Obesity Research & Clinical Practice - Articles in Press

The effects of partial use of formula diet on weight reduction and metabolic variables in obese type 2 diabetic patients—Multicenter trial - Corrected Proof

2012-04-26

Summary: Aims: To clarify the usefulness of protein-sparing modified formula diet in obese type 2 diabetic patients, the effects of partial use of formula diet on weight reduction and changes in related metabolic variables, and the improving rates of risk factors per 1% body weight reduction, were compared with those of conventional subcaloric diet.Subjects and methods: Obese patients [BMI >25kg/m2] with diabetic mellitus were randomly assigned to a low-caloric diet with partial use of formula diet group (FD, n=119) and a conventional low-caloric diet group (CD, n=110). Subjects in FD took one pack of formula diet (MicroDiet®, 240kcal/pack) in place of one of three daily low-caloric meals for 24 weeks. Total daily calorie prescribed was same.Result: Weight reduction was greater in FD than in CD (week 24: −3.5 vs −1.4kg; all p<0.001). Systolic blood pressure decreased significantly only in FD. HbA1c reduction was greater in FD than in CD. HDL-cholesterol increased significantly more in FD than in CD (week 24: +2.8 vs. +0.6mg/dl, p<0.001). Among several improving rates (%) of risk factors/1% body weight reduction, those of HbA1c at weeks 16 and 24, triglyceride at week 8 and HDL-cholesterol at week 24, were significantly higher in FD than CD. Doses of sulfonylurea and thiazolidinedione were significantly decreased in FD than in CD.Conclusion: Partial use of formula diet was much more effective in reducing body weight, and also in improving coronary risk factors than conventional diet in part due to reduced body weight through decreased energy diet intake and due to dietary composition of the formula diet.

A perspective on obesity cardiomyopathy - Corrected Proof

2012-04-09

Summary: Obesity is a major health concern worldwide as obese individuals have a greater risk of death from any cause than normal-weight individuals. As the number of overweight children and adolescents continues to rise, so too has the scope of the obesity epidemic grown substantially. In this article, the authors discuss the role of obesity in the development of heart failure and the pathophysiology of obesity cardiomyopathy, as well as explore the potential role of bariatric surgery and mechanical circulatory support devices (MCSD) as potential therapeutic targets.

Relative shrinkage of adipocytes by paraffin in proportion to plastic embedding in human adipose tissue before and after weight loss - Corrected Proof

Sanne P.M. Verhoef, Paul van Dijk, Klaas R. Westerterp — 2012-04-09

Summary: Adipocyte size is a major modulator of endocrine functioning of adipose tissue and methods allowing accurate determination of adipocyte size are important to study energy metabolism. The aim of this study was to assess the relative shrinkage of adipocytes before and after weight loss by comparing adipose tissue from the same subjects embedded in paraffin and plastic. 18 healthy subjects (5 males and 13 females) aged 20–50 y with a BMI of 28–38kg/m2 followed a very low energy diet for 8 weeks. Adipose tissue biopsies were taken prior to and after weight loss and were processed for paraffin and plastic sections. Parameters of adipocyte size were determined with computer image analysis. Mean adipocyte size was smaller in paraffin compared to plastic embedded tissue both before (66±4 vs. 103±5μm, P<0.001) as after weight loss (62±4 vs. 91±5μm, P<0.001). Relative shrinkage of adipocytes in paraffin embedded tissue in proportion to plastic embedded tissue was not significantly different before and after weight loss (73 and 69%, respectively). Shrinkage due to the type of embedding of the adipose tissue can be ignored when comparing before and after weight loss. Plastic embedding of adipose tissue provides more accurate and sensitive results.

Physiological and behavioural outcomes of a randomised controlled trial of a cognitive behavioural lifestyle intervention for overweight and obese adolescents - Corrected Proof

Leah Brennan, Jeff Walkley, Ray Wilks, Steve F. Fraser, Kate Greenway — 2012-03-21

Summary: Aim: This study evaluates the efficacy of the Choose Health program, a family-based cognitive behavioural lifestyle program targeting improved eating and activity habits, in improving body composition, cardiovascular fitness, eating and activity behaviours in overweight and obese adolescents.Method: The sample comprised 29 male and 34 female overweight (n=15) or obese (n=48) adolescents aged 11.5–18.9 years (M=14.3, SD=1.9). Participants were randomly allocated to treatment or waitlist control conditions; waitlist condition participants were offered treatment after 6 months. DEXA-derived and anthropometric measures of body composition; laboratory-based cycle ergometer and field-assessed cardiovascular fitness data; objective and self-report physical activity measures; and self-report measures of eating habits and 7-day weighed food diaries were used to assess treatment outcome. Adherence to treatment protocols was high.Results: Treatment resulted in significant (p<.05) and sustained improvements in a range of body composition (body fat, percent body fat, lean mass) and anthropometric measures (weight, BMI, BMI-for-age z-score and percentiles). Minimal improvements were seen in cardiovascular fitness. Similar results were obtained in completer and intention-to-treat analysis. Poor adherence to assessment protocols limits conclusions that can be drawn from physical activity and dietary data.Conclusions: Participation in the Choose Health program resulted in significant improvement in body composition. Longer-term follow up is required to determine the durability of intervention effects. Alternative approaches to the measurement of diet and physical activity may be required for adolescents.

Comparison of lipid accumulation product with body mass index as an indicator of hypertension risk among Mongolians in China - Corrected Proof

Xin Gao, Guiyan Wang, Aili Wang, Tan Xu, Weijun Tong, Yonghong Zhang — 2012-03-19

Summary: Objective: To compare associations of lipid accumulation product (LAP) and body mass index (BMI) with risk of hypertension.Methods: Demographic characteristics, blood pressure and body measurements were obtained, blood lipids and fast plasma glucose were examined, BMI and LAP were calculated for 2589 Mongolians. Multiple linear model and covariance analysis was used to analyze the relationship between LAP and blood pressure levels, multivariate logistic analysis was used to analyze the association between BMI and LAP and hypertension.Results: LAP and BMI were all significantly higher in hypertensives than in normotensives in both genders. Multivariate adjusted mean levels of SBP and DBP increased with increased LAP and there was a linear association between LAP and blood pressure. LAP had a stronger association with risk of hypertension compared with BMI, linear trend between LAP and risks of hypertension was better than that between BMI and risks of hypertension in males. Compared to the first quartile, the odds ratios [95% confidence intervals (95% CIs)] of hypertension associated with the second, third and fourth quartiles of LAP were 1.85(1.23,2.79), 2.20(1.47,3.28), 4.21(2.78,6.38) in males; compared to the first quartile, the odds ratios (95% CIs) of hypertension associated with the second, third and fourth quartiles of BMI were 0.93(0.62,1.38), 1.23(0.83,1.84), 2.80(1.86,4.21) in males.Conclusion: LAP was more closely associated with risk of hypertension than BMI in Mongolian males, this study suggested that LAP might be a preferred anthropometry measurement to predict risk of hypertension in males. Future prospective cohort studies should be conducted to test the causal relationship between LAP and the risk of hypertension in Mongolian population.

Association between body mass index and high-sensitivity C-reactive protein in male Japanese - Corrected Proof

Naoko Nishitani, Hisataka Sakakibara — 2012-03-19

Summary: We divided subjects into hs-CRP of ≤1.0mg/l and >1.0mg/l, and investigated the relationship between hs-CRP and basic attributes, lifestyle and health checkup test results. In particular, hs-CRP increased significantly as BMI increased, and hs-CRP of >1.0mg/l was seen in about 40% of people with BMI of ≥25kg/m2 and 75% with BMI of ≥30kg/m2. Persons with 3 or more abnormalities in BMI, blood pressure, serum lipid and glucose were found in 20.0% of those with hs-CRP >1.0mg/l, while 4.3% in hs-CRP≤1.0mg/l. The present findings have suggested that hs-CRP>1.0mg/l can be an indicator for obesity-related risks in male Japanese.

