 6 months after surgery, questionnaires containing a 10-cm visual analogue scale (0 = no change, 10 = drastic change) were mailed to the patients. The questionnaire subjectively assessed the patient's perception of the facial appearance after surgery, whether there was pain or discomfort of the temporomandibular joint, the overall satisfaction with the treatment outcomes, and whether the patient would recommend the operation to other patients. Results Nineteen (76%) questionnaires were completed and returned by 15 men and 4 women. The mean age was 45.3 ± 6.6 years and the mean BMI was 33.1 ± 7.1 kg/m2. The mean RDI improved from 63.6 ± 20.8 to 8.1 ± 5.9 events per hour, and the mean LSAT improved from 73.3 ± 13.2% to 88.1 ± 4.1%. One patient was defined as an incomplete responder (RDI >20). One patient reported transient pain and discomfort of the temporomandibular joint. Although all of the patients felt that there were changes in their facial appearance after surgery, 18 of the 19 patients gave either a neutral or a favorable response to their facial esthetic results. All of these patients were satisfied with the overall outcomes and would recommend the treatment to others. Conclusion MMA is a highly effective treatment for persistent OSA after phase I surgery in patients who otherwise do not have maxillomandibular deficiency. The patient satisfaction is extremely high. Furthermore, previous concerns of unfavorable postoperative facial esthetics and temporomandibular joint dysfunction do not appear to be significant. [source] Obstructive Sleep Apnea Syndrome: A Comparison Between Far-East Asian and White MenTHE LARYNGOSCOPE, Issue 10 2000Kasey K. Li MD Abstract Objectives To investigate the possible differences between Far-East Asian men and white men in obstructive sleep apnea syndrome (OSAS). Study Design Prospective nonrandomized controlled study. Methods This study compared consecutive Far-East Asian men with OSAS (n = 50) with two selected groups of White men with OSAS (n = 50 in each group). One group of white men was controlled for age, respiratory disturbance index (RDI), and minimum oxygenation saturation (LSAT). Another group was controlled for age and body mass index (BMI). Cephalometric analysis was performed on all subjects. Results The majority of the Far-East Asian men were found to be nonobese (mean BMI, 26.7 ± 3.8) but had severe OSAS (mean RDI, 55.1 ± 35.1). When controlled for age, RDI, and LSAT, the white men were substantially more obese (mean BMI, 29.7 ± 5.8, P = .0055). When controlled for age and BMI, the white men had less severe illness (RDI, 34.1 ± 17.9, P = .0001). Although the posterior airway space and the distance from the mandibular plane to hyoid bone were less abnormal in the Far-East Asian men, the cranial base dimensions were significantly decreased. Conclusions The majority of the Far-East Asian men in this study were found to be nonobese, despite the presence of severe OSAS. When compared with white men, Far-East Asian men were less obese but had greater severity of OSAS. There may be differences in obesity and craniofacial anatomy as risk factors in these two groups. [source] BT02 LAPAROSCOPIC SLEEVE GASTRECTOMY AS A SINGLE-STAGE BARIATRIC PROCEDUREANZ JOURNAL OF SURGERY, Issue 2009T. Sammour Purpose: , Laparoscopic sleeve gastrectomy is increasingly being recognised as a stand-alone procedure in bariatric surgery, with long term follow-up data now emerging. We present our early experience patients with a mean BMI in the super-obese range. Methodology: , Retrospective review of laparoscopic sleeve gastrectomies performed by two surgeons at Middlemore Hospital, between March 2007 and July 2008. Results: , One hundred and one patients were identified, with a mean age of 42.7 years (95% CI 40.9,44.5). Maori and Pacific Islanders made up 31% of the patient subset. Patients had a mean BMI of 50.2 kg/m2 (95% CI 48.8,51.7), and 45 patients were super-obese. They had a median hospital stay of 2 days (1,7 days), and a mean follow-up of 6.0 months. Mean excess BMI loss (excluding patients with a major complication) was 46% (95% CI 43.3,48.7). 