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PubMed2003

Overweight and obesity in adults and risk of renal cell carcinoma in Canada.

OBJECTIVES: To assess the role of overweight and obesity in renal cell carcinoma (RCC) risk in Canada. METHODS: Mailed questionnaires were used to obtain data on 1,279 (691 male and 588 female) newly diagnosed, histologically confirmed RCC cases and 5,370 population controls, between 1994 and 1997, in eight Canadian provinces. Data were collected on socio-economic status, height, weight, smoking habits, alcohol use, diet, and residential and occupational histories. Weight was expressed as body mass index (BMI). Odds ratios (ORs) and 95% confidence intervals (CIs) were derived using unconditional logistic regression. RESULTS: The study found an increased risk of RCC associated with overweight and obesity among both male and female adults; the test for trend was statistically significant (p < 0.0001 for both sexes). Compared with normal BMI, the adjusted ORs for obese class III (BMI > or = 40.00) were 3.7 (95% CI = 1.5-9.4) and 3.8 (95% CI = 2.3-6.4) among males and females, respectively. CONCLUSIONS: These findings indicate that overweight and obesity play an important role in the etiology of renal cell among both males and females.

Adult↗
PubMed2001

Cost-effectiveness analysis of intensive blood-glucose control with metformin in overweight patients with type II diabetes (UKPDS No. 51).

AIMS/HYPOTHESIS: To estimate the economic efficiency of intensive blood-glucose control with metformin compared with conventional therapy primarily with diet in overweight patients with Type II (non-insulin-dependent) diabetes mellitus. METHODS: Cost-effectiveness analysis based on patient level data from a randomised clinical controlled trial involving 753 overweight (> 120% ideal body weight) patients with newly diagnosed Type II diabetes conducted in 15 hospital-based clinics in England, Scotland and Northern Ireland as part of the UK Prospective Diabetes Study. Subjects were allocated at random to an intensive blood-glucose control policy with metformin (n = 342) or a conventional policy primarily with diet (n = 411). The analysis was based on the cost of health care resources associated with metformin and conventional therapy and the estimated effectiveness in terms of life expectancy gained from within-trial effects. RESULTS: Intensive blood-glucose control with metformin produced a net saving of 258 Pounds per patient (1997 United Kingdom prices) over the trial period (median duration of 10.7 years) due to lower complication costs, and increased life expectancy by 0.4 years (costs and benefits discounted at 6%). CONCLUSIONS/INTERPRETATION: As metformin is both cost-saving in the United Kingdom and extends life expectancy when used as first line pharmacological therapy in overweight Type II diabetic patients, its use should be attractive to clinicians and health care managers alike.

Adult↗
PubMed2005

Does high-intensity resistance training maintain bone mass during moderate weight loss in older overweight adults with type 2 diabetes?

The aim was to investigate whether the addition of supervised high intensity progressive resistance training to a moderate weight loss program (RT+WLoss) could maintain bone mineral density (BMD) and lean mass compared to moderate weight loss (WLoss) alone in older overweight adults with type 2 diabetes. We also investigated whether any benefits derived from a supervised RT program could be sustained through an additional home-based program. This was a 12-month trial in which 36 sedentary, overweight adults aged 60 to 80 years with type 2 diabetes were randomized to either a supervised gymnasium-based RT+WLoss or WLoss program for 6 months (phase 1). Thereafter, all participants completed an additional 6-month home-based training without further dietary modification (phase 2). Total body and regional BMD and bone mineral content (BMC), fat mass (FM) and lean mass (LM) were assessed by DXA every 6 months. Diet, muscle strength (1-RM) and serum total testosterone, estradiol, SHBG, insulin and IGF-1 were measured every 3 months. No between group differences were detected for changes in any of the hormonal parameters at any measurement point. In phase 1, after 6 months of gymnasium-based training, weight and FM decreased similarly in both groups (P<0.01), but LM tended to increase in the RT+WLoss (n=16) relative to the WLoss (n=13) group [net difference (95% CI), 1.8% (0.2, 3.5), P<0.05]. Total body BMD and BMC remained unchanged in the RT+WLoss group, but decreased by 0.9 and 1.5%, respectively, in the WLoss group (interaction, P<0.05). Similar, though non-significant, changes were detected at the femoral neck and lumbar spine (L2-L4). In phase 2, after a further 6 months of home-based training, weight and FM increased significantly in both the RT+WLoss (n=14) and WLoss (n=12) group, but there were no significant changes in LM or total body or regional BMD or BMC in either group from 6 to 12 months. These results indicate that in older, overweight adults with type 2 diabetes, dietary modification should be combined with progressive resistance training to optimize the effects on body composition without having a negative effect on bone health.

