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PubMed2006

Phytosterols mixed with medium-chain triglycerides and high-oleic canola oil decrease plasma lipids in overweight men.

Phytosterols (PSs) have been recently added to various mediums. Nevertheless, matrices with functional properties, such as medium-chain triglycerides (MCTs), should be precisely examined for supplementary advantages. The objective of this study was to identify the existence of combined biological actions of a functional oil enriched in PSs within MCTs and high-oleic canola (HOC), relative to a control (olive oil), in overweight, hyperlipidemic men using a rigorously controlled dietary intervention. Twenty-three overweight, hyperlipidemic men consumed both types of oil in a randomized, crossover trial for 6 weeks each. Fasted plasma samples were collected on the first and last 2 days of each study period. Body weight decreased -1.22 +/- 0.35 kg (P = .0019) and -1.68 +/- 0.47 kg (P = .0016) after the 6-week study period in the olive oil and functional oil groups, respectively. The end points for total cholesterol and low-density lipoprotein cholesterol (LDL-C) in the functional oil group (P = .0006) were lower than in the olive oil group (P = .0002). Total cholesterol values decreased from comparable baseline to end point of 4.71 +/- 0.16 mmol/L (P < .0001) in the functional oil phase and 5.14 +/- 0.19 mmol/L (P = .0001) in the olive oil phase (P = .0592). In addition, LDL-C demonstrated a similar drop, to an end point of 3.12 +/- 0.16 mmol/L (P < .0001) and 3.54 +/- 0.18 mmol/L (P = .0002), for the functional oil and olive oil groups, respectively, with significant changes (P = .0221). High-density lipoprotein cholesterol levels did not change in either treatment. Triacylglycerol end points decreased in functional oil and olive oil groups (P = .0195 and .0105, respectively) to the same extent from baseline. Results indicate that PSs mixed within an MCT- and HOC-rich matrix lower plasma LDL-C, without significantly changing the high-density lipoprotein cholesterol concentrations, in hyperlipidemic, overweight men, and may therefore decrease the risk of cardiovascular events.

Adolescent↗
PubMed2006

Effects of weight loss on insulin sensitivity and arterial stiffness in overweight adults.

Obesity is characterized by metabolic and vascular abnormalities. We examined the effects of weight loss on insulin sensitivity and arterial stiffness in overweight adults. Twelve (9 females; 3 males) overweight (body mass index, 30.3 +/- 3.7) adults (54.9 +/- 3.9 years) without diabetes or vascular disease were counseled by a registered dietician to lose weight over 6 months. Vascular structure, function, and wall mechanical properties were measured via ultrasound. Intravenous glucose tolerance test, 24-hour blood pressure, body composition (dual-energy x-ray absorptiometry), and lipids were also assessed. There were significant reductions in body mass (86.3 +/- 14.2 vs 79.5 +/- 13.8 kg, P < .0001) and percentage of fat (44.3% +/- 7.0% vs 41.0% +/- 8.5%, P < .01) after weight loss. There were significant improvements in total cholesterol (6.0 +/- 0.9 vs 5.0 +/- 0.8 mmol/L, P < .0001), low-density lipoprotein cholesterol (3.9 +/- 0.7 vs 3.2 +/- 0.6 mmol/L, P < .0001), triglycerides (3.4 +/- 2.3 vs 2.4 +/- 0.9 mmol/L, P < .05), and insulin sensitivity (3.3 +/- 1.7 vs 5.4 +/- 1.6 microU x 10(-4) min(-1) mL(-1), P < .0001) after weight loss. Brachial artery compliance (P < .05) and distensibility (P < .05) curves over the physiologic pressure range improved, whereas endothelial function and intima-media thickness remained unchanged. In overweight adults, 6 months of weight loss resulted in improvements in body composition, insulin sensitivity, lipid profile, and brachial artery compliance and distensibility.

Adult↗
PubMedDate not supplied

Evidence for identifying children at risk for being overweight, cardiovascular disease, and type 2 diabetes in primary care.

