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PubMed2006

Being overweight influences the development of hepatic dysfunction in Japanese patients with non-small-cell lung cancer undergoing cytotoxic chemotherapy.

PURPOSE: The aim of this study was to identify risk factors for hepatic dysfunction during cytotoxic chemotherapy in Japanese patients with non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: We retrospectively reviewed the medical records of patients with NSCLC who received cytotoxic chemotherapy at Okayama University Hospital between January 2003 and March 2006. "Overweight" was defined as a body mass index (BMI) of 25 or more, according to the World Health Organization (WHO) criteria. We investigated the incidence and pattern of hepatic dysfunction during chemotherapy and evaluated the possible associations between hepatic dysfunction and several clinical factors, including BMI. RESULTS: Of the 155 Japanese patients enrolled in this study, 19 (12%) were overweight. Grade 2 or worse hepatic dysfunction was observed in 5 of the 19 overweight patients (26%) but in only 13 of the 136 non-overweight patients (10%). A multivariate analysis demonstrated that a higher BMI significantly increased the risk of grade 2 or worse hepatic dysfunction after the initiation of cytotoxic chemotherapy (odds ratio=4.04, 95% confidence intervals: 1.13-14.5, p=0.032). CONCLUSION: Our data suggest that being overweight can influence the development of hepatic dysfunction in Japanese patients receiving cytotoxic chemotherapy for the treatment of NSCLC, although further investigation is required.

Adult↗
PubMed2006

Body surface area in normal-weight, overweight, and obese adults. A comparison study.

Values for body surface area (BSA) are commonly used in medicine, particularly to calculate doses of chemotherapeutic agents and index cardiac output. Various BSA formulas have been developed over the years. The DuBois and DuBois (Arch Intern Med 1916;17:863-71) BSA equation is the most widely used, although derived from only 9 subjects. More recently, Mosteller (N Engl J Med 1987;317:1098) produced a simple formula, [weight (kg) x height (cm)/3600](1/2), which could be easily remembered and evaluated on a pocket calculator, but validation data in adults are rare. The purpose of the present study was to examine the BSA based on Mosteller's formula in normal-weight (body mass index [BMI], 20-24.9 kg/m(2)), overweight (BMI, 25-29.9 kg/m(2)), and obese (BMI, >/=30 kg/m(2)) adults (>18 years old) in comparison with other empirically derived formulas (DuBois and DuBois, Boyd [The growth of the surface area of the human body. Minneapolis: University of Minnesota Press; 1935], Gehan and George [Cancer Chemother Rep 1970;54:225-35], US Environmental Protection Agency [Development of statistical distributions or ranges of standard factors used in exposure assessments Washington, EPA/600/8-85-010. Office of Health and Environmental Assessment; 1985), Haycock et al [J Pediatr 1978;93:62-6], Mattar [Crit Care Med 1989;17:846-7], Livingston and Scott [Am J Physiol Endocrinol Metab 2001;281:E586-91]) and with the new 3-dimensional-derived formula of Yu et al (Appl Ergon. 2003;34:273-8). One thousand eight hundred sixty-eight patients were evaluated (397 normal weight [BMI, 23 +/- 1 kg/m(2); age, 50 +/- 14 years; M/F, 289/108], 714 overweight [BMI, 27 +/- 1 kg/m(2); age, 52 +/- 11 years; M/F, 594/120], and 757 obese [BMI, 36 +/- 6 kg/m(2); age, 53 +/- 11 years; M/F, 543/215]). The overall BSA was 2.04 +/- 0.24 m(2): 1.81 +/- 0.19 m(2) in normal-weight, 1.99 +/- 0.16 m(2) in overweight, and 2.21 +/- 0.22 m(2) in obese subjects. These values were significantly higher in overweight and obese patients compared with the values using the DuBois-DuBois formula (overall, 2.00 +/- 0.22 m(2), P < .01; normal weight, 1.81 +/- 0.19 m(2), P = .93; overweight, 1.97 +/- 0.16 m(2), P < .01; obese, 2.14 +/- 0.21 m(2), P < .001). We could show an excellent correlation between the results obtained from each formula, with all correlations of 0.97 or higher (between 0.971 and 0.999). Body surface area prediction with the commonly used DuBois formula underestimated BSA in obese patients by as much as 3% (male) to 5% (female). Based on the formula of Yu et al, however, BSA is overestimated when these traditional formulas are used. Although Mosteller's formula is recommended based on its simplicity and suitability for laboratory and clinical work in adults, accuracy studies in whites with 3-dimensional one-pass whole-body scanning are needed.

