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Obese Individuals (obese + individual)

Distribution by Scientific Domains

Medical Sciences	66%
Life Sciences	18%
Psychology	9%
Humanities and Social Sciences	6%

Distribution within Medical Sciences

Cardiovascular Disease	13%

Selected Abstracts

Is obesity protective for osteoporosis?

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 6 2010
Evaluation of bone mineral density in individuals with high body mass index
Summary Background:, Obese individuals often present comorbidities while they appear protected against the development of osteoporosis. However, few and contradictory data are now available on skeletal modifications in obese patients. The aim of this study was to characterise bone mineral density (BMD) in overweight (BMI > 25 < 29.9) and obese (BMI > 30) patients. Methods:, We selected 398 patients (291 women, 107 men, age 44.1 + 14.2 years, BMI 35.8 + 5.9 kg/m2) who underwent clinical examination, blood tests and examination of body composition. Subjects with chronic conditions or taking medications interfering with bone metabolism, hormonal and nutritional status and recent weight loss were excluded. Results:, Interestingly, 37% (n = 146) of this population showed a significantly lower than expected lumbar BMD: 33% (n = 98) of women showed a T -score ,1.84 ± 0.71, and 45% (n = 48) of men showed a T -score ,1.88 ± 0.64. When the population was divided into subgroups based on different BMI, it was noted that overweight (BMI > 25 < 29.9) was neutral or protective for BMD, whereas obesity (BMI > 30) was associated with a low bone mass, compatible with a diagnosis of osteoporosis. No differences were observed in hormones and lipid profiles among subgroups. Conclusions:, Our results indicate that a subpopulation of obese patients has a significant low lumbar BMD than expected for age. Thus, a careful characterisation of skeletal metabolism might be useful in all obese individuals to avoid fragility fractures later in life. [source]

Body Weight and Matching With a Physically Attractive Romantic Partner

JOURNAL OF MARRIAGE AND FAMILY, Issue 5 2008
Julie H. Carmalt
Matching and attribute trade are two perspectives used to explain mate selection. We investigated patterns of matching and trade, focusing on obesity, using Add Health Romantic Pair data (N = 1,405 couples). Obese individuals, relative to healthy weight individuals, were less likely to have physically attractive partners, with this disadvantage greater for women than men, and greater for White women than Black women. Additional education, a more attractive personality, and better grooming increased the probability of having a physically attractive partner and offset the disadvantage of obesity for some individuals. Unexpectedly, we found women, like men, trade education for their partners' physical attractiveness. Despite evidence of attribute trade, matching with respect to physical characteristics was the dominant mate selection pattern. [source]

School physical activity interventions: do not forget about obesity bias

OBESITY REVIEWS, Issue 1 2008
P. B. Rukavina
Summary Obesity bias is the tendency to negatively judge an overweight or obese individual based on assumed and/or false character traits, such as being physically unattractive, incompetent, lazy and lacking self-discipline. Obesity biases, such as teasing or weight criticism during physical activity (PA), can be psychologically or emotionally damaging for overweight children and adolescents. Ultimately, the effects students experience over time may create a psychological barrier and students can become resistant to schools' health and PA interventions that promote lifestyle changes. Fortunately, the psychological effects of obesity bias are mediated by social buffers and coping mechanisms. Several PA-related researchers have proposed strategic intervention components, but no studies have been completed in PA settings. The purpose of this review was to discuss the nature and different types of obesity bias in PA settings. Major theoretical frameworks of the aetiology and change mechanisms of obesity biases from the psychological literature were reviewed and direct applications for strategic component interventions were made for PA settings. Because of the pervasiveness and entrenchment of obesity bias, it is obvious that multiple theoretical frameworks need to be considered and even combined to create safe and caring school PA environments for students. [source]

Pulmonary diffusion and aerobic capacity: is there a relation?

ACTA PHYSIOLOGICA, Issue 4 2010
Does obesity matter?
Abstract Aim:, We sought to determine whether pulmonary diffusing capacity for nitric oxide (DLNO), carbon monoxide (DLCO) and pulmonary capillary blood volume (Vc) at rest predict peak aerobic capacity (O2peak), and if so, to discern which measure predicts better. Methods:, Thirty-five individuals with extreme obesity (body mass index or BMI = 50 ± 8 kg m,2) and 26 fit, non-obese subjects (BMI = 23 ± 2 kg m,2) participated. DLNO and DLCO at rest were first measured. Then, subjects performed a graded exercise test on a cycle ergometer to determine O2peak. Multivariate regression was used to assess relations in the data. Results:, Findings indicate that (i) pulmonary diffusion at rest predicts O2peak in the fit and obese when measured with DLNO, but only in the fit when measured with DLCO; (ii) the observed relation between pulmonary diffusion at rest and O2peak is different in the fit and obese; (iii) DLNO explains O2peak better than DLCO or Vc. The findings imply the following reference equations for DLNO: O2peak (mL kg,1 min,1) = 6.81 + 0.27 × DLNO for fit individuals; O2peak (mL kg,1 min,1) = 6.81 + 0.06 × DLNO, for obese individuals (in both groups, adjusted R2 = 0.92; RMSE = 5.58). Conclusion:, Pulmonary diffusion at rest predicts O2peak, although a relation exists for obese subjects only when DLNO is used, and the magnitude of the relation depends on gender when either DLCO or Vc is used. We recommend DLNO as a measure of pulmonary diffusion, both for its ease of collection as well as its tighter relation with O2peak. [source]