Effect of weight-loss program using self-weighing twice a day and feedback in overweight and obese subject: A randomized controlled trial - Corrected Proof

Yoshitake Oshima, Yukiyo Matsuoka, Naoki Sakane — 2012-03-16

Summary: Objective: To investigate the effectiveness of self-weighing twice a day with a supportive program installed on a body composition monitor in overweight adults.Subjects: Sixty adults with BMI>24kg/m2 were randomly assigned to either a group that weighed themselves once per day (group 1, n=30) or a group that weighed themselves twice per day (group 2, n=30).Intervention: Group 1 was instructed to self-weigh at the same time once per day and group 2 was instructed to self-weigh immediately after waking up in the morning and immediately before going to bed every day for twelve weeks. In addition, participants in group 2 was received the daily target setting during morning weighing and the difference between the measured weight and the target weight during bedtime weighing.Results: Average weight reduction in group 1 was significantly lower than that in group 2 (1.0±1.4kg vs. 2.7±2.1kg, p<0.05). The proportion of participants who lost ≧5% of their pre-program weight in group 2 was significantly higher than that in group 1 (28.6% vs. 3.6%, p<0.05).Conclusion: A self-weighing twice per day plus daily target setting and feedback is more effective in promoting weight loss than once-daily self-measurement.

Low 25-hydroxyvitamin D level is associated with insulin sensitivity in obese adolescents with non-alcoholic fatty liver disease - Corrected Proof

Ozgur Pirgon, Ferhat Cekmez, Huseyin Bilgin, Esra Eren, Bumin Dundar — 2012-03-14

Summary: Aim: The aim of this study was to investigate the relationships between 25-hydroxy-vitamin D (25(OH)D) and insulin resistance in obese adolescents with non-alcoholic fatty liver disease (NAFLD).Patients and methods: Eighty-seven obese adolescents (45 girls and 42 boys, mean age: 12.7±1.3 years, mean body mass index standard deviation score (BMI-SDS): 2.1±0.3) and 30 lean subjects (15 girls and 15 boys, mean age: 12.3±1.45 years, mean BMI-SDS: 0.5±0.7) were enrolled for the study. The obese subjects were divided into two subgroups based on the presence or absence of fatty liver with high transaminases (NAFLD group and non-NAFLD group). Fasting blood samples were assayed for 25(OH)D, transaminases, glucose, and insulin levels. Insulin resistance was calculated by the homeostasis model assessment (HOMA-IR).Results: 25(OH)D measurements were decreased in both obese groups (NAFLD and non-NAFLD) in comparison with the lean group (29.5±18.4 vs. 41.0±17.9 vs. 48.1±22.2ng/mL). However; the NAFLD group had significantly lower measurements of 25(OH)D than the non-NAFLD group (p<0.001) and lean group (p<0.001). 25(OH)D was negatively correlated with HOMA-IR (r=−0.158, p=0.01) and with alanine aminotransferase (r=−0.794, p=0.03) in the NAFLD obese group. There was no significant associations between fasting insulin, BMI-SDS and 25(OH)D in obese groups.Conclusion: We suggest that low 25(OH)D occurs commonly in obese adolescents with NAFLD and we demonstrated an association between insufficient vitamin D status and low insulin sensitivity in obese adolescents with NAFLD.

Effect of bariatric surgery on left ventricular geometry and function in severe obesity - Corrected Proof

2012-03-14

Summary: Objective: Weight loss improves cardiac abnormalities associated with severe obesity. We evaluated the impact of weight loss following laparoscopic gastric bypass (LGBP) on left ventricular (LV) geometry and function in obese patients.Methods: Twenty-six patients with severe obesity (41±8 years, 50% women) underwent Doppler echocardiograms before and after LGBP, to measure LV geometry, excess of LV mass relative to hemodynamic load and systolic and diastolic function.Results: Pre-operatively, 85% of patients exhibited LVH, and 62% hypertension and metabolic syndrome, reflecting high cardiometabolic risk. After 8±4 months of follow-up, the average weight loss was 19±8%. Weight loss was significantly associated with improved metabolic parameters and reduced heart rate (−9bpm), systolic (−11mmHg) and diastolic (−6mmHg) blood pressure (all p<0.02). After surgery, there was significant reduction in relative wall thickness (0.43±0.07 versus 0.39±0.06), LV mass index (63±14g/m2.7 versus 49±10g/m2.7) and excess of LV mass in relation to hemodynamic load (all p<0.004). LVH remained in 54% of patients, hypertension in 23% and metabolic syndrome in 27%. Ejection fraction and Doppler indices of diastolic function did not change significantly, even after adjusting for changes in heart rate. All favorable changes in LV geometry and function were also confirmed in the subgroup with <9 month follow-up (median), whereas no further improvement could be detected in patients with longer follow-up.Conclusions: In patient with severe obesity, LV geometry and systolic function improved rapidly after LGBP, without evidence of further improvement during prolonged follow-up.

Predictors of initial weight loss after gastric bypass surgery in twelve veterans affairs medical centers - Corrected Proof

2012-03-14

Summary: The objective of this study was to identify determinants of significant weight loss one year after gastric bypass surgery among United States veterans. Using data from the Veterans Affairs (VA) Surgical Quality Improvement Program, we identified 516 veterans who had gastric bypass surgery (24% laparoscopic) in one of twelve VA bariatric centers in 2000–2006 and one or more postoperative weight measures. The probability of losing 30% or more of baseline weight at one year was estimated via logistic regression, examining the following potential predictor variables: age, gender, race, marital status, body mass index (BMI), American Society of Anesthesiologists class, comorbidity burden, smoking status, diabetes medications taken and surgical procedure (open or laparoscopic). The 516 cases had a mean BMI of 49kg/m2, mean age of 51.5 years, 74% were male, 77% were Caucasian, and 55% were married. The predicted mean weight loss was 76 (95% CI: 73–79) pounds (22%) at six months and 109 (95% CI: 104–114) pounds (32%) at one-year. Based upon estimated individual trajectories of 370 patients with adequate follow-up data, 58% of the sample lost 30% or more of their baseline weight at one year; and <1% lost <10% of their baseline weight at 1 year. In the logistic regression, patients were more likely to lose 30% or more of their baseline weight if they were female (odds ratio (OR)=2.5, p<0.01) or Caucasian (OR=2.3, p<0.01). We conclude that gastric bypass surgery yields significant weight loss for most patients in Veterans Affairs Medical Centers, but is particularly effective for female and Caucasian patients.

Influence of obesity on blood pressure and arterial stiffness in the early teens - Corrected Proof

2012-03-09

Summary: Problem: We studied the influence of adiposis on the progression of blood pressure and arteriosclerosis in the early teens.Methods: The subjects of this study were 147 boys and girls (72 boys and 75 girls) in junior high school. Height, weight, percentage body fat, blood pressure, brachial-ankle pulse wave velocity (baPWV) and exercise time were measured. All subjects were measured at two points – at 5th grade in elementary school (ages between 10 and 11 years) and 2nd grade in junior high school (8th grade, ages between 13 and 14 years). The relationship between the change values of adiposis over 3 years (from 5th grade to 8th grade) and blood pressure/baPWV at the age of 13–14 were analyzed with multiple regression analysis.Results: For boys, the change values in BMI and percentage body fat were correlated positively with systolic blood pressure. For girls, the change values in BMI and percentage body fat were correlated positively with systolic and diastolic blood pressures and baPWV.Conclusions: In conclusion, raised blood pressure was already observed in obese early teens as a result of arteriosclerosis progression regardless exercise habit, and it was more apparent in girls.

Sarcopenic obesity is closely associated with metabolic syndrome - Corrected Proof

2012-03-07

Summary: Objectives: Obesity is a risk factor for metabolic syndrome (MetS). We aimed to investigate whether sarcopenic obesity (SO) was associated with MetS.Methods: A total of 600 community-dwelling males and females aged 63.6±10.1 years in Northern Taiwan were enrolled in this study. Sarcopenia was defined by the percentage of total skeletal mass (total skeletal muscle mass (kg)/weight (kg)×100). Cut-offs were established at <37% in men and <27.6% in women using the bioelectrical impedance analysis (BIA) method. Obesity was defined as body mass index (BMI) ≥25kg/m2. MetS was defined by the consensus of National Cholesterol Education Program-Adult Treatment Panel III modified for Asians. The association between MetS and SO was examined using multivariate logistic regression analyses after controlling potential confounders.Results: The SO group demonstrated a higher risk for MetS (odds ratio [OR] 11.59 [95% confidence interval [CI] 6.72–19.98]) than the obese group (7.53 [4.01–14.14]) and sarcopenic group (1.98 [1.25–3.16]). The individual components including waist circumference, serum triglycerides, high-density lipoprotein cholesterol (HDL-C), and fasting serum glucose were independently associated with SO.Conclusion: SO is a major risk factor for MetS. The BIA method and BMI can easily identify subjects at high risk for MetS. The underlying mechanism for the relationship between SO and MetS warrants further research.