INTRODUCTION: Practitioners have noted the escalating risk for children being overweight and having cardiovascular disease and type 2 diabetes. The purpose of this study was to apply current recommendations in examining children and to test an expanded model of assessment to predict risk. METHOD: A nonexperimental descriptive design was applied at an academic nurse-managed clinic. Children who consented to participate (n = 118) were examined for height/weight (and calculated body mass index), blood pressure, family history, smoking exposure, acanthosis nigricans, and point-of-care nonfasting blood analysis of glucose, hemoglobin A(1C), total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides. Children with a body mass index greater than the 85th percentile were invited to return for fasting venipuncture, testing glucose, insulin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides (n = 23). RESULTS: High rates of being overweight and additional risk factors were identified. Point-of-care machines had limited usefulness beyond usual measurements in identifying childhood risk. DISCUSSION: Recommendations are made for nurses to take careful family histories and complete analysis of physical measurement to identify children needing further intervention to prevent and treat being overweight and disease risks.

Adolescent↗
PubMed2006

Trends in overweight and obesity in Portuguese conscripts from 1986 to 2000 in relation to place of residence and educational level.

OBJECTIVE: The aim of this study was to analyse changes in the prevalence of overweight and obesity between 1986 and 2000 in Portuguese conscripts, and to examine the role of place of residence and educational level. STUDY DESIGN: Cross-sectional study. METHODS: Data sets from the cross-sectional annual surveys of all 18-year-old Portuguese males born between 1966 and 1981 and examined between 1986 and 2000 (850 081 subjects) were used in this study. Height and weight were measured and body mass index was calculated. Data on educational level (4, 6, 9, 11 and 12+ years) and residence (urban, semi-urban and rural) were collected. RESULTS: The prevalence of overweight increased from 10.5% in 1986 to 21.3% in 2000, and the prevalence of obesity increased from 0.9% to 4.2% in the same period (P<0.001). After adjustment for year of examination, the odds ratio (OR) for being overweight increased with educational level (reference 4-6 years: 1.19; 9 years: 1.30; 11 years: 1.47; 12+ years: 2.41) and place of residence (reference urban-semi-urban: 1.04; rural: 1.06). The prevalence of obesity increased with educational level (reference 4-6 years: 1.27; 9 years: 1.79; 11 years: 1.83; 12+ years: 2.66) and decreased with place of residence, i.e. those who lived in rural areas had a lower risk of becoming obese (OR: 0.94). CONCLUSIONS: Despite the low prevalence of obesity in young males in Portugal compared with other European countries, the sharp increase in recent years indicates that public health strategies are needed to prevent obesity.

Adolescent↗
PubMed2006

Overweight and obesity-related metabolic disorders in hospital employees.

BACKGROUND: Obesity is associated with metabolic disorders and cardiovascular diseases. This study investigated the relationship between overweight and obese status and the incidence of type 2 diabetes, hypertension, hyperlipidemia and hyperuricemia. METHODS: This prospective cohort study comprised 1749 hospital employees who received baseline health check-ups in 1993. Data from the 1027 participants (832 women, 195 men; mean age, 36 +/- 7 years) who repeated check-ups in 2003 were used in the analysis. Relative risks (RRs) for development of metabolic disorders during follow-up associated with different body mass index (BMI) categories at baseline as defined by Asia-Pacific recommendations and the Department of Health in Taiwan were calculated after adjustment for covariates. RESULTS: The prevalence of overweight and obesity at baseline check-up were 17.6% and 14.5%, respectively. Obese subjects with baseline BMI >or= 25 kg/m2 had a significant multivariate-adjusted RR of 2.7 for hypertension, 14.8 for type 2 diabetes, 3.2 for hypertriglyceridemia, and 2.8 for hyperuricemia, compared to subjects with baseline BMI < 23.0 kg/m2. RR for diabetes was higher in women than in men, but RR for hypertriglyceridemia was higher in men. The risks of hypertension and hyperuricemia significantly increased for subjects with baseline BMI >or= 23 kg/m2, while RRs for type 2 diabetes increased significantly for baseline BMI >or= 24 kg/m2 and hypertriglyceridemia increased for baseline BMI >or= 25 kg/m2. The risks attributable to obesity (baseline BMI >or= 25 kg/m2) were 23.0% for hypertension, 70.8% for diabetes, 27.9% for hypertriglyceridemia, and 24.1% for hyperuricemia. CONCLUSION: This study revealed that a high prevalence of overweight and obesity was associated with significantly increased risk of development of type 2 diabetes, hypertension, hypertriglyceridemia and hyperuricemia in hospital employees, suggesting the need for programs to improve weight management.

