Obesity Research & Clinical Practice

Insomnia is associated with impaired quality of life among bariatric surgery candidates

2011-07-11

Summary: Little is known about the prevalence or impact of insomnia symptoms in obese individuals pursuing bariatric surgery. The present study from the Rhode Island Bariatric Surgery (RIBS) project examined insomnia symptoms among 2300 individuals pursuing bariatric surgery. Patients were evaluated using the Structured Clinical Interview for DSM-IV Disorders (SCID), Schedule for Affective Disorders (SADS), Rhode Island Bariatric Surgery Interview (RIBSI), and the SF-36 as a measure of quality of life. The presence of insomnia symptoms was determined via ratings for the SCID items assessing initial, middle, and terminal insomnia symptoms, and the SADS insomnia item was used to measure severity of insomnia symptoms. Clinical and demographic variables were obtained from the SCID and self-report measures. Insomnia symptoms were endorsed by 25.8% of participants. Bariatric patients with insomnia symptoms were rated as having a more severe clinical presentation and lower functioning, and were more likely to have a history of psychiatric treatment and/or hospitalization, compared to bariatric patients without insomnia. Linear regression analyses demonstrated that insomnia severity was a significant predictor for scores on each of the 8 SF-36 subscales after accounting for age, gender, race, education level, BMI, depression severity, and sleep apnea. Additionally, a multivariate analysis of covariance (MANCOVA) controlling for depression severity and sleep apnea demonstrated significantly poorer scores on 6 of the 8 SF-36 subscales for bariatric patients with current insomnia symptoms. Results revealed that insomnia symptoms are common among bariatric patients and are associated with reduced quality of life and poorer current functioning. This suggests that insomnia symptoms are an important clinical target in bariatric patients prior to surgery.

Characteristics of short sleeping time and eating behaviors related to obesity

Naoko Nishitani, Hisataka Sakakibara, Izumi Akiyama — 2011-07-15

Summary: Objective: To clarify the relation between short sleeping time, obesity and eating behaviors in male workers.Methods: A self-completed questionnaire survey of 680 male daytime workers (age 19–60 years, mean age 42.9±12.5 years) at a manufacturing plant was conducted in 2005. Subjects were divided into two groups by body mass index (BMI): 480 non-obese men with BMI of <25.0kg/m2 (mean age 42.8±12.8 years) and 200 obese men with BMI of ≥25.0kg/m2 (mean age 43.3±11.7 years). Basic attributes and living habits were then investigated, and the relation of eating behavior to each BMI level was analyzed. BMI and eating behaviors were also investigated in relation to sleeping time.Results: Sleeping time was significantly shorter in obese men than in non-obese men. Multiple regression analysis showed that sleep time as well as living with family were independent factors for greater BMI. BMI increased as sleeping hours became shorter in the order of ≥9h, 8h, 7h, and ≤6h. With shorter sleeping time, the mean eating behaviors scores also increased for cognition of constitution, substitution eating and drinking, feeling of satiety, meal contents, eating rhythm abnormalities, and eating style. The mean scores for these eating behaviors all increased with level of obesity, and these behaviors were characteristic of the obese men.Conclusions: This study showed that people with short sleeping times tended to have eating behaviors of eating more, which can lead to obesity. Short sleeping time may contribute to eating much and then obesity.

Effect of weight loss on maximal fat oxidation rate in obese men

2011-08-05

Summary: Introduction: The hallmark features of obesity include insulin resistance and an impaired ability to oxidize lipids. As compared to exercise training, it remains relatively unclear if diet-induced weight loss can also induce fat metabolism. This study was undertaken to examine the effects of diet-induced weight loss on fat metabolism during a single session of exercise in middle-aged obese men. Methods: Fifteen obese men who were otherwise healthy (average age of 53.5±6.9yr and average body mass index of 27.8±1.6kg/m2) participated in a 12-wk weight loss program primarily consisting of dietary modification. Maximal fat oxidation (MFO) rates, MFO per lean body mass (MFOLBM) and insulin resistance (HOMA-IR) were measured before and after the program. Participants performed a 24-min graded exercise test on a cycle ergometer, with 15-W increments every 4min. Expired gas analysis was performed by indirect calorimetry, and nonprotein respiratory quotient equations were used to calculate fat oxidation rates. Results: The weight (−8.3±3.8kg), fat mass (−4.5±1.9kg), and lean body mass (−3.8±2.4kg) (P<0.001 for all measurements) of the participants were decreased at the end of the 12-wk program. The MFO tended to increase by 19% (P=0.08) and MFOLBM significantly increased by 28.8% (P=0.02). Although insulin resistance also significantly decreased by 49% (P<0.001), changes in fat oxidation variables did not correlate with changes in insulin resistance. Conclusion: Diet-induced weight loss improves fat metabolism with the improvement in insulin resistance.