Relationship between obesity and blood pressure in school-going adolescents in the Limpopo Province of South Africa - Corrected Proof

Seth S. Mkhonto, Musawenkosi L.H. Mabaso — 2012-03-05

Summary: Objective: Hypertension and obesity are increasingly becoming a common problem among adolescents in South Africa. The aim of this study is to assess the relationship between obesity and hypertension in school-going adolescents in Limpopo, South Africa.Methods: A total of 1114 school-going black Africa adolescents (505 boys and 609 girls) were randomly selected from grades 7 to 12. Obesity was measured using body mass index (BMI), waist circumference (WC) and hip circumference (HC). Normotensive was defined as systolic blood pressure (SBP) and diastolic blood pressure (DBP) <90th percentile and hypertensive as SBP and DBP ≥90th percentile.Results: Bivariate analysis SBP showed a significant positive association with age, BMI, HC and WC in boys (p<0.05), and with only WC in girls while HC was marginally significant (p=0.060). DBP showed a significant increase with age, BMI and WC in both sexes, including HC in girls. The odds of being hypertensive were associated with increase in BMI and HC in boys and with WC and WHR in girls. In the multivariate analysis age showed a significant positive association with SBP and DBP in boys (p=0.001), and SBP with WC in girls (p=0.049). The odds of being hypertensive increased significantly with BMI in boys (p=0.015), and HC in girls (p=0.042).Conclusion: The study confirmed that among school-going adolescent boys and girls increase in elevated BP is related to increase in body weight as measured by the selected anthropometric parameters. Blood pressure monitoring as part of school health programme may be useful for risk assessment and promotion of preventive measures.

2 years change of waist circumference and body mass index and associations with type 2 diabetes mellitus in cohort populations - Corrected Proof

2012-03-05

Summary: Objective: Compare the association between 2 years change of waist circumference (WC) or body mass index (BMI) and incident type 2 diabetes mellitus (T2DM) in cohort populations.Methods: Prospective cohort study, based on a baseline investigation from 1999, we conducted the first follow-up for subjects whose follow time met 2 years, and the second follow-up for subjects whose follow time met 5 years. Two years change of WC or BMI was measured by the D-value between baseline and the first follow up values. The association between 2 years change of WC or BMI and incident T2DM were analyzed by using Poisson regression model.Results: Among 3461 participants without T2DM at baseline, 160 subjects developed T2DM during follow up period. Across quartiles of WC D-value, hazards ratio (HR) of incident T2DM increased, but there was no significant dose response relationship was found between BMI D-value and incident T2DM. Compared with subjects whose both WC and BMI were modified, there was no significant increase for T2DM risk in subjects whose WC was modified but BMI was not modified [HR(95%CI)=1.66(0.70–3.97)], but the T2DM risk was significantly higher in subjects whose WC was not modified but BMI was modified [HR(95%CI)=1.73(1.17–2.54)].Conclusions: WC change was a better predictor for incident T2DM than BMI change. Intervention programs designed to reduce WC through lifestyle modification, including physical activity and diet, may have significant public health significance in preventing incident T2DM.

Prevalence of elevated blood pressure and its relationship with fat mass, body mass index and waist circumference among a group of Moroccan overweight adolescents - Corrected Proof

2012-03-05

Summary: This study aimed to estimate the prevalence of hypertension among a group of adolescents and to assess the relationship of systolic and diastolic blood pressure (SBP, DBP) with body fat mass (BFM), body mass index (BMI) and waist circumference (WC).A total of 167 subjects aged 11–17 years were recruited, 29.3% and 12.6% were overweight and obese respectively. BMI, WC, SBP and DBP were determined using standardized equipment. BFM was estimated by the deuterium oxide dilution.Hypertension (HT) and prehypertension (pre-HT) were observed in 17.4% and 9.6%, of the study population, respectively. The prevalence of HT and pre-HT was significantly higher in boys and in overweight-obese groups (p=0.044; p=0.003 respectively). Both SBP and DBP were significantly higher in overweight-obese compared to healthy-weight groups (p<0.001; p=0.002 respectively). SBP was significantly higher in boys than girls (p=0.013). With some exceptions, SBP and DBP were significantly correlated with BMI, WC and BFM in the study population and different weight-status groups of both genders. The relationship of blood pressure with BMI appeared to be more significant than with WC and BFM.The prevalence of hypertension was higher in boys than girls and in overweight-obese than healthy-weight adolescents. Overall SBP and DBP were associated with BFM, BMI and WC. However, the strong association between these variables was seen in girls, and the greater risk of developing hypertension could be associated with increasing BMI.

Relationship between obesity, depression, and disability in middle-aged women - Corrected Proof

2012-03-05

Summary: Background: Obesity and depression are closely linked, and each has been associated with disability. However, few studies have assessed inter-relationships between these conditions.Design and methods: In this study, 4641 women aged 40–65 completed a structured telephone interview including self-reported height and weight, the Patient Health Questionnaire (PHQ) assessment of depression, and the World Health Organization Disability Assessment Schedule II (WHODAS II). The survey response rate was 62%. We used multivariable regression models to assess relationships between obesity, depression, and disability.Results: The mean age was 52 years; 82% were White; and 80% were currently employed. One percent were underweight, 39% normal weight, 27% overweight, and 34% obese. Mild depressive symptoms were present in 23% and moderate-to-severe symptoms were present in 13%. After multivariable adjustment, depression was a strong independent predictor of worse disability in all 7 domains (cognition, mobility, self-care, social interaction, role functioning, household, and work), but obesity was only a significant predictor of greater mobility, role-functioning, household, and work limitations (P<0.05) (overweight was not significantly associated with any disability domain). Overall, the effect on disability was stronger and more pervasive for depression than obesity, and there was no significant interaction between the two conditions (P>0.05). Overweight and obesity were associated with 5760 days of absenteeism per 1000 person-years, and depression was associated with 18,240 days of absenteeism per 1000 person-years.Conclusions: The strong relationships between depression, obesity and disability suggest that these conditions should be routinely screened and treated among middle-aged women.

Reduction in cardiovascular risk factors and insulin dose, but no beta-cell regeneration 1 year after Roux-en-Y gastric bypass in an obese patient with type 1 diabetes: A case report - Corrected Proof

2012-02-23

Summary: Experience with Roux-en-Y gastric bypass in patients with type 1 diabetes is very limited, despite an increasing prevalence of obesity also in this population. We describe changes in anthropometric measures, insulin dose, HbA1c, blood pressure, lipid status, and metabolic response to a liquid mixed meal throughout the first year after RYGB in an obese patient with type 1 diabetes. No change in HbA1c was observed, but a 48% reduction in weight-adjusted insulin dose and improvements in cardiovascular risk factors was seen 1 year after surgery. Exaggerated secretions of anorexigenic gut hormones were seen during the meals.

Cell proliferation in ventromedial hypothalamic lesioned rats inhibits acute gastric mucosal lesions - Corrected Proof

2012-02-10

Abstract: Aim: The role of mucosal layer thickness on prevention of acute gastric mucosal lesions (AGMLs) was examined in ventromedial hypothalamic (VMH)-lesioned rats.Materials and methods: The incidence of AGMLs after 48-h fasting and 60% ethanol injection into the stomach after 24-h fasting, aggressive factors (gastric acid and serum gastrin) and defensive factors [hexosamine, gastric mucosal blood flow (GMBF), serum thiobarbituric acid reacting substances (TBARS), and thickness of the gastric mucosal layer] were evaluated in VMH-lesioned rats. The effects of cell proliferation on the gastric mucosal layer of these rats were evaluated by H–E staining and immunostaining with proliferating cell nuclear antigen (PCNA).Results: After 48-h fasting, no AGMLs were observed in VMH-lesioned and sham VMH-lesioned rats (controls). With 60% ethanol administration after 24-h fasting, the numbers of AGMLs were similar in the two groups, but the ulcer index, a marker of ulcer formation, was lower in VMH-lesioned rats compared to that in sham VMH-lesioned rats. VMH-lesioned rats showed increased gastric acid secretion and serum gastrin compared to sham VMH-lesioned rats, indicating an increase in aggressive factors in VMH-lesioned rats. The two groups had similar levels of gastric mucosal hexosamine, GMBF, and gastric mucosal TBARS, but VMH-lesioned rats had an increased thickness of the mucosal cell layer, indicating an increase in defensive factors in these rats. Histologically, VMH-lesioned rats had an increased total mucosal cell layer, especially for the surface epithelial cell layer, and an increased PCNA-labeling index, a marker of cell proliferation, especially in the proliferative zones of gastric mucosa, indicating increased cell proliferation in the proliferative zone of the gastric mucosa.Conclusion: VMH-lesioned rats are resistant to AGML formation due to increased cell proliferation in gastric mucosa through elevating the levels of defensive factors over those of aggressive factors.

