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PubMed2003

Effect of moderate intensity exercise on acute energy intake in normal and overweight females.

The purpose of this study is to determine the impact of moderate intensity exercise on acute post-exercise energy intake (EI) in normal and overweight females. Twelve normal weight (BMI<25), and 12 over weight (BMI>25) inactive women (mean age 35+/-8) participated in a 2-day experimental study. On the exercise day, participants were asked to walk on a treadmill at 60% maximum heart rate for 1h. After the exercise, participants selected and ate food at a university cafeteria. Post-exercise EI was compared to a non-exercise day. A single mixed model repeated 2 x 2 ANOVA was used to determine the impact of exercise on post-exercise EI. The overweight women consumed significantly more (p<0.02) than the normal weight women on both experimental days and there was a significant (p<0.03) difference in fat intake. The higher post -exercise EI of the overweight group may have been due to the energy needs associated with a higher BMI but it is also possible that cognitive factors, food availability and environment may influence post-exercise EI.

Adult↗
PubMed1985

Dietary fat intake and taste responses to fat in milk by under-, normal, and overweight women.

Dietary fat intake, with special emphasis on dairy products, was estimated from questionnaires for 42 underweight, 80 normal weight, and 64 overweight adult women. Frequency of consumption of fresh and processed meats, frozen dairy desserts, pastries, and snacks such as potato chips was greater for the overweight than for the underweight subjects. However, preferences between verbally-described high- and low-fat versions of 14 food pairs did not differ by body size. Overweight subjects reported that they consumed more non-fat milk and less whole milk than did the other groups. Discrimination, perceived intensity, paired preference, and hedonic rating of fat in milk and in chocolate milk did not differ significantly according to body size, fat intake, or type of milk consumed. Ad libitum mixing of non-fat milk and "half and half" (12% fat) to individual levels of liking also showed no significant variation with body size. However, subjects with higher dietary fat intakes mixed to higher fat-preference levels in milk than did the low- and medium-fat intake subjects. Those reporting consumption of regular milk (3.5% fat) mixed to higher fat levels than did those who consumed low-fat (2% fat) or non-fat milk. The ad libitum procedure gave better reproducibility and appeared to be a more realistic measure of liking than the hedonic rating or paired-preference tests.

Adolescent↗
PubMed2000

Glomerular filtration rate in severely overweight normotensive humans.

The study examined whether indexing glomerular filtration rate (GFR) for body surface area is appropriate for people who are severely overweight. Twenty normotensive adult men who were severely overweight but without microalbuminuria were enrolled into this study. The control group consisted of 20 healthy subjects matched for age, sex, and height. GFR was determined by measuring insulin with the continuous-infusion method. The clearance of endogenous creatinine was also measured after two daily urine collections. Renal plasma flow (RPF) was measured by p-aminohippurate clearance using the continuous-infusion method. Lean body weight was measured by impedentiometry. Adjusting for body surface area (in 1.73 m(2)) caused a significant reduction in GFR (P < 0.0001) in overweight humans (84.1 +/- 2.32 versus 109.6 +/- 3.07 mL/min/1.73 m(2)). The difference disappeared when GFR/height criteria were adopted. No difference between obese and healthy controls occurred after adjusting for lean body weight. Data for creatinine clearance paralleled those with insulin clearance; a significant reduction (P < 0.001) occurred after indexing for basal surface area, which disappeared after correction for height, as well as for lean body weight.

Adipose Tissue↗
PubMed2002

Increased inhibition by agouti-related peptide of ventromedial hypothalamic neurons in rats overweight due to early postnatal overfeeding.

Melanocortins, e.g. alpha-melanocyte stimulating hormone, are involved in the central nervous regulation of body weight. Agouti-related peptide (AGRP) as an endogenous melanocortin receptor antagonist induces feeding. Overexpression leads to obesity. Rats that grow up in small litters develop persistent hyperphagia and are overweight throughout life. Changes in the neuronal activity of the ventromedial hypothalamic nucleus (VMH) that signals satiety with activation might be involved. We studied single unit activity in hypothalamic brain slices. Melanocortins activated or inhibited similarly in control and small litter rats. AGRP mainly inhibited VMH neurons of overweight rats (t-test, P < 0.005, n = 33), whereas it also activated neurons of controls. This increased inhibition of VMH neurons by AGRP in early postnatally overnourished rats might contribute to the changed regulation leading to a persistent overweight condition throughout life.

