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PubMed2005

Physical activity, aerobic fitness, self-perception, and dietary intake in at risk of overweight and normal weight children.

Differences in physical activity, aerobic fitness, self-perception, and dietary intake were examined in a sample of six- to ten-year-olds at risk of overweight, and in normal weight boys and girls. Participants (n=20 at risk of overweight [BMI > or =85th percentile]; n=115 normal weight [BMI <85th percentile]; n=68 boys; n=67 girls) had anthropometric, physical activity, aerobic fitness, self-perception, and dietary intake measurements at zero, three, six, and 12 months. Over the 12-month period, normal weight children were more physically active (F=4.1, p<0.05) and aerobically fit (F=14.3, p<0.001), and possessed higher self-perceptions of social acceptance (F=7.3, p<0.01) than their at risk of overweight peers. Fitness differences between the sexes were not apparent at baseline, but emerged over the long term (F=7.9, p<0.01). Overall, boys consumed more total energy, fat, carbohydrate, and protein than did girls, while the entire sample consumed diets low in vegetables and fruits and meat and alternatives, and high in "other" foods. These observations highlight key disparities in lifestyle-related behaviours and perceptions between groups of children according to overweight status and sex. The findings underscore the importance of longitudinal studies in youth because cross-sectional studies may reflect transient differences.

Anthropometry↗
PubMed2005

Changes since 1980 in body mass index and the prevalence of overweight among inschooling children in Nuuk, Greenland.

OBJECTIVE: The aim of the study was to examine the trends which have occurred during the past generation in body mass index (BMI) and in the prevalence of overweight and obesity among children in public schools in Nuuk, Greenland. STUDY DESIGN: The study is a retrospective cohort study of BMI among inschooling children (age 6 or 7 years old). A database was created on the basis of files from school-nurses containing information on height and weight among children having attended school in Nuuk since 1970. The database contained 10,121 measurements in total, whereas 2,801 were on inschooling children. Measurements from these children form the basis of this study. Mean and quartiles of BMI among the inschooling children in 5-year intervals were used to determine the development in BMI since 1980. On the basis of international cut-points for use among children and adolescents, the proportion of overweight and obese children and the trends since 1980 were determined. RESULTS: The mean BMI has risen by a total of a bit more than 6% since 1980, corresponding to a rise of 1.2-3.8% for every 5-year period. Increases are also observed when assessing the proportion of overweight and obese, which were 6.6% and 0.9%, respectively, among the inschooling children during the period 1980-1984. These proportions increased to 16.5% and 5.2%, respectively, in 2000-2004. CONCLUSION: This study has provided evidence that during the past two decades, children in Nuuk have undergone a development towards a higher prevalence of overweight and obesity.

Anthropometry↗
PubMed2000

Prevalence of overweight and obesity in bipolar patients.

BACKGROUND: Patients who receive pharmacologic treatment for bipolar illness frequently gain weight. This study evaluated the prevalence of overweight and obesity in an unselected group of bipolar patients and matched reference subjects. METHOD: The prevalence of overweight, obesity, and central adiposity was evaluated in 89 euthymic bipolar (DSM-IV) patients and 445 reference subjects, matched for age and sex, using a cross-sectional study design. RESULTS: Female patients were more often overweight and obese than female reference subjects (chi2 = 9.18, df = 2, p = .01). The frequency of overweight was similar in male patients and male reference subjects, but male patients were more likely to be obese. Patients were more centrally obese than the general population in women (chi2 = 32.21, df = 1, p = <.001) and in men (chi2= 8.81, df = 1, p = .003). Patients treated with antipsychotic drugs were more obese than patients not receiving these drugs (chi2= 4.7, df = 1, p = .03). CONCLUSION: Body fat is more centrally distributed in pharmacologically treated bipolar patients than in matched population controls. Obesity is more prevalent in patients than in the general population. Obesity prevalence is clearly related to the administration of antipsychotic drugs.

Adipose Tissue↗
PubMed2006

Posttraumatic stress disorder in male military veterans with comorbid overweight and obesity: psychotropic, antihypertensive, and metabolic medications.

