Physical activity and pattern of blood pressure in postmenopausal women with hypertension in Nigeria

Background

Hormonal changes during menopause have been attributed to hypertension-a common public health concern. This study investigated physical activity (PA) and pattern of blood pressure (BP) in postmenopausal women newly diagnosed with hypertension and referred for treatment at the medicine outpatient clinic of a tertiary health facility in Ibadan, Oyo State, Nigeria. It compared BP pattern and adiposity variables [body mass index (BMI) and waist-hip ratio (WHR)] between two PA groups.

Methods

Purposive sampling technique was used to recruit 220 participants in this cross-sectional survey after obtaining their informed consent. International Physical Activity Questionnaire was used to assess PA level, while a 16-item questionnaire was used to assess socio-demographic and clinical profiles of the women. BP, BMI and WHR were assessed using standard measurement procedures. Descriptive statistics of mean ± standard deviation were used for data summarization and independent t-test was used to compare variables between low level and moderate to vigorous level PA groups.

Results

Participants' mean values include: age 61.6 ± 8.5 years, years since menopause 12.75± 8.15, BMI 28.63±4.99kg/m², WHR 1.11±0.08, SBP and DBP 145.9±17.9; 93.7±11.4 mmHg respectively. Mean values of SBP, DBP, BMI and WHR were higher among participants with low PA compared to those with moderate to vigorous even though the difference was not statistically significant (P>0.05).

Conclusion

Involvement in moderate to vigorous physical activities among menopausal women in Nigeria should be encouraged. This may reduce hypertension and adiposity with a possible control of cardiovascular disease risk.

The relationship between body fat mass percentiles and inflammation in children

OBJECTIVE

Obesity has been associated with markers of increased systemic inflammation in both human and animal studies. Increased inflammation is linked to metabolic and cardiovascular disease. The objective of this study was to evaluate the association between percentile body fat and inflammation in a nationally representative sample of US children.

METHODS

6,950 children 8-18 years of age between 1999 and 2004 were studied. Measurement of body fat percentage was measured by dual-energy X-ray absorptiometry scan and converted to an age- and sex-adjusted percentile. The main outcome measures were abnormal c-reactive protein (CRP > 1.0 mg/dl) and absolute neutrophil count (ANC > 6,600).

RESULTS

Children with higher levels of body fat (≥70th percentile) had a higher odds of having elevated CRP (OR 2.88-10.69) and elevated ANC (OR 2.14-3.24) compared with children with body fat <70th percentile.

CONCLUSIONS

The link between inflammation and body fat in children warrants further longitudinal research to understand the temporal relationship between overweight/obesity and inflammation in the pediatric obese population and its implications for chronic disease risk.

Adult fat content: reinterpreting and modelling the Benn Index and related sex differences

BACKGROUND

In women, the height exponent, p, of the Benn Index, (body mass)/height(p), is typically lower than in men, body masses are more weakly correlated with height and fat masses tend to be higher. In both sexes fat masses correlate only weakly with height. Changes in fat mass are typically accompanied by changes in fat-free mass.

AIMS

To integrate these facts, together with other published findings relating to fat content and to explain why p is lower in women.

METHODS

Data and statistics are taken from the literature. The differences in p are explored by Monte Carlo and algebraic modelling. Mean transverse areas of the body (MTAs), calculated as (body mass)/height, are related to height.

RESULTS AND CONCLUSIONS

The body can be modelled as consisting of a component, M1, varying roughly with the cube of height and another, M2, varying little with height. The low correlation between total body mass and height is due both to M2 and to data scatter. The low p values in women relate especially to M2. Relationships amongst height, fatness, MTAs and girths of body parts generally conform to this interpretation. Questions are raised as to how health risks are best related to fat mass.

Use of a simple liquid meal test to evaluate insulin sensitivity and beta-cell function in children

