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PubMed2001

Body size, fat distribution, menarcheal age and blood pressure in 14-year-old girls.

BACKGROUND: The relationships between body size and fatness and blood pressure are generally acknowledged. The majority of the few studies that have examined the effect of fat distribution and maturation rate on blood pressure have used secondary sex characteristics as the measure of maturity. The aim of the present study is to examine the associations between blood pressure and relative weight, fat distribution, recalled menarcheal age and occurrence of menstruation (yes/no) in a sample comprising of 1149 14-year-old girls. METHODS: Systolic and diastolic blood pressure (DBP), height, weight and body circumferences were measured using standard protocols. Fatness was expressed as body mass index (BMI, kg/m2), whereas fat distribution was estimated by using waist-to-hip ratio. The girls' maturity status was assessed from exact recalled date of menarche. One-way analysis of covariance and multiple linear regression analyses were used to determine the strength of association among systolic blood pressure (SBP), DBP and BMI, menarcheal age and indices of fat distribution. RESULTS AND CONCLUSION: Height and BMI are significantly associated with SBP. Relative weight is the most important factor related to SBP independently of chronological age and maturity status. Height and age at menarche are significantly associated with DBP. Height of 14-year-old girls shows the same strength of association with SBP and DBP, whereas maturity status negatively correlates with DBP. Fat distribution shows no effect on the level of DBP in girls.

Adipose Tissue↗
PubMed1982

Adipose tissue cellularity in man: the relationship between fat cell size and number, the mass and distribution of body fat and the history of weight gain and loss.

The aims of this work were to establish whether, in an obese population, a group characterized by a distinctly high fact cell number could be observed and whether the number of body fact cells was affected by slimming. In the obese group there were 75 obese females (kg/m2 greater than 27.0) and 19 obese males (kg/m2 greater than 27.5); the lean group contained 37 females and 11 males. Body fat was estimated either from skinfold thickness or from body potassium measurements. Fat cell size was measured by a well-established microscopic method. No clear distinction could be made between types of obese patients on the basis of their estimated total number of measurable body fact cells. This number was weakly related to the degree of obesity (r = 0.342; P less than 0.001). Weight reduction caused no appreciable change in fat cell number. We conclude that the whole concept of adipocyte hypercellularity as a causal factor in obesity has been overemphasized.

Adipose Tissue↗
PubMed1996

Overview of non-insulin-dependent diabetes mellitus (NIDDM) in different population groups.

There are remarkable world-wide differences in the prevalence of diabetes, ranging from virtually 0% in Papua, New Guinea, to over 50% in the Pimas of Arizona. There are also notable rural-urban (e.g. Polynesians in rural and urban Western Samoa) and native-migrant (eg Chinese in China and in Mauritius) differences. The reporting of a high prevalence of diabetes in many populations that have undergone either urbanization or migration suggests that environmental factors related to lifestyle are contributory. Two such factors may be physical inactivity and dietary animal fat. There are also remarkable differences in ethnic susceptibility to non-insulin dependent diabetes mellitus (NIDDM), indicative of a strong genetic factor. Obesity is a risk factor for NIDDM. In addition to body weight, however, the pattern of distribution of body fat must also be considered. In some ethnic groups a central pattern of body fat distribution has been shown to be a significant risk factor even in the absence of obesity. This is particularly true in many Asian populations. It is proposed that genetic predisposition plus environment (lifestyle) interact and lead to visceral adiposity and insulin resistance, and that heredity and lifestyle also interact to cause a beta-cell lesion that affects insulin production and secretion. Development of insulin resistance facilitates the emergence of the beta-cell lesion. A consequence of this sequence of events is the development of glucose intolerance, and eventually, NIDDM.

Arizona↗
PubMed1991

Increased upper body and overall adiposity is associated with decreased sex hormone binding globulin in postmenopausal women.