Appetite after rope skipping may differ between males and females

2011-08-02

Summary: Background: When previously sedentary males and females follow the same exercise training programs with ad libitum feeding, males reduced body mass, but females do not, which suggests that females may increase appetite in response to exercise training compared with males. Rope skipping is traditional exercise modality that everyone had experienced during elementary school years in Japan. The purpose of this study was to determine whether there is a sex difference on appetite after acute rope skipping exercise.Methods and results: Thirteen healthy young males (22.5±0.8 years, 172.2±1.7cm, 68.8±2.3kg, 18.4±0.9%) and 13 females (22.9±0.8 years, 160.6±1.5cm, 52.9±1.6kg, 25.0±1.0%) participated in this study. Subjects consumed their lunch by 13:00, and performed a total of 20min rope skipping exercise (2 sets×10min with 5min interval) from 16:00. In females, appetite significantly increased from immediately after the exercise to 30min after the exercise (from 13mm to 30mm), but remained unchanged in males. Although heart rate, ratings of perceived exertion, and lactate concentrations increased from baseline to immediately after exercise, there were no differences in the increase between males and females. Blood glucose concentrations at baseline and 30min after exercise were higher in females than in males.Conclusion: These results indicated that rope skipping exercise induces an increase in appetite in females, but not in males. This increased appetite in females after the rope skipping exercise was induced without change in blood glucose concentrations.

Possible criteria for obesity based on insulin resistance in Japanese college athletes

Keiko Aoishi, Hisataka Sakakibara — 2011-08-11

Summary: Objective: The purpose of this study was to search for possible criteria for obesity in Japanese college student athletes by examining insulin resistance.Methods: The subjects were 219 male college students (mean age 20.4±1.3years), including 119 athletes who belonged to a university sports team and 100 non-athletic individuals who did not. Fasting blood glucose, hemoglobin A1c (HbA1c), fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) levels were examined in relationship to body mass index (BMI) and waist circumference (WC).Results: Although none of the subjects had diabetes mellitus, 15 (5 athletes (4.2%) and 10 non-athletes (10.0%)) had insulin resistance with HOMA-IR ≥2.5. HOMA-IR was significantly higher in athletes with BMI ≥27.0kg/m2 and non-athletes with BMI ≥25.0kg/m2 than in subjects with BMI <25.0kg/m2. A similar pattern was seen for WC ≥90cm in athletes and ≥85cm in non-athletes. Nearly all athletes with increased insulin resistance had BMI ≥27.0kg/m2 and WC ≥90cm. Among non-athletes, nine of the 10 subjects with insulin resistance had BMI ≥25.0kg/m2 and WC ≥85cm. According to these criteria, the sensitivity and specificity were nearly 100% and 93% for athletes, and 90% and 70% for non-athletes, respectively.Conclusion: Japanese college athletes may be at risk for increased insulin resistance when BMI exceeds 27.0kg/m2 and WC exceeds 90cm.

Depression, anxiety, and neuroticism in obese patients waiting for bariatric surgery: Differences between patients with and without eating disorders and subthreshold binge eating disorders

2011-08-22

Summary: Objective: This study investigated self-reported levels of depression, anxiety and neuroticism in obese patients waiting for bariatric surgery. The patients who indicated that they might have eating disorders (ED) or subthreshold binge eating disorders (SBED) were compared with those without.Method: The design was cross sectional. Obese patients (n=160, 117 women, 43 men) returned self-report questionnaires: Eating Disorders in Obesity (EDO) indicated eating disorder status; Hospital Anxiety and Depression Scale (HADS) assessed symptoms and caseness of depression and anxiety; and the Eysenck Personality Questionnaire (EPQ-12) captured neuroticism. Age, BMI and gender were also recorded.Results: Patients with ED (n=28) presented significantly higher levels of depression, anxiety and neuroticism as well as more HADS-cases for depression and anxiety than those without ED (n=109). Patients with sub-diagnostic binge eating disorders (SBED, n=23) also reported significantly more depression symptom levels, and number of HADS-cases of depression, than those without ED. In addition, the SBED group showed significantly more neuroticism than patients without ED. No significant differences were found between men and women, for high/low age, or for high/low BMI.Conclusion: The data displayed that obese pre-surgery patients with eating disorders have more psychological problems than those without. Patients with SBED were more similar to those with full scale eating disorders in their level of depression and neuroticism than those without ED. Clinically, obese patients with SBED should probably be regarded as those who have full scale ED.