64% of diabetics and 37% of hypertensives showed in an improvement in medication requirement. There was a major complication rate of 8%, including 3 staple line leaks (one of which required laparotomy), 2 staple line bleeds (one requiring laparotomy), 1 infected haematoma, and 1 critical stricture. There were no deaths. Conclusion: , Laparoscopic sleeve gastrectomy has achieved satisfactory weight-loss results with an acceptable complication rate in the short to medium term. [source] Change in joint space width: Hyaline articular cartilage loss or alteration in meniscus?ARTHRITIS & RHEUMATISM, Issue 8 2006D. J. Hunter Objective To explore the relative contribution of hyaline cartilage morphologic features and the meniscus to the radiographic joint space. Methods The Boston Osteoarthritis of the Knee Study is a natural history study of symptomatic knee osteoarthritis (OA). Baseline and 30-month followup assessments included knee magnetic resonance imaging (MRI) and fluoroscopically positioned weight-bearing knee radiographs. Cartilage and meniscal degeneration were scored on MRI in the medial and lateral tibiofemoral joints using a semiquantitative grading system. Meniscal position was measured to the nearest millimeter. The dependent variable was joint space narrowing (JSN) on the plain radiograph (possible range 0,3). The predictor variables were MRI cartilage score, meniscal degeneration, and meniscal position measures. We first conducted a cross-sectional analysis using multivariate regression to determine the relative contribution of meniscal factors and cartilage morphologic features to JSN, adjusting for body mass index (BMI), age, and sex. The same approach was used for change in JSN and change in predictor variables. Results We evaluated 264 study participants with knee OA (mean age 66.7 years, 59% men, mean BMI 31.4 kg/m2). The results from the models demonstrated that meniscal position and meniscal degeneration each contributed to prediction of JSN, in addition to the contribution by cartilage morphologic features. For change in medial joint space, both change in meniscal position and change in articular cartilage score contributed substantially to narrowing of the joint space. Conclusion The meniscus (both its position and degeneration) accounts for a substantial proportion of the variance explained in JSN, and the change in meniscal position accounts for a substantial proportion of change in JSN. [source] Molecular analysis of the CART gene in overweight and obese Italian children using family-based association methodsACTA PAEDIATRICA, Issue 5 2010L Rigoli Abstract Aim:, In our study, we evaluated if CART gene A1475G and ,A1457 polymorphisms could be associated with obesity. Patients and methods:, We recruited 133 Italian trios from among 103 (50 males and 53 females) overweight children (mean age 10.5 years, range 6,14 years; mean BMI 26.1 ± 3.2 kg/m2), and 30 (16 males and 14 females) obese children (mean age 9.0 years, range 6,11 years; mean BMI 32.3 ± 2.0 kg/m2). We also selected 187 non-obese unrelated controls. Results:, The allele frequencies of the A1475G single nucleotide polymorphism (SNP) were significantly higher in overweight children (0.07) than in control children (0.02) (p = 0.03) and control adults (0.02) (p = 0.02). Moreover, the allele frequencies were significantly different between obese children (0.08) and control children (0.02) (p = 0.03), and between obese children (0.08) and control adults (0.02) (p = 0.02). The ,A1457 SNP showed no significant association with overweight/obesity. TDT statistic revealed a preferential transmission of the 1475G allele from heterozygous parents to overweight children (p < 0.01) and to obese children (p < 0.05). No statistically significant excess transmission of the ,A1457 allele was found. Conclusion:, Our results supported the hypothesis that inherited variations of the CART gene could influence the development of obesity also in Italian children. [source] Obesity in girls and penetrative sexual abuse in childhoodACTA PAEDIATRICA, Issue 1 2009Orit Pinhas-Hamiel Abstract Aim: To assess the relationship between childhood obesity and penetrative sexual abuse in girls. Methods: All obese girls referred to a hospital based pediatric endocrine unit were interviewed by a social worker or psychologist. Questions aimed to elicit any history of physical, emotional and sexual abuse are included. Overweight was defined as BM >95th percentile for age and gender. Body mass index (BMI) Z score (BMIZ) was calculated as measured BMI minus mean BMI for age and gender divided by standard deviation. Penetrative abuse was defined if a history was elicited of forced intercourse with any form of oral, vaginal or anal penetration. Results: A history of penetrative abuse was elicited in 5 out of 145 (3.5%) obese girls, their mean ± SD age was 11.9 ± 3.1 years. Abused girls were significantly more obese than the remainder of the patients (BMIZ 4.76 ± 1.34 vs. 3.39 ± 1.28 p = 0.02). Forty-two of all girls