UNLABELLED: Posttraumatic stress disorder (PTSD) is an important syndrome among military veterans. Little has been written about comorbid medical conditions of PTSD, particularly overweight and obesity. We focus on psychotropic and non-psychotropic drugs, their interactions, and metabolic issues most relevant to primary care physicians. METHOD: Data from the recently constituted PTSD program at the Department of Veterans Affairs Medical Center in Richmond, Va., were retrospectively reviewed to assess the prevalence and severity of comorbid overweight and obesity in male veterans with PTSD. Also, our database allowed us to correlate various drugs used to treat hypertension, diabetes mellitus, and dyslipidemia with body mass index (BMI). RESULTS: The mean BMI of 157 veterans with PTSD (DSM-IV criteria) in this sample was in the obese range (30.3 ± 5.6 kg/m²). The number of drugs a given patient was taking for treatment of hypertension, diabetes mellitus, and dyslipidemia correlated with BMI. Psychotropic drugs associated with weight gain did not explain our findings. CONCLUSIONS: Overweight and obesity among our male veterans with PTSD strikingly exceeded national findings. The administration of psychotropic drugs associated with weight gain did not explain these findings. The number of medications used to treat hypertension, diabetes mellitus, and dyslipidemia correlated significantly with BMI. Rather than these medications explaining the high prevalence of overweight and obesity in our study population, obesity probably worsened these components of the metabolic syndrome, necessitating more aggressive treatment reflected in the high number of drugs prescribed.

Journal Article↗
PubMedDate not supplied

One-hour meal tolerance test to assess withdrawal of insulin therapy in overweight patients with type 2 diabetes.

OBJECTIVE: To evaluate the clinical usefulness of a 1-hour meal tolerance test to determine the feasibility and safety of discontinuation of insulin therapy in overweight, insulin-treated patients with type 2 diabetes mellitus. METHODS: Overweight patients who presented with metabolic decompensation at initial diagnosis of type 2 diabetes were hospitalized and treated with insulin. A 1-hour meal tolerance test was performed in an outpatient setting when patients had maintained a stable metabolic status with decreasing daily insulin requirement and the possibility of withdrawal of insulin therapy was considered. After an overnight fast, venous blood samples were collected before and 1 hour after consumption of an oral liquid meal (240 mL, 240 kcal, approximately 30 g of sucrose) to measure glucose and C-peptide levels. If the postmeal glucose level was < or = 10 mmol/L, the insulin therapy was discontinued. Patients underwent follow-up to validate the clinical decision. RESULTS: Twenty-four overweight adult Mexican American patients (8 of whom had ketoacidosis) were treated with insulin at initial diagnosis of type 2 diabetes. The mean insulin dosages were reduced progressively from 71 +/- 8 U/day to 31 +/- 3 U/day during a period of 4 +/- 0.5 months. At that stage, the mean fasting and 1-hour postmeal blood glucose levels were 5.0 +/- 0.2 mmol/L and 8.4 +/- 0.4 mmol/L, respectively. Meal-induced plasma C-peptide levels showed 1.9- to 4-fold increases, confirming substantial endogenous insulin secretion. The C-peptide responses were similar in the two subgroups of patients with or without initial ketoacidosis. On the basis of postmeal blood glucose levels, the insulin therapy was discontinued in all cases. After 3 months of follow-up, all patients were in good metabolic control. Fourteen patients underwent follow-up for >12 months; 10 of them were maintained without antidiabetic medications for 21.4 +/- 2.8 months. Two patients were treated with sulfonylurea drugs after 4 months, and another two required insulin therapy by the 4th and 18th months, respectively. CONCLUSION: A 1-hour postmeal blood glucose level is helpful for deciding the withdrawal of insulin therapy in overweight, insulin-treated patients with type 2 diabetes.

Adult↗
PubMedDate not supplied

Correlates of overweight and weight-loss practices in Missouri.