Adult↗
PubMed2005

Positive maternal attitude to the family eating together decreases the risk of adolescent overweight.

OBJECTIVES: To determine whether maternal attitude towards the family regularly eating together and maternal report of how often the family eat together are associated with adolescent offspring overweight. RESEARCH METHODS AND PROCEDURES: A cross-sectional mother-child-linked analysis was carried out using 14-year follow-up data from a population-based prospective birth cohort of 3795 children (52% males) who were participants in the Mater-University study of pregnancy, Brisbane, Australia. Maternal reports on family eating pattern reported at age 14 were used. RESULTS: The prevalence of overweight at age 14 was 24.1% (95% confidence interval (CI), 22.3, 26.1) for males and 27.1% (CI, 25.1, 29.2) for females. The majority of mothers (78%) reported that the family ate together at least once a day, but only 43% reported that they felt that family eating together was important. The offspring of women who felt that the family eating together was not important had increased odds of being overweight at age 14 (odds ratio, 1.27; 95% CI, 1.05, 1.53) in age- and sex-adjusted models. Adjustment for potential confounding factors had no substantive effect on the association. There was no association between maternal reports of how often the family actually did eat together and overweight at age 14 in the offspring. DISCUSSION: These findings suggest that maternal attitude towards family eating patterns, but not maternal report of how often the family do eat together, are associated with childhood overweight status. Maternal attitude towards family eating (as opposed to a report of actual frequency at one time-point) may reflect broader maternal influences (beyond family eating pattern) on their child's diet and eating patterns over a long time course.

Adolescent↗
PubMed2006

Transition from overweight to obesity worsens pregnancy outcome in a BMI-dependent manner.

OBJECTIVE: To assess pregnancy outcomes in different BMI groups. RESEARCH METHODS AND PROCEDURES: We analyzed 25,601 singleton pregnancies from January 1989 to December 2001. Overweight women (prepregnancy BMI = 26 to 29 kg/m2) represented 13.2% (3388) of the cases, and 7.3% (1880) were obese (BMI > or = 30 kg/m2). The data were obtained from self-administered questionnaires at 20 weeks of pregnancy, complemented by nurse interviews and clinical records. Multiple logistic regression analysis was used to control for confounding factors. RESULTS: Overweight and obese women had more previous deliveries, pregnancy terminations, miscarriages, and stillbirths, to have more diabetes and hypertension, and to smoke more often than normal weight women. The pregnancies were more often complicated by preeclampsia or chorioamnionitis (p < 0.001). Pregnancy outcomes were impaired in overweight and obese pregnant women, with respective odds ratios (95% confidence index) as follows: low Apgar score at 5 minutes, 1.54 (1.20 to 1.98) and 1.64 (1.22 to 2.28); newborn admission to a neonatal unit, 1.20 (1.06 to 1.37) and 1.38 (1.17 to 1.61); cesarean delivery, 1.22 (1.10 to 1.35) and 1.68 (1.48 to 1.91); fetal death, 1.54 (0.88 to 2.68) and 2.35 (1.28 to 4.32); perinatal death, 1.54 (0.98 to 2.42) and 2.19 (1.33 to 3.62). DISCUSSION: Obesity, in particular during pregnancy, should be considered as an abnormal situation. An overweight condition increases obstetric risks in a BMI-dependent manner. The risk of perinatal death more than doubles in the transition from an overweight to an obese condition. Modest weight loss could bring substantial advantages to obstetric outcome.

Adolescent↗
PubMed2006

Blood pressure among overweight adolescents from urban school children in Pune, India.