Insulin sensitivity and β-cell function are useful indices of metabolic disease risk but are difficult to assess in young children because of the invasive nature of commonly used methodology. A meal-based method for assessing insulin sensitivity and β-cell function may at least partially alleviate concerns. The objectives of this study were to: (i) determine the association of insulin sensitivity assessed by liquid meal test with that determined by an insulin-modified frequently sampled intravenous glucose tolerance test (FSIGT); (ii) examine the association of insulin sensitivity derived from each test with measures of body composition, fat distribution and metabolic health (lipids, fasting insulin and glucose, and surrogate indices of insulin sensitivity); and (iii) examine the associations of indices of β-cell function derived from each test with total and regional adiposity. Forty-seven children (7-12 years) underwent both a liquid meal test and an FSIGT. The insulin sensitivity index derived from the meal test (SI-meal) was positively associated with that from the FSIGT (SI-FSIGT; r = 0.63; P < 0.001), and inversely with all measures of insulin secretion derived from the meal test. Both SI-meal and SI-FSIGT were associated with measures of total and regional adiposity. SI-meal, but not SI-FSIGT, was associated with triglycerides and fasting insulin, after adjusting for ethnicity, gender, pubertal stage and fat mass. Basal insulin secretion measured during the meal test was positively associated with all measures of adiposity, independent of insulin sensitivity. In conclusion, a liquid meal offers a valid and sensitive means of assessing insulin sensitivity and β-cell responsivity in young children.

The relationship of oxidative stress, adiposity and metabolic risk factors in healthy Black and White American youth

What is already known about this subject African Americans are disproportionately affected by obesity and other metabolic risk factors in comparison to White Americans. Increasing prevalence of obesity has been associated with concomitant increases in childhood hypertension, dyslipidaemia and type 2 diabetes. Oxidative stress is associated with obesity in both adults and children. What this study adds Oxidative stress is positively associated with total body fat and truncal fat, but not with body mass index (BMI) or BMI z-score in healthy youth. Oxidative stress is associated with diastolic blood pressure in African American but not in White American healthy youth.

BACKGROUND

Oxidative stress is elevated in obese youth, but less is known regarding racial disparities in the relationship of oxidative stress with metabolic risk factors.

OBJECTIVES

To determine the relationship between oxidative stress and metabolic risk factors, adiposity, leptin, adiponectin and cardiovascular fitness (VO2PEAK ) in healthy African American and White American youth.

METHODS

A marker of oxidative stress (F2 -isoprostane), validated markers of metabolic risk factors, fitness and body composition were measured in African American (n = 82) and White American (n = 76) youth (8-17 years old) recruited over a range of BMI percentiles (4th to 99th).

RESULTS

F2 -isoprostane concentration was positively correlated with percentage body fat (r = 0.198) and percentage truncal fat (r = 0.173), but was not different between African American and White American males and females (P = 0.208). African American youth had significantly higher mean systolic and diastolic blood pressure (P = 0.023 and P = 0.011, respectively), body weight, BMI percentile and Tanner stage. After adjusting for gender, age, BMI and Tanner stage, African American youth varied from White Americans in the association of F2 -isoprostane with diastolic blood pressure (P = 0.047), but not with systolic blood pressure, triglycerides, VO2PEAK or homeostatic model assessment for insulin resistance (all P > 0.05).

CONCLUSIONS

Oxidative stress, as measured by urinary F2 -isoprostane concentrations, was positively associated with percent body fat and truncal fat in youth. Oxidative stress levels were similar among African American and White American youth. Among markers of the metabolic syndrome, a significant difference between African American and White American youth was demonstrated only in the association of oxidative stress with diastolic blood pressure.

Women are diagnosed with type 2 diabetes at higher body mass indices and older ages than men: Korea national health and nutrition examination survey 2007-2010

BACKGROUND

Many epidemiologic studies have shown that women with type 2 diabetes have an increased risk of developing cardiovascular disease compared with men with diabetes. The aim of this study is to elucidate whether disparities of adiposity, age and insulin resistance (IR) at the time of diabetes diagnosis exist between women and men in the adult Korean population.

METHODS

Data from The Korea National Health and Nutrition Examination Survey, performed in Korea from 2007 to 2010, were used. In the survey, anthropometric data and blood samples were obtained during a fasting state. IR and β-cell function were calculated using the homeostasis model assessment (HOMA-IR and HOMA-β, respectvely).

RESULTS

The mean age of diabetes diagnosis was 58.5 years in women and was 55.1 years in men (P=0.015). The mean body mass index (BMI) of newly diagnosed diabetes subjects was 26.1 kg/m(2) in women and 25.0 kg/m(2) in men (P=0.001). The BMI was inversely related to age in both genders, and the higher BMI in women than men was consistent throughout all age groups divided by decade. The HOMA-IR in women with diabetes is higher than in men with diabetes (7.25±0.77 vs. 5.20±0.32; P=0.012).

CONCLUSION

Korean adult women are diagnosed with type 2 diabetes at higher BMI and older age than men and are more insulin-resistant at the time of diabetes diagnosis. This may help explain why women with diabetes have an increased risk of developing cardiovascular disease after the diagnosis of diabetes, compared to men.