Adult↗
PubMed2006

Overweight induced by high-fat diet delays rat cutaneous wound healing.

Prolonged wound healing is a complication that contributes to morbidity and mortality. Overweight people regularly undergo surgery and trauma, and often develop chronic wounds, but the effects of the adipose tissue excess on cutaneous wound healing are not well understood. This study tested the hypothesis that overweight induced by a high-fat diet impairs rat cutaneous wound healing. Male Wistar rats were fed with either a high-fat or a standard (control) diet. After 15 weeks, an excisional lesion was done and the animals were killed 21 d later. Wound contraction and re-epithelialization, blood pressure, glucose and retroperitoneal fat were evaluated. After killing, lesion and adjacent normal skin were formol-fixed and paraffin-embedded. Inflammatory infiltrate, myofibroblasts, collagen fibres and cellular proliferation were analysed and blood vessels were evaluated using stereological methods. There was no difference in blood pressure and glucose, but retroperitoneal fat increased in the high-fat diet group. Animals fed with the high-fat diet presented delayed wound contraction and re-epithelialization. It was found that 21 d after wounding, overweight induced by a high-fat diet increased the inflammatory infiltrate and delayed myofibroblastic differentiation, collagen deposition, epithelial and connective tissue cell proliferation, and angiogenesis. These findings support the hypothesis that a high-fat diet exerts negative effects on rat cutaneous wound healing, due mainly to the prolongation of the inflammatory phase.

Adiposity↗
PubMed2005

Accelerometry-measured activity or sedentary time and overweight in rural boys and girls.

OBJECTIVE: The aim of this study was to examine the association between overweight and physical activity or sedentary time measured by accelerometry in rural boys and girls 7 to 19 years old. RESEARCH METHODS AND PROCEDURES: A cross-sectional study was conducted involving 130 girls and 99 boys in elementary, middle, and high school in rural Maryland. After weight, height, and body composition were measured, children wore an Actiwatch accelerometer for 6 days. Comparisons for activity counts were made between normal and overweight or at risk for overweight (at-risk/overweight) participants (>or=85th percentile of BMI). The associations between body composition and accelerometry-defined activity levels (sedentary, light, moderate, and vigorous) were analyzed by age group for boys and girls. RESULTS: Differences in total activity in counts per day or counts per minute were not observed between normal and at-risk/overweight boys or girls in all age groups. No associations between measures of body composition and time spent in an activity level were seen in boys. Fat mass and percentage fat were positively correlated to time spent in sedentary activity (range r = 0.42 to 0.54, all p < 0.01) for girls. In contrast, fat mass and percentage fat were negatively related to time spent in light activity (range, r = -0.40 to -0.51, p < 0.05) for girls. DISCUSSION: In girls, but not boys, greater body fat is associated with greater time spent being inactive, and lower levels of body fat are associated with more time spent in light activity. Physical activity interventions targeting inactive children in rural communities are warranted.

Adolescent↗
PubMed2006

Modifiable environmental and behavioral determinants of overweight among children and adolescents: report of a workshop.