An unfavorable body fat distribution is associated with many metabolic abnormalities including a high prevalence and incidence of noninsulin dependent diabetes mellitus and decreased high density lipoprotein cholesterol and increased triglyceride levels. One mechanism for the effect of body fat distribution on metabolic variables may be through sex hormones. We examined the relationship of body mass index (BMI), ratio of subscapular-to-triceps skinfold ratio (centrality index) and ratio of waist-to-hip ratio (WHR) to sex hormone binding globulin (SHBG) (an in vivo measure of androgenicity) in 101 postmenopausal Mexican-American and non-Hispanic white women from the San Antonio Heart Study, a population based study of diabetes and cardiovascular disease. SHBG was significantly correlated with BMI (r = -0.440, P less than 0.001), WHR (r = -0.255, P less than 0.01) and centrality index (r = -0.210, P less than 0.05). In a multiple linear regression analysis, SHBG remained significantly associated with BMI (P less than 0.001) and WHR (P less than 0.05) but not with age, ethnicity or centrality index. This work suggests that in postmenopausal women overall adiposity and an unfavorable body fat distribution are associated with increased androgenicity as measured by a lower SHBG concentration. Our finding may help to explain the association of body fat distribution with diabetes and cardiovascular risk factors in older women.

Adipose Tissue↗
PubMed1997

Influence of menopause on blood cholesterol levels in women: the role of body composition, fat distribution and hormonal milieu. Virgilio Menopause Health Group.

OBJECTIVES: In this study we investigated the relationships between blood lipids and menopausal status. SETTING AND SUBJECTS: All data were obtained from the first cross-sectional examination of the Virgilio Menopause Health Project in a large cohort of middle-aged women in pre, peri-, and postmenopausal age. The data refer to 426 women without metabolic or endocrine diseases, relevant hepatic, renal and cardiovascular abnormalities, none were dieting or taking medications. MAIN OUTCOME MEASURES: A precoded questionnaire including full clinical history, socio-economic and personal information, habitual diet, physical activity, drug use and smoking habits, careful recording of gynaecological events and family history for disease was completed. Several anthropometric parameters and the bioelectrical impedance analysis was used to measure free fatty mass. Blood samples for hormones and biochemistry were also obtained. RESULTS: There were no significant differences on body mass index, fatty mass, free fatty mass and parameters of body fat distribution between the three groups. Again, there were no differences in smoking habits, dietary intake or indices of physical activity amongst the groups. There was a significant increase from pre to postmenopause of LH and FSH and a decrease of oestradiol and testosterone, whereas no difference was found in sex hormone-binding globulin. Age-adjusted values of glucose, triglycerides and high density lipoprotein (HDL-) cholesterol were similar in all groups, whereas postmenopausal women had significantly higher values of total and low density lipoprotein (LDL-) cholesterol. On the contrary, there was a significant fall in insulin levels passing from pre to postmenopause. In multiple regression models, total and LDL-cholesterol correlated positively with body mass index, waist-to-hip ratio and age, and negatively with free fatty mass and oestradiol blood levels. CONCLUSIONS: These results are consistent with the hypothesis that menopausal status may have a significant and independent effect in determining increased total and LDL-cholesterol concentrations in postmenopausal women.

Adipose Tissue↗
PubMed2004

Body composition, fat distribution and metabolic characteristics in lean and obese women with polycystic ovary syndrome.

The polycystic ovary syndrome (PCOS), characterized by chronic anovulation and hyperandrogenism, has many features of metabolic syndrome and can be considered a metabolic disease. Approximately 50% of patients with PCOS are overweight or obese with abdominal fat accumulation. Some metabolic alterations and abdominal fat distribution have also been reported in lean women with PCOS. The aim of this study was to evaluate the effect, if any, of obesity on metabolic features, body composition and fat distribution in patients with PCOS. Body composition and abdominal fat distribution (evaluated by DEXA), waist circumference, blood pressure, lipid profile, glucose tolerance and homeostasis model assessment index were determined in 23 lean [mean age 23 +/- 5 yr, mean body mass index (BMI) 22 +/- 2 kg/m2] and 27 overweight-obese (mean age 21 +/- 5 yr, mean BMI 32 +/- 5 kg/m2) patients with PCOS and in 20 age- and weight-matched eumenorrhoic women. Patients exhibited slight but non-significant differences in metabolic parameters, waist circumference, blood pressure and total and abdominal fat content compared with weight-matched controls. None of the lean subjects suffered from metabolic syndrome according to the National Cholesterol Education Program--Adult Treatment Panel III (NCEP-ATPIII) criteria as opposed to 10 overweight-obese patients and three overweight-obese control subjects (37% and 33.3% of each subgroup, respectively). Our data do not show significant metabolic alterations in lean PCOS women. Results indicate that obesity seems to underpin the metabolic alterations exhibited by the overweight-obese patients. However, since women with PCOS are at increased cardiovascular risk, further studies are needed to evaluate metabolic alterations and body composition in these patients.