Obesity as an independent risk for left ventricular diastolic dysfunction in 692 Japanese patients - Corrected Proof

2012-02-02

Summary: Background: Both obesity and left ventricular (LV) diastolic dysfunction are associated with an increased risk of cardiovascular morbidity and mortality. There is a paucity of data as to whether obesity is independently associated with LV diastolic dysfunction.Methods: Adult patients with sinus rhythm referred for a transthoracic echocardiography between July, 2007, and December, 2007, were prospectively included. Exclusion criteria were patient who had a history of congenital or valvular heart disease, treatment with pacemaker implantation or implantable cardioverter defibrillator, myocardial infarction, or impaired LV systolic function. Diastolic function was classified by an algorithm incorporating data from mitral and pulmonary venous flow indices, and Doppler tissue imaging. Body mass index (BMI) was evaluated as a categorical variable (normal weight <25.0kg/m2; overweight 25.0 to <30.0kg/m2; and obese ≥30kg/m2). Logistic models were used to assess the risk of abnormal LV diastolic function associated with BMI categories.Results: Of a total number of 692 patients who met all study criteria (mean 59±15year-old; 50% women, 48% hypertension, 16% diabetes, 26% overweight, 8% obese), 538 (78%) had abnormal LV diastolic function. In multivariate analyses adjusting for age, sex, and cardiovascular risk factors, obesity was independently associated with LV diastolic dysfunction (odds ratio [OR]: 2.98, 95% confidence interval [CI]: 1.12–7.88; P=0.03) compared to normal weight. LV mass did not weaken this association (OR: 2.88, 95% CI: 1.08–7.68; P=0.04). Overweight was not independently associated with LV diastolic dysfunction.Conclusion: Obesity was associated with LV diastolic dysfunction independent of cardiovascular risk factors and LV mass.

Overweight is associated with low hemoglobin levels in adolescent girls - Corrected Proof

Ursula Viana Bagni, Ronir Raggio Luiz, Gloria Valeria da Veiga — 2012-01-30

Summary: Objective: To verify the prevalence of iron deficiency anemia according to sexual maturation stages and its association with overweight as well as excessive body fat in adolescents.Design: A school-based cross-sectional study was performed. Anemia was assessed by measuring the hemoglobin level (Hb). Nutritional status was defined by sex and age specific body mass index (BMI) cutoffs, and body fat (BF) was determined by bioelectrical impedance. Sexual maturation was assessed by breasts/genitalia and pubic hair development stages. Statistical analyses considered the effect of cluster sampling design (classes) and sampling expansion corrected by relative weight. Odds ratio and general linear modeling were used to assess the associations, regarding the value of p<0.05 for statistical significance.Setting: Public schools in the Metropolitan area of Rio de Janeiro, Brazil.Subjects: Probabilistic sample of 707 teenagers between 11.0 and 19.9years old.Results: The prevalence of anemia among the adolescents was 22.8% (95%CI 16.7–30.2%), higher among girls than among boys (30.9% vs. 10.9%; p<0.01). The chance of developing anemia did not change with the nutritional status according BMI or BF percentage, however, overweight girls presented lower Hb levels than those who were not overweight (12.2g/dL vs. 12.8g/dL, p<0.01). In boys this association was not observed. Sexual maturation did not change the association of Hb and anemia with overweight and excessive body fat.Conclusion: The reduction of Hb levels points at overweight as a risk factor for the development of iron deficiency among adolescents.

Ventromedial hypothalamic lesions enhance small intestinal cell proliferation in mice - Corrected Proof

2012-01-27

Summary: Background: We have found previously that ventromedial hypothalamic lesions (VMH) enhance cell proliferation in the visceral organs through vagal hyperactivity in rats. The goal of the current study was to determine the characteristics and nature of cell proliferation in the small intestine in VMH-lesioned mice.Methods: The weight and length of the small intestine, thickness of the mucosal and muscle layers, number of proliferating cell nuclear antigen (PCNA)-positive cells, and mitotic cell count in the mucosal layer in VMH-lesioned and Sham VMH-lesioned mice were determined at 7 days after the operation.Results: The weight and length of the small intestine in VMH-lesioned mice were significantly greater than those in Sham VMH-lesioned mice, by 11.6% and 15.0%, respectively. The thicknesses of the mucosal and muscle layers of the small intestine in VMH-lesioned mice were also significantly greater than those in Sham VMH-lesioned mice, by 12.7% and 12.5%, respectively. PCNA-positive cells and mitotic cells in the mucosal layer were densely present in crypts in VMH-lesioned mice, and were significantly increased by 31.9% and 71.7%, respectively, compared to Sham VMH-lesioned mice.Conclusions: These results demonstrate that VMH lesions in mice enhance cell proliferation in the mucosal layers and cause cell hypertrophy or cell proliferation in the muscle layers of the small intestine, which increases the weight and length of the small intestine. VMH lesions in mice may be a new tool for identifying growth factors and related genes involved in enlarging the small intestine mainly through cell proliferation.

Variant rs1421085 in the FTO gene contribute childhood obesity in Chinese children aged 3–6years - Corrected Proof

2012-01-27

Summary: Objective: Childhood obesity has become a public health crisis worldwide due to an alarming increase in its prevalence. Numerous studies have demonstrated that the common variants (rs1421085 and rs17817449) of the fat mass and obesity associated (FTO) gene are associated with the obesity in adult and children in European. However, these two variants of FTO gene in childhood obesity have not been established in Chinese populations.Methods: In this population-based case-control study, 158 obese preschooler and 397 normal population controls aged 3–6years were recruited between June 2007 and April 2008 from 6 kindergartens of Huai-an city in Jiangsu Province, China. All the children were conducted the body examinations and provided blood sample to detect the serum lipid levels and FTO rs1421085 T>C and rs17817449 T>G genetic variances.Results: In the association analysis between the FTO gene variant and risk of childhood obesity, compared with the rs1421085TT wide-type genotype, rs1421085 CC and CT/CC genotypes were associated with 59% and 71% increased risks of childhood obesity (adjusted OR=1.59, 95%CI=1.00–2.53 for CC; adjusted OR=1.71, 95%CI=1.10–2.65 for CT/CC), while the rs17817449 T>G variant was not associated with the significantly increased risk of childhood obesity. In addition, the higher level of serum TG (>0.64mmol/l) was associated with 93% increased risk of childhood obesity (adjusted OR=1.93, 95%CI=1.30–2.87), and the higher serum HDL-C level (>1.14mmol/l) was associated with 45% decreased risk of childhood obesity (adjusted OR=0.55, 95%CI=0.37–0.81). But the quantitative phenotypes analysis regarding the levels of TC, TG, HDL-C, and LDL-C were not found to be significantly associated with the variants of rs1421085 and rs17817449 both in the cases and controls.Conclusion: The FTO rs1421085 T>C polymorphism may modulate the magnitude of dyslipidemia in Chinese early-onset obesity.

New diagnostic criteria for obesity and overweight in Korean children and adolescents using 2007 Korean National Growth Charts - Corrected Proof

2012-01-13

Summary: The diagnostic criteria (KCDC Criteria) to define obesity and overweight of Korean children and adolescents were newly presented in the 2007 Korean National Growth Charts. The KCDC Criteria were criticized for several problems caused by upward shift of body mass index (BMI) percentile curves of the growth charts. This study was conducted to establish new diagnostic criteria (New Criteria) for obesity and overweight in Korean children and adolescents that would be less affected by a change of BMI distribution in the reference population of the Growth Charts. The BMI values for ages 2–18 years corresponding to Asia-Pacific adult BMI cutoffs of obesity (25.0kg/m2) and overweight (23.0kg/m2) were calculated with L, M and S values presented in the 2007 Korean National Growth Charts. Additionally, we examined the frequencies of obesity and overweight among children and adolescents who participated in the 2005 National Growth Survey based on both New Criteria and KCDC Criteria. The Z-scores corresponding to BMIs of 25 and 23kg/m2 at 18-years-of-age were 0.99 and 0.41 in boys, and 1.34 and 0.71 in girls, respectively. The BMI values corresponding to these Z-scores from age 2 to 18 years were determined as new BMI cutoffs for obesity and overweight. The frequencies of obesity and overweight estimated by New Criteria were greater by 2 times in boys and 1.5 times in girls than those by KCDC Criteria. We suggest that New Criteria could be a good alternative that can resolve problems caused by upward shift of BMI percentile curves of the 2007 Korean National Growth Charts.