The number of children at risk for overweight and the number of overweight children are increasing and have become a serious public health concern. Interventions that could be applied at the population level have not been proven effective. The development of effective strategies is thought to be hampered by the lack of understanding of which behavioral and environmental factors need to be modified. On June 14 and 15, 2004, the NIH held a meeting of experts to discuss the issue of modifiable determinants of obesity in children and adolescents. Included were presentations on interventions among children that have been proven effective, dietary and physical activity behavioral determinants, physical, social, and family environmental determinants, and the quality of measures of determinants and correlates of overweight.

Adolescent↗
PubMed2006

Economic evaluation of weight loss interventions in overweight and obese women.

OBJECTIVE: To conduct a clinical and economic evaluation of outpatient weight loss strategies in overweight and obese adult U.S. women. RESEARCH METHODS AND PROCEDURES: This study was a lifetime cost-use analysis from a societal perspective, using a first-order Monte Carlo simulation. Strategies included routine primary care and varying combinations of diet, exercise, behavior modification, and/or pharmacotherapy. Primary data were collected to assess program costs and obesity-related quality of life. Other data were obtained from clinical trials, population-based surveys, and other published literature. This was a simulated cohort of healthy 35-year-old overweight and obese women in the United States. RESULTS: For overweight and obese women, a three-component intervention of diet, exercise, and behavior modification cost 12,600 US dollars per quality-adjusted life year gained compared with routine care. All other strategies were either less effective and more costly or less effective and less cost-effective compared with the next best alternative. Results were most influenced by obesity-related effects on quality of life and the probabilities of weight loss maintenance. DISCUSSION: A multidisciplinary weight loss program consisting of diet, exercise, and behavior modification provides good value for money, but more research is required to confirm the impacts of such programs on quality of life and the likelihood of long-term weight loss maintenance.

Adult↗
PubMed2006

ABCA1 single nucleotide polymorphisms on high-density lipoprotein-cholesterol and overweight: the D.E.S.I.R. study.

The adenosine triphosphate-binding cassette A1 (ABCA1) gene plays a key role in reverse cholesterol transport. Some ABCA1 gene polymorphisms have been associated with high-density lipoprotein-cholesterol (HDL-C) concentrations. The aim of this study was to assess the effect of three polymorphisms, C69T, G378C, and G1051A (R219K), on HDL-C levels and their interaction with BMI in more than 5000 French whites from the D.E.S.I.R. (Data from an Epidemiological Study on the Insulin Resistance syndrome) cohort study. The T allele of the C69T single nucleotide polymorphism (SNP) was associated with higher HDL-C levels in normal-weight men (BMI <25 kg/m(2)). The C allele of the G378C SNP was associated with lower HDL-C in overweight subjects (BMI > or =25 kg/m(2)). For the G1051A SNP, in the normal-weight group, the minor A allele was significantly associated with higher HDL-C levels. In contrast, in overweight people, the minor allele was associated with lower HDL-C levels. After accounting for multiple testing, empiric p values remained significant for the associations between G378C SNP and HDL-C in the overweight group and between G1051A SNP and HDL-C in the normal-weight group. This study suggests that ABCA1 gene polymorphisms modulate HDL-C concentrations, in interaction with BMI, and, thus, they might influence cardiovascular risk in the general population.

ATP Binding Cassette Transporter 1↗
PubMed2006

Comparison of three bioelectrical impedance methods with DXA in overweight and obese men.