Adipose Tissue↗
PubMed2001

Pericardial fat accumulation in men as a risk factor for coronary artery disease.

An increment of abdominal visceral fat accumulation has been reported to be a coronary risk factor. We determined the predictive power of pericardial fat (Pfat) accumulation as intra-thoracic visceral fat, in the diagnosis of coronary artery disease (CAD). Among 251 (181 non-obese [body mass index<25], 70 obese [body mass index> or =25]) Japanese male patients who underwent computed tomography (CT), 128 (90 non-obese, 38 obese) patients were suffering from CAD. Pfat volume was determined by the sum of cross-sectional images 1cm thick from the atrial appendage to the apex over the diaphragm. Abdominal visceral fat (Vfat) and subcutaneous fat (Sfat) areas were measured by a single scan at the L4-L5 region. Pfat was most associated with Vfat in body fat distribution. In non-obese patients, Pfat was most associated with CAD among the various risk factors including body fat distribution. Moreover, Pfat was the strongest independent variable for the severity of CAD, determined by coronary angiogram. This result showed that pericardial fat accumulation was a stronger coronary risk factor than the other body fat distributions in non-obese men.

Adult↗
PubMed1999

Studies of body composition and fat distribution in HIV-infected and control subjects.

OBJECTIVE: Recent studies have documented alterations in body fat distribution that have been associated with protease inhibitor therapy. We compared body composition, including measurements of fat distribution, in 96 HIV-infected subjects studied since January 1996 (current HIV), subjects seen prior to January 1996 (previous HIV), and healthy controls. DESIGN: Retrospective cross-sectional studies of subjects matched by gender, race, age, and height. METHODS: Body weight, height, body cell mass by whole-body counting of 40K plus fat, fat-free mass, and body fat distribution by anthropometry were measured. RESULTS: Current HIV men weighed more (p = .025) and had more body cell mass than previous HIV men, but less than controls (p < .001). In women, the between group differences in fat were greater than the differences in body cell mass. Current and previous HIV study subjects had lower indices of subcutaneous and higher indices of visceral fat than controls. In current HIV subjects, body fat distribution was significantly associated with log plasma HIV RNA content but not with antiretroviral or protease inhibitor usage, nor with CD4+ lymphocyte counts. In 7 of 9 current HIV subjects studied, 24-hour urinary free cortisol excretion was abnormally high. CONCLUSIONS: Alterations in body fat distribution are a characteristic feature in HIV infection. The occurrence of increased visceral fat content and decreased subcutaneous fat content preceded the era of combination antiretroviral therapy. The alteration in fat distribution may be affected by plasma HIV RNA content rather than antiretroviral or protease-inhibitor therapy. The body composition alterations might be associated with endogenous hypercortisolism.

Adult↗
PubMed1995

Familial clustering of multiple measures of adiposity and fat distribution in the Québec Family Study: a trivariate analysis of percent body fat, body mass index, and trunk-to-extremity skinfold ratio.

OBJECTIVE: To assess whether independent or common (pleiotropic) familial factors (i.e., genetic and/or common environment) underlie the observed associations among measures of body mass, body fat, and its distribution. DESIGN: A familial correlation model involves both parents and offspring, and gives rise to three types of familial correlations (spouse, parent-offspring, and sibling). A pattern of significant familial correlations suggests that the trait is determined by familial factors (i.e., genetic and/or environmental heritability). Cross-trait familial correlations are also estimated, both within individuals (intraindividual) and between family members (interindividual). Interindividual cross-trait familial correlations (e.g., trait 1 in parents with trait 2 in offspring) lead to the same type of familial inferences regarding bivariate heritabilities. SUBJECTS AND MEASURES: Measures of total body fat (% body fat-%BF), fat distribution (trunk/extremity skinfold ratio-TER), and body mass index (BMI) were assessed in 1239 individuals from 309 nuclear families participating the Québec Family Study. RESULTS: All three adiposity measures are cross-correlated within individuals. However, interindividual cross-trait correlations, which alone are capable of suggesting common familial determinants, are significant only for BMI with each of %BF and TER (bivariate heritabilities of 10% and 18%, respectively), and not for %BF and TER. CONCLUSION: Although all three adiposity measures are correlated within individuals, there appear to be entirely different underlying genes and/or environmental factors influencing the adiposity phenotypes of total body fat and fat distribution. The BMI, however, apparently shares some familial determinants with both total body fat and fat distribution.