OBJECTIVE: To examine potential correlates of overweight and weight-loss practices in Missouri. METHODS: Two probability surveys (n=3,010) were used to investigate the associations of sociodemographic and health-related factors with overweight and attempting, exercising, dieting, and desiring to lose weight. RESULTS: Race, gender, and receiving professional advice were strongly associated with being overweight. Gender, receiving professional advice, and leisure-time physical activity were positively associated with attempting and desiring to lose weight. CONCLUSIONS: Public health programs can utilize this knowledge to reduce the prevalence of overweight by encouraging professional advice and promoting regular exercise.

Adolescent↗
PubMed2000

Dyslipoproteinemias in industrial workers: relationship with hypertension and overweight.

The aim of the investigation was to study the lipid profile of industrial workers with attention to the relationship of lipid indexes with hypertension and overweight. 139 hypertensive male blue-collar workers were investigated, compared to 107 normotensive ones. The overweight and obese workers in each group were compared with normal body mass ones. Cholesterol and triacylglycerols (TG) were assayed by enzymatic tests CHOD-PAP and GPO-PAP respectively and the lipoprotein fractions were separated by precipitation method. Our results show high rate of industrial workers with dyslipoproteinemias, especially among the hypertensive and overweight and obese ones. The hypertension is associated with total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and low density lipoprotein TG (LDL-TG), while overweight is related with TG and high density lipoprotein cholesterol (HDL-C), effecting significantly on very low density lipoprotein TG (VLDL-TG). The high rate of persons with concentrations of the examined lipid indexes indicating moderate and high cardiovascular risk motivates multifactorial preventive strategy towards coping the hypertension, optimizing the nutritional habits, increase in physical activity and reduction of body mass.

Adult↗
PubMed2001

Flat and cavus foot, indexes of obesity and overweight in a population of primary-school children.

BACKGROUND: Obesity and overweight during the developmental years are related to certain dysmorphisms of the foot, in particular with flat foot. METHODS: The authors evaluated the incidence of this dysmorphism in a population of 243 primary-school pupils, (3rd and 4th class - age range 8-10 years) of ULSS no. 16 in Padua and, at the same time, determined the index of overweight and obesity and the extent and quality of exercise practised. From the anthropometric data collected, it was calculated that the Cole index (ideal ratio between the ideal BMI at the 50 degrees percentile of weight and height as a function of age, sex and real BMI). A photo-podoscopic examination was done in a bipodalic station and the report analysed later on a Polaroid photograph. RESULTS: The incidence of flat foot in the population studied was found to be 16.4%, of which 18.1% were males and 14.6% females. Fifty percent showed slight flat-footedness (1st degree), 28% moderate (2nd degree) and 22% showed very marked flat-footedness (3rd degree). The frequency of obesity and overweight in the same population was found to be 27.3% (Cole index >120). An analysis of the variance showed a significant difference between the Cole Index in subjects with flat feet (121.77+/-19.2) and the rest of the population examined (110.12+/-15.3) (p<.00001). CONCLUSIONS: In this study, the children suffering from this dysmorphism were also found to be obese or overweight.

Age Factors↗
PubMedDate not supplied

Prevalence of overweight and obesity in diabetic and non-diabetic Saudis.

A total of 14,660 individuals were included in the study. A fasting blood sample and 2-hour post-glucose load blood sample from each participant were analysed for blood sugar. Participants were classified as diabetic or non-diabetic and as either obese (BMI > 30 kg/m2), overweight (BMI 25-29.9 kg/m2) or normal (BMI < 25 kg/m2). The prevalence of obesity was calculated in the total sample and separately for diabetic and non-diabetic males and females. The results showed obesity and overweight in 13.05% and 27.23% of males and 20.26% and 25.20% of females respectively. The prevalence of both obesity and overweight were significantly higher among diabetics than non-diabetics. In each province, diabetics had a significantly higher prevalence of obesity than non-diabetics. Several interprovincial variations were seen. Public education on obesity and overweight and ways to decrease them are recommended in Saudi Arabia.

Adolescent↗
PubMed2001

Relationships between walk/run performance and cardiorespiratory fitness in adolescents who are overweight.