OBJECTIVES: To examine the magnitude of overweight and its association with blood pressure (BP) among adolescents. DESIGN: Cross-sectional study with all children in age range 9-16 years (n=1146 boys and 1077 girls) from two schools catering to urban affluent high socio-economic class (HSE), for anthropometric measurements by trained investigators and BP measurement by a pediatrician using sphygmomanometer. RESULTS: The prevalence of overweight based on conventional body mass index (BMI) cutoff was 27.5% for boys and 20.9% for girls but varied for different indicators. Prevalence of high systolic blood pressure (HSBP) was 12.0% in boys and 9.7% in girls and increased with increasing levels of BMI, weight, triceps skin fold thickness (TSFT) and percent body fat. Mean level of SBP among overweight children was significantly (P<0.001) higher by about 12 mm Hg, whereas that for diastolic blood pressure was higher by 8 mm Hg (P<0.001) as compared to their non-overweight (age, sex-matched) counterparts. This was true in both sexes and for all indicators used for assessing overweight. Prevalence of HSBP increased suddenly beyond BMI value of 20 kg/m2 in boys and 21.5 kg/m2 in girls, beyond TSFT value of 12 mm for boys and 14 mm for girls whereas such cutoffs for body fat were above 25% in both sexes. These cutoffs appear much lower than the conventional ones and therefore indicate the need for validation of conventional cutoffs in different populations. CONCLUSIONS: Our findings highlight that BP measurement needs to be a routine part of physical examination in school children, and the use of cutoffs anchored to metabolic risks may be essential for assessment of obesity.

Adolescent↗
PubMed2006

Exercise does not feel the same when you are overweight: the impact of self-selected and imposed intensity on affect and exertion.

OBJECTIVE: The lower rates of adherence to physical activity commonly found among overweight adults compared to their normal-weight counterparts might be due to the activity being experienced as more laborious and less pleasant, particularly when its intensity is prescribed (or imposed) rather than self-selected. DESIGN: Within-subject design, with two 20-min sessions of treadmill exercise, one at self-selected speed and one at imposed speed, 10% higher than the self-selected. SUBJECTS: A total of 16 overweight (BMI: 31 kg/m2) and 9 normal-weight (BMI: 22 kg/m2) previously sedentary but healthy women (age: 43 years). MEASUREMENTS: Heart rate, oxygen uptake relative to body weight, and ratings of perceived exertion and pleasure-displeasure were assessed every 5 min. RESULTS: The overweight women showed higher oxygen uptake and perceived exertion than the normal-weight women during both sessions. Although the two groups did not differ in ratings of pleasure-displeasure during the session at self-selected speed, only the overweight women showed a significant decline when the speed was imposed. CONCLUSIONS: Imposing a speed that is just 10% higher than what overweight women would have self-selected led to a significant decline in reported pleasure. Over time, this could diminish the enjoyment of and intrinsic motivation for physical activity, reducing adherence.

Adult↗
PubMed2006

Efficacy of exercise for treating overweight in children and adolescents: a systematic review.

BACKGROUND: Overweight prevalence among children/adolescents is increasing, while adult obesity may potentially cause a decline in life expectancy. More exercise is uniformly recommended, although treatment efficacy remains unclear. OBJECTIVE: To determine the efficacy of exercise alone for treating overweight in children/adolescents. DESIGN: A systematic review and meta-analysis of randomized trials published in English were completed following multiple database searches performed on December 10, 2004. Studies of isolated or adjunctive exercise/physical activity treatment in overweight/obese children or adolescents which reported any overweight outcome were included. Literature searches identified 645 papers which were manually searched, of which 45 were considered for inclusion, of which 13 papers which reported 14 studies were included (N=481 overweight boys and girls, aged approximately 12 years). Two reviewers independently identified relevant papers for potential inclusion and assessed methodological quality. Principal measures of effects included the mean difference (MD) (between treatment and control groups), the weighted MD (WMD), and the standardized MD (SMD). RESULTS: Few studies were of robust design. The pooled SMD was -0.4 (-0.7, -0.1, P=0.006) for percent body fat, and -0.2 (-0.6, 0.1, P=0.07) for central obesity outcomes, whereas the pooled WMD was -2.7 kg (-6.1 kg, 0.8 kg, P=0.07) for body weight, all of which favored exercise. Pooled effects on body weight were significant and larger for studies of higher doses, whereas nonsignificant and smaller effects were seen for studies of lower doses of exercise (155-180 min/weeks vs 120-150 min/weeks). CONCLUSIONS: Based on the small number of short-term randomized trials currently available, an aerobic exercise prescription of 155-180 min/weeks at moderate-to-high intensity is effective for reducing body fat in overweight children/adolescents, but effects on body weight and central obesity are inconclusive. Recommendations for future study designs are discussed.