Aged↗
PubMed1993

Effect of an energy-restrictive diet, with or without exercise, on lean tissue mass, resting metabolic rate, cardiovascular risk factors, and bone in overweight postmenopausal women.

PURPOSE: To study the effect of exercise added to an energy-restrictive diet in overweight postmenopausal women. SUBJECTS AND METHODS: In a longitudinal clinical study, 121 healthy, overweight postmenopausal women (age 53.8 +/- 2.5 years, body mass index: 29.7 +/- 3.1 kg/m2) were randomly assigned to 3 groups: controls, a 4,200 kJ/d diet, or a 4,200 kJ/d diet with combined aerobic and anaerobic exercise. Body composition (measured by dual-energy x-ray absorptiometry), fat distribution, resting metabolic rate, blood pressure, serum lipids and lipoproteins, bone mineral densities, and markers of collagen and bone turnover were measured before and after 12 weeks of intervention. RESULTS: One hundred eighteen women completed the study. The mean loss of body weight (9.5 kg versus 10.3 kg, NS) was similar in the intervention groups, but compared with the diet-only group, the diet-plus-exercise group lost more fat (7.8 kg versus 9.6 kg, p < 0.001) and no lean tissue mass (1.2 kg versus -0.0 kg, p < 0.001). The resting metabolic rate (per kg wt) was increased in the diet-plus-exercise group compared with the control group (11% versus 4%, p < 0.009). The levels of serum triglycerides, total cholesterol, low-density lipoprotein, and very-low-density lipoprotein decreased, and the ratio of high-density lipoprotein to low-density lipoprotein increased by 20% to 30% in both intervention groups compared with the control group (p < 0.001). The systolic blood pressure dropped, and the waist-to-hip circumference ratio and abdominal-to-total body fat decreased in both intervention groups compared with the control group (10%, p < 0.003, and 3.5%, p < 0.0001). There were no consistent, major differences between the groups in terms of changes in total body, spinal, or forearm bone mineral densities, or in markers of collagen and bone turnover. CONCLUSION: Overweight postmenopausal women benefit from addition of combined aerobic and anaerobic exercise to an energy-restrictive diet. The diet itself has a positive effect on cardiovascular risk factors.

Blood Pressure↗
PubMed1988

Maternal weight gain: effect on infant birth weight among overweight and average-weight low-income women.

A study was performed to compare the influence of pregnancy weight gain on infant birth weight and outcome among two groups of indigent women from the rural South: those who were highly overweight before pregnancy (greater than or equal to 135%) and those who were of average weight (90% to 120% of standard weight for height). The groups had comparable numbers of black and white subjects. Pregnancy weight gain affected birth weight in the average-weight group but did not significantly affect birth weight in the highly overweight group. Infant outcomes for both groups were similar. These findings suggest that consideration should be given to not requiring a minimum weight gain for women whose degree of overweight equals or exceeds 135% of standard body weight for height.

Birth Weight↗
PubMed1995

Gestational weight gain among average-weight and overweight women--what is excessive?

OBJECTIVE: Our purpose was to determine the association between increased gestational weight gain and birth weight outcomes for low-income women. STUDY DESIGN: A total of 53,541 single, live infants delivered from 1990 to 1991 to white, black, and Hispanic women in eight states were evaluated. Multiple logistic regression was used to calculate risk of low and high (> 4500 gm) birth weight, adjusting for selected factors. RESULTS: The association between gestational weight gain and birth weight varied by prepregnancy body mass index. Risk for low birth weight decreased with increasing weight gain for average-weight women. There was no reduction in risk for low birth weight, however, beyond weight gains of 30 to 34 pounds for overweight women and 15 to 19 pounds for very-overweight women. Risk for high birth weight, however, increased with increasing weight gain in all three groups. CONCLUSION: Very-overweight women (body mass index > 29 kg/m2) may benefit from an upper guideline of 25 pounds of weight gain to help reduce risk for high birth weight.

Adolescent↗
PubMed1986

Cephalic phase insulin secretion in relation to food presentation in normal and overweight subjects.

