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PubMed2001

Energy expenditure and physical activity of obese and non-obese Thai children.

The objective of this study was to assess the energy expenditure and physical activity in obese (n=21) and non-obese (n=21) children (aged 9-12 years) in Bangkok. Anthropometric measurements were performed. Energy expenditure and physical activity were determined by indirect calorimetry (based on oxygen consumption) and the heart rate monitoring method. Physical activity index was calculated by the ratio of total energy expenditure (TEE) to sedentary energy expenditure (SEE). The results showed that obese children had significantly greater (p<0.05) body weight, body mass index, relative weight, body fat (%), fat mass except for height, and fat free mass than the non-obese group. The TEE, SEE, and activity energy expenditure (AEE) were higher (p<0.05) in the obese children when compared with the non-obese ones. The mean values of respiratory quotient (RQ) were 0.91+/-0.06 in obese and 0.89+/-0.08 in the non-obese group, respectively, indicating the contribution of carbohydrate substrate to energy production. Both obese and non-obese children were similar in the physical activity index level of 1.48+/-0.17 and 1.51+/-0.22, respectively, which was lower than that recommended by the World Health Organization (1.7). In conclusion, energy expenditure of obese children was higher than non-obese children because of greater body weight. Furthermore, the physical activity of both groups was lower than that recommended by WHO. To prevent obesity in children, programmimg of exercise and activities as well as nutritional education should be emphasized for school children and parents.

Anthropometry↗
PubMed2002

Energy intake and expenditure of obese and non-obese urban Bangladeshi children.

A case control study was conducted in Dhaka city to measure the energy intake and expenditure among 220 obese children of 4-10 years age group and 220 randomly selected age and sex matched controls. A 24 hour dietary recall was used to assess the energy intake. Data on energy expenditure was obtained by 24 hour physical activity recall. The mean energy intake of obese children (2056 +/- 751 kcal/d) was found to be significantly higher (P<0.001) compared to the non obese (1508 +/- 529 kcal/d). No sex difference was found in both obese and non obese groups. Mean energy expenditure of the obese children (1868 +/- 313 kcal/d vs 1495 +/- 200 kcal/d) was significantly higher than the non-obese (P<0.001). Of the obese, boys expended more energy than the girls (P=0.01). Furthermore, physical activity level (1.40 +/- 0.09 vs 1.35 +/- 0.14) was significantly higher among the non obese than their obese counterpart (P<0.001). However, energy balance was significantly higher among the obese (P<0.001). Dose response of energy balance shows the estimated relative risk of obesity increases with higher level of energy balance (P<0.001). The findings of this study revealed that energy balance as a result of higher energy intake and lower energy expenditure was one of the important risk factors for the development of obesity among the children of Dhaka city. Thus, appropriate interventions like behavioural change regarding food habits and physical activities are recommended.

Bangladesh↗
PubMed2003

Prevalence and correlates of obesity and central obesity among Omani adults.

OBJECTIVE: Overweight, particularly obesity is a major risk factor for several important diseases, especially hypertension, coronary heart diseases and diabetes mellitus. Our aim is to determine the prevalence of obesity and central obesity among Omani adults aged > or =20 years, and to identify the socio-demographic and health variables that correlate to obesity and central obesity in a community based survey (National Health Survey, 2000). METHODS: A community based cross-sectional survey representing all parts of Oman was designed in the year 2000. A part of the survey was a door to door interviews including demographic data, weight, height, hip and waist measurements, blood pressure and fasting blood glucose and serum cholesterol for adults aged > or =20 years. RESULTS: The crude prevalence of overweight and obesity (body mass index >25 kg/m2) was 47.9% for the whole sample, and 46.2% for males, 49.5% for females. The crude prevalence of central obesity (abnormal weight hips ratio) was 49.3% for the whole sample, 31.5% for males, and 64.6% for females. Obesity and central obesity were less prevalent among younger age groups and highly educated subjects. Both obesity and central obesity increased the odds of having diabetes, hypertension and hyperchlostremia. CONCLUSION: The prevalence of obesity and central obesity is quietly high in Oman. Launching nutritional programs and promotional life style modification programs are recommended.