Adipose Tissue↗
PubMed2006

Gastric sensorimotor functions and hormone profile in normal weight, overweight, and obese people.

BACKGROUND & AIMS: Peptide YY (PYY) levels are reported to be decreased in obesity. The relation between gastric functions, satiation, and gut hormones in obesity is incompletely understood. The aim of this study was to compare gastric volumes, emptying, maximum tolerated volumes, postchallenge symptoms, and selected gut hormones in normal, overweight, or obese healthy volunteers. METHODS: In 73 nonbulimic normal, overweight, or obese participants weighing less than 137 kg, we measured gastric emptying of solids and liquids by scintigraphy (gastric emptying half-time [GE t(1/2)]); gastric volumes by single-photon emission computed tomography; maximum tolerated volumes and symptoms by satiation test; and plasma leptin, ghrelin, insulin, glucagon-like peptide 1, and PYY levels. Groups were compared using 1-way analysis of covariance adjusted for sex. Univariate associations among measured responses were assessed using Spearman correlations. Multiple linear regression models, adjusting for weight and sex, assessed the independent ability of gastric functions and hormones to predict satiation volume. RESULTS: Obese and overweight subjects had significantly lower postprandial gastric volumes, higher fasting and postprandial insulin and leptin levels, and lower fasting ghrelin and lower postprandial reduction in ghrelin levels. PYY levels were not different in obese or overweight subjects compared with controls. The GE t(1/2) was correlated inversely with postprandial PYY; increased body weight was associated with faster GE t(1/2) of solids (r(s) = 0.33, P = .005) and liquids (r(s) = 0.24, P = .04). Postprandial changes in gastric volume and PYY were independent predictors of satiation (both P = .01). CONCLUSIONS: Overweight or obesity are associated with lower postprandial gastric volumes and normal PYY levels. Gastric emptying influences postprandial PYY levels. Postprandial PYY and gastric volume independently predict satiation volume in nonbulimic people across a wide body mass index range.

Adolescent↗
PubMed2005

Overweight and all-cause mortality in a Swedish rural population: Skaraborg Hypertension and Diabetes Project.

AIMS: To explore the prevalence of overweight in men and women in a Swedish rural community and to examine its associations with all-cause mortality. METHODS: A community-based cohort study. A total of 1,109 men and women aged >or= 40 years participated in a survey of cardiovascular disease (CVD) risk factors in the city of Skara in Skaraborg, Sweden, in 1993-94. Overweight was defined as a BMI >or=25.0 kg m(-2). Vital status was ascertained to 31 December 1999 and sex-specific associations between overweight and mortality were explored. RESULTS: The prevalence of overweight according to the WHO's criteria exceeded 50% in men and 35% in women. In men there was an inverse association between BMI and mortality. Men in the lowest quartile of BMI experienced the highest mortality with 44.1 deaths per 1,000 person-years. The hazard ratio (HR) in the highest quartile was 0.6 (95% CI 0.4-0.9). In women there were no significant differences in mortality between quartiles of BMI. In both men and women with previous CVD the mortality rates decreased with quartiles of increasing BMI. The inverse association between BMI and mortality was confined to elderly men with a history of CVD. CONCLUSION: In both sexes the association between BMI and mortality differed across subgroups of age and of a history of previous CVD. No indication of overweight being negative for longevity was found in this population. Higher age and a history of previous CVD contribute to the excess mortality seen in subjects with low BMI.

Abdominal Fat↗
PubMed2005

Growing social inequalities in the occurrence of overweight and obesity among young men in Sweden.

AIMS: The aims of the present study are to investigate time trends and social inequalities in mean body mass index (BMI), overweight, and obesity among 18-year-old men in Sweden from 1970 to 2000 and to explore whether social inequalities in these conditions have increased. METHODS: A record linkage was made between the Military Service Conscription Register, Population and Housing Censuses, the Register of Education and the Register of the Total Population. All 1,748,800 males born in 1952-82 who were living in Sweden at the age of 17 years in 1969-99 were eligible for this nationwide study. The study population comprises 1,500,499 18-year-old men with information on BMI (86% of eligible subjects). RESULTS: During the study period from 1970 to 2000, mean BMI increased from 20.89 kg/m2 to 22.49 kg/m2, the prevalence of overweight increased from 6.6% to 13.6% and the prevalence of obesity increased from 1.0% to 3.8%. Mean BMI and the prevalence of overweight and obesity were higher among young men with low-educated mothers than among those with high-educated mothers. A noteworthy finding was that the socioeconomic gap increased over time. CONCLUSIONS: Between 1970 and 2000, the prevalence of overweight increased twofold and the prevalence of obesity increased fourfold in this study population. The social inequalities in overweight and obesity have steadily increased among young men in Sweden during the past three decades.

