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National study of health and growth: social and family factors and overweight in English and Scottish parents.

Lower social class, several children, and overweight partner and increasing age were factors significantly associated with overweight in parents aged 20-55 years in England and Scotland. These associations were greater for women than men in both countries. These results support the contention that social circumstances contribute to overweight in adults. However, both the magnitude of the explained variation and the relative risk of each factor for overweight were low. We conclude that the selection of families for preventive health measures using the above risk factors would exclude a large proportion of the population who will become obese.

Adult↗

Hepatic lipase gene polymorphism, pre-pregnancy overweight status and risk of preeclampsia among Peruvian women.

We examined the association between the hepatic lipase (LIPC) gene promoter polymorphism (-514C/T) and risk of preeclampsia among Peruvian women. We also evaluated whether this association is modified by maternal pre-pregnancy overweight status. Using a case control study design, 157 preeclampsia cases and 180 normotensive controls were enrolled in the study. Genotyping was conducted using PCR amplification, NlaIII enzyme digestion and gel electrophoresis. Logistic regression procedures were used to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CI). After adjusting for confounding by maternal age, parity and pre-pregnancy body mass index (BMI), the relative risks of preeclampsia for women with LIPC -514CT and LIPC -514TT genotypes were 1.0 (95% CI 0.5-2.2) and 1.5 (95% CI 0.7-3.3) respectively, using women with LIPC -514CC genotype as a reference. Women who were both overweight and who had the LIPC -514TT genotype had a significant 3-fold increased risk of preeclampsia (Adj. OR:3.0 95% CI 1.3-6.8) as compared to those women who were not overweight and had the LIPC -514CC/CT genotype. In this study, we found that LIPC -514TT genotype and overweight status, when occurring together, were associated with a 3-fold increase in risk of preeclampsia among Peruvian women.

Body Mass Index↗

Adiponectin/ACP30, a collagen-like plasma protein in relation to anthropometric measurement in Thai overweight and obese subjects.

Adiponectin, anthropometric parameters including weight, height, body mass index (BMI), arm circumference, triceps skinfold, subscapular skinfold, waist, hip circumferences and waist/hip ratio were recorded in 48 male and 166 female overweight and obese Thai volunteers (BMI=25.0 kg/m(2)), and in 26 male and 81 female normal subjects (BMI=18.5-24.9 kg/m(2)). Thai volunteers were investigated. Statistically significantly lower adiponectin concentrations in overweight and obese subjects were found when compared with control subjects of both sexes. Anthropometric parameters, including weight, height, BMI, arm circumference, triceps skinfold, subscapular skinfold, waist, hip circumferences and waist/hip ratio, except arm span, were statistically significantly higher in overweight and obese subjects than in control subjects. The overweight and obese subjects had higher glucose concentrations than the control subjects. The BMI and glucose concentrations were found to be significantly related, under these conditions, to adiponectin.

Adiponectin↗

Maternal pre-pregnancy overweight status and obesity as risk factors for cesarean delivery.

OBJECTIVE: To determine the extent to which, if at all, maternal pre-pregnancy adiposity and other anthropometric factors are related to risk of cesarean delivery. METHODS: This hospital-based prospective cohort study included 738 nulliparous women who initiated prenatal care prior to 16 weeks gestation. Participants provided information about their pre-pregnancy weight and height and other sociodemographic and reproductive covariates. Labor and delivery characteristics were obtained from maternal and infant medical records. Risk ratios (RR) and 95% CI were estimated by fitting generalized linear models. RESULTS: The proportion of cesarean deliveries in this population was 26%. Women who were overweight (BMI 25.00-29.99 kg/m2) were twice as likely to deliver their infants by cesarean section as lean women (BMI<20.00 kg/m2) (RR=2.09; 95% CI 1.27-3.42). Obese women (BMI>or=30.00 kg/m2) experienced a three-fold increase in risk of cesarean delivery when compared with this referent group (RR=3.05; 95% CI 1.80-5.18). The joint association between maternal pre-pregnancy overweight status and short stature was additive. When compared with tall (height>or=1.63 m), lean women, short (<1.63 m), overweight (BMI>or=25.00 kg/m2) women were nearly three times as likely to have a cesarean delivery (RR=2.79; 95% CI 1.72-4.52). CONCLUSION: Our findings suggest that nulliparous women who are overweight or obese prior to pregnancy, and particularly those who are also short, have an increased risk of delivering their infants by cesarean section.