Adolescent↗
PubMedDate not supplied

Effects of combined female sex hormone replacement therapy on body fat percentage and distribution.

The effectiveness of hormone replacement therapy for patients with cardiovascular disease and for postmenopausal women with associated cardiovascular risks is currently under wide investigation. Among the cardiovascular risks are those related to body fat percentage and distribution. The present study undertook to investigate the effects of combined hormone replacement therapy on body fat percentage and distribution in postmenopausal women. Data for the present study were collected via retrospective analyses of 287 healthy postmenopausal women (146 as a study group, 141 as controls). Participants in the study group received 0.625 mg conjugated equine estrogen combined with 2.5 mg medroxyprogesterone acetate per day for 18 months. Body fat percentage and fat distribution were evaluated through the electrical impedance method and measurements of skinfold thickness, respectively. Two indices of centripetal fat distribution were defined: ratio of trunk-to-extremity skinfold thickness (T/E index), and ratio of upper-to-lower body skinfold thickness (U/L index). Investigators found that a daily dose of 0.625 mg of conjugated equine estrogen combined with 2.5 mg of medroxyprogesterone acetate taken for 18 months increased body fat percentage by decreasing lean body mass and by affecting upper-to-lower body fat distribution, without producing significant changes in overall weight. A slight decrease in the trunk-to-extremity body fat ratio was noted at 18 months of treatment, but this decrease did not reach statistical significance. Data related to the effects of hormone replacement therapy on body fat percentage and distribution in postmenopausal women are scarce. Additional research is needed to clarify the possible health benefits of hormone replacement therapy.

Adipose Tissue↗
PubMed2000

Weight gain during menopause. Is it inevitable or can it be prevented?

The years surrounding the menopause are associated with weight gain, increased central adiposity, and decreased physical activity. While weight change occurs independent of menopausal status, adverse changes in body fat distribution and body composition may be due to hormonal changes occurring during the menopausal transition. The one factor most consistently related to weight gain is physical activity. To avoid weight gain, women should make regular physical activity a priority. Although HRT use is widely believed to cause weight gain, data from the PEPI trial do not support this belief. Moreover, HRT may have a protective effect in reducing central adiposity, although more long-term studies using CT or MRI to measure visceral fat are needed to confirm this hypothesis. Data from the Women's Healthy Lifestyle Project provide clear evidence that weight gain and increased waist circumference, along with elevations in lipid levels and other CHD risk factors, are preventable through use of lifestyle intervention in healthy menopausal-aged women. Given the prevalence and chronic course of obesity, weight gain prevention should be recognized as an important health goal for women before they approach menopause.

Body Composition↗
PubMed1989

Obesity, obesity-related behaviors and coronary heart disease risk factors in black and white premenopausal women.

Obesity is more common in black women than in white women in the USA, but there are few studies comparing black and white females on behaviors related to obesity or on the relationship between obesity and cardiovascular risk factors. We studied 490 white and 48 black premenopausal, nondiabetic, nonhypertensive women, aged 42-50 years, who were participating in the Pittsburgh Healthy Women Study. Black women had a higher BMI than white women and had a higher suprailiac:triceps ratio, suggesting a more central distribution of body fat. Weight gain since age 20 was greater in black women than in white women. Blacks and whites did not differ in caloric intake, smoking or alcohol consumption. However, there were marked differences in physical activity, with blacks reporting significantly less activity than whites. Differences in body fat distribution, weight gain since age 20 and activity remained after adjusting for education. Blacks also had higher blood pressure and poorer glucose tolerance than whites. The low activity level of black women should be considered when designing weight loss interventions.

Adipose Tissue↗
PubMed1991

Obesity in Mexican American subgroups: findings from the San Antonio Heart Study.

This study describes the prevalence of overweight in 2013 Mexican Americans and 928 non-Hispanic whites, aged 25-65 y, who participated in phase 2 of the San Antonio Heart Study, 1984-1988, and examines differences in overall obesity and body fat distribution among diverse Mexican American subgroups defined by neighborhood, socioeconomic status (SES), and assimilation to mainstream US society. Prevalence of overweight was greater in Mexican Americans than in non-Hispanic whites, and the ethnic difference was greater in women than in men. In Mexican Americans the effects of SES and assimilation on overall obesity and body fat distribution differed by sex group. In men SES and cultural assimilation were associated with less favorable body fat distribution. In women SES and assimilation were associated with lower overall obesity and more favorable body fat distribution. Interventions to reduce obesity in Mexican Americans should take these subgroup differences into account.