Errors in patient perception of caloric deficit required for weight loss,observations from the Diet Plate Trial,

DIABETES OBESITY & METABOLISM, Issue 5 2010
G. A. Kline
Persons with obesity may be poor estimators of caloric content of food. Health care professionals encourage patients to consult nutritional labels as one strategy to assess and restrict caloric intake. Among subjects enrolled in a weight loss clinical trial, the objective is to determine the accuracy of subjects' estimates of caloric deficit needed to achieve the desired weight loss. A 6-month controlled trial demonstrated efficacy of a portion control tool to induce weight loss in 130 obese people with type 2 diabetes. All subjects had previously received dietary teaching from a dietician and a nurse. At baseline, patients were asked how much weight they would like to lose and to quantitatively estimate the caloric deficit required to achieve this weight loss. The stated amount of weight loss desired ranged from 4.5 to 73 kg, with an average of 26.6 kg (n = 127 respondents). Only 30% of participants were willing to estimate the required caloric deficit to lose their target weight. Subjects' per kilograms estimate of caloric deficit required ranged from 0.7 to 2 000 000 calories/kg with a median of 86 calories/kg. Nearly half of subjects (47.4%) underestimated the total required caloric deficit to achieve their target weight loss by greater than 100 000 calories. Despite attendance at a diabetes education centre, this population of obese individuals had a poor understanding of the quantitative relationship between caloric deficit and weight loss. Educational initiatives focused upon quantitative caloric intake and its impact on weight change may be needed to assist obese patients in setting appropriate weight loss goals and achieving the appropriate daily caloric restriction required for success. [source]

Obesity and lifestyle risk factors for gastroesophageal reflux disease, Barrett esophagus and esophageal adenocarcinoma

DISEASES OF THE ESOPHAGUS, Issue 5 2006
P. J. Veugelers
SUMMARY., The aim of this study was to examine the association of obesity with esophageal adenocarcinoma, and with the precursor lesions Barrett esophagus and gastroesophageal reflux disease (GERD). This case-control study included cases with GERD (n = 142), Barrett esophagus (n = 130), and esophageal adenocarcinoma (n = 57). Controls comprised 102 asymptomatic individuals. Using logistic regression methods, we compared obesity rates between cases and controls adjusting for differences in age, gender, and lifestyle risk factors. Relative to normal weight, obese individuals were at increased risk for esophageal adenocarcinoma (Odds Ratio [OR] 4.67, 95% Confidence Interval [CI] 1.27,17.9). Diets high in vitamin C were associated with a lower risk for GERD (OR 0.40, 95% CI 0.19,0.87), Barrett esophagus (OR 0.44, 95% CI 0.20,0.98), and esophageal adenocarcinoma (OR 0.21, 95% CI 0.06,0.77). For the more established risk factors, we confirmed that smoking was a significant risk factor for esophageal adenocarcinoma, and that increased liquor consumption was associated with GERD and Barrett esophagus. In light of the current obesity epidemic, esophageal adenocarcinoma incidence rates are expected to continue to increase. Successful promotion of healthy body weight and diets high in vitamin C may substantially reduce the incidence of this disease. [source]

Impact of Body Mass Index on Markers of Left Ventricular Thickness and Mass Calculation: Results of a Pilot Analysis