Adult↗
PubMed1992

Association of obesity and distribution of obesity with glucose tolerance and cardiovascular risk factors in the elderly.

The association of obesity and fat distribution with glucose tolerance and cardiovascular risk factor levels were investigated in a population-based study in East Finland including 396 non-diabetic men and 673 women aged from 65 to 74 years. Obese men and women (BMI greater than 27 kg/m2) had higher levels (P less than 0.001) of fasting and 2 h plasma glucose and insulin as well as total triglycerides and diastolic blood pressure, and lower levels of HDL cholesterol than normal weight men and women. Central fat distribution (the highest vs. the lowest tertile of waist-hip ratio) was associated independently of obesity with high fasting glucose (5.7 vs. 5.5 mmol/l in non-obese subjects, 5.9 vs. 5.7 mmol/l in obese subjects, P less than 0.05) and insulin levels (13.7 vs. 10.6 mU/l in non-obese subjects, 18.4 vs. 15.6 mU/l in obese subjects, P less than 0.01) and with adverse changes (P less than 0.05) in lipid and lipoprotein levels (triglycerides: 1.59 vs. 1.41 mmol/l in non-obese subjects, 1.92 vs. 1.69 mmol/l in obese subjects; HDL cholesterol: 1.33 vs. 1.43 mmol/l in non-obese subjects, 1.20 vs. 1.32 mmol/l in obese subjects). There were no marked differences in metabolic aberrations related to obesity between men and women. However, the association between waist-hip ratio and risk factors was non-linear in men whereas it was linear in women. In conclusion, obesity per se rather than its distribution was a more significant determinant of glucose and insulin as well as total triglyceride and HDL cholesterol levels in elderly subjects.

Aged↗
PubMed2006

Obesity related complications in 100 obese subjects and their age matched controls.

OBJECTIVE: To note obesity related complications in subjects of age range 50-59 years. METHODS: A case control study was conducted at Medical Unit of District Headquarters Hospital, Rawalpindi for 6 months. Hundred obese subjects in the age range 50-59 years and their age matched non-obese 100 controls were included consecutively from general population. Obese subjects had body mass index (BMI) >30Kg/m2. Controls had BMI of 18.5-22.9Kg/m2 and normal waist hip ratio. Obesity related complications i.e., hypertension, diabetes mellitus, ischemic heart disease, stroke, hyperlipidemia, gall stones, varicose veins, psychological problems, sleep related problems, and degenerative arthritis, were sought in all subjects. Waist hip ratio was noted as measure of central distribution of body fat in obese subjects. RESULTS: Of the 200 subjects, 59% (n=118) were female and 41% (n=82) male. Of the obese subjects 74% and 44% of non-obese controls were female. Mean age of obese subjects and their controls was 54.4 +/- 3.22 and 54.57 +/- 3.54 years respectively. Central obesity was noted in 84% of obese subjects. Hyperlipidemia (87%), hypertension (71%), diabetes mellitus (65%), gallstones (57%), ischaemic heart disease (49%), osteoarthritis (46%), and sleep disorders (35%) were significant (p<0.05) obesity related complications. CONCLUSION: Hyperlipidemia, hypertension, diabetes mellitus, gallstones, ischaemic heart disease, osteoarthritis and sleep disorders are common obesity related complications in subjects of age range 50-59 years.

Case-Control Studies↗
PubMed2006

Skinfold thickness, body fat percentage and body mass index in obese and non-obese Indian boys.

Childhood obesity is presently increasing worldwide and has created enormous concern for researchers working in the field of obesity related diseases with special interest in child health and development. Selected anthropometric measurements including stature, body mass, and skinfolds are globally accepted sensitive indicators of growth patterns and health status of a child. The present study was therefore aimed not only at evaluating the body mass index (BMI), skinfolds, body fat percentage (%fat) in obese school going boys of West Bengal, India, but also aimed to compare these data with their non-obese counterparts. Ten to sixteen year old obese boys (N = 158) were separated from their non-obese counterparts using the age-wise international cut-off points of BMI. Skinfolds were measured using skinfold calipers, BMI and %fat were calculated from standard equations. Body mass, BMI, skinfolds and %fat were significantly (P<0.001) higher for the sample of obese boys when compared to their non-obese counterparts. The obese group also showed progressive age-wise increments in all recorded anthropometric parameters. Stature (cm) showed no significant inter-group variation except in the 10 year age group (P<0.001). All data for the non-obese group were comparable with other national and international studies, but those collected for the obese group could not feasibly be compared because the availability of data on obese children is limited. Current data and prediction equations will not only serve as a reference standard, but also be of vital clinical importance in order to identify or categorize obese boys, and to take preventative steps to minimise serious health problems that appear during the later part of life.