BACKGROUND AND PURPOSE: Little is known about the methods used to assess the physical fitness of adolescents who are overweight. We investigated the relationship between walk/run performance and cardiorespiratory fitness in adolescents who are overweight. SUBJECTS: Eight African-American adolescents (5 female, 3 male) and 10 Caucasian adolescents (5 female, 5 male) who were overweight (mean age=14.5 years, SD=2.0, range=12-17; mean body mass index [BMI]=42.9 kg/m2, SD=11.5) participated in this study. METHODS: Subjects performed a 12-minute walk/run test. The distances traveled at both 9 minutes (D9) and 12 minutes (D12) were recorded, and the distance traveled between 9 and 12 minutes (D9-12) was calculated. Subjects also completed a maximal cycle ergometry test, during which peak oxygen uptake (VO2peak), anaerobic threshold (AT), peak power (Wpeak), and power at the anaerobic threshold (WAT) were determined. Body composition was determined by air displacement plethysmography. RESULTS: The mean percentage of body fat was 48.6% (SD=5.3%, range=40.3%-60.4%). Percentage of body fat and BMI were each inversely related to D9, D12, and VO2peak (all P<.005). Peak oxygen uptake (r=.72, P=.0001), VO2peak/kg lean body mass (r=.60, P<.005), Wpeak (r=.88, P<.0001), and WAT (r=.72, P=.0007) were all related to D12, with greater r values than for D9. If D9-12was included in regression analyses, D9 did not account for additional variance in any of the cycle ergometry variables. DISCUSSION AND CONCLUSION: These results suggest that an easily obtained measurement of physical performance (distance traveled during a 12-minute walk/run test) is related to cardiorespiratory fitness and to body composition in adolescents who are overweight. The 12-minute walk/run distance is more predictive of cycle ergometry test results than the 9-minute distance.

Adolescent↗
PubMed2002

Trend in the prevalence of overweight and obesity among urban African American hospital employees and public housing residents.

INTRODUCTION: To help understand the impact of socioeconomic status, we examined the current prevalence and age-specific trend in overweight and obesity among two socioeconomically diverse groups of African Americans in the Washington, DC, area. MATERIALS AND METHODS: Data on height and weight were collected between March 1995 and December 1996 as a part of nutrition survey to develop a food frequency questionnaire. Gender-stratified multiple logistic regression analyses were used to examine factors related to the current prevalence of overweight and obesity. RESULTS: Three hundred nine African American public housing residents and 293 African American hospital employees participated in this survey. Overall, hospital workers and public housing residents differed significantly in the distribution of BMI (p = 0.003). Among men, the prevalence of overweight and obesity were 34.9% and 29.4% for hospital workers and 27.0% and 18.2% for public housing residents, respectively. For females these rates were 31.3% and 46.3% for hospital employees and 26.1% and 42.9% for public housing residents, respectively. CONCLUSION: Overweight and obesity were highly prevalent among all age and socioeconomic groups. Future research should focus on a more in-depth study of the relationship between socioeconomic status and the correlates of obesity among African-Americans, particularly women.

Adult↗
PubMed2001

Increasing plasma levels of soluble cell adhesion molecules (sE-Selectin, sP-Selectin and sICAM-1) in overweight adults with combined hyperlipidemia.