ECHOCARDIOGRAPHY, Issue 3 2005
Ranjini Krishnan M.D.
Specific correlations between body mass index (BMI) and left ventricular (LV) thickness have been conflicting. Accordingly, we investigated if a particular correlation exists between BMI and echocardiographic markers of ventricular function. Methods: A total of 122 patients, referred for routine transthoracic echocardiography, were included in this prospective pilot study using a 3:1 randomization approach. Patient demographics were obtained using a questionnaire. Results: Group I consisted of 80 obese (BMI was >30 kg/m2), Group II of 16 overweight (BMI between 26 and 29 kg/m2), and Group III of 26 normal BMI (BMI < 25 kg/m2) individuals. No difference was found in left ventricular wall thickness, LV end-systolic cavity dimension, fractional shortening (FS), or pulmonary artery systolic pressure (PASP) among the groups. However, mean LV end-diastolic cavity dimension was greater in Group I (5.0 ± 0.9 cm) than Group II (4.6 ± 0.8 cm) or Group III (4.4 ± 0.9 cm; P < 0.006). LV mass indexed to height2.7 was also significantly larger in Group I (61 ± 21) when compared to Group III (48 ± 19; P < 0.001). Finally, left atrial diameter (4.3 ± 0.7 cm) was also larger (3.8 ± 0.6 and 3.6 ± 0.7, respectively; P < 0.00001).Discussion: We found no correlation between BMI and LV wall thickness, FS, or PASP despite the high prevalence of diabetes and hypertension in obese individuals. However, obese individuals had an increased LV end-diastolic cavity dimension, LV mass/height2.7, and left atrial diameter. These findings could represent early markers in the sequence of cardiac events occurring with obesity. A larger prospective study is needed to further define the sequence of cardiac abnormalities occurring with increasing BMI. [source]

Gender, age and menopause effects on the prevalence and the characteristics of obstructive sleep apnea in obesity

EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 12 2003
O. Resta
Abstract Background, In the 1970s and 80s it was believed that obstructive sleep apnea (OSA) was primarily a disease of men. The present study was addressed to evaluate the effect of gender and menopause on the prevalence and the characteristics of OSA and on anthropometric, clinical, respiratory and polysomnographic data in a population of obese individuals. Patients and methods, A total of 230 obese subjects (BMI , 30 kg m,2), 148 women and 82 men, aged 16,75 years, were recruited and evaluated for general and anthropometric parameters, respiratory function, sleep-related symptoms and sleep disorders of breathing. Results, Respiratory disturbance index (RDI) and the prevalence of OSA were lower in women than in men (P < 0·001 and P < 0·001, respectively). Among subjects < 55 years, neck circumference, percentage of predicted normal neck circumference (PPNC), waist-to-hip ratio (WHR), PaCO2, RDI and the prevalence of OSA were lower in female subjects (P = 0·05, P < 0·05, P < 0·001, P < 0·01 and P < 0·01, respectively). BMI, neck circumference, PPNC, WHR, RDI and the prevalence of OSA were higher in postmenopausal compared with premenopausal women (P < 0·01, P < 0·01, P < 0·01, P < 0·01 and P < 0·01, respectively). Conclusions, Our study demonstrates that (i) the male dominance regarding the prevalence and the severity of OSA disappears in men older than 55 years, and (ii) menopause seems to play a pivotal role in modulating both the presence and the degree of sleep disorder. [source]

Aerobic exercise training reduces hepatic and visceral lipids in obese individuals without weight loss,

HEPATOLOGY, Issue 4 2009
Nathan A. Johnson
Weight loss remains the most common therapy advocated for reducing hepatic lipid in obesity and nonalcoholic fatty liver disease. Yet, reduction of body weight by lifestyle intervention is often modest, and thus, therapies which effectively modulate the burden of fatty liver but are not contingent upon weight loss are of the highest practical significance. However, the effect of aerobic exercise on liver fat independent of weight loss has not been clarified. We assessed the effect of aerobic exercise training on hepatic, blood, abdominal and muscle lipids in 19 sedentary obese men and women using magnetic resonance imaging and proton magnetic resonance spectroscopy (1H-MRS). Four weeks of aerobic cycling exercise, in accordance with current physical activity guidelines, significantly reduced visceral adipose tissue volume by 12% (P < 0.01) and hepatic triglyceride concentration by 21% (P < 0.05). This was associated with a significant (14%) reduction in plasma free fatty acids (P < 0.05). Exercise training did not alter body weight, vastus lateralis intramyocellular triglyceride concentration, abdominal subcutaneous adipose tissue volume, 1H-MRS,measured hepatic lipid saturation, or HOMA-IR (homeostasis model assessment of insulin resistance; P > 0.05). Conclusion: These data provide the first direct experimental evidence demonstrating that regular aerobic exercise reduces hepatic lipids in obesity even in the absence of body weight reduction. Physical activity should be strongly promoted for the management of fatty liver, the benefits of which are not exclusively contingent upon weight loss. (HEPATOLOGY 2009.) [source]

Is obesity protective for osteoporosis?