Adipose Tissue↗
PubMed1990

Body weight regulation in obese and obese-reduced rats.

We previously developed a model of dietary obesity in adult male rats where duration of feeding a high fat diet (HFD; 60 percent of calories from fat) influences reversibility of the obesity following a reduction in dietary fat. In the model, rats fed the HFD for 4 months show an apparent complete reversal of obesity when switched to a low fat diet (LFD; 14 percent of calories from fat), but rats fed the HFD for 7 months show persistent obesity even when switched to the LFD. This model of dietary obesity is useful for studies of energy balance and energy requirements during obesity development and reversal. In the present study, rats fed the HFD for 4 or 7 months were switched to the LFD and, after weights stabilized, were subjected to food restriction followed by ad libitum refeeding. Food restriction (15 g/day of the LFD, or about 60 percent of usual control food intake) continued until body weights of the groups stabilized at new, reduced levels (about 2-2.5 months). This was followed by ad libitum refeeding of the LFD for 3--4.5 months. Rats fed the HFD for 4 months showed complete obesity reversal after 2 months of eating the LFD. They showed a similar response to food restriction to LFD controls, but surprisingly regained significantly more body weight, body fat and total body energy during refeeding than LFD controls. Rats fed the HFD for 7 months remained heavier and fatter than LFD controls after 2 months of eating the LFD. Despite losing more carcass energy than controls during food restriction, their body weights and body energy content stabilized at higher levels than LFD controls. During refeeding, they regained their obese state relative to controls. These results demonstrate that: (1) the duration of HFD feeding is an important factor in the reversibility of the obese state; (2) sustained HFD feeding produces an obese state that is defended more by a greater restoration of carcass energy during refeeding than by a preservation of carcass energy during food restriction; (3) sustained obesity appears to produce some reductions in energy requirements; (4) even a brief period of obesity may leave the rats prone to reattain an obese state when body weight is challenged.

Animals↗
PubMed1988

[Regional hemodynamics of the forearm. Comparison between obese and non-obese hypertensive patients].

Forearm hemodynamics using pulsed Doppler flowmetry were studied in 83 men: 15 non-obese and 8 obese normotensive subjects; and 30 non-obese and 30 obese hypertensive patients. Mean ages were similar in the four subgroups. The blood pressure of normotensives and hypertensives was identical in obese and non-obese subjects. Blood flow expressed in ml/mn was significantly higher in obese subjects whether normotensive or hypertensive. However, when blood flow was expressed per unit liter of forearm volume, it was similar in the four subgroups. Forearm vascular resistance, whether expressed as absolute of normalized values, was significantly higher (p less than 0.001) in non-obese hypertensives. When obese and non-obese hypertensives were compared, the former were characterized by higher values of blood velocity and blood flow, and lower values of vascular resistance, whether absolute or normalized values were used. The present study shows that: (i) forearm vascular resistance in hypertensives is increased exclusively in non-obese subjects, and (ii) obese hypertensives, when compared with non-obese hypertensives, are characterized by a hyperkinetic forearm circulation.

Adult↗
PubMed1994

Overnight secretion pattern of growth hormone, sex hormone binding globulin, insulin-like growth factor-1 and its binding protein in obese and non-obese women with polycystic ovarian disease.