The adipokines and inflammatory marker in young type 2 diabetics with metabolic syndrome: A pilot study - Corrected Proof

2012-01-09

Summary: Objective: The purpose of the metabolic syndrome (MetS) concept was to early identify subjects having risk for developing cardiovascular diseases and diabetes, which of both are involved in low grade inflammation and obesity. We wish to explore the role of adipokines and inflammatory marker in young type 2 diabetics (YDM) with MetS.Methods: Forty-eight YDM patients were divided to 2 and 3 groups according to the presence of the MetS (MetS+ and MetS−), and the numbers of MetS component (MetS-2 to MetS-4 with 1–2, 3, and 4–5 components) respectively. Plasma adipokines (tumor necrosis factor-α; TNF-α and adiponectin) and C-reactive protein (CRP) were measured and compared among groups.Results: Blood pressure (BP), body mass index (BMI), and plasma triglyceride (TG) levels were higher in the group with MetS+ than that of MetS−. Except for diastolic BP, BMI, waist, and plasma TG levels, which were generally lower in the MetS-2 group, the rest demographic characteristics were not different among these three groups. Finally, the plasma adiponectin, CRP and TNF-αlevels were not different between both groups with or without MetS; and also among these three groups regardless the component numbers they had.Conclusion: YDM with MetS might have non-significant lower adiponectin and higher CRP levels compared to subjects without MetS. It needs prospective study with larger scale to explicit the role of cytokines and inflammatory markers in YDM with MetS.

Waist circumference is a better predictor than body mass index of insulin resistance in type 2 diabetes - Corrected Proof

Lin-Huang Huang, Ying-Li Liao, Chung-Hua Hsu — 2011-12-26

Summay: Background: Insulin resistance is an important pathogenic factor in type 2 diabetes patents. An easy and efficiency measurement predicting insulin resistance; which can be done easily by type 2 patients is desired.Objective: To examine whether waist circumference is a better predictor of insulin resistance in type 2 diabetes than body mass index (BMI).Methods: From a population of 1356 registered diabetic patients, 144 who met (1) aged between 30 and 75years, (2) being Chinese, (3) having had type 2 diabetes for more than one year, and (4) having been taking gliclazide and metformin for more than 6months were enrolled in this study. The main outcome evaluated is the associations of HOMA insulin resistance index (HOMA index); which were assessed using multiple linear regression analysis.Results: The coefficients of multiple regression analysis with stepwise model showed that waist circumference (β=0.35, p<0.001) but not BMI (β=0.01, p=0.94), adiponectin (β=−0.25, p=0.04) and hemoglobulin A1c% (HbA1c) (β=0.25, p=0.01) were the main predictors of HOMA index.Conclusions: These initial findings indicate that waist circumference is a better predictor of insulin resistance in type 2 diabetes than BMI.

Masked function of amino acid sensors on pancreatic hormone secretion in ventromedial hypothalamic (VMH) lesioned rats with marked hyperinsulinemia - Corrected Proof

2011-12-22

Summary: In neural regulation of the endocrine pancreas, there is much evidence to suggest that vagal efferents alter insulin and glucagon secretion, but less information on the effects of vagal afferents. In this study, we investigated the role and function of afferent fibers of the vagus nerve in normal and ventromedial hypothalamic (VMH) lesioned rats with marked hyperinsulinemia. In normal rats, hepatic vagotomy was associated with intraperitoneal (ip) arginine-induced enhancement of insulin and glucagon secretion without an accompanying change in blood glucose levels, ip leucine induced enhancement of insulin secretion accompanied by a decrease in blood glucose levels, and ip alanine-induced enhancement of glucagon secretion accompanied by an increase in blood glucose levels. In VMH lesioned rats with marked hyperinsulinemia, none of these amino acids caused significant changes in insulin and glucagon secretion. We conclude that amino acid sensors in normal rats inhibit excess release of pancreatic hormones induced directly by intake of amino acids, such as that in excess protein ingestion, and maintain blood glucose levels within the normal range. In contrast, in VMH lesioned rats with marked hyperinsulinemia, the function of the amino acid sensors is masked due to the marked hyperinsulinemia in these rats.

Ethnic difference in liver fat content: A cross-sectional observation among Japanese American in Hawaii, Japanese in Japan, and non-Hispanic whites in United States - Corrected Proof

2011-12-20

Summary: Background: We recently reported that Japanese had higher liver fat at a lower level of BMI compared with non-Hispanic whites (NHW).Objective: We hypothesize that ethnic difference in fat storage capacity contributes to this ethnic difference in liver fat.Design: To examine this, we assessed liver fat among 244 Japanese-American aged 40–49, using regional computed-tomography images, along with metabolic variables.Results: Despite the similar BMI between Japanese-Americans and NHW men, Japanese-Americans had more liver fat (liver to spleen attenuation ratio: 1.03±0.22 for Japanese-Americans, and 1.07±0.15 for NHW men; p<0.05) and tended to have a greater disposition for fatty liver with an increase in BMI than NHW, indicating a clear difference between the two groups. In addition, liver fat is less in Japanese-Americans compared with Japanese men (1.03±0.22 vs. 1.01±0.16; p<0.05), despite of a much higher BMI. These ethnic differences support the hypothesis that higher fat storage capacity indeed seems to be associated with less liver fat. In all the groups, liver fat content strongly correlated with triglycerides, homeostasis model assessment-insulin resistance, and C-reactive protein (CRP). Nevertheless, these metabolic variables were worse in Japanese-Americans, despite of less liver fat, compared with Japanese. Moreover, CRP levels were least among Japanese with highest liver fat, and highest among NHW men with least liver fat, despite of a strong positive association between CRP and fatty liver within each population.Conclusions: Fat content in the liver is intermediate for Japanese-Americans compared with Japanese and NHW men, which supports the hypothesis of less fat storage capacity among Japanese, closely linked to ethnic difference in predisposition to fatty liver.

Improvement of fundamental movement skills through support and mentorship of class room teachers - Corrected Proof

2011-12-19

Summary: Project Energize, a multicomponent through-school programme aims to improve the overall health and reducing weight gain of Waikato primary school children by increasing their physical activity and encouraging healthy eating. The aim of this report is to describe the efficacy of one intervention that provided classroom teachers with tools for improving fundamental movement skill (FMS) proficiency in years 0–8 school children.In 2008 the Test of Gross Motor Development (TGMD) was used to measure the FMS proficiency of children from 11 schools and 41 classes; before (n=701) and after (n=598) the teacher support was provided. Children were identified only by class years.At baseline less than half of the children exhibited proficiency in kicking (21%), throwing (31%) and striking (40%) while most children were able to run (84.6%) and slide (78.0%). All skills were substantially improved (P<0.001) after the intervention with the biggest changes in kicking, throwing and striking; 49.8%, 63.5% and 76.3% proficient. At baseline children in years 0–3 from higher decile schools performed better than lower decile schools and after intervention this gap was reduced or removed.After receiving tailored FMS physical education classes led by the teacher, younger children were more competent than the older children were at baseline. The large, positive effects of the intervention have implications for long term physical activity participation and fitness with subsequent health benefits. The school-based FMS teacher support intervention by Team Energize is an effective way to improve outcomes for children.