OBJECTIVE: To compare bioelectrical impedance analysis (BIA) of body composition using three different methods against DXA in overweight and obese men. RESEARCH METHODS AND PROCEDURES: Forty-three healthy overweight or obese men (ages 25 to 60 years; BMI, 28 to 43 kg/m(2)) underwent BIA assessment of body composition using the ImpediMed SFB7 (version 6; ImpediMed, Ltd., Eight Mile Plains, Queensland, Australia) in multifrequency mode (Imp-MF) and DF50 single-frequency mode (Imp-SF) and the Tanita UltimateScale (Tanita Corp., Tokyo, Japan). Validity was assessed by comparison against DXA using linear regression and limits of agreement analysis. RESULTS: All three BIA methods showed good relative agreement with DXA [Imp-MF: fat mass (FM), r(2) = 0.81; fat-free mass (FFM), r(2) = 0.81; percentage body fat (BF%), r(2) = 0.69; Imp-SF: FM, r(2) = 0.65; FFM, r(2) = 0.76; BF%, r(2) = 0.40; Tanita: BF%, r(2) = 0.44; all p < 0.001]. Absolute agreement between DXA and Imp-MF was poor, as indicated by a large bias and wide limits of agreement (bias, +/-1.96 standard deviation; FM, -6.6 +/- 7.7 kg; FFM, 8.0 +/- 7.1 kg; BF%, -7.0 +/- 6.6%). Imp-SF and Tanita exhibited a smaller bias but wide limits of agreement (Imp-SF: FM, -1.1 +/- 8.5 kg; FFM, 2.5 +/- 7.9 kg; BF%, -1.7 +/- 7.3%; Tanita: BF%, 1.2 +/- 9.5%). DISCUSSION: Compared with DXA, Imp-MF produced large bias and wide limits of agreement, and its accuracy estimating body composition in overweight or obese men was poor. Imp-SF and Tanita demonstrated little bias and may be useful for group comparisons, but their utility for assessment of body composition in individuals is limited.

Absorptiometry, Photon↗
PubMed2007

Psychosocial and physical impairment in overweight adolescents at high risk for eating disorders.

OBJECTIVE: Many overweight adolescents display elevated risk for the development of eating disorders, as seen in higher rates of weight/shape concerns and disordered eating behaviors, but the extent of impairment in this subset of high-risk adolescents has not been explored. RESEARCH METHODS AND PROCEDURES: Eighty-one overweight adolescents (63% girls) presenting for an Internet-based weight loss program were assessed at baseline using the Eating Disorder Examination Questionnaire, the Depression, Anxiety, and Stress Scale, and the Pediatric Quality of Life questionnaire. Adolescents who earned elevated scores on both the Weight Concern and Shape Concern subscales of the Eating Disorder Examination Questionnaire were considered at high risk for the development of eating disorders (56.8%). RESULTS: Comparisons of high- and normal-risk groups revealed that high-risk adolescents reported higher levels of depression [F(3,76) = 5.75, p = 0.019], anxiety [F(3,76) = 5.67, p = 0.020], and stress [F(3,75) = 8.50, p = 0.005], and greater impairments in physical health [F(3,77) = 10.7, p = 0.002], emotional functioning [F(3,77) = 5.3, p = 0.024], and social functioning [F(3,77) = 10.0, p = 0.002]. There were no differences in school functioning [F(3,77) = 1.5, p = 0.219]. Among the high-risk adolescents, over half (52.2%) reported binge eating at least once in the past month. DISCUSSION: Results suggest that overweight adolescents at high risk for the development of eating disorders also experience elevated levels of negative affect, impairment in health-related quality of life, and eating disturbances, although prospective data are needed to determine the directionality between eating disorder pathology and general psychopathology. Further research is warranted to evaluate whether behavioral weight loss interventions should be enhanced for this high-risk subset.

Adolescent↗
PubMed2005

Angiogenic factors are elevated in overweight and obese individuals.