The pathophysiological mechanism underlying polycystic ovarian disease (PCOD) is different in obese and lean women. In obese patients the basic disorder is insulin resistance and hyperinsulinemia. In non-obese women the dominant derangement is a relative excess of luteinizing hormone (LH) and growth hormone (GH) production. The levels of GH, LH, sex hormone binding globulin (SHBG) and insulin-like growth factor binding protein-1 (IGFBP-1) were significantly lower and insulin levels considerably higher in obese PCOD women as compared to their non-obese counterparts. There was, however, no difference in the mean IGF-1 levels found in these two groups. The present study was designed to investigate whether, in addition to the mean levels, the overnight pattern of GH, IGF-1, IGFBP-1 and SHBG differed in obese women with polycystic ovaries as compared to that observed in the non-obese PCOD patients. Eight women with PCOD diagnosed by clinical, sonographic and hormonal means were studied. Four had basal body mass index exceeding 27. Blood samples were collected every 20 min over a period of 8 h, starting at 23:00 h. Twenty-four samples were collected from each patient and examined in one batch for GH, IGF-1, IGFBP-1, SHBG and insulin. The secretion patterns of the above substances during the late night (23:00-03:00 h) and early morning (03:00-07:00 h) hours were examined and compared in obese and non-obese PCOD women. Neither GH nor IGF-1 showed a distinct overnight secretion pattern. The overnight secretion patterns of IGFBP-1 and SHBG were similar in obese and non-obese women--the former showing a constant rising during the night and the latter exhibiting a converse trend. The integrated insulin levels were much higher during the late night as compared to early morning hours in all patients. It is proposed that the specific secretion pattern of IGFBP-1 is not directly dependent on body fat mass but is regulated by insulin in both obese and non-obese patients.

Adult↗
PubMed2005

Attitudes and reported practice for obesity management in Korea after introduction of anti-obesity agents.

This study aimed to evaluate current clinical assessments and management of obesity in the primary care setting in Korea since anti-obesity agents have become available. A questionnaire was sent to eligible primary care physicians selected from a national probability sample in two specialties: family physicians and internists. Of 939 randomly selected physicians, 452 (48.1%) replied. We found that 51.8% of physicians were aware of the definition of obesity, and 33.8% were aware of the definition of abdominal obesity proposed by Asia-Pacific guideline. When evaluating apparently obese patients, 50.0% of respondents measured body mass index (BMI) and 20.4% measured waist circumference. Fewer than 50% of physicians measured blood glucose or lipid profiles, both of which are risk factors for obesity. About 47.3% of physicians prescribed an anti-obesity medication without allowing sufficient time for nonpharmacologic therapy to take effect, and 68.8% of physicians prescribed anti-obesity medications to patients that requested them regardless of obesity status. The majority of respondents did not appropriately evaluate obesity and its risk factors, and were readily susceptible to prescribing anti-obesity medications. Our findings suggest that primary care physicians in Korea need additional education on obesity and its management.

Adult↗
PubMed2004

Single nucleotide polymorphisms of protein tyrosine phosphatase 1B gene are associated with obesity in morbidly obese French subjects.

AIMS/HYPOTHESIS: The development of insulin resistance may contribute to the occurrence and progression of the metabolic syndrome associated with obesity. Components contributing to the insulin pathway and its regulation are good candidates for the molecular study of metabolic syndrome pathogenesis. Protein tyrosine phosphatase 1B (PTP 1B) is an important negative regulator of insulin. We investigated whether PTP 1B SNPs are associated with obesity and obesity-related traits as well as global metabolic syndrome in morbidly obese subjects. METHODS: Untranslated and coding regions of the PTP 1B gene were screened in groups of non-diabetic and diabetic obese subjects and in non-obese subjects. Unrelated morbidly obese ( n=711) and non-obese ( n=427) French Caucasian subjects were genotyped for a case-control study. RESULTS: Six SNPs were identified: two rare variants were located in 5'UTR (-109 C>T and -69 C>T), two in the intronic regions (IVS3+38 G>T and IVS5+3666delT) and two have been described previously (P303P in exon 8 and P387L in exon 9). A case-control study showed an association between the frequent IVS5+3666delT SNP and obesity ( p=0.02). In the obese group, associations between PTP 1B SNPs and features of dyslipidaemia were found. P303P was associated with lower apolipoprotein A1 levels ( p=0.05) whereas P387L was associated with higher triglyceride ( p=0.0003), apolipoprotein B ( p=0.09) and lipoprotein a concentrations ( p=0.006). CONCLUSIONS/INTERPRETATION: Our results support the hypothesis that the PTP 1B gene contributes to the polygenic basis of obesity. PTP 1B SNPs may interact with environmental factors to induce more severe phenotypes, e.g. atherogenic dyslipidaemia, in morbidly obese subjects.