Adipose Tissue↗

Energy requirements and energy expenditure of lean and overweight women, measured by indirect calorimetry.

To estimate the energy requirement of lean and overweight women, 29 lean (body weight, 59 +/- 1 kg; means +/- SEM) and 18 overweight (94 +/- 5 kg) women consumed a weight-maintenance diet for 8 d. The final 80 h were spent in a whole-body indirect calorimeter. Actual metabolizable energy intake (ME) was measured by analyzing food, feces, and urine. Mean ME was 8.88 +/- 0.13 MJ/d (2123 +/- 30 kcal/d) (lean) and 10.12 +/- 0.29 MJ/d (2419 +/- 70 kcal/d) (overweight). Mean 24-h energy expenditure (24hEE) of the lean (8.58 +/- 0.13 MJ or 2052 +/- 32 kcal) was lower than that of the overweight (10.70 +/- 0.45 MJ or 2558 +/- 108 kcal; p less than 0.001) women. Energy balance was close to zero in both groups. Therefore, 24hEE was used as an estimation of energy requirement. Multiple-regression analysis showed body weight to be the best single predictor of 24hEE. Our data may be useful for prediction of energy requirements of women (aged 20-50 yr) in normal life.

Adult↗

The predictive value of childhood body mass index values for overweight at age 35 y.

Larger body mass index values (BMI in kg/m2) are associated with increased morbidity and mortality in adulthood and there are significant correlations between BMI values in childhood and in adulthood. The present study addresses the predictive value of childhood BMI for overweight at 35 +/- 5 y, defined as BMI > 28 for men and > 26 for women. Analyses of data for 555 white children indicated that overweight at 35 y can be predicted from BMI at younger ages. The prediction is excellent at age 18 y, good at 13 y, but only moderate at ages younger than 13 y. For 18-y-olds with a BMI value exceeding the 60th percentile, the odds of overweight at 35 y are 34% for men and 37% for women. A clinically applicable method is provided to assign an overweight child to a group with a known probability of high BMI values in adulthood.

Adolescent↗

Eating in the absence of hunger and overweight in girls from 5 to 7 y of age.

BACKGROUND: Eating when exposed to large portions of palatable foods in the absence of hunger has been suggested to contribute to overweight. OBJECTIVE: This research evaluated whether young girls' eating in the absence of hunger was stable across a 2-y period in middle childhood, was associated with an increased risk of overweight, and could be predicted by parents' use of restriction in child feeding. DESIGN: The participants were 192 non-Hispanic white girls and their parents, assessed when the girls were 5 and 7 y of age. The girls' eating when exposed to palatable foods in the absence of hunger was measured after they consumed a standard lunch and indicated that they were no longer hungry. RESULTS: Eating in the absence of hunger showed moderate stability across the 2-y period for most of the girls. The girls who ate large amounts of snack foods in the absence of hunger at 5 and 7 y of age were 4.6 times as likely to be overweight at both ages. Parents' reports of restricting their daughter's access to foods at age 5 y predicted girls' eating in the absence of hunger at age 7 y, even when the girls' weight status and eating in the absence of hunger at age 5 y were controlled for. CONCLUSIONS: This study provides the first evidence that young girls' eating in the absence of hunger may represent a stable phenotypic behavior of young overweight girls. In addition, these findings are consistent with previous work indicating that parents' restrictive feeding practices may contribute to this behavior.

Body Weight↗

Physical activity in free-living, overweight white and black women: divergent responses by race to diet-induced weight loss.

BACKGROUND: Black women are at greater risk of obesity than are white women, perhaps because of their lower levels of physical activity. OBJECTIVE: We compared free-living activity energy expenditure (AEE) in sedentary white and black women (in overweight and normal-weight states) and in never-overweight control subjects. DESIGN: Subjects included 46 women (23 white, 23 black) studied while overweight and after reaching a normal weight and 38 female control subjects (23 white, 15 black). Diet, without exercise training, resulted in a mean weight loss of 13 kg and a body mass index (in kg/m(2)) < 25. Body composition, sleeping energy expenditure, free-living total energy expenditure, and the energy cost of activity and aerobic capacity were assessed before and after weight loss under 4-wk, diet-controlled, weight-stable conditions and in the control subjects. AEE was defined as above-sleep energy expenditure. RESULTS: No significant racial differences in body composition, before or after weight loss, were found. After weight loss, AEE and aerobic capacity increased in the white women and decreased in the black women (P < 0.05 and P < 0.02, respectively). After weight loss, but not before, the white women had a significantly higher mean AEE than did the black women (2448 +/- 979 and 1728 +/- 1373 kJ/d, respectively; P < 0.05), approximating AEEs in the white (2314 +/- 1105) and black (2310 +/- 1251) control subjects. CONCLUSIONS: Relative to the responses of the white women to diet-induced weight loss, the black women became less fit and less physically active. Induction of a normal body weight in overweight black women appeared to produce a more obesity-prone state, favoring weight relapse.