Effects of octreotide on nitric oxide synthase expression in the small intestine of high fat diet-induced obese rats - Corrected Proof

Yan Ou, Rui Liu, Na Wei, Xian Li, Ou Qiang, Wei Huang, Chengwei Tang — 2011-12-19

Summary: Objective: To investigate whether obesity induced by high fat diet is associated with expression of neuronal, endothelial, and inducible nitric oxide synthase (nNOS, eNOS, and iNOS) in the intestine, and to test the effects of the somatostatin analog octreotide on this expression.Methods: The study included high fat diet-induced obese and normal control rats. The obese rats were further separated into an obese control group and an octreotide intervention group. Rats in the intervention group were injected with 40μg/kg octreotide every 12h for 8days. Expressions of nNOS, eNOS, and iNOS in the small intestine were analyzed by RT-PCR and immunohistochemistry. The NO level of small intestinal homogenate was measured with an ELISA kit.Results: The body weight; Lee's index; small intestinal eNOS and iNOS mRNA and protein expression levels; nNOS protein expression levels; and small intestinal homogenate NO levels were all significantly higher in the obese control group than in the normal controls (p<0.01); nNOS mRNA expression was also higher in the obese control group, but not significantly so. Octreotide intervention significantly reduced the body weight and small intestinal homogenate NO level of the obese rats relative to the obese control group (p<0.05). The mRNA and protein expression levels of eNOS and iNOS; the protein expression level of nNOS in the small intestine were also significantly lower in the octreotide intervention group than in the obese control group (p<0.01), while nNOS mRNA expression was lower but not significantly so.Conclusion: High fat diet-induced obesity is associated with elevated small intestinal nNOS, eNOS, and iNOS expression levels. Octreotide treatment can inhibit nNOS, eNOS, and iNOS expression and lead to weight loss.

Periodontal treatment with topical antibiotics improves glycemic control in association with elevated serum adiponectin in patients with type 2 diabetes mellitus - Corrected Proof

2011-12-19

Summary: Objectives: Chronic inflammation of periodontitis aggravates glycemic control in type 2 diabetic patients through aggravation of insulin resistance. Increased or decreased release of various inflammatory mediators, such as high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor (TNF)-α, interleukin (IL)-6 and adipokines, such as adiponectin, leptin, and resistin, are presumed to be responsible for developing and progressing insulin resistance. The purpose of this study was to examine the effects of periodontal treatment on glycemic control, serum inflammatory mediators and adipokines in type 2 diabetes patients with periodontitis.Methods: Twenty-one type 2 diabetic patients with periodontitis received periodontal treatment with topical antibiotics (intervention group) and 8 patients did not receive periodontal treatment (control group). Periodontal examination, including probing pocket depth (PPD) and bleeding on probing (BOP), and blood sampling were performed at baseline, 2 and 6 months after periodontal treatments. Glycated hemoglobin (HbA1c), hs-CRP, TNF-α, IL-6, adiponectin, leptin, and resistin were analyzed.Results: In the intervention group, improvements of PPD and BOP, decrease in HbA1c and elevation of serum adiponectin were observed, while in the control group, all parameters were not changed. Generalized linear model revealed that changes of serum adiponectin and TNF-α and change of BOP correlated significantly with the reduction of HbA1c at 6 months after periodontal treatments.Conclusion: The results demonstrated that periodontal treatment improves periodontal status and glycemic control with elevation of serum adiponectin in type 2 diabetic patients. The results suggest that HbA1c is reduced by amelioration of insulin resistance due to elevated serum adiponectin after periodontal treatments.

Anthropometry: A new approach to identify communal body fat status in an urban south Indian population - Corrected Proof

K.B. Kishore Mohan, V. Sapthagirivasan, M. Anburajan — 2011-12-19

Summary: Background and objectives: Deep penetration of obesity into geographical and ethnic communities based on profession is being highly evidenced by researchers. Impact of this penetration in the Indian urban population is addressed by the accepted factors of professional and cultural changes. High risk of Atherosclerosis, hyperinsulinaemia, impaired glucose tolerance; prothrombotic is not addressed by the relationship between BMI vs. body fat, while body fat plays major role in all risks. The present study attempts to prove an anthropometrical empirical formula which can be an indicator of body fat in a group, based on profession or life style.Methods: A total number of 159 (77 males of age 36.95±14.795, 82 females of age 38.07±13.16) subjects participated in the study. Body composition analysis and anthropometric measurements were performed after conducting careful clinical examination. Body fat was measured using body composition analyzer and used as a reference to justify indication of anthropometrical empirical indicator (AEI). Indicative accuracy of AEI was cross verified by male and female analysis individually.Results: Community specific mean body fat 23.15±8.47 (kg) for the mean weight of 66.05±13.46 (kg) indicated prevalence of excess 35% body fat. This much of body fat has not been addressed by mean BMI 25.56±4.66 (kg/m2).Conclusions and interpretation: Statistical relation between AEI and body fat reflects original information of risk (where as BMI does not) in the selected community. AEI outperforms the identification of obesity affected profession or life style based communities over BMI analysis.

Dietary supplementation with long chain omega-3 polyunsaturated fatty acids and weight loss in obese adults - Corrected Proof

Irene A. Munro, Manohar L. Garg — 2011-12-15

Summary: Background: Obesity is associated with elevated levels of inflammation and metabolic abnormalities, with increased risk of developing insulin resistance, type 2 diabetes, stroke and CVD. Nutrients that can assist in weight loss may also reduce the risk of obesity related co-morbidities.Aim: The aim of this study was to investigate whether LCn-3PUFA, combined with a reduced energy diet, facilitated weight loss and improvements in blood lipids and inflammatory mediators.Design: A double blind randomised controlled trial with two parallel groups. Both groups followed a low energy diet for 12weeks, one group consumed 6×1g capsules/d monounsaturated oil (Placebo) (n=18), the other 6×1g capsules/d LCn-3PUFA (fish oil) (n=17). Fasting blood samples, anthropometric measurements and 3-day food diaries were collected at baseline and post intervention.Results: There was a two-fold increase in plasma levels of EPA and DHA in the fish oil group (p<0.001). There were no significant difference within and between the placebo and the fish oil groups for weight reduction (3.37% and 4.35% respectively), fat mass reduction (8.95% and 9.76% respectively), or changes in inflammatory biomarkers and blood lipids apart from triglycerides, reduced by 27% in fish oil group (p<0.05). For fish oil group there were significant correlations between leptin and weight loss (p=0.01) and leptin and EPA and DHA (p<0.05 for both).Conclusion: Dietary LCn-3PUFA supplementation during a weight loss program does not appear to assist weight loss. Poor dietary compliance may be a contributing factor in accurate assessment of the role of these fatty acids in weight loss.

Intraperitoneal administration attenuates thiazolidinedione-induced hepatic steatosis in KKAy mice with increased hepatic peroxisome proliferator-activated receptor (PPAR)γ mRNA expression - Corrected Proof

2011-12-02

Summary: Background: The pathogenesis of thiazolidinediones (TZDs)-induced hepatic steatosis in genetically obese diabetic mice has not been fully clarified. We herein examined the effects of pioglitazone treatment on liver histology.Methods: To investigate TZDs-induced hepatic steatosis, KKAy mice were treated with pioglitazone orally or by intraperitoneal injection.Results: Orally administered pioglitazone at 15 and/or 50mg/kg/day worsened the hepatic steatosis in KKAy mice, however, the treatment at 50mg/kg/day was not worse than that at 15mg/kg/day. The basal expression of peroxisome proliferator-activated receptor (Ppar)γ mRNA in the liver was upregulated to approximately 10% of that in white adipose tissue in these mice. Although no induction of hepatic Pparg mRNA by pioglitazone treatment was observed, the mRNA expression of the downstream lipogenic enzymes significantly increased. On the other hand, intraperitoneal administration of 15mg/kg/day did not lead to deterioration of the hepatic steatosis of KKAy mice. Moreover, intraperitoneal administration led to an accompanying shift of fat distribution from intra-abdominal to subcutaneous adipose depots, and further increases in the serum adiponectin levels. In addition, a 5 day treatment without any change in body weight led to an obvious improvement in hepatic steatosis.Conclusions: Intraperitoneal administration of pioglitazone can act more strongly on intra-abdominal adipose tissues, and attenuates TZDs-induced hepatic steatosis in KKAy mice. The present study suggests that hepatic steatosis due to chronic treatment with TZDs is affected by the balance between endogenous lipogenesis in the liver and the lipid storage in adipose tissues, both occurring through PPARγ.