Adolescent↗
PubMed2006

Effects of socioeconomic change from birth to early adulthood on height and overweight.

BACKGROUND: In this work we explored the association of height and overweight with change in socioeconomic position between birth and 19 years of age. METHODS: A birth cohort has been followed-up in Pelotas, Brazil, since 1982. All 5914 hospital births were enrolled in the study just after delivery. In 2001, 27% of the cohort subjects were sought, and 1031 (69% of the survivors) were interviewed. Weight and height were obtained for women; men had been examined 6 months earlier. Information on family income in 1982 and 2001 was used to classify the sample into tertiles, the lowest classified as 'poor' and the other two as 'non-poor'. Four trajectories resulted: always poor, never poor, poor at birth/non-poor at 19, and non-poor at birth/poor at 19-which were compared in terms of mean height and prevalence of overweight. RESULTS: Height showed a similar behaviour for men and women, with the never poor presenting the highest mean, followed by those who were non-poor at birth and later became poor. Those who were poor at birth, regardless of later status, were shortest. Overweight was approximately twice as common among men who were never poor in relation to the others. Among women, those who were always poor presented the highest prevalence of overweight. In this case, social determination seems to be complex and may involve aspects of lifestyle and behaviour acting differently for each gender. CONCLUSION: Socioeconomic trajectories affected both height and overweight, the effect on the latter being different for each gender.

Birth Weight↗
PubMed2006

Family mealtime interactions and overweight children with asthma: potential for compounded risks?

OBJECTIVE: Exploratory study aimed to examine differences in family interaction patterns during a routine mealtime between overweight, at-risk for overweight, and average weight children with asthma. METHODS: Eighty families of children with asthma, aged 5-12 years, were videotaped during a mealtime in their homes. The videotapes were rated using the McMaster Mealtime Family Interaction Coding System (MICS). Structural aspects of the meal such as presence of sugary drinks and whether the television was on were also coded. RESULTS: Significant differences were found on the MICS with families of children with asthma who were overweight scoring lower on task accomplishment, affect management, interpersonal involvement, and roles. Families of overweight children with asthma also displayed an increased presence of sugary beverages, shorter meal length, and fewer adults at the table. CONCLUSIONS: Preliminary findings suggest that families with children with asthma who are overweight may have a more difficult time managing mealtimes and feel overwhelmed by this family routine.

Asthma↗
PubMed2006

Breast-feeding and overweight in adolescence: within-family analysis [corrected].

BACKGROUND: Previous reports have found associations between having been breast-fed and a reduced risk of being overweight. These associations may be confounded by sociocultural determinants of both breast-feeding and obesity. We addressed this possibility by assessing the association of breast-feeding duration with adolescent obesity within sibling sets. METHODS: We surveyed 5,614 siblings age 9 to 14 years and their mothers. These children were a subset of participants in the Growing Up Today Study, in which we had previously reported an inverse association of breast-feeding duration with overweight. We compared the prevalence of overweight (body mass index exceeding the age-sex-specific 85th percentile) in siblings who were breast-fed longer than the mean duration of their sibship with those who were breast-fed for a shorter period. Then we compared odds ratios from this within-family analysis with odds ratios from an overall (ie, not within-family) analysis. RESULTS: Mean +/- standard deviation breast-feeding duration was 6.4 +/- 4.0 months, and crude prevalence of overweight was 19%. On average, siblings who were breast-fed longer than their family mean had breast-feeding duration 3.7 months longer than their shorter-duration siblings. The adjusted odds ratio (OR) for overweight among siblings with longer breast-feeding duration, compared with shorter duration, was 0.92 (95% confidence interval = 0.76-1.11). In overall analyses, the adjusted OR was 0.94 (0.88-1.00) for each 3.7-month increment in breast-feeding duration. CONCLUSION: The estimated OR for the within-family analysis was close to the overall estimate, suggesting that the apparent protective effect of breast-feeding on later obesity was not highly confounded by unmeasured sociocultural factors. A larger study of siblings, however, would be needed to confirm this conclusion.