Agouti-Related Protein↗
PubMed2001

Original article underweight, overweight and obesity: relationships with mortality in the 13-year follow-up of the Canada Fitness Survey.

The purpose of this study was to determine the risk of all-cause mortality in the Canadian population across the new WHO/NIH BMI categories for the classification of overweight and obesity. The sample includes 10,725 adult participants (20-69 years) in the 1981 Canada Fitness Survey. A total of 593 deaths occurred during 13 years of follow-up. Hazard ratios (HR) for mortality were estimated using Cox proportional hazards models. Compared to normal weight individuals, there is an increased risk of mortality in the underweight category (HR 1.63, 95% CI 0.93-2.85) in addition to increasing levels of risk across the overweight (HR 1.16, 95% CI 0.96-1.39), obese class I (HR 1.25, 95% CI 0.96-1.65) and obese class II and III (HR 2.96, 95% CI 1.39-6.29) categories. Similar patterns were observed in sex-specific analyses. Underweight, overweight and obese Canadians are all at increased risk of mortality compared to those who are normal weight.

Adult↗
PubMed2000

Predictive values of waist circumference for dyslipidemia, type 2 diabetes and hypertension in overweight White, Black, and Hispanic American adults.

Waist circumferences (WC) >/=102 cm for men and >/=88 cm for women have been proposed by an expert panel as cut-points for identifying increased risk for the development of obesity comorbidities for most adults. The aim of this investigation was to examine the predictive values of these WC cut-points for hypercholesterolemia, low concentration of high (HDL-C), and high concentration of low (LDL-C) density lipoprotein cholesterol, hypertriglyceridemia, type 2 diabetes, and hypertension in overweight American adults. Data from NHANES III were utilized for the analysis. Predictive abilities were determined by calculating sensitivity, specificity, positive (PV+) and negative (PV-) predictive values in overweight subjects with BMI 25-29.9 kg/m(2). Sensitivity of WC cut-point was stronger for high LDL-C compared to other risk factors with the highest values recorded in the 40-59 and 60-69 year age groups in men and women, respectively. PV+ of WC cut-points for dyslipidemia, type 2 diabetes, and hypertension were low in men compared to women. PV+ tended to increase with age, from 19-39, 40-59 to 60-90 year age groups in Whites, Blacks, and Hispanic men. In men, the highest PV+ were recorded for hypertriglyceridemia in the 60-90 years old groups, with values of 71.6%, 52.5%, and 43.3% in Whites, Blacks, and Hispanics, respectively. The CVD risk factor associated with the highest PV+ in women was diabetes with values of 97.2% in Whites and 88.9% in Blacks, and hypertriglyceridemia with a value of 93.8% in the 17-39 year age group in Hispanics. Among Black men 40-59 years of age, only 32% of a population of overweight hypertensives were detected by the WC cut-points, and among Black women, 40-59 years of age, only 54% were detected. Given the low sensitivity of these cut-points for detecting hypertension, one of the major co-morbidities of obesity, these cut-points failed to provide adequate evidence for the use of WC in determining or evaluating patients as to co-morbid states. We recommend further studies to determine a set of specific cut-points associated with increased risk of CVD in different population groups.

Adolescent↗
PubMed2002

Decreases in serum uric acid by amelioration of insulin resistance in overweight hypertensive patients: effect of a low-energy diet and an insulin-sensitizing agent.