Adult↗

Body fat percentages measured by dual-energy X-ray absorptiometry corresponding to recently recommended body mass index cutoffs for overweight and obesity in children and adolescents aged 3-18 y.

BACKGROUND: Body mass index (BMI; in kg/m2) cutoffs for use with children and adolescents aged 2-18 y that correspond to the well-accepted BMI cutoffs for overweight (> or = 25 but < 30) and obesity (> or = 30) in adults were published recently. OBJECTIVE: The objective was to estimate the percentage body fat (%BF) values typically associated with these BMI cutoffs in children and adolescents. DESIGN: The %BF was measured by dual-energy X-ray absorptiometry in 661 subjects (49% male) aged 3-18 y. Regression equations using BMI, age, and sex were developed to predict the %BF associated with BMI cutoffs for overweight (age-specific BMI equivalent to a BMI of 25 in an 18-y-old) and obesity (age-specific BMI equivalent to a BMI of 30 in an 18-y-old) over this age range. RESULTS: Measurements classified 17.1% of males and 19.8% of females as overweight and 5.5% of males and 7.5% of females as obese. The %BF associated with an obese BMI tended to be higher in peripubertal males (34-36%) than in younger (24-30%) or older (27-30%) males. Although the predicted %BF of young females was similar to that of young males, values rose steadily with age, such that an 18-y-old female with a BMI of 30 had an estimated %BF of 42%, whereas that in males of similar age was 27%. CONCLUSION: The %BF values associated with BMI classifications of overweight and obesity vary considerably with age in growing children, particularly in girls.

Absorptiometry, Photon↗

Plasma fatty acid composition is associated with the metabolic syndrome and low-grade inflammation in overweight adolescents.

BACKGROUND: Together with adiposity, plasma fatty acid (FA) composition can modulate the development of the metabolic syndrome (MS). OBJECTIVE: Our aim was to investigate the relations of FA composition in plasma phospholipids and cholesterol esters (CEs) with weight status, MS, and inflammation in adolescents. DESIGN: Plasma FA composition was measured by gas-liquid chromatography in 120 (60 normal-weight and 60 overweight) 12-y-old adolescents. We also measured the presence of MS, insulin resistance with the homeostasis model assessment, and interleukin 6 and C-reactive protein concentrations in the adolescents. RESULTS: MS was present in 25% of the overweight adolescents but in none of the normal-weight adolescents. Compared with overweight adolescents, normal-weight adolescents had lower saturated FAs (SFAs) in both phospholipids (P < 0.001) and CEs (P < 0.01) and higher docosahexaenoic acid in phospholipids (P < 0.001). In overweight subjects, FA composition was associated with MS features independent of body fat. The odds ratios of MS for a 0.1 increase in the ratio of polyunsaturated FAs (PUFA) to SFAs (PUFA:SFA) were 0.91 in phospholipids (P = 0.03) and 0.90 in CEs (P = 0.06). In phospholipids, PUFA:SFA and linoleic acid were associated positively with HDL cholesterol (P < 0.01 for both). PUFA:SFA in phospholipids and CEs were associated inversely with interleukin 6 (P < 0.05 for both). Eicosapentaenoic acid in phospholipids (P = 0.06) and CEs (P < 0.05) and linolenic acid in CEs (P < 0.05) were inversely related to C-reactive protein. These relations remained significant after adjustment for the waist-to-hip ratio. No significant relation between FA composition and the homeostasis model assessment was observed. CONCLUSIONS: Plasma FA composition is associated with weight status in healthy adolescents. High intake of long-chain PUFAs, especially n-3 PUFAs, may protect obese subjects against MS and low-grade inflammation as early as adolescence.

Body Weight↗

Helicobacter pylori and overweight status in the United States: data from the Third National Health and Nutrition Examination Survey.