The existence of a preabsorptive insulin reflex is well known in animals but remains controversial in humans. Glycemia and insulin variations following olfactive and visual presentation of a standard meal were studied in 25 subjects, 10 of them (5 men and 5 women) of normal weight and 15 overweight (7 men and 8 women), after a 15 hour fast. Blood samples were collected continuously, every minute for 16 minutes after the meal was presented. The presentation produced an early blood insulin increment, variable in magnitude and time course and occurring between the 3rd and 9th minute, in both normal and overweight subjects. Glycemia variations were not significant. Our study demonstrated a positive correlation between the reflex insulin release, body weight and a conscious effort to maintain current body weight. However, the differences between overweight and normal subjects remained small. The physiological and psychological determinants of the cephalic phase of insulin secretion are discussed.

Adult↗
PubMed1992

Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight.

OBJECTIVES: This study was designed to determine the most appropriate method to normalize left ventricular mass for body size. BACKGROUND: Left ventricular mass has been normalized for body weight, surface area or height in experimental and clinical studies, but it is uncertain which of these approaches is most appropriate. METHODS: Three normotensive population samples--in New York City (127 adults), Naples, Italy (114 adults) and Cincinnati, Ohio (444 infants to young adults)--were studied by echocardiography. Relations of left ventricular mass to body size were similar in all normal weight groups, as assessed by linear and nonlinear regression analysis, and results were pooled (n = 611). RESULTS: Left ventricular mass was related to body weight to the first power (r = 0.88), to body surface area to the 1.5 power (r = 0.88) and to height to the 2.7 power (r = 0.84), consistent with expected allometric (growth) relations between variables with linear (height), second-power (body surface area) and volumetric (left ventricular mass and body weight) dimensions. Strong residual relations of left ventricular mass/body surface area to body surface area (r = 0.54) and of ventricular mass/height to height (r = 0.72) were markedly reduced by normalization of ventricular mass for height2.7 and body surface area1.5. The variability among subjects of ventricular mass was also reduced (p < 0.01 to p < 0.002) by normalization for body weight, body surface area, body surface area1.5 or height2.7 but not for height. In 20% of adults who were overweight, ventricular mass was 14% higher (p < 0.001) than ideal mass predicted from observed height and ideal weight; this increase was identified as 14% by left ventricular mass/height2.7 and 9% by ventricular mass/height, whereas indexation for body surface area, body surface area1.5 and body weight erroneously identified left ventricular mass as reduced in overweight adults. CONCLUSIONS: Normalizations of left ventricular mass for height or body surface area introduce artifactual relations of indexed ventricular mass to body size and errors in estimating the impact of overweight. These problems are avoided and variability among normal subjects is reduced by using left ventricular mass/height2.7. Simple nomograms of the normal relation between height and left ventricular mass allow detection of ventricular hypertrophy in children and adults.

Adult↗
PubMed2005

Overweight and obese in gestational diabetes: the impact on pregnancy outcome.

OBJECTIVE: We sought to investigate the relationship between prepregnancy weight, treatment modality (diet or insulin), level of glycemic control, and pregnancy outcome. STUDY DESIGN: We recruited women with gestational diabetes (GDM) from inner city prenatal clinics. All women were instructed in the use of an intensified management protocol using memory reflectance meters. Outcomes were analyzed according to maternal prepregnancy body mass index (BMI, kg/m 2 ) categories: normal weight (BMI 18.5-24.9), overweight (BMI 25-29.9), and obese (BMI > or =30), and by diet or insulin therapy and glycemic control (mean blood glucose <100 mg/dL = good control). Pregnancy outcome variables included a composite outcome (at least 1 of the following: neonatal metabolic complications, large-for-gestational age or macrosomic infants, NICU admission for >24 hours, and the need for respiratory support) (not including oxygen therapy). In addition to composite outcome, a bivariate analysis was performed for each single variable, including preeclampsia and cesarean section delivery. RESULTS: Four thousand and one women were enrolled. Obese women who achieved targeted levels of glycemic control had comparable pregnancy outcomes to normal weight and overweight women only when they were treated with insulin. Normal weight women treated with diet therapy who achieved targeted levels of glycemic control had good outcomes, but obese women treated with diet therapy who achieved targeted levels of glycemic control, nevertheless, had a 2- to 3-fold higher risk for adverse pregnancy outcome when compared with overweight and normal weight patients with well-controlled GDM. Women with GDM who failed to achieve established levels of glycemic control had significantly higher adverse pregnancy outcomes in all 3 maternal weight groups. CONCLUSION: In obese women with BMI > or =30 with GDM, achievement of targeted levels of glycemic control was associated with enhanced outcome only in women treated with insulin.