Restraint, hunger, and disinhibition following treatment for binge-eating disorder

INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 6 2009
Kristina A. Downe MS
Abstract Objective: To examine changes in total, flexible and rigid restraint, hunger, and disinhibition in obese individuals with Binge-Eating Disorder (BED), and assess whether these variables are associated with binge abstinence at post-treatment and during two-year follow-up. Method: A total of 116 obese individuals with BED were randomized to a 20-week treatment trial plus two-year follow-up. Using the Eating Inventory (EI), we assessed these factors at pretreatment, post-treatment, and follow-up time-points and examined their relationship to binge abstinence at post-treatment, 12- and 24-month follow-up. Results: Low disinhibition and high-total restraint are associated with post-treatment binge abstinence. There are no significant relationships between post-treatment EI variables and binge abstinence at 12- and 24-month follow-up. Discussion: Reducing disinhibition as well as increasing EI dietary restraint during BED treatment may be important for short-term success. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2009 [source]

Abdominal Obesity Is Associated With Potassium Depletion and Changes in Glucose Homeostasis During Diuretic Therapy

JOURNAL OF CLINICAL HYPERTENSION, Issue 6 2008
Lydia Sebba Souza Mariosa MD
The activation of the renin-angiotensin system (RAS) is an important mechanism that contributes to hypertension in obese individuals. Thiazide diuretics also activate the RAS in response to volume contraction and can lead to a decrease in serum potassium values and glucose metabolism abnormalities. To evaluate the impact of abdominal obesity on potassium depletion and glucose homeostasis in hypertensive patients receiving thiazide therapy, the authors studied 329 hypertensive patients without known diabetes or impaired renal function. Patients were stratified into 2 major groups according to whether they used thiazide diuretic therapy, and each group was further divided in 2 subgroups according to the presence of abdominal obesity. The authors demonstrated that obese patients receiving diuretic therapy had lower plasma potassium levels and higher glucose values compared with nonobese patients receiving diuretic therapy. In conclusion, abdominal obesity predisposes to potassium depletion during diuretic therapy in association with effects on glucose homeostasis. [source]

Obesity: attitudes of undergraduate student nurses and registered nurses

JOURNAL OF CLINICAL NURSING, Issue 16 2009
Man-Yuk Poon
Aim., To investigate undergraduate student nurses' and registered nurses' attitudes towards obese persons and towards the management of obese patients. Background., Obesity is a global public health problem. Escalating rates of overweight and obesity are also taking a toll in Asian countries that have historically had much lower rates. Despite the growing prevalence of obesity worldwide, studies show that nurses and other health professionals hold negative attitudes towards obese people, which may affect the care of obese patients. Design., Cross-sectional study. Methods., A self-administered questionnaire was completed by 352 undergraduate student nurses and 198 registered nurses. The questionnaire consisted of the Fat Phobia Scale, the Attitudes Toward Obese Adult Patients Scale and a demographic profile. Data were analysed using descriptive statistics and student's t -tests. Results., Overall mean scores on the Fat Phobia Scale (3·53 SD 0·47) indicated average levels of fat phobia and mean scores on the Attitudes Toward Obese Adult Patients scale (2·64 SD 0·51) indicated neutral attitudes towards obese patients. Registered nurses had significantly higher levels of fat phobia and more negative attitudes than did student nurses. The majority of participants perceived that obese people liked food, overate and were shapeless, slow and unattractive. Additionally, over one-half of participants believed that obese adults should be put on a diet while in hospital. Conclusions., Results of this study show that both registered nurses and student nurses have negative perceptions of obesity and are unlikely to attribute positive characteristics to obese individuals. That registered nurses hold more negative attitudes towards obese person is cause for concern. Relevance to clinical practice., Given the increasing prevalence of obesity and the disproportionate number of obese persons affected by many health conditions, current and future nurses should have positive professional attitudes towards obese individuals. Obesity needs to more be adequately addressed, both in basic nursing education programs and in continuing professional education for practising nurses. [source]

Sonographic measurements of subcutaneous fat in obese individuals may correlate better with peripheral artery disease indices

JOURNAL OF CLINICAL ULTRASOUND, Issue 5 2009
Serafim Tsitsilonis MD
Purpose. The purpose of this study was to investigate the association of various methods for body fat assessment with indices of peripheral artery disease in the deep and superficial femoral arteries. Methods. The intima,media thickness (IMT), maximal IMT (max IMT), femoral wall thickness (FWT), maximal FWT (max FWT), cross-sectional intima media area (CIMA), and atherosclerotic burden score (ABS) were measured sonographically in 26 subjects. The minimum thickness of the abdominal subcutaneous fat layer (Smin) was measured sonographically close to the xyphoid process, and body fat percentage was calculated using various formulas. Results. Smin correlated significantly with body fat percentage calculated with all formulas and was the sole parameter that was associated significantly with all the femoral artery atherosclerotic indices IMT: r = 0.74, p < 0.001; max IMT: r = 0.53, p < 0.05; FWT: r = 0.78, p < 0.001; max FWT: r = 0.57, p < 0.005; ABS: r = 0.52, p < 0.05; CIMA: r = 0.86, p < 0.001; Smin was the major independent predictor of femoral IMT on a multiple stepwise regression analysis (, = 0.02; SE = 0.008, R2 = 0.35, p < 0.05). Conclusions. Smin correlates better than indirect indices and formulas of body fat estimation with markers of extracoronary atherosclerosis. Sonographic measurement of Smin may serve in the future as a useful tool in everyday clinical practice. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009 [source]