Adolescent↗
PubMed2006

Use of markers of dyslipidemia to identify overweight youth with insulin resistance.

CONTEXT: Markers to identify overweight youth with insulin resistance are of clinical importance. OBJECTIVE: To determine if markers of dyslipidemia could identify overweight adolescents with insulin resistance. SETTING, PARTICIPANTS, AND STUDY DESIGN: We retrospectively examined the association between markers of dyslipidemia and insulin resistance in 35 overweight [body mass index (BMI) of > or =95th percentile], white adolescents [mean age 13.5 +/- (SD) 1.6 yr] who had participated in hyperinsulinemic-euglycemic clamp studies to evaluate insulin action. Total body fat was measured by dual-energy X-ray absorptiometry and abdominal fat with computed tomography. Using receiver-operating curves, cut-points for triglyceride (TG)/high-density lipoprotein (HDL) and TG level to identify overweight individuals in the lowest tertile for insulin sensitivity were determined. MAIN OUTCOME MEASURE: Difference in the values for insulin sensitivity among the groups. RESULTS: Of the markers examined (TG, TG/HDL, adiponectin, measures of adiposity and fasting insulin), fasting insulin was the strongest correlate of insulin sensitivity (r = 0.87, p < 0.001). Youth with TG/HDL level > or =3 had lower insulin sensitivity (50% lower median values, p < 0.01) and higher visceral fat (p < 0.05) despite BMI comparable to that of youth with TG/HDL level <3. Youth with TG/HDL > or =3 had a sensitivity of 61% and specificity of 82% for identifying participants with the greatest degree of insulin resistance. CONCLUSIONS: TG and TG/HDL are easily obtained markers associated with insulin resistance. Further research is needed to determine if a constellation of clinical findings, such as components of the metabolic syndrome along with other metabolic markers including adiponectin, better predicts insulin resistance in overweight youth.

Abdominal Fat↗
PubMedDate not supplied

Recognition and management of childhood overweight and obesity by clinicians.

AIM: (i) To determine the ability of general practitioners (GPs) and paediatricians to correctly identify children as overweight or obese by visual cues alone; (ii) to describe the current management practices of overweight and obese children by these practitioners; and (iii) to compare these with National Health and Medical Research Council (NHMRC) Clinical Practice Guidelines. METHODS: Forty-four GPs and 29 paediatricians participated in the study. Respondents completed a questionnaire based on a series of body images, rating the size of the child as acceptable weight, overweight or obese and indicating the likelihood of carrying out a series of management options. RESULTS: There was considerable variation in ability to rate images correctly with the total number of correct responses being 72% and 68%, respectively, for GPs and paediatricians. There were statistically significant differences in management between GPs and paediatricians in terms of conducting appropriate anthropometry and screening for co-morbidities, with paediatricians performing closer to the NHMRC Clinical Practice Guidelines. CONCLUSION: GPs and paediatricians have the opportunity to screen children for overweight and obesity during their everyday practice. Accurate determination of weight status cannot be performed by visualisation alone and all children should have height and weight measured and correctly interpreted. Some areas of current GP and paediatrician management of overweight and obese children fall short of the NHMRC clinical guidelines and areas for improvement are highlighted in this paper.

Adolescent↗
PubMedDate not supplied

Cross-validation and discriminant validity of Adolescent Health Promotion Scale among overweight and nonoverweight adolescents in Taiwan.

This study used cross-validation and discriminant analysis to evaluate the construct and discriminant validity of Adolescent Health Promotion (AHP) scale between the overweight and nonoverweight adolescents in Taiwan. A cross-sectional survey method was used and 660 adolescents participated in this study. Cluster and discriminant analyses were used to analyze the data. Our findings indicate that the AHP is a valid and reliable scale to discriminate between the health-promoting behaviors of overweight and nonoverweight adolescents. For the total scale, cluster analyses revealed two distinct patterns, which we designated the healthy and unhealthy groups. Discriminate analysis supported this clustering as having good discriminant validity, as nonoverweight adolescents tended to be classified as healthy, while the overweight tended to be in the unhealthy group. In general, overweight adolescents practiced health-related behaviors at a significantly lower frequency than the nonoverweight. These included exercise behavior, stress management, life appreciation, health responsibility, and social support. These findings can be used to further develop and refine knowledge of adolescent overweight and related strategies for intervention.