Cholesterol↗
PubMed2006

Measurement error of DXA: interpretation of fat and lean mass changes in obese and non-obese children.

Information on reproducibility of dual-energy X-ray absorptiometry (DXA) measurements is essential because DXA is frequently used by clinicians and researchers to assess body composition changes. We estimated measurement error and absolute and relative smallest detectable differences (SDDs) for fat, lean, and bone mass in children. The SDD is the change necessary to be confident that the change is not a consequence of measurement error. Duplicate whole body DXA (Hologic QDR 4500A, Hologic Inc., Waltham, MA) scans were obtained on 32 obese and 34 non-obese children ages 6-19 yr. Absolute (kg) and relative (coefficient of variation) measurement error and SDD were calculated. Absolute SDDs for fat and lean were higher for obese (1.39 and 1.30 kg, respectively) than for non-obese children (0.42 and 0.47 kg, respectively). The %SDD for fat was lower for obese (3.58%) than non-obese children (5.24%), but for lean the %SDD was higher for obese (2.60%) than non-obese children (1.32%). The SDDs for bone mass were similar for obese and non-obese children. An obese child must lose or gain more absolute fat and lean mass than a non-obese child to be confident that the change is not a reflection of measurement error. Overall, SDD values for fat, lean, and bone mass are low.

Absorptiometry, Photon↗
PubMed1997

Growth hormone secretion and synthesis are depressed in obesity-susceptible compared with obesity-resistant rats.

Human obesity is characterized by a low basal growth hormone (GH) concentration and a blunted response to GH secretagogues. The aim of this experiment was to determine whether a perturbation in GH synthesis or secretion occurs in rats that develop obesity only in response to a dietary fat challenge. Female Sprague-Dawley rats were fed a purified 32.5% fat diet ad libitum for 21 weeks. Approximately half of the rats fed this diet developed obesity (obesity-susceptible) while the others remained lean (obesity-resistant) compared with chow-fed (control) animals. Pituitary glands obtained from all three groups were enzymatically dissociated, and somatotrope response to GH secretagogues and inhibitors was determined in vitro. Plasma GH concentrations were decreased in obesity-susceptible rats compared with obesity-resistant rats, and in vitro GH secretory response was blunted in cells obtained from the pituitary glands of obese compared with lean rats. In addition, pituitary GH content was reduced in obese versus lean rats even though the proportion of somatotropes in the two groups did not differ. Since the changes in GH concentration in this dietary obese rat model parallel those found in human obesity, this model may be useful in determining the relationship between GH and obesity.

Animals↗
PubMed2005

Weight change following total hip replacement: a comparison of obese and non-obese patients.

BACKGROUND: Weight loss is desirable in obese patients prior to hip replacement but poor mobility secondary to hip dysfunction may limit attempts at weight reduction because of reduced exercise tolerance. METHODS: We followed 140 patients prospectively to investigate weight change and functional outcome in obese and non-obese patients following total hip arthroplasty. Weight and the Harris hip score was measured one week prior to surgery and three years post-operatively. RESULTS: Fifty nine patients were obese (BMI > or = 30). The mean weight of obese patients increased from 88 kg pre-operatively to 92 kg following surgery (p<0.001). In non-obese patients pre-operative weight was 69 kg and post-operative weight 70 kg (p=0.106). In the obese group 75% of patients gained a mean of 6.77 kg (p<0.001) and 19% of patients lost a mean of 4.8 kg (p<0.01). In the non-obese group, 60% of patients gained a mean of 4.2 kg (p<0.001) and 31% of patients lost an average of 4.7 kg (p<0.001). The mean Harris hip score was 90 in non-obese patients and 85 in obese patients three years post-operatively (p<0.01). CONCLUSION: Weight increase is common following total hip replacement despite improved function but the magnitude of weight increase appears to be greater in patients who are obese. Obesity was also associated with lower functional hip scores but the differences were small and unlikely to be of clinical significance.

Adult↗
PubMed1995

Overexpression of the obese (ob) gene in adipose tissue of human obese subjects.