Uncoupling protein 2 gene polymorphisms in association with overweight and obesity susceptibility: A meta-analysis

A meta-analysis was performed to evaluate the associations of uncoupling protein 2 (UCP2) gene polymorphisms (Ala55Val, 45-bp insertion/deletion, and -866G/A) with overweight and obesity. A total of 42 studies were included in our analysis. Pooled effect estimates and 95% confidential intervals of each polymorphism were calculated under different inherited models. Fixed or random effect model was selected based on the between-study heterogeneity evaluated with I². Source of heterogeneity was explored by subgroup analysis and meta-regression analysis. Potential publication bias was assessed using funnel plot and Peters test. After excluding studies that deviated from the Hardy–Weinberg equilibrium, T allele of Ala55Val polymorphism was associated with an increased risk of overweight and obesity under recessive model in the overall (OR = 1.24, 95%CI = 1.06–1.45) and Asian (OR = 1.28, 95%CI = 1.06–1.55) populations; and A allele of -866G/A polymorphism had a protective effect on overweight and obesity, especially for European populations (dominant model: OR = 0.88, 95%CI = 0.81–0.96, co-dominant 1 model: OR = 0.89, 95%CI = 0.81–0.98, co-dominant 2 model: OR = 0.85, 95%CI = 0.74–0.94, additive model: OR = 0.88, 95%CI = 0.80–0.95, and allelic model: OR = 0.91, 95%CI = 0.86–0.97). No evidence was observed in the association of 45-bp insertion/deletion polymorphism with overweight and obesity susceptibility. We failed to fully explore the between-study heterogeneity regarding the association of Ala55Val polymorphism with overweight and obesity. Further studies are required to provide more convincing evidence.

•

We evaluated the association of UCP2 gene polymorphisms with overweight and obesity.

•

Ala55Val polymorphism was associated with an increased risk in Asian populations.

•

No association was observed for 45-bp insertion/deletion polymorphism.

•

-866G/A polymorphism was associated with a decreased risk in European populations.

Employment status, depressive symptoms, and waist circumference change in midlife women: the Study of Women's Health Across the Nation (SWAN)

PURPOSE

Changes in employment status have shown inconsistent associations with adiposity. This study tested whether the presence of elevated depressive symptoms explains variability in the time-varying association between employment status and central adiposity.

METHOD

Employment status, depressive symptoms, and waist circumference (WC) were assessed annually over 10 years in a multiethnic sample of 3220 midlife women enrolled in the Study of Women's Health Across the Nation. Linear mixed-effects models tested time-varying associations of employment status, depressive symptoms, and their interaction with WC.

RESULTS

WC increases were greatest during the years of combined nonemployment and elevated depressive symptoms (1.00 cm/y) and lowest in the years of full-time employment and elevated depressive symptoms (0.25 cm/y), compared with the years of full-time employment and nonelevated depressive symptoms (0.51 cm/y). Employment status was unrelated to WC in years without elevated depressive symptoms. The pattern of results was unchanged when analyses were restricted to preretirement observations and did not vary according to WC at baseline or ethnicity/race.

CONCLUSIONS

Identifying and managing depressive symptoms in midlife women who are not working may help prevent increases in central adiposity.

Association of vitamin D with adiposity measures and other determinants in a cross-sectional study of Cypriot adolescents

OBJECTIVE

To assess vitamin D status among Cypriot adolescents and investigate potential determinants including BMI and body fat percentage (BF%).

DESIGN

Participants had cross-sectional assessments of serum vitamin D, physical activity, dietary vitamin D intake and sun exposure. Linear and logistic regression models were used to explore the associations of vitamin D with potential predictors.

SETTING

Hospitals, Cyprus, November 2007-May 2008.

SUBJECTS

Adolescents (n 671) aged 16-18 years.

RESULTS

Mean serum vitamin D was 22·90 (sd 6·41) ng/ml. Only one in ten children had sufficient levels of vitamin D (≥30 ng/ml), while the prevalence of vitamin D deficiency (12-20 ng/ml) and severe deficiency (<12 ng/ml) was 31·7 % and 4·0 %, respectively. Lower vitamin D was associated with winter and spring season, female gender, reduced sun exposure in winter and darker skin. Participants with highest BMI and BF% when compared with a middle reference group had increased adjusted odds of vitamin D insufficiency (OR = 3·00; 95 % CI 1·21, 7·45 and OR = 5·02; 95 % CI 1·80, 13·97, respectively). A similar pattern, although not as strong, was shown for vitamin D deficiency with BF% (OR = 1·81; 95 % CI 1·04, 3·16) and BMI (OR = 1·51; 95 % CI 0·85, 2·67). Participants in the lowest BMI and BF% groups also displayed compromised vitamin D status, suggesting a U-shaped association.