had BMI Z scores ,4, and of these four (9.5%) had been abused. All girls had changes in normal daily behaviour including seductive behaviour, seclusion, self-mutilation and new onset day enuresis. Conclusion: In the evaluation of girls with marked obesity, particularly if associated with behavioural changes and failure to respond to therapy, the possible occurrence of penetrative sexual abuse should be considered. [source] Self-esteem in a clinical sample of morbidly obese children and adolescentsACTA PAEDIATRICA, Issue 1 2009P Nowicka Abstract Aim: To study self-esteem in clinical sample of obese children and adolescents. Methods: Obese children and adolescents aged 8,19 years (n = 107, mean age 13.2 years, mean BMI 32.5 [range 22.3,50.6], mean BMI z-score 3.22 [range 2.19,4.79]; 50 boys and 57 girls) were referred for treatment of primary obesity. Self-esteem was measured with a validated psychological test with five subscales: physical characteristics, talents and skills, psychological well-being, relations with the family and relations with others. A linear mixed effect model used the factors gender and adolescence group, and the continuous covariates: BMI z-scores, and BMI for the parents as fixed effects and subjects as random effects. Results: Age and gender, but neither the child's BMI z-score nor the BMI of the parents were significant covariates. Self-esteem decreased (p < 0.01) with age on the global scale as well as on the subscales, and was below the normal level in higher ages in both genders. Girls had significantly lower self-esteem on the global scale (p = 0.04) and on the two subscales physical characteristics (p < 0.01) and psychological well-being (p < 0.01). Conclusion: Self-esteem is lower in girls and decreases with age. In treatment settings special attention should be paid to adolescent girls. [source] Dynamics of GH secretion during incremental exercise in obesity, before and after a short period of training at different work-loadsCLINICAL ENDOCRINOLOGY, Issue 4 2010Alberto Salvadori Summary Background, Growth hormone (GH) secretion is normally sensitive to physical exercise. Intensity and duration of exercise, fitness and age can all influence the GH response to exercise. In obesity, GH secretion is decreased both in basal conditions and in response to exercise. Objective, To analyse the dynamics of GH response to a progressive cycloergometric test, conducted up to exhaustion, in adult normal subjects and obese patients, after a reconditioning program at different workloads. Design and methods, We studied eight lean subjects (four men, mean age 34·3 years, range 26,47 years, mean body mass index (BMI) 22·1 kg/m2). GH was sampled at baseline and during the last 30 s of each power output increase. Anaerobic threshold (AT) was detected by the V-slope method. The same test was carried out in 16 obese subjects (seven men, mean age 39·1 years, range 20,59 years, mean BMI 35·8 kg/m2) and repeated after a 4-week reconditioning program consisting of aerobic workout (Group A, eight subjects, three men, mean age 40·5 years, range 22,59 years, mean BMI 33·6 kg/m2), and aerobic plus anaerobic work (group B, eight subjects, four men, mean age 37·6 years, range 20,56 years, mean BMI 38·0 kg/m2) for 6 days/week, with no dietary restrictions. Results, Mean exercise peak occurred at higher intensity in controls (140 vs 110 W, P < 0·05), and AT exceeded at higher work outputs than in obese subjects (102 vs 74 W, P < 0·05). In controls, GH response to exercise was prompt and further sustained after AT; in obese subjects, GH increased slowly and insignificantly before AT, thereafter it increased to lower levels than in controls (P < 0·001). Following the reconditioning period, both Group A and Group B of obese subjects failed to improve exercise performance as well as GH response to exercise before AT; beyond AT, a greater GH response to exercise occurred in Group B than Group A (7·59 ± 0·32 ,g/l at peak of exercise) with significantly different Delta AUCs (Area Under the Curves) following AT: 30·5 ± 12 ,g.min/l in Group A vs 124·2 ± 38 ,g.min/l in Group B, P < 0·05. Conclusions Our results confirm the blunted GH response to exercise in obese adults when compared to lean counterparts. With obesity, aerobic training poorly increases the GH response beyond AT, while supplemental anaerobic workload appears to increase GH response beyond AT. These observations may have implications for the prescription of physical exercise, which is one of the recommendations in the management of obesity. [source] | |||||||||||||