Acculturation↗
PubMed1994

The independent effects of polycystic ovary syndrome and obesity on serum concentrations of gonadotrophins and sex steroids in premenopausal women.

OBJECTIVE: To investigate the basal levels of gonadotrophins and sex steroids, with special reference to the effects of obesity and body fat distribution, in premenopausal women, both those with polycystic ovary syndrome (PCOS) and those with normal ovaries and regular menstrual cycles. DESIGN: Cross-sectional study. The separate effects of obesity (and body fat distribution and fasting insulin levels) and PCOS on endocrine variables were evaluated by means of analysis of covariance. PATIENTS: Sixty-seven women with anovulatory menstrual cycles and polycystic ovaries according to ultrasonography and 59 women with normal ovaries and regular cycles, both groups covering a wide range of body mass index (BMI, PCOS, 17.6-37.4, mean 25.7 kg/m2; controls, 18.8-40.9, mean 25.1 kg/m2). MEASUREMENTS: Serum levels of gonadotrophins, sex steroid hormones, prolactin and GH obtained in the early follicular phase in the controls, fasting insulin levels, anthropometric measures (BMI, skinfolds, waist hip ratio). RESULTS: Mean serum concentrations of LH, androstenedione, testosterone, the free androgen index (FAI; all P < 0.0001) and DHEAS (P < 0.01) were higher, and serum FSH (P < 0.01) and serum SHBG levels lower (P < 0.0001), in the PCOS group than in the controls. Women with PCOS had a more pronounced upper body fat distribution and higher fasting insulin levels than the controls. Independent of PCOS, BMI was positively associated with serum levels of FSH (P < 0.001) and negatively with levels of LH (P < 0.05), LH/FSH ratio (P < 0.0001), SHBG (P < 0.0001) and androstenedione (P < 0.01), whereas for levels of testosterone, FAI and DHEAS the impact of obesity differed significantly between the groups. Thus, in the PCOS group, testosterone levels (P < 0.05) and the FAI (P < 0.001) were positively associated with BMI, whereas they were constant throughout the entire range of BMI in the controls. DHEAS levels were positively associated with BMI in the PCOS group (P < 0.05) and negatively in the controls (P < 0.01). Measures of upper body fat were related to testosterone and FAI levels, independent of BMI. CONCLUSIONS: Lower FSH levels were found in women with PCOS than during the early follicular phase of normally ovulating women, suggesting a role in anovulation in PCOS. Obesity itself exerted effects on endocrine variables, with the net result of a reduced LH/FSH ratio and lower serum levels of androstenedione and SHBG in both groups; obesity was associated with increased levels of DHEAS, testosterone and FAI exclusively in the women with PCOS. The results underline the endocrine impact of obesity and body fat distribution and the necessity of applying reference values of BMI matched subjects when establishing the endocrine profile of women with PCOS.

Adult↗
PubMed2002

The relationship of waist circumference to blood pressure: the Olivetti Heart Study.

BACKGROUND: The association between overweight, high blood pressure (BP), and insulin resistance is well established, but the role of body fat distribution in this association has yet to be fully elucidated. The aim of this study was to investigate the role of central adiposity in the association between overweight, high BP, and insulin resistance. METHODS: A total of 1,079 men participated in the follow-up of the Olivetti Heart Study from 1994 to 1995. The present analysis includes 768 men, after the exclusion of 184 participants on pharmacological treatment for hypertension. In 65 men fasting blood glucose was >7 mmol/L; in 48, age was below or above 2 standard deviations from the mean of the population; and in 14 the data set was incomplete. Anthropometric indices of adiposity, metabolic variables (including fasting serum insulin and homeostasis model assessment [HOMA] index of insulin sensitivity), and BP were measured. RESULTS: In univariate analysis, waist circumference was the anthropometric index that best correlated with BP (P < .001). In multiple regression analysis, waist circumference remained the strongest independent predictor of BP after adjustment for confounders. Significant increase of systolic (P value for trend analysis < .001) and diastolic (P < .001) pressure, heart rate (P = .003), fasting and postload serum insulin (P < .001), and HOMA index of insulin sensitivity (P < .001) were observed across age-adjusted quintiles of waist circumference. Greater degrees of central adiposity were associated with higher prevalence of elevated BP values and insulin resistance (P value < .001, chi2 for linear trend). CONCLUSIONS: In middle-aged men, a central distribution of body fat is associated with increased BP, independently of body mass index and insulin resistance, thus suggesting a key role of central adiposity in the full expression of the "metabolic syndrome."