BACKGROUND: Hyperuricemia and hyperinsulinemia/insulin resistance are commonly seen in obese subjects and hypertensive patients. To clarify whether the insulin resistance plays a role in hyperuricemia, we investigated alterations in serum uric acid (UA) concentrations during treatment with a low-energy diet or an insulin-sensitizing agent in overweight hypertensive patients. METHODS: Twenty-eight overweight hypertensive patients (14 men and 14 women, mean age 61 +/- 2 years) were assigned to a weight reduction program with a low-energy diet (3360 kJ/day for 3 weeks, n = 14) and to treatment with troglitazone (200 mg twice daily for 8 weeks, n = 14). Measurements of body weight, blood pressure (BP), serum UA, and a 75-g oral glucose tolerance test were performed at baseline and the end of the intervention periods. RESULTS: Body weight and BP decreased significantly in the diet group but not in the troglitazone group at the end of the intervention periods. Levels of blood glucose, plasma insulin, and homeostasis model assessment-insulin resistance index (HOMA-R) improved similarly in the two groups. Serum UA concentration decreased by treatment both in the diet (0.4 +/- 0.2 mg/dL, P < .05) and troglitazone groups (1.0 +/- 0.2 mg/dL, P < .001). CONCLUSIONS: The amelioration of insulin resistance by either a low-energy diet or troglitazone decreased the serum UA level in overweight hypertensive patients. Insulin resistance or hyperinsulinemia, independent of body weight and BP, may play an important role in UA metabolism in multiple risk factor syndrome.

Adult↗
PubMed1999

Overweight, but not high dietary fat intake, increases risk of gastroesophageal reflux disease hospitalization: the NHANES I Epidemiologic Followup Study. First National Health and Nutrition Examination Survey.

PURPOSE: Gastroesophageal reflux disease is an important and increasingly common condition. Both overweight and high fat food consumption have been implicated as causes of reflux disease. We examined the relationship of overweight, high dietary fat intake, and other factors with reflux disease hospitalization. METHODS: We studied participants in the first National Health and Nutrition Examination Survey, a population-based sample examined in 1971-75 and followed through 1992-93. Persons with a physician-diagnosed hiatal hernia at baseline or reflux disease hospitalization within the first five years of study were excluded. A second analysis included follow-up of 9851 participants free of reflux disease in 1982-84. Ninety-six percent of the baseline cohort were recontacted. Reflux disease cases were persons hospitalized with a diagnosis of esophagitis or uncomplicated hiatal hernia. Hazard rate ratios for reflux disease hospitalization according to body mass index (BMI) (kg/m2), total daily servings of high fat foods and other factors were calculated using Cox proportional hazards analysis. RESULTS: A total of 12,349 persons were followed for a median of 18.5 years (range 5.0-22.1). Cumulative incidence of reflux disease hospitalization was 5.2% at 20 years. Multivariate survival analysis revealed higher reflux disease hospitalization rates with higher BMI (5 kg/m2) [hazard ratio (HR) = 1.22, 95% confidence interval (CI) = 1.13-1.32]. No relationship was found between higher fat intake and reflux disease hospitalization. Other factors associated with reflux disease hospitalization included age, low recreational activity, and history of doctor-diagnosed arthritis. CONCLUSIONS: Overweight, but not high dietary fat intake, increases risk of gastroesophageal reflux disease hospitalization.

Adult↗
PubMedDate not supplied

Resumption of fertility with diet in overweight women.

In young women being overweight appears to be one of the major and still neglected causes of subfertility. Not only the excessive amount but also the distribution of body fat is clearly related to loss of fertility. The mechanism through which obesity impairs ovulation and fertility is largely unknown, but it is well known that being overweight lowers the concentration of sex hormone binding globulin and increases androgen and insulin secretion and insulin resistance. These high concentrations of androgen and insulin in turn are important factors in the preferential abnormal localization of body fat. In addition, ovulation induction or ovarian stimulation in overweight women is a not easy task, since these patients are often unresponsive to the stimulatory drugs and, in addition, have a higher rate of miscarriages. Weight reduction improves these patients' biochemical indices and fertility rates. The spontaneous pregnancy rate can be expected to be around 30%, but an additional 40-50% drug-induced pregnancy rate can be achieved with a 10-15% weight loss. Drugs increasing insulin sensitivity also improve spontaneous ovulation and fertility in obese women but still need to be tested in larger controlled trials. In conclusion, appropriate counselling about weight reduction through diets and exercise can restore both health and fertility, avoiding much frustration, and saving time and money.