Combined hyperlipidemia (coincident present hypercholesterolemia and hypertriglyceridemia) may contribute to the development of atherosclerosis and coronary artery disease by increasing of cell adhesion molecules (CAMs). Although the cellular expression of CAMs is difficult to assess clinically, soluble forms of CAMs (sCAMs) are present in the circulation and may serve as marker of CAMs. The aim of this study was to determine whether combined hyperlipidemia in overweight adults without clinical evidence of cardiovascular disease, diabetes mellitus or hypertension is associated with increased expression of CAMs. We examined the levels of soluble cell adhesion molecules (sICAM-1, sE-Selectin and sP-Selectin) in blood plasma of overweight adults (n = 36), mean of BMI 27.08 +/- 4.12 kg/m2 with combined hyperlipidemia, with total cholesterol (TC) 7.27 +/- 1.50 mmol/l, LDL cholesterol 4.89 +/- 1.35 mmol/l, HDL cholesterol 1.27 +/- 0.51 mmol/l and triglycerides (TG) 4.08 +/- 2.22 mmol/l before lipid-lowering therapies, and in equal numbers of age, sex and BMI matched controls. Patients with combined hyperlipidemia had significantly higher plasma levels of soluble intercellular adhesion molecule-1 (sICAM-1) (298.13 +/- 41.24 ng/ml versus 241.35 +/- 37.48 ng/ml; P < 0.001), sE-Selectin (63.31 +/- 9.48 ng/ml versus 42.16 +/- 14.18 ng/ml; P < 0.001) and sP-Selectin (161.18 +/- 20.85 ng/ml versus 111.54 +/- 26.12 ng/ml; P < 0.001) compared with overweight, non-hyperlipidemic control subjects. Combined hyperlipidemia in adults with overweight is associated with elevated soluble plasma levels of CAMs. We suppose that levels of CAMs in these patients may be determined as a marker for appreciation of their potential atherosclerotic burden.

Arteriosclerosis↗
PubMed1976

[Psychological and social aspects of overweight children (author's transl)].

If children who were originally fully capable and active according to their respective age groups, remain more than 50% overweight for a period of more than 3 years, develop a significantly lower motor, intellectual and social activity. They tend to develop an anxious auto-aggressive behavior, because it is difficult for them to transmit to others the social pressures to which they are subject. The probability of a permanent therapeutic success diminishes as the duration of the period of overweight increases. Only physically and emotionally orientated therapy is rational as 78% of our overweight children come from neurotically disturbed families. Overweight can often be due to lack of love where intensity of affection is wrongly applied.

Age Factors↗
PubMed2002

[The relation between overload and variability of blood pressure and overweight or obesity in patients with essential hypertension].

OBJECTIVE: To investigate the relationship between blood pressure variability, overweight or obesity in patients with essential hypertensive. METHODS: A hundred ninety-one patients with essential hypertension were divided into three groups: normal, overweight and obese according to body mass index (BMI). The characteristics of the variability of 24-hour ambulatory blood pressure monitoring (ABPM) in three groups were compared. RESULTS: Blood pressure overload and variability increased parallel with the increase of BMI. In overweight group, the variabilities of systolic blood pressure at night (nSBPSD) increased 14.10%, the variabilities of diastolic blood pressure at night (nDBPSD) increased 13.15% and the variabilities of mean arterial pressure at night (nMAPSD) increased 15.92% respectively. In the obese group, the above three variabilities increased more significantly (compared to normal group P < 0.05-0.01). However, increases of the three blood pressure variabilities were observed only in the male patients. CONCLUSIONS: The overweight or obesity increased the blood pressure overload and variabilities in patients with essential hypertension. The increases of blood pressure variabilities were observed only in male patients and at night.

Adult↗
PubMed2003

Overweight, obesity, and associated disease burden in the Veterans Affairs ambulatory care population.

BACKGROUND: This report describes the prevalence of overweight and obesity and estimates the disease burden associated with excess weight in ambulatory Veterans Affairs (VA) patients. METHODS: Height and weight were measured, and self-reported age and self-reported morbidities were obtained for 1,731 patients. Prevalence odds ratios explain the association of self-reported disease on increasing weight status category using body mass index. RESULTS: Seventy-five percent of the participants were overweight or obese. Obesity was significantly higher in the younger patients. Graded increases in odds ratios were observed with increasing severity of overweight and obesity for all morbidities, except heart disease. CONCLUSION: Overweight, obesity, and associated disease burden are prevalent in the VA health care system, particularly in younger VA patients, which may contribute to the higher prevalence of certain morbidities observed in VA populations compared with private sector outpatients. Department of Veterans Affairs should emphasize obesity prevention and treatment during the design and implementation of ambulatory care services.

Adult↗
PubMed2003

[Evaluation of discomfort and complications in a population of 18,102 patients overweight or obese patients].