Obesity is accompanied by complications such as hypertension, non-insulin-dependent diabetes mellitus and atherosclerosis, which in turn cause ischaemic heart disease, stroke and premature death. The underlying mechanisms behind imbalance in energy intake and energy expenditure that lead to obesity are still controversial. In most populations, obesity is more common among women than men and is a multifactorial phenotype, which may result from a complex network of genetic and nongenetic factors. The relative importance of genetic factors for obesity is under debate. Genome searches using polymorphic markers in inbred mice with phenotypes that result in extreme obesity and studies of human candidate genes are being performed in an attempt to identify genes that contribute to obesity. There is evidence that body weight is physiologically regulated and it has been postulated that the storage of fat may provide signals to the brain that the body is obese, which in turn may make the subject eat less and burn more fuel. One of the molecules that may be involved in such signalling is the obese (ob) gene product. Mutations in ob result in profound obesity and type II diabetes in mice. The mouse ob gene and its human homologue have been cloned and sequenced. The gene is expressed in adipose tissue and the product has features of a secreted protein. We have investigated human ob expression in subcutaneous and omental adipose tissue obtained from non-obese and massively obese subjects using in situ hybridization histochemistry and report on overexpression in obese people.

Adipose Tissue↗
PubMed2002

Classification of obesity and assessment of obesity-related health risks.

The barriers to the evaluation and treatment of obesity by health-care providers include a lack of awareness of obesity as an independent risk factor for morbidity and mortality and inadequate training in the medical management of obesity. However, the increased risk of medical disorders and emotional consequences associated with obesity make the disorder a priority for physicians to assess and treat. Obesity researchers have published and promoted the use of evidence-based, practical guidelines to educate physicians about how best to approach obesity as a medical disorder. The guidelines support classification and assessment of obesity as an important component of the patient's medical care. Assessment begins with classification by body mass index (BMI), with overweight and obesity defined as a BMI of 25 and 30 kg/m(2), respectively. Patients with high-risk combinations of BMI, waist circumference, and specific cardiovascular risk factors should begin a weight-loss program if no contraindications are present. Proper assessment also includes evaluation of complicating factors for obesity, such as sleep apnea and type 2 diabetes, psychosocial factors, and the use of medications that may contribute to obesity. Special attention should be paid to elements of the physical examination that often are performed incorrectly in obese patients, such as pelvic exams. Gathering this information will allow the clinician to tailor a weight-loss program to each patient individually. Although this represents the most challenging component of obesity care, resources are available to guide the clinician.

Adipose Tissue↗
PubMed2001

Plantar pressure differences between obese and non-obese adults: a biomechanical analysis.

OBJECTIVE: To investigate plantar pressure differences between obese and non-obese adults during standing and walking protocols using a pressure distribution platform. SUBJECTS: Thirty-five males (age 42.4+/-10.8 y; 67-179 kg) and 35 females (age 40.0+/-12.6 y; 46-150 kg) divided into obese (body mass index (BMI) 38.75+/-5.97 kg/m2) and non-obese (BMI 24.28+/-3.00 kg/m2) sub-groups, respectively. MEASUREMENTS: Data collection was performed with a capacitive pressure distribution platform with a resolution of 2 sensors/cm2 (Emed F01, Novel GmbH, München). The measurement protocol included half and full body weight standing on the left, right and both feet, respectively, and walking across the platform, striking with the right foot. Pressures were evaluated for eight anatomical sites under the feet. RESULTS: For both men and women, the mean pressure values of the obese were higher under all anatomical landmarks during half body weight standing. Significant increases in pressure were found under the heel, mid-foot and metatarsal heads II and IV for men and III and IV for women. Foot width during standing was also significantly increased in obese subjects. For walking, significantly higher peak pressures were also found in both obese males and females. CONCLUSION: Compared to a non-obese group, obese subjects showed increased forefoot width and higher plantar pressures during standing and walking. The greatest effect of body weight on higher peak pressures in the obese was found under the longitudinal arch of the foot and under the metatarsal heads. The higher pressures for obese women compared to obese men during static weight bearing (standing) may be the result of reduced strength of the ligaments of the foot.

Adult↗