Adult↗
PubMed2006

Usefulness of a home-based exercise program for overweight and obese patients with advanced heart failure.

Exercise is an important behavior for long-term weight control in overweight and obese patients. However, little evidence exists confirming such findings in patients with advanced heart failure (HF). Using a prospective, experimental design, the effects of 24 weeks of a low-level, home-based walking program on weight loss were studied in overweight and obese (body mass index > or =27 kg/m(2)) patients with advanced HF who were randomized to exercise (n = 48) and control (n = 51) groups. Weight changes between the 2 groups at baseline and 6 months were compared using repeated-measures analysis of variance. Patients were on average aged 53.3 +/- 10.1 years and predominantly male (75%), Caucasian (57%), and married (55%). Most patients were in New York Heart Association class III or IV (67%), with a mean ejection fraction of 25%. Patients in the exercise group showed significant weight reduction from baseline to 6 months compared with those in the control group (-6.37 +/- 11.7 vs -0.33 +/- 9.3 kg, p = 0.002). No significant differences were noted between the 2 groups in 6-minute walk distance or depression, although the changes were in the anticipated direction. Modest weight losses of >5% were associated with cardiopulmonary exercise test-documented workload levels at 6 months (r = 0.331, p = 0.006), as well as decreased depression (r = -0.315, p = 0.01) and hostility (r = -0.355, p = 0.005). The number of hospital admissions was significantly smaller for patients in the exercise group compared with those in the control group (0.63 +/- 0.94 vs 1.07 +/- 0.95, p <0.05). In conclusion, the findings demonstrate the beneficial effects of a low-level, home-based walking program on weight loss in overweight and obese patients with advanced HF.

Adolescent↗
PubMed2004

Hypertension in overweight and obese primary care patients is highly prevalent and poorly controlled.

BACKGROUND: Although the relationship between body weight and blood pressure (BP) is well established, there is a lack of data regarding the impact of obesity on the prevalence of hypertension in primary care practice. The objective of this study was to assess the prevalence of hypertension and the diagnosis, treatment status, and control rates of hypertension in obese patients as compared to patients with normal weight. METHODS: A cross-sectional point prevalence study of 45,125 unselected consecutive primary care attendees was conducted in a representative nationwide sample of 1912 primary care physicians in Germany (HYDRA). RESULTS: Blood pressure levels were consistently higher in obese patients. Overall prevalence of hypertension (blood pressure >/=140/90 mm Hg or on antihypertensive medication) in normal weight patients was 34.3%, in overweight participants 60.6%, in grade 1 obesity 72.9%, in grade 2 obesity 77.1%, and in grade 3 obesity 74.1%. The odds ratio (OR) for good BP control (<140/90 mm Hg) in diagnosed and treated patients was 0.8 (95% confidence interval [CI] 0.7-0.9) in overweight patients, 0.6 (95% CI 0.6-0.7) in grade 1, 0.5 (95% CI 0.4-0.6) in grade 2, and 0.7 (95% CI 0.5-0.9) in grade 3 obese patients. CONCLUSIONS: The increasing prevalence of hypertension in obese patients and the low control rates in overweight and obese patients document the challenge that hypertension control in obese patients imposes on the primary care physician. These results highlight the need for specific evidence-based guidelines for the pharmacologic management of obesity-related hypertension in primary practice.

Adolescent↗
PubMed2005

Overweight and obesity as risk factors for atrial fibrillation or flutter: the Danish Diet, Cancer, and Health Study.