BACKGROUND: Adipose tissue produces both vascular growth factors and inhibitors. Since obesity is associated with expansion of the capillary bed in regional adipose depots the balance between these factors may favor angiogenesis. OBJECTIVE: To investigate the relationship between body mass index and serum concentrations of vascular growth factors in human subjects. METHODS: Vascular endothelial growth factor (VEGF), VEGF-C, VEGF-D, soluble VEGF receptor-2 (sVEGFr2), hepatocyte growth factor (HGF), angiopoietin-2, angiogenin and endostatin concentrations were measured in serum collected from 58 lean (24 males, 34 female, mean BMI, 22.2+/-0.3) and 42 overweight and obese (16 males and 26 females, mean BMI, 33.5+/-1.2) subjects after an overnight fast. RESULTS: Sexual dimorphism was apparent in the serum concentrations of VEGF-C, VEFG-D and angiopoietin-2 with significantly higher levels in female compared to male subject. VEGF, VEGF-C, VEGF-D, soluble VEGF receptor-2, angiopoietin-2, angiogenin and endostatin but not HGF were significantly elevated in overweight and obese subjects. Positive correlations between BMI and the serum concentrations of VEGF-C, VEGF-D, sVEGF-R2, angiopoietin-2, angiogenin and endostatin were observed even after adjustment for gender and age. CONCLUSIONS: Increased levels of vascular growth factors as well as the angiogenesis inhibitor endostatin are present in overweight and obese subjects and may contribute to previously documented increased risk of metastatic disease in obese subjects with cancer.

Adiponectin↗
PubMed2005

Obesity and overweight in relation to organ-specific cancer mortality in London (UK): findings from the original Whitehall study.

OBJECTIVE: To examine the relation of obesity and overweight with organ-specific cancer mortality. METHODS: In the Whitehall prospective cohort study of London-based government employees, 18 403 middle-age men participated in a medical examination between 1967 and 1970. Subjects were followed up for cause-specific mortality for up to 35 y (median: interquartile range (25th-75th centile); 28.1 y: 18.6-33.8). RESULTS: There were over 3000 cancer deaths in this cohort. There was a raised risk of mortality from carcinoma of the rectum, bladder, colon, and liver, and for lymphoma in obese or overweight men following adjustment for range of covariates, which included socioeconomic position and physical activity. These relationships held after exclusion of deaths occurring in the first 20 y of follow-up. CONCLUSION: Avoidance of obesity and overweight in adult life may reduce the risk of developing some cancers.

Cohort Studies↗
PubMed2005

Smoking status, cigarettes per day, and their relationship to overweight and obesity among former and current smokers in a national adult general population sample.

BACKGROUND: Weight gain after smoking cessation is perceived to be a barrier against quitting smoking. The goal was to analyze overweight and obesity depending on smoking status and number of cigarettes per day (cpd) among former and current smokers. METHODS: The sample included 7124 residents of Germany aged 18-79 y from a national health examination survey (participation rate: 61.4%). Body weight and height were objectively measured; smoking status and cpd were assessed by a questionnaire administered in a health examination center. RESULTS: The number of cpd was positively related to being overweight and more so to obesity among former smoking men, but not women. The results were adjusted for age, school education, exercise and alcohol consumption. Men who formerly had smoked more than 30 cpd had an adjusted odds ratio (OR) of 5.0 for obesity compared to men who had never smoked. CONCLUSION: With an increasing number of cpd more psychological and physiological processes of compensation of nicotine supply after smoking cessation may be expected. Male smokers should be provided with information on how to prevent weight gain after smoking cessation. To foster smoking cessation, female smokers should be informed that women who stop smoking manage to have no increase in the rates of overweight or obesity when considered at the general population level.

Adolescent↗
PubMed2006

Atherogenic inflammatory and oxidative stress markers in relation to overweight values in male former athletes.

OBJECTIVE: To evaluate inflammation- and oxidative stress-related (OxS) background in former athletes in relation to overweight and abdominal obesity status. DESIGN: Cross-sectional data from ongoing follow-up study. SUBJECTS: A total of 60 middle-aged former athletes (46.6+/-7.5 years; 181.1+/-7.2 cm; 88.1 +/- 12.9 kg) and 54 age-matched controls (48.1+/-7.3 years; 181.4 +/- 6.2 cm; 89.7 +/- 14.4 kg). MEASUREMENTS: Anthropometric characteristics, serum lipoproteins (CHOL, HDL-C, LDL-C, TG), oxidized LDL (oxLDL), diene conjugates (DC) and high-sensitive C-reactive protein (hsCRP). Information about the physical activity and other lifestyle variables were collected by the questionnaire. RESULTS: Ex-athletes were characterized by significantly higher physical activity characteristics and lower CHOL and oxLDL in comparison with controls. Correlation analysis among ex-athletes revealed negative associations between all measured overweight data (body mass index, fat percentage, waist to hip circumferences and waist circumference (WC)), and current physical activity. Current physical activity was significantly related to OxS and inflammatory characteristics (oxLDL, DC and hsCRP) among the ex-athletes, but not among the control group. The most expressed positive correlations were found between WC, hsCRP, triglycerides (TG), DC and oxLDL in both study groups. CONCLUSION: Our study results suggest that there exists an independent (adjusted for potential confounders) association between overweight, abdominal obesity, and atherogenic inflammatory and oxidative stress markers in ex-athletes as well as in age-matched controls. Major findings of our study show that WC is the best correlate of hsCRP, oxLDL, DC and TG levels.