Adolescent↗
PubMed2006

Advising overweight persons about diet and physical activity in primary health care: Lithuanian health behaviour monitoring study.

BACKGROUND: Obesity is a globally spreading health problem. Behavioural interventions aimed at modifying dietary habits and physical activity patterns are essential in prevention and management of obesity. General practitioners (GP) have a unique opportunity to counsel overweight patients on weight control. The purpose of the study was to assess the level of giving advice on diet and physical activity by GPs using the data of Lithuanian health behaviour monitoring among adult population. METHODS: Data from cross-sectional postal surveys of 2000, 2002 and 2004 were analysed. Nationally representative random samples were drawn from the population register. Each sample consisted of 3000 persons aged 20-64 years. The response rates were 74.4% in 2000, 63.4% in 2002 and 61.7% in 2004. Self-reported body weight and height were used to calculate body mass index (BMI). Information on advising in primary health care was obtained asking whether GP advised overweight patients to change dietary habits and to increase physical activity. The odds of receiving advice on diet and physical activity were calculated using multiple logistic regression analyses according to a range of sociodemographic variables, perceived health, number of visits to GPs and body-weight status. RESULTS: Almost a half of respondents were overweight or obese. Only one fourth of respondents reported that they were advised to change diet. The proportion of persons who received advice on physical activity was even lower. The odds of receiving advice increased with age. A strong association was found between perceived health and receiving advice. The likelihood of receiving advice was related to BMI. GPs were more likely to give advice when BMI was high. More than a half of obese respondents (63.3%) reported that they had tried to lose weight. The association between receiving advice and self-reported attempt to lose weight was found. CONCLUSION: The low rate of dietary and physical activity advice reported by overweight patients implies that more lifestyle counselling should be provided in primary health care. There is an obvious need for improved training and education of GPs in counselling of overweight patients focusing on methods of giving dietary and physical activity advice.

Adult↗
PubMed2006

Low-dose orlistat effects on body weight of mildly to moderately overweight individuals: a 16 week, double-blind, placebo-controlled trial.

BACKGROUND: Lifestyle measures are considered the first line of therapy for treating overweight individuals, but many are unable to achieve a meaningful weight loss. OBJECTIVE: To determine the efficacy and safety of orlistat 60 mg, given 3 times daily, for weight loss in mildly to moderately overweight individuals. METHODS: A multicenter, 16 week, randomized, double-blind, placebo-controlled study was conducted in 391 overweight subjects at 20 US centers. The main outcome measure was change in weight from baseline to week 16; secondary measures included changes in body mass index, waist circumference, blood pressure, and fasting lipoprotein and glucose levels. RESULTS: Subjects in both groups lost weight over the treatment period; however, orlistat-treated subjects lost significantly more weight than placebo-treated subjects beyond 2 weeks of treatment. Weight loss from baseline to week 16 was significantly greater in participants receiving orlistat versus those receiving placebo (3.05 vs 1.90 kg; p < 0.001, intent-to-treat analysis). Orlistat-treated subjects who completed 16 weeks of treatment lost 4.8 +/- 0.35% (mean +/- SE) of baseline weight compared with 3.1 +/- 0.38% for the placebo group (p < 0.001). Orlistat-treated subjects, compared with those receiving placebo, also demonstrated a greater relative reduction in total (-4.4% vs 0.0%; p = 0.004) and low-density lipoprotein cholesterol (-7.2% vs -0.6%; p = 0.005) and both diastolic (-3.9% vs -0.5%; p = 0.001) and systolic blood pressure (-4.7% vs -1.8%; p = 0.004). Both groups showed a similar safety profile; gastrointestinal events were significantly more common in the orlistat-treated subjects. CONCLUSIONS: The use of orlistat 60 mg by mildly to moderately overweight individuals produced significant weight loss in conjunction with a reduced calorie diet and self-instructional materials. This amount of weight loss was associated with improvements in several weight-related risk factors. Orlistat 60 mg may be a useful adjunct to lifestyle measures and has the potential to contribute significantly to weight and risk factor improvement for overweight individuals.

Adult↗