PURPOSE: We examined the association between the body mass index analyzed as a continuous variable and by categorization according to World Health Organization criteria (normal weight, overweight and obesity) and the risk of a hospital (inpatient as well as outpatient) diagnosis of atrial fibrillation or flutter. METHODS: Population-based prospective cohort study conducted from December 1993 to December 2001 among 47589 participants (22482 men and 25107 women) without preexisting cardiovascular or endocrine disease and with a mean age at baseline of 56 years (range 50-64 years) in the Danish Diet, Cancer, and Health Study. Subjects were followed up in the Danish National Registry of Patients and in the Danish Civil Registration System. RESULTS: During follow-up (mean, 5.7 years) atrial fibrillation or flutter developed in 553 subjects (372 men and 181 women). The adjusted hazard ratio for atrial fibrillation or flutter per unit of increase in the body mass index was 1.08 (95% confidence interval [CI]: 1.05 to 1.11) in men and 1.06 (95% CI: 1.03 to 1.09) in women. When using normal weight as a reference, the adjusted hazard ratio for atrial fibrillation or flutter by overweight was 1.75 (95% CI: 1.35 to 2.27) in men and 1.39 (95% CI: 0.99 to 1.94) in women. The adjusted hazard ratio by obesity was 2.35 (95% CI: 1.70 to 3.25) in men and 1.99 (95% CI: 1.31 to 3.02) in women. CONCLUSION: Overweight and obesity are associated with an increased risk of a diagnosis of atrial fibrillation or flutter.

Atrial Fibrillation↗
PubMed2004

Sensitivity to reward: implications for overeating and overweight.

Sensitivity to reward (STR)-a personality trait firmly rooted in the neurobiology of the mesolimbic dopamine system-has been strongly implicated in the risk for addiction. This construct describes the ability to derive pleasure or reward from natural reinforcers like food, and from pharmacologic rewards like addictive drugs. Recently experts in the field of addiction research have acknowledged that psychomotor stimulant drugs are no longer at the heart of all addictions, and that brain circuits can also be deranged with natural rewards like food. The present study tested a model in which STR was expected to relate positively to overeating, which in turn would be associated with higher body weight in woman aged 25-45 years. As predicted, STR was correlated positively with measures of emotional overeating. Also, overweight woman were significantly more sensitive to reward than those of normal weight. Interestingly, however, the obese woman (Body Mass Index>30) were more anhedonic than the overweight woman (Body Mass Index>25<30). These findings are discussed in the context of neuroadaptations to overactivity of brain reward circuits. Results also indicate that STR may serve as a risk factor for overeating and overweight, especially in cultures such as ours where palatable, calorically-dense food is plentiful.

Adult↗
PubMedDate not supplied

Hypertension, overweight and abdominal adiposity in women. An analytical perspective.

BACKGROUND: The aim of our study was to determine in a group of premenopausal (preM) and postmenopausal women with hormone replacement therapy (postM-HRT) or without HRT (postM-noHRT) whether the strength of the association of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) with hypertension is affected by the way in which these variables are used (i.e., continuous or dichotomous) in logistic regression modeling, where weight and age are set as continuous variables only. METHODS: We studied 639 preM, 341 postM-noHRT, and 77 postM-HRT healthy women age 20-69 years. The main outcome variable was hypertension: BP > or =140 or 90 mmHg on two occasions or hypertension treatment. Risk factors were assessed as continuous variables (age, postmenopausal years, weight, stature, BMI, WC, hip circumference, and WHR); and dichotomous variables (overweight: BMI > or =25; high WC: WC > or =88 cm; and high WHR: WHR > or =0.84). Stepwise regression models for hypertension were developed for continuous (model 1) and dichotomous (model 2) variables in each group. RESULTS: In preM, model 1 included BMI (OR=1.202, CI: 1.115-1.296) and age (OR=1.154, CI: 1.081-1.296); and model 2 included weight (OR=1.070, CI: 1.040-1.100) and age (OR=1.157, CI: 1.084-1.235). In postM-noHRT, both models included age (OR=1.074, CI: 1.035-1.113) and weight (OR=1.025, CI: 1.004-1.046). Overweight and age were associated with hypertension in preM and postM-noHRT; overweight being more relevant in preM, and age in postM-noHRT. No models were found for postM-HRT. CONCLUSIONS: The strength of the association of risk factors with hypertension depends on how the variables are analyzed. Acknowledging these differential effects and assigning differential risks by age could be useful in intervention programs.

Abdomen↗
PubMed2003

Metabolic risk markers in an overweight and normal weight population with oversampling of carriers of the IRS-1 972Arg-variant.