Diet, Reducing↗
PubMedDate not supplied

Soft drinks, childhood overweight, and the role of nutrition educators: let's base our solutions on reality and sound science.

The percentage of overweight children in the United States and other countries has now reached epidemic proportions. Both physical activity and food intake contribute to the energy equation, but research increasingly points to physical inactivity as the primary culprit in weight gain. Singling out and restricting specific foods and beverages are unlikely to be effective in reducing the prevalence of overweight children. Nutrition educators need to emphasize overall lifestyle, including physical activity, as well as caloric intake, in childhood overweight intervention efforts. Long-lasting solutions to the obesity epidemic must be comprehensive and must include all of the key stakeholders: children, parents, schools, health professionals, businesses, and community leaders and organizations. Nutrition educators can play a key role in developing wide-ranging and diverse coalitions, including food and beverage companies, designed to affect social change aimed at achieving healthy weight for children.

Adolescent↗
PubMed2000

Association of the G-2548A polymorphism in the 5' region of the LEP gene with overweight.

Mutations in the translated part of the leptin gene (LEP) have been found in only two families. Nevertheless DNA polymorphisms in the LEP region are linked to extreme obesity. We previously found in the 5' region of LEP a polymorphism, G-2548A, associated with a differerce in BMI reduction following a low calorie diet in overweight women. Recently, this polymorphism was associated with extreme obesity in women. In this work, we genotyped a new sample from the general population including 314 normal weight (BMI < 27 kg/m2) and 109 overweight subjects (BMI > or = 27 kg/m2). The genotype and allele frequencies were significantly different between groups, with the G-2548 allele being more frequent in the overweight subjects (p < 0.01). In men, carriers of this allele had lower leptin concentrations adjusted for fat mass (p = 0.05). Our results indicate that variations at the leptin locus are associated with common obesity phenotypes, and not only with extreme obesity or the rare mendelian obesity syndromes.

Adult↗
PubMedDate not supplied

[Epidemiology of overweight and obesity among Italian early adolescents: relation with physical activity and sedentary behaviour].

AIMS: The prevalence of overweight and obesity and the role of possible related factors were analysed among Italian early adolescents. METHOD: The survey reported here is part of the larger "Health Behaviour in School Aged Children" (HBSC) trans-national study, which is co-ordinated by the European Office of the World Health Organization. The data were gathered through self-administered questionnaires filled out by a representative sample of 4,386 (48.4% males) Italian students (11-, 13- and 15-year old). RESULTS: The overall prevalence is 16.7% for overweight and 2.5% for obesity. Boys are more at risk than girls for the two phenomena. Moreover, age group, mother's education, area of residence, physical activity, and sedentary behaviour show a significant association with both outcomes. CONCLUSION: Findings of the present study are in agreement with similar studies carried out on early adolescents population, showing that prevalence in overweight and obesity decreases during this phase and is more diffused among boys than girls. The prevalence of both diseases is higher in the South and Islands. Sedentary behaviour and physical activity are substantive factors which preventive interventions could act on.

Adolescent↗
PubMed1998

The relation of weight, length and ponderal index at birth to body mass index and overweight among 18-year-old males in Sweden.

The intrauterine environment seems to be important for the occurrence of cardiovascular and other chronic diseases in adulthood. The aim of the present study is to analyze the importance of birthweight, birthlength and Ponderal Index (PI) for Body Mass Index (BMI) and overweight at 18 years of age. In this cohort study, the nationwide Swedish Medical Birth Registry for the years 1973-1976 was linked with the national Military Service Conscription Registry for 1990-1996. Of 193,056 children born at term 1973-1976, 165,109 (85.5%) could be followed-up at 18 years of age. The children were divided into percentile groups according to birthweight and birthlength for each gestational week. They were also assigned to three different categories, according to birthweight and birthlength for each gestational week: infants with values < or = 5th percentile, values > 5th and < or = 95th percentile, and values > 95th percentile. Clear-cut associations were found between birthweight and BMI, and between PI at birth and BMI at 18 years of age. High birthweight and normal birthlength and also high birthweight and high birthlength for gestational age were found to be risk factors for overweight and severe overweight among young men in Sweden.