Fat tissue, aging, and cellular senescence

AGING CELL, Issue 5 2010
Tamara Tchkonia
Summary Fat tissue, frequently the largest organ in humans, is at the nexus of mechanisms involved in longevity and age-related metabolic dysfunction. Fat distribution and function change dramatically throughout life. Obesity is associated with accelerated onset of diseases common in old age, while fat ablation and certain mutations affecting fat increase life span. Fat cells turn over throughout the life span. Fat cell progenitors, preadipocytes, are abundant, closely related to macrophages, and dysdifferentiate in old age, switching into a pro-inflammatory, tissue-remodeling, senescent-like state. Other mesenchymal progenitors also can acquire a pro-inflammatory, adipocyte-like phenotype with aging. We propose a hypothetical model in which cellular stress and preadipocyte overutilization with aging induce cellular senescence, leading to impaired adipogenesis, failure to sequester lipotoxic fatty acids, inflammatory cytokine and chemokine generation, and innate and adaptive immune response activation. These pro-inflammatory processes may amplify each other and have systemic consequences. This model is consistent with recent concepts about cellular senescence as a stress-responsive, adaptive phenotype that develops through multiple stages, including major metabolic and secretory readjustments, which can spread from cell to cell and can occur at any point during life. Senescence could be an alternative cell fate that develops in response to injury or metabolic dysfunction and might occur in nondividing as well as dividing cells. Consistent with this, a senescent-like state can develop in preadipocytes and fat cells from young obese individuals. Senescent, pro-inflammatory cells in fat could have profound clinical consequences because of the large size of the fat organ and its central metabolic role. [source]

Gender-related differences in urinary 6-sulfatoxymelatonin levels in obese pubertal individuals

JOURNAL OF PINEAL RESEARCH, Issue 3 2006
Hugo L. Fideleff
Abstract:, The objective of this study was to measure the urinary excretion of the main melatonin metabolite 6-sulfatoxymelatonin in obese and normal weight (wt) boys and girls. The study included 94 subjects, aged 4,15.7 yr (50 obese and 44 normal wt; 48 boys) classified as: mid-childhood (4,7.99 yr), late-childhood (8,12 yr) and pubertal (10.1,15.7 yr, Tanner II,IV). Normal wt subjects were children with a body mass index (BMI) between the 25th and 75th percentiles, and the group of obese subjects included children whose BMI was above the 97th percentile. A 24-hr urine sample was collected during two intervals: (i) 18:00,08:00 hr, and (ii) 08:00,18:00 hr. Analysis of urinary 6-sulfatoxymelatonin levels was performed by radioimmunoassay. Excretion of 6-sulfatoxymelatonin was expressed as: (i) total amount excreted (,g); (ii) ,g excreted per time interval, nocturnal or diurnal; and (iii) the difference between nocturnal and diurnal samples (,g, estimated amplitude). A factorial analysis of variance indicated that nocturnal 6-sulfatoxymelatonin excretion and amplitude were significantly higher in the obese individuals. A significant interaction ,BMI × age' was detected, i.e. the effect of BMI was significant in the pubertal group only. Total, nocturnal and diurnal 6-sulfatoxymelatonin excretion was significantly higher in girls. The increase in 6-sulfatoxymelatonin excretion found in obesity occurred only in boys and at the pubertal age. To what extent this increase in melatonin production contributes to a delayed puberty in some pubertal obese males remains to be established. [source]

Obesity and type 2 diabetes

NUTRITION BULLETIN, Issue 2 2006
C. Waine
Summary, The rise in obesity , and specifically abdominal obesity , is driving the global increase in type 2 diabetes. Excess visceral fat, the causative factor behind abdominal obesity, is closely linked with ,-cell dysfunction and insulin resistance, two of the key components of type 2 diabetes pathogenesis. Attempts to curb the current abdominal obesity and type 2 diabetes epidemics will require a government-led public health approach, in tandem with a personal approach aimed at helping abdominally obese individuals reduce their cardiovascular and metabolic (cardiometabolic) risk profile. [source]

Health benefits of dietary fiber

NUTRITION REVIEWS, Issue 4 2009
James W Anderson
Dietary fiber intake provides many health benefits. However, average fiber intakes for US children and adults are less than half of the recommended levels. Individuals with high intakes of dietary fiber appear to be at significantly lower risk for developing coronary heart disease, stroke, hypertension, diabetes, obesity, and certain gastrointestinal diseases. Increasing fiber intake lowers blood pressure and serum cholesterol levels. Increased intake of soluble fiber improves glycemia and insulin sensitivity in non-diabetic and diabetic individuals. Fiber supplementation in obese individuals significantly enhances weight loss. Increased fiber intake benefits a number of gastrointestinal disorders including the following: gastroesophageal reflux disease, duodenal ulcer, diverticulitis, constipation, and hemorrhoids. Prebiotic fibers appear to enhance immune function. Dietary fiber intake provides similar benefits for children as for adults. The recommended dietary fiber intakes for children and adults are 14 g/1000 kcal. More effective communication and consumer education is required to enhance fiber consumption from foods or supplements. [source]