Both eating till feeling full and rapid eating are associated with clustering of psychosomatic problems and preference for strong tastes - Corrected Proof

Shiun Dong Hsieh, Takashi Muto, Toshio Murase, Hiroshi Tsuji, Yasuji Arase — 2011-11-28

Summary: Background: Both eating till feeling full and eating rapidly may increase metabolic risk factors including obesity. The associations of such habits with psychosomatic problems and preference for strong tastes require further exploration.Methods: The associations between various eating behaviors and 12 psychosomatic problems (mental burden, sleep disorder, tendency to palpitation, diarrhea, pessimism, amnesia, anger, poor personal relationship, fatigue, epigastric distress, shoulder stiffness, and lumbago), and preference for strong tastes were compared in 8240 men and 2955 women who underwent routine health examinations. The subjects were divided into four groups defined by subjective reporting – G1: not eating till feeling full and not eating rapidly; G2: eating till feeling full only; G3: eating rapidly only; G4: eating both rapidly and till feeling full.Results: Compared to G1, the age-adjusted odds ratios were significantly higher in G2–G4 for mental burden [1.17 (1.01–1.35), 1.26 (1.14–1.41), 1.50 (1.31–1.73) in men; and 1.28 (1.003–1.62), 1.50 (1.21–1.85), 1.94 (1.50–2.51) in women], and for 8, 8, 11 items in men and 9, 6, 11 items in women among 11 psychosomatic problems other than mental burden, and for preference for strong tastes [2.25 (1.91–2.64), 1.89 (1.67–2.14), 3.36 (2.89–3.91) in men; and 3.26 (2.34–4.51), 2.88 (2.10–3.93), 5.59 (4.02–7.78) in women].Conclusions: Both eating till feeling full and eating rapidly are associated with mental burden, clustering of psychosomatic problems and a preference for strong tastes. Mental consultation and attention to choosing mild tasting foods may alleviate such eating behaviors and improve health.

Effects of regular exercise and nutritional guidance on body composition, blood pressure, muscle strength and health-related quality of life in community-dwelling Japanese women - Corrected Proof

2011-11-21

Summary: Objective: This study aimed to investigate the effects of 6-month regular exercise and nutritional guidance for body composition, blood pressure, muscle strength and health-related quality of life (HRQOL) in community-dwelling Japanese women aged 40–74 years.Methods: Participants were divided into an intervention group (n=48) comprising women registered for health guidance and a control group without intervention (n=66). The intervention group received 6-month exercise and nutritional guidance to modify lifestyle. Before and after the intervention period, body mass index (BMI), waist circumference, body fat percentage, blood pressure, muscle strength and HRQOL using the 36-item Short-Form Health Survey version 2 (SF-36) questionnaire were measured.Results: At baseline, no significant differences were found between intervention and control groups. Waist circumference decreased significantly in the intervention group (from 82.4 to 79.9cm) compared to the control group (from 80.5 to 79.7cm). BMI and body fat percentage also decreased significantly more in the intervention group than in the control group. General health perception, vitality and social functioning in the SF-36 showed significantly greater improvements in the intervention group than in the control group.Conclusions: Six-month regular exercise and nutritional guidance had beneficial effects on body composition and health-related quality of life especially for mental components of SF-36. Based on these findings, our intervention was expected to provide benefits to mental components of HRQOL and facilitate sustained participation and motivation in modify lifestyles. As a result, beneficial effects on body composition might also be sustained.

LST8 level controls basal p70 S6 kinase and Akt phosphorylations, and mTORC1 and mTORC2 negatively regulate each other by competing for association with LST8 - Corrected Proof

2011-10-28

Summary: LST8 is a component of both mTOR complex 1 (mTORC1) and mTOR complex 2 (mTORC2). Herein, to examine the role of LST8, a common component of mTOR complexes, in the regulation of mTORC1 and mTORC2, first, we showed over-expression of LST8 in HepG2 to markedly enhance basal phosphorylation levels of not only p70 S6 kinase but also Akt. In contrast, LST8 knockdown by siRNA in HepG2 decreased phosphorylation levels of both p70 S6 kinase and Akt. These results indicate the LST8 expression level to determine basal mTORC1 and mTORC2 activities, since LST8 appears to be the component present at the lowest level in both mTORC1 and mTORC2 complexes.Previously, we reported S6 kinase phosphorylation to be reduced by over-expression of the Cterminally deleted Raptor mutant (Raptor-ΔCT) not binding to mTOR or LST8, while phosphorylation levels of Akt were markedly enhanced with no alteration in IRS-1 phosphorylation or PI 3-kinase activity. Using Raptor-ΔCT, we investigated the competition for association with LST8 between mTORC1 and mTORC2. Over-expression of Raptor-ΔCT abolished formation of the Raptor, S6 kinase, mTOR and LST8 complex, while the amount of LST8 in the Rictor–mTOR complex was increased. Therefore, it is likely that Raptor–mTOR and Rictor–mTOR complexes compete for association with LST8, and this mechanism may contribute to the reciprocal negative regulations of mTORC1 and mTORC2 activities, in terms of their LST8 components.

Weight loss improves serum mediators and metabolic syndrome features in android obese subjects - Corrected Proof

Ching-Ya Chou, Hui-Fen Lang, Wanye Huey-Herng Sheu, Jin-Yuarn Lin — 2011-10-26

Summary: Serum anti-/pro-inflammatory molecules such as adiponectin, IL-6, IL-10, and TNF-α, and metabolic syndrome (Met Syn) features in 15 android obese (6 Met Syn and 9 non-Met Syn) subjects were assessed during an 8-week weight control program. The results showed that the body mass index, weight, lean body mass, triglyceride, total cholesterol/high density lipoprotein cholesterol ratio, and TNF-α in Met Syn subjects were significantly (P<0.05) improved. This study suggests that weight reduction in android obese subjects may be beneficial in reducing cardiovascular diseases via improving serum IL-6 and TNF-α levels, as well as Met Syn features.

Predicting success: Factors associated with weight change in obese youth undertaking a weight management program - Corrected Proof

Kimberley A. Baxter, Robert S. Ware, Jennifer A. Batch, Helen Truby — 2011-10-24

Summary: Objective: To explore which baseline physiological and psychosocial variables predict change in body mass index (BMI) z-score in obese youth after 12 weeks of a dietary weight management study.Methods: Participants were obese young people participating in a dietary intervention trial in Brisbane Australia. The outcome variable was change in BMI z-score. Potential predictors considered included demographic, physiological and psychosocial parameters of the young person, and demographic characteristics of their parents. A multivariable regression model was constructed to examine the effect of potential predictive variables.Results: Participants (n=88) were predominantly female (69.3%), and had a mean(standard deviation) age of 13.1(1.9) years and BMI z-score of 2.2(0.4) on presentation. Lower BMI z-score (p<0.001) and insulin resistance (p=0.04) at baseline, referral from a paediatrician (p=0.02) and being more socially advantaged (p=0.046) were significantly associated with weight loss. Macronutrient distribution of diet and physical activity level did not contribute.Conclusions: Early intervention in obesity treatment in young people improves likelihood of success. Other factors such as degree of insulin resistance, social advantage and referral source also appear to play a role. Assessing presenting characteristics and factors associated with treatment outcome may allow practicing clinicians to individualise a weight management program or determine the ‘best-fit’ treatment for an obese adolescent.

Reducing obesity related chronic disease: Global policy development and actions from New Zealand - Corrected Proof

Elaine Rush — 2011-10-24

Participants at the two-day inaugural UN summit on NCDs, hosted by the General Assembly, have adopted a declaration and called for a multi-pronged campaign by governments, industry and civil society and to set up by 2013 the plans needed to curb the risk factors behind the four groups of NCDs – cardiovascular diseases, cancers, chronic respiratory diseases and diabetes.

Association between obesity and various parameters of physical fitness in Korean students - Corrected Proof

Jae-Woo Kim, Dong-il Seo, B. Swearingin, Wi-Young So — 2011-10-14

Summary: The purpose of this study was to evaluate the association between the types of obesity classified according to the body mass index (BMI) and/or waist circumference (WC) and the various parameters of physical fitness in Korean college students. BMI, WC, and fitness assessments were performed on 726 male college student volunteers who visited a public health center in Seoul, Korea. Classification based on BMI and/or WC was established according to the data in the WHO's Asia-Pacific standard report, and the subjects were divided into the following 4 groups: (1) obese as determined by BMI, but not WC (BMI Obesity Group, BOG); (2) obese as determined by WC, but not BMI (WC Obesity Group, WOG); (3) obese as determined by both BMI and WC (BWOG); and (4) non-obese normal group (NG). Fitness assessment parameters such as cardiorespiratory endurance, cardiovascular function, muscular endurance, muscular strength, flexibility, power, agility, and balance were evaluated through the following measurements: time required to run 1.5km, physical efficiency index (PEI), vital capacity (ℓ), push-ups (reps/2min), sit-ups (reps/2min), back strength (kg), grip strength (kg), sit and reach distance (cm), vertical jumps (cm), whole body reaction time (ms), side steps (reps/30s), and maximum time of standing on 1 foot with closed eyes (s). The odds ratios (OR) (95% confidence interval [CI]) of the BOG and WOG for the 1.5-km run were 0.367 (0.192–0.701) and 0.168 (0.037–0.773), respectively; of the BWOG and WOG for vital capacity were 5.900 (1.298–26.827) and 5.364 (1.166–24.670), respectively; of the BOG for push-ups was 0.517 (0.279–0.959); of the WOG for back strength was 0.206 (0.045–0.945); of the BWOG and BOG for grip strength were 5.973 (1.314–27.157) and 2.036 (1.089–3.807), respectively; and of the BOG for the whole body reaction time was 0.405 (0.212–0.774), as compared to the NG. We conclude that all 3 types of obesity (classified into the BWOG, BOG, and WOG) result in reduced cardiorespiratory and muscular endurance, but increased muscular strength and vital capacity.