Different waist circumference measurements and prediction of cardiovascular risk factors and metabolic syndrome in children

2011-08-31

Summary: Objective: To compare the effectiveness of three waist circumference (WC) measurement sites to predict cardiovascular risk factors and metabolic syndrome (MS) in Brazilian children.Methods: 187 children (mean age=9.9±0.7 years) were evaluated for weight, height, WC at three different sites: midpoint between the lower rib and iliac crest (WC1), umbilicus (WC2), and narrowest waist (WC3). Skinfolds (triceps and subscapular) and blood pressure were also measured. Analyses for triglycerides, HDL-C and glucose were carried out in 141 children.Results: For boys, the most accurate predictor of overweight and obesity (from body mass index, BMI) and low HDL-C levels was WC3, and for high percentage of body fat (from skinfolds) was WC1. For girls, WC2 was the most accurate predictor of MS, and hypertriglyceridemia, and for overweight and obesity, high body fat percentage, and low HDL-C levels, WC3 was the best predictor. WC1 was the most accurate in the prediction of high blood pressure.Conclusions: Each WC measurement site was accurate in predicting cardiovascular risk factors and MS. However, our results indicate that WC3 was the best predictor of cardiovascular risk factors and MS in boys and girls.

Relationship between obesity in Korean adolescents and the frequency of alcohol consumption, the amount of alcohol consumed, and the frequency of severe alcohol intoxication

Seong-Ik Baek, Wi-Young So — 2011-09-05

Summary: The purpose of this study is to determine whether the frequency of alcohol consumption, the amount of alcohol consumed, and the frequency of severe alcohol intoxication are related with obesity in Korean adolescents. In 2009, 72,399 students from the 7th to 12th grades participated in the 5th Korea Youth Risk Behavior Web-based Survey (KYRBWS-V) project. Multiple logistic regression analyses were used to assess whether body mass index (BMI) was associated with the frequency of alcohol consumption, the amount of alcohol consumed, and the frequency of severe alcohol intoxication, after controlling for covariate variables such as age, parent's education level, household economic status, frequency of vigorous and moderate physical activities, and frequency of muscular strength exercises during the week, sedentary lifestyle during the week, mental stress, and sleep duration. No relationship was observed between the frequency of alcohol consumption and body weight in adolescents. However, for boys, the odds ratio (95% confidence interval [CI]) between becoming overweight and the amount of alcohol consumed was 0.678 (range, 0.534–0.862; p=0.002) for 2 to <3 bottles of beer and 0.810 (range, 0.674–0.973; p=0.025) for 3 to <4 bottles of beer. The odds ratio (95% CI) between becoming obese and the amount of alcohol consumed was 0.794 (range, 0.653–0.964; p=0.020) for 3 to <4 bottles of beer and that between becoming obese and the frequency of severe alcohol intoxication was 0.758 (range, 0.598–0.959; p=0.021) when alcohol was consumed 1–2 times per month. For girls, the odds ratio (95% CI) between becoming overweight and the amount of alcohol consumed was 0.752 (range, 0.579–0.978; p=0.033) for 3 to <4 bottles of beer and that between becoming obese and the amount of alcohol consumed was 1.753 (range, 1.033–2.972; p=0.037) for ≥4 bottles of beer. We conclude that there is no relationship between the frequency of alcohol consumption and becoming overweight or obese. Although weight gain and obesity in boys and girls due to moderate consumption of alcohol are less prevalent, high alcohol consumption can increase weight gain in girls.

Relationship between body mass index and body fat in children—Age and gender differences

2011-09-19

Summary: When defining obesity body mass index (BMI) has been used as the main criterion. However it indicates only the nutritional status, whereas body fat demonstrates the real body composition picture. This study aimed at analyzing the relationship between nutritional status and adiposity in the population of 2284 Serbian children (1217 boys and 1067 girls). According to BMI subjects were divided into underweight, normal-weight, overweight and obese, and %BF values (based on skinfold thickness measurements) were analyzed with regard to BMI-category, age and gender. Girls showed stronger correlation between BMI and %BF comparing to boys (r=0.834 vs. 0.577). Differences in %BF between underweight, normal weight and overweight children from different age groups were more obvious in girls, whereas in boys younger than 8 years overlapping in %BF values between different BMI-categories was registered. In normal weight children we found age-related oscillations in %BF values: 8- and 9-year-old boys had lower %BF comparing to 7-year-old boys, which was followed by %BF increasement in 10- and 11-year-old ones; in girls %BF values gradually increased with aging, with significant jumps in 9-, 10- and 11-year-old ones. Thus, adiposity rebound may appear somehow later in boys. In overweight and obese children of both genders %BF continually increased with aging, whereas in underweight children %BF values remained unchanged. Our results pointed to age- and gender-dependent variations of %BF in normal weight and overweight children. We also indicated inconsistency between %BF and BMI especially in boys, and the need for definition of references for %BF.