Intentional weight loss and mortality among initially healthy men and women

NUTRITION REVIEWS, Issue 7 2008
Mette K Simonsen
Most prospective observational studies suggest that weight loss increases the risk of premature death among obese individuals. This is surprising because clinical studies show that weight loss generally leads to overall improvements in cardiovascular risk factors. It is sometimes argued that the increased mortality observed with weight loss must depend on confounding or poor study designs. This review was conducted to summarize results from studies on intentional weight loss and mortality among healthy individuals, while carefully considering the designs and problems in these studies. Evaluation criteria with a rating scale were developed. Of the studies evaluated, two found decreased mortality with intentional weight loss, three found increased mortality, and four found no significant associations between intentional weight loss and total mortality. Thus, it is still not possible for health authorities to make secure recommendations on intentional weight loss. More studies designed to specifically address this issue are warranted. [source]

Dietary Fiber and Weight Regulation

NUTRITION REVIEWS, Issue 5 2001
Nancy C. Howarth M.Sc
The influence of dietary fiber on energy regulation remains controversial. This review summarizes published studies on the effects of dietary fiber on hunger, satiety, energy intake, and body composition in healthy individuals. Under conditions of fixed energy intake, the majority of studies indicate that an increase in either soluble or insoluble fiber intake increases postmeal satiety and decreases subsequent hunger. When energy intake is ad libitum, mean values for published studies indicate that consumption of an additional 14 g/day fiber for >2 days is associated with a 10% decrease in energy intake and body weight loss of 1.9 kg over 3.8 months. Furthermore, obese individuals may exhibit a greater suppression of energy intake and body weight loss (mean energy intake in all studies was reduced to 82% by higher fiber intake in overweight/obese people versus 94% in lean people; body weight loss was 2.4 kg versus 0.8 kg). These amounts are very similar to the mean changes in energy intake and body weight changes observed when dietary fat content is lowered from 38% to 24% of energy intake in controlled studies of nonobese and obese subjects. The observed changes in energy intake and body weight occur both when the fiber is from naturally high-fiber foods and when it is from a fiber supplement. In view of the fact that mean dietary fiber intake in the United States is currently only 15 g/day (i.e., approximately half the American Heart Association recommendation of 25,30 g/day), efforts to increase dietary fiber in individuals consuming >25 g/day may help to decrease the currently high national prevalence of obesity. [source]

Perspectives: molecular genetic research in human obesity

OBESITY REVIEWS, Issue 3 2003
J. Hebebrand
Summary Within the past decade the molecular basis of single forms of monogenic obesity has been elucidated. With the exception of functionally relevant mutations in the melanocortin-4 receptor gene, which occur in approximately 2,4% of extremely obese individuals, all other currently known monogenic forms are rare and additionally associated with distinct endocrinological abnormalities. A large number of association studies have been performed in ,normal' obesity. Whereas many associations have been reported, it is largely unclear which of these represent true positive findings. Over 20 genome scans pertaining to obesity and related phenotypes have been performed; specific chromosomal peak regions have been identified in different scans. We review the current status and discuss relevant issues related to phenotyping, association and linkage studies. We recommend that the procedure via which a consensus is reached as to what constitutes a true positive association finding requires formalization. [source]

Quality of life and obesity

OBESITY REVIEWS, Issue 4 2001
R. L. Kolotkin
Abstract Interest in the quality of life of patients with different diseases continues to grow. Recent years have witnessed a dramatic rise in the prevalence of obesity worldwide, stimulating interest in the health and quality of life consequences of this phenomenon. The body of research on the quality of life of obese individuals has grown to a point that a review of this literature is warranted. Numerous studies have demonstrated that obese persons experience significant impairments in quality of life as a result of their obesity, with greater impairments associated with greater degrees of obesity. Weight loss has been shown to improve quality of life in obese persons undergoing a variety of treatments. Further research is needed to clarify whether quality of life differs among subsets of obese persons. Until recently, there has been little standardization of quality of life measures in obesity. The SF-36 has been used in a number of studies of obese persons. Several obesity-specific instruments have also been developed and have shown great promise. The quality of life of obese individuals is an important issue that should be included in weight management treatment and research. [source]

The Effects of Obesity on Functional Work Capacity and Quality of Life in Phase II Cardiac Rehabilitation