The relationship between the Gly972Arg polymorphism in the insulin receptor substrate-1 (IRS-1) gene and metabolic risk markers is not clear, possibly due to small sample sizes. Modification by body mass index (BMI) has also been suggested. Our aim was therefore to quantify the association of this 972Arg-variant with insulin, glucose and lipid levels in overweight and non-overweight subjects with oversampling of subjects with the 972Arg-variant. We first genotyped 3684 subjects selected from a large population-based cohort (n approximately 23000) according to BMI (26-40 or 18-24 kg/m(2)). Next, we examined 600 of these subjects for fasting metabolic risk markers according to BMI-group and genotype. Subjects with the 972Arg-variant had significantly higher insulin concentrations (4.09 pmol/l or 9.6%, P=0.024) and lower triglyceride levels (0.13 mmol/l or 11%, P=0.001) compared with non-carriers when adjusted for age, sex, waist-to-hip ratio, BMI, alcohol consumption, physical activity and cigarette smoking. These associations were more pronounced in the high BMI-group, although the interactions were not statistically significant. Our large population-based sample shows that the IRS-1 Gly972Arg polymorphism relates to higher fasting insulin levels and lower triglyceride levels. The impact of this genotype and its modification by overweight may be smaller than suggested previously.

Adult↗
PubMed2004

Use of sibutramine in overweight adult hispanic patients with type 2 diabetes mellitus: a 12-month, randomized, double-blind, placebo-controlled clinical trial.

BACKGROUND: The management of type 2 diabetes mellitus is complicated by the presence of risk factors related to overweight and obesity, particularly visceral adiposity. However, weight loss and weight maintenance are difficult for patients with diabetes, and the benefits of dietary modifications are typically modest. Sibutramine is a serotonin- and norepinephrine-reuptake inhibitor that reduces food intake by inducing early satiety and attenuates the decrease in basal energy expenditure associated with weight loss. Previous trials of sibutramine in overweight and obese patients with type 2 diabetes have shown significant weight loss accompanied by better glycemic control. OBJECTIVE: The goal of this study was to assess the effect on body weight and glycemic control of sibutramine in combination with glibenclamide in obese Hispanic patients with type 2 diabetes. METHODS: This was a 12-month, randomized, double-blind, placebo-controlled clinical trial conducted at the Endocrinology Service, General Hospital of Mexico, Mexico City. Included were overweight or obese (body mass index [BMI] >27 kg/M2) patients with type 2 diabetes between the ages of 24 and 65 years who had been receiving glibenclamide monotherapy for at least 2 weeks and whose glucose concentrations were stable. Patients were randomized to receive sibutramine 10 mg or placebo once daily. The primary efficacy measures were change in body weight, waist circumference, and glycosylated hemoglobin (HbA1c). Anthropometrics and fasting glucose concentrations were measured monthly. HbA1c was determined at baseline and at 6 and 12 months. Laboratory parameters were measured at baseline and at the end of the study. RESULTS: Forty-four patients were randomized to receive sibutramine (28 women, 16 men; mean [SD] age, 47.6 [9.0] years), and 42 were randomized to receive placebo (31 women, 11 men; mean age, 45.8 [8.1] years). Twenty-four patients in the sibutramine group and 23 in the placebo group completed the trial. In the sibutramine group, body weight was reduced from a mean (SD) of 73.9 (10.3) kg at baseline to 69.8 (10.6) kg at month 12; BMI decreased from 29.9 (2.6) to 28.2 (2.9) kg/M2; waist circumference was reduced from 94.9 (8.4) to 90.8 (8.4) cm; the plasma fasting glucose concentration decreased from 140.4 (29.4) to 114.2 (32.0) mg/dL; and the HbA1c value was reduced from 8.9% (1.2) to 8.3% (1.2) (all, P < 0.001). In the placebo group, the corresponding changes were from 74.5 (10.3) kg at baseline to 73.1 (11.2) kg at month 12; from 30.1 (2.5) to 29.5 (2.9) kg/M2; from 94.4 (7.3) to 93.1 (8.3) cm (P < 0.05); from 140.7 (25.2) to 123.9 (38.3) mg/dL (P < 0.05); and from 9.0% (1.2) to 9.1% (1.3). In the sibutramine group, weight loss continued for up to 12 months. CONCLUSION: In this population of obese Hispanic patients with type 2 diabetes, sibutramine combined with glibenclamide therapy achieved weight loss for up to 12 months and was associated with better glycemic control than placebo.

Adult↗
PubMed2005

Effects of switching from olanzapine to risperidone on the prevalence of the metabolic syndrome in overweight or obese patients with schizophrenia or schizoaffective disorder: analysis of a multicenter, rater-blinded, open-label study.