Adolescent↗
PubMed1997

Overweight and obesity in Saudi Arabian adult population, role of socio-demographic variables.

The objectives of this Community-based National Epidemiological Household Survey, conducted between 1990-1993, were to estimate the prevalence of overweight and obesity in Saudi Arabia and to examine its association with the socio-demographic characteristics of the adult population. A sample of Saudis 20 years and over was selected using a multistage stratified cluster sampling technique with probability proportionate to size. The selected subjects were requested to visit primary health care centers in their localities. Physicians in these clinics took measurements of heights and weights and collected other relevant data. Obesity was measured by the Body Mass Index, using the Quetelet Index. The results showed the sample of 10,651 subjects of which 50.8% were males, had a mean age of 35.8 years (SD = 14.27 years). The prevalence of overweight was 31.2% (95% confidence interval: 30.3%, 32.1%); 33.1% for males and 29.4% for females. For obesity, the overall prevalence was 22.1%; males 17.8% and females 26.6%. The study design suggested that these estimates could be closer to the true values. The multiple logistic regression analysis showed that age, residential area, region, income, gender, and education are statistically significant predictors of obesity. The prevalence of obesity was higher in females than males, lower in subjects living in rural areas with traditional lifestyles than those in more urbanized environments, and increased with increasing age. The observed prevalence and pattern of overweight and obesity with age and gender is similar to those observed in the Arab community and some Western nations. There is a need for increased physical activity and better nutrition education programs to reduce the extent of obesity and to prevent the serious health consequences, especially, in the middle age group.

Adult↗
PubMed2001

Bupropion for weight loss: an investigation of efficacy and tolerability in overweight and obese women.

OBJECTIVE: On the basis of the clinical observations that bupropion facilitated weight loss, we investigated the efficacy and tolerability of this drug in overweight and obese adult women. RESEARCH METHODS AND PROCEDURES: A total of 50 overweight and obese (body mass index: 28.0 to 52.6 kg/m(2)) women were included. The core component of the study was a randomized, double-blind, placebo-controlled comparison for 8 weeks. Bupropion or placebo was started at 100 mg/d with gradual dose increase to a maximum of 200 mg twice daily. All subjects were prescribed a 1600 kcal/d balanced diet and compliance was monitored with food diaries. Responders continued the same treatment in a double-blind manner for an additional 16 weeks to a total of 24 weeks. There was additional single-blind follow-up treatment for a total of 2 years. RESULTS: Subjects receiving bupropion achieved greater mean weight loss (last-observation-carried-forward analysis) over the first 8 weeks of the study (p = 0.0001): 4.9% +/- 3.4% (n = 25) for bupropion treatment compared with 1.3% +/- 2.4% (n = 25) for placebo treatment. For those who completed the 8 weeks, the comparison was 6.2% +/- 3.1% (n = 18) vs. 1.6% +/- 2.9% (n = 13), respectively(p = 0.0002), with 12 of 18 of the bupropion subjects (67%) losing over 5% of baseline body weight compared with 2 of 13 in the placebo group (15%; p = 0.0094). In the continuation phase, 14 bupropion responders who completed 24 weeks achieved weight loss of 12.9% +/- 5.6% with fat accounting for 73.5% +/- 3.7% of the weight lost and no change in bone mineral density as assessed by DXA. Bupropion was generally well-tolerated in this sample. DISCUSSION: Bupropion was more effective than placebo in achieving weight loss at 8 weeks in overweight and obese adult women in this preliminary study. Initial responders to bupropion benefited further in the continuation phase.

Adult↗
PubMed2003

Effects of a longitudinal training program on responses to exercise in overweight men.