Obesity is an important public health problem in the United States. Because of its potential effects on gastric leptin homeostasis, Helicobacter pylori may play a role in regulating body weight. The authors' aim in this study was to examine the association between H. pylori colonization and overweight status. Nonpregnant participants in the Third National Health and Nutrition Examination Survey (1988-1994) aged > or = 20 years who had had H. pylori testing performed and body mass index (weight (kg)/height (m2)) measured were studied. Overweight was defined as a body mass index greater than or equal to 25. On the basis of serologic results, the participants were categorized into three H. pylori status groups: H. pylori-positive and cytotoxin-associated gene A (cagA)-positive (H. pylori+ cagA+), H. pylori-positive and cagA-negative (H. pylori+ cagA-), and H. pylori-negative (H. pylori-). Of the 7,003 subjects with complete body mass index and H. pylori data, 2,634 (weighted percentage, 22.9%) were H. pylori+ cagA+, 1,385 (15.1%) were H. pylori+ cagA-, and 2,984 (62.0%) were H. pylori-. The adjusted odds of being overweight were 1.17 (95% confidence interval: 0.98, 1.39; p = 0.075) for the H. pylori+ cagA+ group and 0.99 (95% confidence interval: 0.80, 1.22; p = 0.92) for the H. pylori+ cagA- group in comparison with H. pylori- subjects. Serum leptin levels did not differ significantly between the three H. pylori groups. In this US population-based study, there was no significant association between H. pylori colonization, cagA+ strains of H. pylori, and being overweight.

Adult↗

Effects of insulin on left ventricular function during dynamic exercise in overweight and obese subjects.

AIMS: We designed this study in order to determine the effect of insulin on cardiac function in overweight and obese subjects during exercise. METHODS AND RESULTS: The cardiac function of 62 normal glucose tolerant subjects, aged 30-40 and divided into normal weight (group 1, n=22, BMI 20-24.9 kg/m(2)), overweight (group 2, n=20, BMI 25-29.9 kg/m(2)), and obesity (group 3, n=20, BMI 30-35 kg/m(2)) was evaluated at rest and during dynamic exercise through angiocardioscintigraphy, when on hyperinsulinaemic euglycaemic clamp (test A) and when on normal saline infusion (test B). Left ventricular function at rest was statistically greater (P<0.05) in both tests in overweight and obese subjects compared with normal weight controls, with no statistical difference (P=0.057) within groups between insulin and normal saline infusion. During exercise, cardiac function improved in all the subjects in both tests. The increase was lower in overweight and obese patients, even if statistically significant only in obese vs. control subjects in both tests (P<0.05). Insulin sensitivity showed a significant correlation (P< or =0.001) with left ventricular ejection fraction (LVEF) at rest and with change in LVEF during clamp. CONCLUSION: Our findings suggest a metabolic pathogenesis for the impaired LV function in obesity.

Adult↗

Stunting is associated with overweight in children of four nations that are undergoing the nutrition transition.

A higher risk of obesity in stunted children has been described in Hispanic-American, Jamaican and Andean populations, but little systematic exploration has been done concerning this area in nutrition. This paper examines the relationship between stunting and overweight status for children aged 3-6 and 7-9 y in nationally representative surveys in Russia, Brazil, and the Republic of South Africa and a large nationwide survey in China. Using identical cut-offs for body mass index, the prevalence of child overweight in these countries ranges from 10.5 to 25.6% (based on the 85th percentile); recent NHANES III results indicate that this prevalence is around 22% in the U.S. Stunting is also common in the surveyed countries affecting 9.2-30.6% of all children. Our results showed a significant association between stunting and overweight status in children of all countries. The income-adjusted risk ratios of being overweight for a stunted child ranged from 1.7 to 7.8. Clearly, there is an important association between stunting and high weight-for-height in a variety of ethnic environmental and social backgrounds. Although the underlying mechanisms remain unexplored, this association has serious public health implications particularly for lower income countries. As these countries enter the nutrition transition experiencing large changes in dietary and activity patterns, they may face, among other problems, additional difficulties in their fight against obesity.

Body Mass Index↗

Long-term Food Stamp Program participation is positively related to simultaneous overweight in young daughters and obesity in mothers.