AIMS: The burden of disorders associated with overweight and obesity is a major public health problem. It is therefore important to better identify these concomitant disorders and how their frequencies vary with sex and age. METHODS: A survey was carried out during a 5 month-period from September 2001 to January 2002) among 4 727 general practitioners distributed throughout France in 18 102 patients with a body mass index (BMI)>25 kg/m2. The practitioners evaluated the presence of concomitant disorders using a closed questionnaire. The patients assessed global discomfort linked to overweight using an analog visual scale. Univariate and multivariate analyses of the concomitant disorders and self-reported discomfort depending on age, gender and BMI were performed. RESULTS: The survey population comprised 66.8% of women (W) and 33.2% of men (M). Mean age was 48.0 +/- 13.2 years and mean BMI was 34.6 +/- 6.1, with no differences between the two sexes. The most frequent concomitant disorders were back pain (44.6%), hypertension (44.2%), dyslipidemia (39.9%), knee osteoarthritis (30.8%), lower limb edema (24.3%), hypersudation (23.8%), skin fold mycosis (22.8%) and type 2 diabetes (21.6%). In multivariate analyses, the distribution of these disorders varied with sex: hypertension, type 2 diabetes, dyslipidemia, and hypersudation were more frequent in men, whereas knee osteoarthritis, back pain, and skin fold mycosis were more frequent in women. The prevalence (odd ratio, OR) of back pain and dyslipidemia did not increase with higher BMI and the prevalence of back pain did not increase with age. Overall discomfort related to overweight was rated as 61.3 +/- 19.9 mm on a 0 to 100-mm scale. Discomfort was less marked in men, decreased with age and increased with BMI (and with the consultations in the Paris area). CONCLUSIONS: This study shows the complexity of relationships between concomitant diseases, overall discomfort, BMI, age and sex (in the population of overweight and obese patients) and should improve the management of such patients and their complications.

Adult↗
PubMed2003

The relationship between asthma symptoms and anthropometric markers of overweight in a Hispanic population.

BACKGROUND: Previous studies have revealed the relationship between asthma and obesity, but the relationship with other markers of overweight and obesity has not yet been investigated. OBJECTIVE: To establish the relationship between asthma symptoms and simple anthropometric indexes (BMI, waist circumference (WC), and waist-to-hip ratio (WHR)) as markers of overweight in an adult Hispanic population. METHODS: The data were obtained from the PRIT (Prevalence of Cardiovascular Risks in General Hospital Workers) 2001 survey. The participants were workers at the Hospital General de México in Mexico City and included 135 men and 398 women aged 43.8 +/- 11.9 and 43.0 +/- 10.5, respectively. Odds ratios for asthma symptoms at different BMI, WC, and WHR cutoff points associated with excessive weight were calculated. The likelihood ratios for having asthma symptoms in participants with various cutoff values of BMI, WC, and WHR also were calculated. RESULTS: Asthma symptoms were not related to anthropometric markers of overweight or obesity in men, while they were associated in women with WC cutoff levels of 80 and 85 cm, and BMI of 25 and 27 kg/m2. No level of WHR was related to asthma symptoms in women. In women, the likelihood ratio for asthma symptoms increased proportionally from WC levels of 73.5 cm up to 86 cm, while this risk increased significantly from BMI levels of 22 up to 29 kg/m2. CONCLUSION: Overweight as assessed by BMI and WC (but not WHR) was related to asthma symptoms in women in the studied population.

Adult↗
PubMed1992

Activity decreases as percentage overweight increases.

The purpose of the present research was to clarify the empirical relationship between percentage overweight and degree of ambulatory activity. Two week activity measurements were obtained, over two studies, using pedometers, from 127 women aged 19 to 55 years ranging from 14% underweight to 99% overweight. Regression analysis indicated that activity decreased by 7.6457 x 10(-4) mph for every 1% increase in percentage overweight from 0.25279 mph associated with zero percentage overweight. These data are in good agreement with data published by Chirico and Stunkard in 1960.16 Implications for small activity increases on obesity and general health are discussed.

Adult↗