PREVENTIVE CARDIOLOGY, Issue 2 2007
John Gunstad PhD
Many patients referred to cardiac rehabilitation (CR) programs are obese. It is unknown, however, whether obese patients derive reduced benefit from CR. A total of 388 CR patients were categorized into normal-weight, overweight, class I obese, and class II/III obese groups. Functional work capacity and quality of life were examined at baseline and after 12-week completion of the CR program. After adjusting for demographic and medical conditions, class II/III obese persons showed lower work capacity and physical quality of life at both baseline and follow-up. Class II/III obese individuals also showed smaller gains in work capacity from baseline to follow-up than all other groups. Further work is needed to identify strategies for improving outcome in obese patients, including incorporating structured weight loss into CR or post-CR referral to an exercise maintenance program. [source]

Peer victimization and pediatric obesity: A review of the literature

PSYCHOLOGY IN THE SCHOOLS, Issue 8 2009
Wendy N. Gray
Childhood obesity is associated with a variety of medical and psychosocial consequences. Children who are obese are at an increased risk of being victims of weight-based stigmatization by their peers. Negative views toward obese individuals may be expressed through children's friendship selections and expressed levels of overt (e.g., pushing, hitting) and relational (e.g., spreading rumors, weight-based teasing) forms of aggression. This report provides a review of the existing research on peer victimization and its impact on children's psychological, social, and behavioral functioning. Interventions for weight-based stigmatization and victimization are reviewed, and recommendations to improve the effectiveness of such interventions are provided. Future directions for the research literature are suggested to address limitations in the extant literature and highlight potential areas of inquiry that can provide information for the development of effective interventions for the victimization of obese youth. © 2009 Wiley Periodicals, Inc. [source]

Obesity is Associated with Genetic Variants That Alter Dopamine Availability

ANNALS OF HUMAN GENETICS, Issue 3 2006
A. C. Need
Summary Human and animal studies have implicated dopamine in appetite regulation, and family studies have shown that BMI has a strong genetic component. Dopamine availability is controlled largely by three enzymes: COMT, MAOA and MAOB, and by the dopamine transporter SLC6A3, and each gene has a well-characterized functional variant. Here we look at these four functional polymorphisms together, to investigate how heritable variation in dopamine levels influences the risk of obesity in a cohort of 1150, including 240 defined as obese (BMI , 30). The COMT and SLC6A3 polymorphisms showed no association with either weight, BMI or obesity risk. We found, however, that both MAOA and MAOB show an excess of the low-activity genotypes in obese individuals (MAOA:,2= 15.45, p = 0.004; MAOB:,2= 8.05, p = 0.018). Additionally, the MAOA genotype was significantly associated with both weight (p = 0.0005) and BMI (p = 0.001). When considered together, the ,at risk genotype' - low activity genotypes at both the MAOA and MAOB loci - shows a relative risk for obesity of 5.01. These results have not been replicated and, given the experience of complex trait genetics, warrant caution in interpretation. In implicating both the MAOA and MOAB variants, however, this study provides the first indication that dopamine availability (as opposed to other effects of MAOA) is involved in human obesity. It is therefore a priority to assess the associations in replication datasets. [source]

New method of abdominoplasty for morbidly obese patients

ANZ JOURNAL OF SURGERY, Issue 6 2004
Jacob Ollapallil
Introduction: We report two cases of morbidly obese patients with huge infected abdominal aprons who underwent apronectomies at Alice Springs Hospital, Northern Territory, Australia. We describe a novel technique which to date has not been described in the available literature. Patients afflicted by morbid obesity with large aprons can be incapacitated by immobility as well as suffer from recurrent infections. Apronectomy in this situation can be difficult because of the heavy weight of the apron. Method: This technique involves the use of a small crane and large orthopaedic K-nails. Two K-nails were inserted into the apron and attached to a small crane. This facilitated the elevation and manipulation of the apron during surgical dissection. The abdominal tissue removed from the female and male weighed 30 kg and 64 kg, respectively. The wounds were closed primarily and drained by three large bore suction drains. Results: The female patient had a largely uneventful postoperative course with a minor wound infection that resolved with conservative treatment. The other patient required a more protracted course of antibiotics for his more severe infection. Mobility was markedly improved in both individuals. Conclusion: This novel technique can be used successfully for severely morbidly obese individuals and can significantly reduce the surgeon's and assistants' difficulty in manipulating and handling a heavy apron during dissection. [source]

High insulin levels are positively associated with peripheral nervous system function