Serum leptin concentrations in Mongolian women - Corrected Proof

Qimuge Suyila, Hongwei Cui, Ling Yang, Lingyan Zhao, Ruifang Zhang, Xiulan Su — 2011-10-13

Summary: Objective: The aim of our study is to elucidate the association between leptin and obesity in Mongolian women.Method: Total 181 women participated in the study including 118 Mongolians and 63 Han. Body mass index (BMI) was calculated by weight (kg) divided by square height (m2). Percent body fat (%fat) was detected by bioelectrical impedance analysis (BIA). Fasting serum leptin was determined by ELISA.Result: The average BMI and %fat of Mongolian and Han women was 25.14±4.48kg/m2, 24.30±3.62kg/m2 and 36.10±6.23%, 33.84±5.98%, respectively. Fasting serum leptin level in obese women (BMI≥25) was remarkably higher than in normal weight women (18.5

Effects of body weight reduction on cardio-ankle vascular index (CAVI) - Corrected Proof

2011-10-07

Summary: Objective: Obesity is associated with type 2 diabetes, dyslipidemia and hypertension, contributing to atherogenesis. Weight reduction is the fundamental therapy for obesity. Recently, a novel arterial stiffness parameter called cardio-ankle vascular index (CAVI) has been developed. We hypothesized that CAVI may be a candidate marker of increased vascular stiffness in obese patients. The aim of this study is to investigate the effect of weight reduction on CAVI.Subjects and methods: Using CAVI as an indicator, we assessed the changes in arterial stiffness in 47 obese Japanese subjects (aged 46±13 years) who underwent a 12-week weight reduction program consisting of a calorie restriction diet (20–25kcal/day) and exercise therapy. Visceral fat area (VFA) was evaluated by CT.Results: At baseline, CAVI correlated positively with age (r=0.70), blood pressure (r=0.23), VFA (r=0.26) and HbA1c (r=0.39). After 12 weeks of weight reduction, mean BMI decreased from 33.3±7.5 to 30.7±6.4kg/m2 (p<0.0001), and mean CAVI decreased from 8.3 to 7.9 (p<0.01). The change in VFA correlated positively with change in CAVI in subjects with decrease in CAVI (r=0.47). Furthermore, change in VFA was a significant independent predictor for change in CAVI. No significant correlation was observed between change in CAVI and clinical variables such as BMI, HbA1c and lipids.Conclusion: This study demonstrated that CAVI decreased after weight reduction, and was associated with a decrease in VFA. CAVI reduction maybe a marker of improved vascular stiffness after weight reduction in subjects with visceral adiposity.

Intracellular lipid content of liver and skeletal muscle in patients with adult growth hormone deficiency without diabetes mellitus - Corrected Proof

2011-10-03

Summary: Background: Insulin resistance (IR) and visceral obesity are often observed in adult growth hormone deficiency patients (AGHDs). However, there is little information regarding the intrahepatic lipid (IHL) or the intramyocellular lipid (IMCL) content and their association with IR in AGHDs. The aim of this study was to directly assess IHL and IMCL in AGHDs by proton magnetic resonance spectroscopy and to evaluate the association of lipid levels with IR.Methods: Appropriate hormone replacement therapy (RT) other than GH and estrogen was prescribed before evaluation. Ten AGHDs (aged 23–75 years) without diabetes or elevation of aminotransferases were examined the percent body fat, visceral fat area (VFA), IHL, IMCL, adipokines and glucose metabolism. In two AGHDs, changes of these parameters were evaluated after GHRT.Results: Visceral obesity and metabolic syndrome was found in 100% and in 80% of the patients, respectively. IHL was significantly higher than that in non-obese healthy controls (12.5±4.6 vs. 0.69±0.46%, M±SE, p=0.0330), while IMCL did not differ between AGHDs and controls (528.8±137.2 vs. 378±51.1mM, p=0.2728). Homeostasis model assessment of IR was significantly correlated with IHL (r=0.896, p=0.0001) and IMCL (r=0.749, p=0.0102), but not with the VFA or percent truncal fat mass. A decrease of IHL and improvement of glucose tolerance were observed in the two patients after 6M GHRT.Conclusion: These results demonstrated that IHL, but not IMCL, may increase in AGHDs, and that IHL may associate with IR. GHRT may decrease IHL along with amelioration of IR.

Predictors of retention and BMI loss or stabilization in obese youth enrolled in a weight loss intervention - Corrected Proof

2011-09-28

Summary: Objective: To evaluate predictors for intervention dropout and successful reduction of metabolic syndrome risk factors among obese children enrolled in a short-term, clinic-based weight-loss intervention.Design, setting, subjects: Retrospective database review of 1080 children 8 months to 17years. seen a pediatric obesity clinic.Interventions: Behavior modification counseling to induce change in dietary and exercise choices.Main outcome measures: (1) Pre-/post-intervention change in body mass index (BMI), waist circumference, blood pressure, glucose, insulin, and cholesterol (LDL, HDL, & total). (2) Predictors of successful decrease in BMI and clinic drop-out.Analysis: Paired t-tests for pre-/post-intervention comparisons. Linear regression to assess predictors of success and predictors of drop-out, with adjustment for age, gender, race, insurance status, and service area.Results: Among children evaluated, adolescent females were most likely to achieve successful decrease in BMI, insulin level, and LDL cholesterol post-intervention. Nearly 40% of children dropped out early in the intervention. Predictors of drop out included age <6years, public insurance status, follow-up scheduled during summer months, and residence in a tertiary service area.Conclusions: Clinic-based weight loss interventions can lead to successful improvements in BMI and other metabolic parameters in pediatric populations and may be more likely among adolescent females than in younger children or males. Drop-out is common, particularly among younger children, children with public insurance and children scheduled for follow-up in the summer. Identification of these drop-out predictors in individual patients may help in targeting children likely to succeed in short-term, clinic-based, weight-loss interventions.

Value of dual-energy X-ray absorptiometry derived parameters vs anthropometric obesity indices in the assessment of early atherosclerosis in abdominally obese men - Corrected Proof

Qiang Lu, Chun-Ming Ma, Rui Wang, Fu-Zai Yin, Chun-Mei Qin, Dong-Hui Lou, Bo Liu — 2011-09-19

Summary: Objective: The purpose of this study was to evaluate the value of dual-energy X-ray absorptiometry (DEXA) derived parameters vs anthropometric obesity indices in the assessment of early atherosclerosis in abdominally obese men.Methods: This case–control study included 44 abdominally obese men (waist circumference≥90cm) and 30 non-abdominally obese men (waist circumference<90cm) who were between 20 and 50 years of age. All subjects were of the Han ethnicity. The carotid intima-media thickness (CIMT) was used as a surrogate marker of early atherosclerosis. In the first multiple linear regression model, body fat distribution was assessed by anthropometric obesity indices, while in the second one it was quantified by DEXA-derived parameters.Results: CIMT (0.74±0.11 vs 0.67±0.04mm) were significantly higher in the abdominally obese men than in the non-abdominally obese men (P<0.01). CIMT was positively correlated with anthropometric obesity indices (r: 0.352–0.488, P<0.01) and the indices from DEXA(r: 0.244–0.482, P<0.05). The correlation coefficients of anthropometric obesity indices and the indices from DEXA were highest for waist to height ratio and trunk fat mass, respectively. In model 1, 23.8% of the total variance of CIMT was due to waist to height ratio. In model 2, trunk fat mass explained 23.2% of the total variance of CIMT.Conclusions: The present study demonstrates the importance of characterizing body fat distribution in identifying early atherosclerosis. Body fat distribution evaluated by dualenergy X-ray absorptiometry was associated with CIMT, but was not superior to anthropometric measurements.