Abdomen↗
PubMed2001

Cardiovascular disease risk factors in males with normal body weight and high waist-to-hip ratio.

BACKGROUND: Overweight and the distribution of body fat are both associated with the development of cardiovascular diseases (CVD). The relation of abdominal body fat distribution to CVD may depend on the degree of obesity. OBJECTIVE: The purpose of the present study was to evaluate the cardiovascular disease risk factor levels in males with high waist-to-hip ratio (WHR) in the absence of overweight. DESIGN: Cross-sectional study of 231 male subjects (21-69 years old). METHODS: Anthropometric measurements (height, weight, BMI, fat%, skinfolds, waist circumference, WHR), systolic and diastolic blood pressure (BPsyst, BPdiast), serum lipids and lipoproteins (CHOL, HDL-C, LDL-C, TG), glucose (GL), and physical working capacity. A questionnaire was drawn up to evaluate physical activity level and lifestyle patterns. RESULTS: Subjects with WHR > or = 0.9, BMI < 27.0 and with WHR > or = 0.9, BMI > or = 27.0 showed statistically significant differences in all measured anthropometric and blood pressure values in comparison with the control group (WHR < 0.9, BMI < 27.0). Compared with the controls, subjects with WHR > or = 0.9, BMI > or = 27.0 had significantly higher risk (OR) for hypertension and elevated LDL-C. Physical activity was a significant determinant of the high WHR. CONCLUSIONS: WHR has independent associations with some CVD risk factors, but the effect increases with weight.

Adult↗
PubMed2006

Metabolic and hormonal control of the desire for food and sex: implications for obesity and eating disorders.

During evolution, the ability to overeat and store the extra energy as glycogen and lipids in specialized tissues must have conferred a reproductive advantage by releasing animals from the need to eat constantly, enabling them to engage in behaviors that improved reproductive success. Mechanisms that inhibited ingestive behavior might have been most adaptive when they caused individuals to stop foraging, hoarding and eating in order to find and court potential mates. Conversely, the ability to abstain from reproductive activities to engage in foraging and eating was probably critical for individual survival during severe energetic challenges because reproductive processes are energetically costly and can be delayed until the energetic conditions improve. The mechanisms that control ingestive behavior most likely evolved under conditions in which both food and mates were available, and thus, our understanding might be limited by our narrow focus on food intake in animals isolated from potential mates, and reproductive behaviors in the absence of food. Our understanding of obesity and eating disorders will be enriched by the study of the choice between ingestive and reproductive behaviors and by a renewed attention to "reproductive" hormones such as gonadal steroids and hypothalamic releasing hormones. Furthermore, leptin and reproductive hormones have both organizational and activational effects on the energy balancing system including those mechanisms that control appetite, body fat content and body fat distribution. Understanding these organizational and activational effects on body fat distribution might lead to a better understanding of sex differences in the propensity to develop obesity, type II diabetes and eating disorders.

Animals↗
PubMed1986

Obesity: overview of pathogenesis and treatment.

This paper presents an overview of selected current concepts of the pathogenesis and treatment of obesity. It has been estimated using the 1981 Canada Fitness Survey data that 14.1% of Canadian adult men and 20.6% of women are greater than 20% above reference table weight. Recent advances in adipocyte metabolism and control have shown that hyperplastic obesity can occur at any age and that there are differences in the replicative rate of adipocyte precursor cells from the massively obese. Furthermore, a number of the complications of obesity, including hypertension, have been related to regional body fat distribution, independent of total body fat. It is suggested that some of the controversy on the relationship between body weight/weight loss and hypertension may be due to failure to account for this. There is now suggestive evidence that abnormalities in diet-induced thermogenesis and (or) brown adipose tissue may result in human obesity. The roles of the major treatment modalities (diet, behaviour therapy, and exercise) are reviewed as are the potential hazards of the weight loss process.

Adipose Tissue↗