Adult↗
PubMed2006

Cultural conflicts in the weight loss experience of overweight Latinos.

OBJECTIVE: In spite of the high prevalence of obesity in the Latino population, there is limited recent information that can be used by health-care providers to develop culturally appropriate weight loss strategies for this population. Therefore, we describe weight loss experiences, attitudes and barriers in overweight Latino adults. DESIGN: Qualitative study using focus group methodology. SUBJECTS: Twenty-one overweight adults (body mass index >/=25, age >/=20 years) self-identified as Latinos. METHODS: Subjects participated in one of three focus groups. Reccurring themes within group discussions were identified by three independent investigators, one who was ethnicity concordant. RESULTS: Themes included the presence of mixed messages when determining one's appropriate weight, with participants' desire to lose weight to be healthy (based on professional advice and personal experience) conflicting with the cultural idea that being overweight is healthy. Participants described discordance when adapting to the mainstream, leading to the loss of healthy traditional habits. Participants expressed interest in weight loss and familiarity with dieting and weight loss interventions. They desired culturally appropriate nutrition education and reassurance regarding healthy dieting from health-care providers. The importance of interactions with peers during education was another relevant theme, and participants were overwhelmingly positive about group education. CONCLUSIONS: To improve health promotion for Latinos, cultural factors distinctive to this underserved population, and barriers they articulate, should be considered when developing weight loss interventions.

Adult↗
PubMed2006

Relationship between metabolic syndrome and platelet responsiveness to leptin in overweight and obese patients.

OBJECTIVE: To verify whether platelet responsiveness to leptin is associated with metabolic syndrome risk factors. DESIGN: Cross-sectional study. SUBJECTS: We studied 169 consecutive patients, mean age=43.6+/-9.9 years, with overweight (N=57) or obesity (N=112). MEASUREMENTS: Cluster analysis was used to generate three clusters based on platelet responsiveness to increasing doses of leptin. Profiles of metabolic syndrome risk factors of the three clusters were compared by discriminant analysis. RESULTS: Platelet responsiveness to leptin was absent in cluster 1, whereas cluster 3 had the greatest platelet aggregation response to leptin pre-incubation. Plasma leptin levels significantly decreased from cluster 1 to cluster 3 in both gender. Patients in cluster 2 had an intermediate profile of leptin responsiveness. Highest body mass index (BMI) values were more frequent in non-responders, whereas the prevalence of high waist circumference, as well as hypertriglyceridemia and hypertension, increased with increasing responsiveness to leptin from cluster 1 to cluster 3. Pattern of metabolic syndrome risk factors qualified as group specific in 69.0% of the cluster 1, 54.9% of the cluster 2 and 55.8% of the cluster 3. Circulating leptin, waist circumference, plasma triglycerides and BMI defined distinctive patterns of metabolic syndrome risk factors in the clusters. CONCLUSIONS: In overweight and obese outpatients, metabolic syndrome risk factors parallel to some extent platelet responsiveness to leptin. Such a correlation involves plasma leptin levels, waist circumference, plasma triglycerides and BMI, and may contribute to the excess risk of cardiovascular events in overweight and obese patients.

Adult↗