BACKGROUND: A major contributor to mortality inpatients with schizophrenia or schizoaffective disorder is cardiovascular disease, an important risk factor for which is the cluster of clinical abnormalities that define the metabolic syndrome (eg, abdominal/visceral obesity, hypertriglyceridemia, impaired glucose tolerance). OBJECTIVE: The aim of this article was to examine the effects of switching from the antipsychotic olanzapine to risperidone on the prevalence of the metabolic syndrome in high-risk overweight or obese patients with schizophrenia or schizoaffective disorder. METHODS: This post hoc analysis was based on data from a previous 2-phase, 20-week, multicenter (19 US sites), rater-blinded, open-label study. High-risk overweight or obese (body mass index [BMI], >26 kg/m(2)) patients aged 18 to 65 years with schizophrenia or schizoaffective disorder whose treatment was switched from olanzapine to risperidone were enrolled. Patients who entered the phase 1 switch from olanzapine to risperidone (6 weeks) and the phase 2 extension (14 weeks) were included in the assessment. The primary end point was the difference from baseline in the prevalence of the metabolic syndrome at week 20, determined using measurements of weight, BMI, waist circumference, and systolic and diastolic blood pressure (SBP/DBP). RESULTS: Baseline assessments for the metabolic syndrome were available from 121 of 123 patients recruited for phase 1 of the study (61 men, 60 women; mean [SD] age, 41.1 [10.2] years; mean [SD] BMI, 33.9 [6.9] kg/m(2)); 71 patients entered phase 2 (29 men, 42 women; mean [SD] age, 40.2 [10.3] years; mean [SD] BMI, 35.1 [7.3] kg/m(2)), of whom 39 (54.9%) ere diagnosed with schizophrenia, and 32 (45.1%) with schizoaffective disorder. The metabolic syndrome was identified in 63 (52.1%) patients at study entry. In the 71 patients with data available from baseline and week 20 (using the last observation carried forward method), the prevalence of the metabolic syndrome was reduced from 38 (53.5%) patients at baseline to 26 (36.6%) at study end (McNemar chi(2) = 8.0, P < 0.005). Significant improvements at study end were seen in mean weight (P = 0.031), BMI (P = 0.002), waist circumference (P = 0.003), SBP (P = 0.006), and DBP (P = 0.010). There was no significant difference in the reduction in the prevalence of the metabolic syndrome between patients who did or did not receive the behavioral therapy for weight loss. CONCLUSIONS: In this post hoc analysis of switching from the antipsychotic olanzapine to risperidone on the prevalence of the metabolic syndrome in high-risk overweight or obese patients with schizophrenia or schizoaffective disorder, the metabolic syndrome was highly prevalent at baseline. Switching from olanza- pine to risperidone was associated with a significant reduction in this prevalence.

Adult↗
PubMed2005

Seven eating styles linked to overeating, overweight, and obesity.

OBJECTIVE: To broaden the perspective on the causes of overeating, overweight, and obesity and provide cross-cultural, comprehensive treatment approaches. BACKGROUND: Through food-related research into the world's wisdom traditions, cultural traditions, Eastern healing systems, and Western nutritional science, the authors present recurrent themes derived from ways in which cultures regarded, experienced, prepared, and shared food for millennia. DESIGN: An 80-item questionnaire, designed to measure food, nutrition, and eating themes was administered to 5,256 participants who registered for a Web-based integrative nutrition e-course. When the 80-items were factor analyzed separately in two randomly split halves of the sample as well as within age and sex categories, seven coherent and consistent factors or eating styles emerged. These eating styles were entered into a multiple regression analysis to predict overeating frequency and body mass index (BMI). RESULTS: Each of the newly identified eating styles was independently related to self-reports of overeating frequency; five of the seven were significantly related to overweight and obesity. The eating styles include the following: (1) "Emotional Eating" (eating to manage feelings); (2) "Fresh Food, Fast Food" (eating mostly processed, high-calorie food; less fresh food); (3) "Food Fretting" (judgmental thoughts and overconcern about food); (4) "Task Snacking" (eating while doing other activities); (5) "Sensory, Spiritual Nourishment" ("flavoring" food with meaning); (6) "Eating Atmosphere" (dining aesthetics and surroundings); (7) "Social Fare" (eating alone vs with others). CONCLUSIONS: Further research is needed to assess the degree to which practicing and implementing these eating styles integratively will decrease overeating, overweight, and obesity.

Adult↗