OBJECTIVE: The aim of this study was to determine how training modifies metabolic responses and lipid oxidation in overweight young male subjects. RESEARCH METHODS AND PROCEDURES: Eleven overweight subjects were selected for a 4-month endurance training program. Before and after the training period, they cycled for 60 minutes at 50% of their VO(2)max after an overnight fast or 3 hours after eating a standardized meal. Various metabolic and endocrine parameters, and respiratory exchange ratio values were evaluated. RESULTS: Exercise-induced plasma norepinephrine concentration increases were similar before and after training in fasted or fed conditions. After food intake, exercise promoted a decrease in plasma glucose and a higher increase in epinephrine than in fasting conditions. The increase in epinephrine after the meal was more marked after training (264 +/- 32 vs. 195 +/- 35 pg/mL). Training lowered the resting plasma nonesterified fatty acids. During exercise, changes in glycerol were similar to those found before training. Lipid oxidation during exercise was higher in fasting than in fed conditions (15.5 +/- 1.4 vs. 22.3 +/- 1.7 g/h). Training did not significantly increase fat oxidation when exercise was performed in fed conditions, but it did in fasting conditions (18.6 +/- 1.4 vs. 27.2 +/- 1.8 g/h). DISCUSSION: Endurance training decreased plasma nonesterified fatty acids, cholesterol, and insulin concentrations. Training increased lipid oxidation during exercise, in fasting conditions, and not when exercise was performed after the meal. During exercise in overweight subjects, the fasting condition seems more suited to oxidizing fat and maintaining glucose homeostasis than a 3-hour wait after a standard meal.

Adult↗
PubMed2003

Assessment of global coronary heart disease risk in overweight and obese African-American women.

OBJECTIVE: To examine, with the use of national guidelines, coronary heart disease (CHD) risk with increasing BMI for primary prevention in urban African-American women. RESEARCH METHODS AND PROCEDURES: Participants were recruited for CHD risk factor screening from 20 churches as part of a larger study of nutrition and fitness (Project Joy). All participants had a demographic, smoking and medical history assessment, and the following measurements were taken: weight, height, waist circumference, blood pressure, lipid levels, and glucose. Three methods of defining risk, the Framingham Point Scoring System, a count of risk factors, and the presence of the multiple metabolic syndrome, based on the National Cholesterol Education Program Adult Treatment Panel III Report and BMI classes established by the Clinical Guidelines, were used. RESULTS: A total of 396 women were eligible. Participants were 40 to 80 years of age and had marked excess prevalence of overweight and obesity (84%); 55% were obese. There was a linear increase in risk factors as BMI increased. Lipids did not differ significantly among BMI classifications. Seventeen percent of women had multiple metabolic syndrome. Eight percent and 16% of women in the normal and overweight BMI classes, respectively, had two or more modifiable risk factors. There was no difference in number of modifiable risk factors among the obese classes. The Framingham Point Scoring System assigned a <10% risk of a hard CHD event in 10 years to 97% of the women. DISCUSSION: National risk assessment guidelines for primary prevention of CHD may not be adequate for overweight and obese urban African-American women and require further study.

Adult↗
PubMed2004

Longitudinal relationships among overweight, life satisfaction, and aspirations in young women.

OBJECTIVE: This study investigated associations of overweight status and changes in overweight status over time with life satisfaction and future aspirations among a community sample of young women. RESEARCH METHODS AND PROCEDURES: A total of 7865 young women, initially 18 to 23 years of age, completed two surveys that were 4 years apart. These women provided data on their future life aspirations in the areas of further education, work/career, marital status, and children, as well as their satisfaction with achievements to date in a number of life domains. Women reported their height and weight and their sociodemographic characteristics, including current socioeconomic status (occupation). RESULTS: Young women's aspirations were cross-sectionally related to BMI category, such that obese women were less likely to aspire to further education, although this relationship seemed explained largely by current occupation. Even after adjusting for current occupation, young women who were obese were more dissatisfied with work/career/study, family relationships, partner relationships, and social activities. Weight status was also longitudinally associated with aspirations and life satisfaction. Women who were overweight or obese at both surveys were more likely than other women to aspire to "other" types of employment (including self-employed and unpaid work in the home) as opposed to full-time employment. They were also less likely to be satisfied with study or partner relationships. Women who resolved their overweight/obesity status were more likely to aspire to being childless than other women. DISCUSSION: These results suggest that being overweight/obese may have a lasting effect on young women's life satisfaction and their future life aspirations.

Adolescent↗