Previous research using longitudinal data has found a positive and significant relationship between Food Stamp Program (FSP) participation and overweight in young girls and obesity in low-income women. This paper examined whether these relationships occurred simultaneously for members of the same family using longitudinal data on young (aged 4.5-11.5 y) girls and their mothers from the National Longitudinal Survey of Youth 1979. The results of ordinary least squares models that included detailed measures of individual, family, and environment characteristics and daughter or mother fixed effects indicated that all of the positive association between long-term FSP participation and overweight in daughters was accounted for by the association between long-term FSP participation and simultaneous overweight in daughters and obesity in mothers. Similarly, all of the positive association between long-term FSP participation and obesity in mothers was accounted for by the association between long-term FSP participation and simultaneous obesity in mothers and overweight in at least 1 young daughter. These results suggest that the relationship between long-term FSP participation and weight is a family phenomenon.

Body Weight↗

Has the WIC incentive to formula-feed led to an increase in overweight children?

We explored the relationship between the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and overweight status in children, with a focus on WIC's provision of infant formula, through secondary analyses and review of existing literature. Because of the complexity involved and the lack of previous research on the combined link between WIC, breast-feeding, and overweight status, we considered evidence for each of these relations separately. Using food-cost data from the WIC's 1996 Participant and Program Characteristics Survey, we found that the state-level average for 1 y of program benefits for women who formula-fed was over twice the value of program benefits for those who breast-fed (BF). This difference in benefit levels, or formula incentive, was negatively associated with both the in-hospital and 6-mo BF rates in state-level multiple regression models. Despite WIC's efforts to promote BF, other large-scale studies have found a negative association of program participation with BF rates. An inverse association of BF on subsequent overweight in children also has been shown in a number of studies. Despite this accumulating evidence for the protective effect of BF, it has not been seen in African American or Latino populations. In sum, there is reason to be concerned that WIC's incentive to formula-feed may have led to an increase in overweight children; yet there is too much uncertainty about the issue to conclude that this is so. Further research is needed to understand this relationship, as is the development of applied interventions to increase BF rates.

Black or African American↗

Weight control behaviors among obese, overweight, and nonoverweight adolescents.

OBJECTIVE: To evaluate weight control behaviors, eating, and physical activity behaviors among obese, overweight, and nonoverweight female and male adolescents. METHODS: A representative sample of 8,330 7th, 9th, and 11th grade public school students in Connecticut participated in the study. Adolescents responded to questions about weight control behaviors (dieting, exercise, vomiting, diet pills, and laxatives), healthy eating behaviors, breakfast consumption, and vigorous physical activity. RESULTS: In comparison to nonoverweight youths, overweight adolescents were less likely to eat breakfast and less likely to engage in vigorous physical activity than nonoverweight youths. Higher prevalences of unhealthy weight control behaviors were evident among overweight youths. CONCLUSIONS: Overweight adolescents use more unhealthy weight management strategies and are not engaging in healthier strategies, such as increased physical activity or healthier eating. These findings suggest the need to provide consistent messages about healthy weight loss methods to adolescents.

Adolescent↗

Changes in commingled body mass index distributions associated with secular trends in overweight among Danish young men.

The authors present results from a novel approach to understanding recent secular trends in overweight in terms of changes in underlying component distributions. On the basis of an examination of two large overlapping samples of Danish young men (ns = 16,557 and 21,747) spanning birth cohorts 1939-1958, the authors found evidence for two-component distributions, normal and overweight, in all cohorts. In cohorts born after 1940, the authors observed an increase in the size of the overweight component with no corresponding changes in overall mean or component means. On the basis of these results and other published reports, the authors speculate that the secular increase in overweight may be understood as a differential response to environmental change that may be mediated by genotype. The net effect appears to have been an increased penetrance in obesity-prone Danish young men.

Adult↗

Inhibition by insulin of hypothalamic VMN neurons in rats overweight due to postnatal overfeeding.

Single unit activity was studied in brain slices of normal and overweight adolescent rats, the latter grown up until weaning in small litters of three pups per mother (SL). Significantly fewer neurons of the ventromedial hypothalamic nucleus (VMN) were activated by insulin in overweight SL rats than in normal (NL) rats (chi2 p < 0.01). Although there is no significant difference between NL and SL rats in the number of VMN neurons responsive to insulin, the neurons differ in the type of reaction. In overweight SL rats neurons were mainly inhibited by insulin (Wilcoxon test p < 0.0001, n = 45). This altered response to the satiety signal insulin in postnatally overnourished rats might contribute to their persisting hyperphagia and overweight.

Action Potentials↗