ACTA NEUROLOGICA SCANDINAVICA, Issue 2 2009
H. Isojärvi
Objective,,, The aim of this study was to analyze peripheral nervous system (PNS) function in overweight and obese individuals. Materials and Methods,,, Forty-four adult non-diabetic overweight individuals were recruited. Peroneal motor nerve conduction and radial, sural, and medial plantar sensory nerve conduction were studied. Insulin and glucose levels were determined twice (over a 2- to 3-year period) with an oral glucose tolerance test (OGTT). Multiple stepwise linear regression models adjusted for age, height, weight, and skin temperature were used to analyze the data. Results,,, Analysis revealed that baseline insulin levels measured 120 min after an OGTT explained 18% of the variation in peroneal F -wave minimum latency, 8% of peroneal F -wave maximum latency variation, 15% of sural sensory latency variation, 13% of sural sensory nerve conduction velocity (NCV) variation, and 10% of the variation in medial plantar sensory NCV. Discussion and Conclusion,,, Our study shows that serum insulin levels measured 120 min after an OGGT are positively associated with PNS function. High insulin levels without notably high glucose levels appear to be beneficial for the function of the PNS. [source]

Adipocytokines and the metabolic syndrome among older persons with and without obesity: the InCHIANTI study

CLINICAL ENDOCRINOLOGY, Issue 1 2010
Sari Stenholm
Summary Objectives, Adipose tissue-derived inflammation may contribute to metabolic alterations and eventually to the metabolic syndrome (MetS). The purpose of this study was to: (1) examine the role of adipocytokines in the association between obesity and the MetS and (2) to determine whether the association is different in obese and non-obese persons. Design, Cross-sectional population-based InCHIANTI study. Subjects, A total of 944 community-dwelling adults aged 65 years and older living in Tuscany, Italy. Measurements, Obesity was defined as body mass index ,30 kg/m2 and MetS as ,3 of the ATP-III criteria. Circulating levels of C-reactive protein, interleukin (IL)-6, IL-1 receptor antagonist (IL-1ra), IL-18, tumour necrosis factor (TNF)-, R1, adiponectin, resistin and leptin were measured. Additionally, insulin resistance was determined using the homeostasis model assessment (HOMA-IR). Results, The prevalence of the MetS was 32%. Both overall and abdominal obesity were significantly associated with the MetS after adjusting for inflammatory cytokines, adipokines and lifestyle factors. After adjusting for multiple confounders and HOMA-IR, IL-1ra, TNF-, R1 and adiponectin (P < 0·05) remained significantly associated with the MetS. Having multiple cytokines in the highest tertile increased the likelihood of having the MetS in both obese (P for trend 0·002) and non-obese persons (P for trend 0·001) independent of insulin resistance. Conclusions, Non-obese and obese individuals who develop an intense pro-inflammatory state may be more prone to develop the MetS than those with lower levels of inflammation. [source]

CYR61 polymorphisms are associated with plasma HDL-cholesterol levels in obese individuals

CLINICAL GENETICS, Issue 3 2007
L Bouchard
We have recently characterized the transcriptome of the omental adipose tissue of non-diabetic, obese men with and without the metabolic syndrome (MS). The cysteine-rich protein 61 (CYR61) is one of the most differentially expressed genes between the groups and has been selected for a detailed molecular investigation. Direct sequencing of complete CYR61 gene revealed five polymorphisms with minor allele frequency >5% in the promoter region (rs3753794, rs3753793 and rs2297140), intron 1 (rs2297141) and intron 2 (IVS2+50). Chi-square test and logistic regression were applied to test for association between CYR61 polymorphisms and the individual MS components in a cohort of 697 obese individuals. In men and women, rs3753794 and rs3753793 (r2 = 0.77) were associated plasma HDL-cholesterol levels (p = 0.016 and p = 0.008). Carriers of the A allele for rs3753794 were more likely to have high plasma HDL-cholesterol levels (1.50-fold; p = 0.016), as compared with G/G homozygotes and the A/A homozygotes for rs3753793 were more likely to exhibit low plasma HDL-cholesterol levels (1.56-fold; p = 0.008), as compared with C/C homozygotes. Furthermore, an association between IVS2+50 polymorphism and HDL-cholesterol was found in women and in men analyzed separately (p = 0.002 and p = 0.038, respectively). These results suggest that CYR61 is a promising candidate gene for lipoprotein/lipid perturbations. [source]

Elucidating the Relationship Between Obesity and Depression: Recommendations for Future Research

CLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 1 2008
Joshua I. Hrabosky
The obese population is heterogeneous in its experiences of psychosocial disturbances, yet many obese individuals do experience such problems as body image disturbance, low self-esteem, diminished self-efficacy, and binge eating. Furthermore, recent research has repeatedly found obesity to correlate with negative affect, depressed mood, and clinical depression. In their comprehensive review, Markowitz, Friedman, and Arent (2008) identify numerous psychosocial and biological processes that they hypothesize to act as mediating factors in the relationship between obesity and depression. This commentary extends Markowitz and colleagues' review and proposed causal pathway model by (a) evaluating the specificity of the relationship between obesity and depression, and (b) providing recommendations for the empirical evaluation of causal hypotheses. [source]