CONCLUSIONS

Vitamin D deficiency in adolescence is very prevalent in sunny Cyprus, particularly among females, those with darker skin and those with reduced sun exposure in winter. Furthermore, vitamin D status appears to have a U-shaped association with adiposity measures.

Metabolic effects of a high-fat diet post-weaning after low maternal dietary folate during pregnancy and lactation

SCOPE

Investigate the influence of low-folate supply during pregnancy and lactation on obesity and markers of the metabolic syndrome in offspring, and how provision of a high-fat diet post weaning may exacerbate the resultant phenotype.

METHODS AND RESULTS

Female C57Bl/6 mice were randomized to low or normal folate diets (0.4 or 2 mg folic acid/kg diet) prior to and during pregnancy and lactation. At 4 wk of age, offspring were randomized to high- or low-fat diets, weighed weekly and food intake assessed at 9 and 18 wk old. Adiposity was measured at 3 and 6 months. Plasma glucose and triacylglycerol (TAG) concentrations were measured at 6 months. Maternal folate supply did not influence adult offspring body weight or adiposity. High-fat feeding post weaning increased body weight and adiposity at 3 and 6 months (p > 0.001). Maternal low folate lowered plasma glucose (p = 0.010) but increased plasma TAG (p = 0.048). High-fat feeding post weaning increased plasma glucose and TAG (p = 0.023, p = 0.049 respectively). Offspring from folate-depleted (but not folate-adequate) dams had 30% higher TAG concentration when fed the high-fat diet from weaning (p = 0.005 for interaction).

CONCLUSION

Inadequate maternal folate intake has long-term effects on offspring metabolism, manifested as increased circulating TAG, particularly in offspring with high-fat intake post weaning.

The influence of aging on the association between adiposity and bone mineral density in Jordanian postmenopausal women

The objective of this study was to assess the relative association between body weight, body mass index (BMI), lean mass (LM) and fat mass (FM), and bone mineral density (BMD) in a group of Jordanian postmenopausal women and investigate if this possible association changes with age. A total of 3256 patients had dual-energy X-ray absorptiometry (DXA) scan in the period from January 2009 till January 2012 at the Radiology and Nuclear Medicine Department of Jordan University Hospital. Only 584 women met the selection criteria. Age has been recorded, and patients were divided into subgroups according to age. Body weight and height were measured, and BMI was calculated. Body composition (LM, FM, percentage of android fat, and percentage of gynoid fat) was assessed by DXA. BMD of the lumbar spine (L1-L4) and femoral neck was measured by DXA. Weight, BMI, FM, LM, percentage of android fat, and percentage of gynoid fat were positively correlated to BMD at both lumbar spine and femoral neck. However, this correlation disappeared at the age of 70 yr at lumbar spine and 75 yr at femoral neck. This study suggests that both FM and LM are important determinants of BMD in Jordanian postmenopausal women, and this correlation disappears after the age of 70 yr at lumbar spine and 75 yr at femoral neck.

Changes in metabolite profiles caused by genetically determined obesity in mice

The Berlin Fat Mouse Inbred (BFMI) line harbors a major recessive gene defect on chromosome 3 (jobes1) leading to juvenile obesity and metabolic syndrome. The present study aimed at the identification of metabolites that might be linked to recessively acting genes in the obesity locus. Firstly, serum metabolites were analyzed between obese BFMI and lean B6 and BFMI × B6 F₁ mice to identify metabolites that are different. In a second step, a metabolite-protein network analysis was performed linking metabolites typical for BFMI mice with genes of the jobes1 region. The levels of 22 diacyl-phosphatidylcholines (PC aa), two lyso-PC and three carnitines were found to be significantly lower in obese mice compared with lean mice, while serine, glycine, arginine and hydroxysphingomyelin were higher for the same comparison. The network analysis identified PC aa C42:1 as functionally linked with the genes Ccna2 and Trpc3 via the enzymes choline kinase alpha and phospholipase A2 group 1B (PLA2G1B), respectively. Gene expression analysis revealed elevated Ccna2 expression in adipose tissue of BFMI mice. Furthermore, unique mutations were found in the Ccna2 promoter of BFMI mice which are located in binding sites for transcription factors or micro RNAs and could cause differential Ccna2 mRNA levels between BFMI and B6 mice. Increased expression of Ccna2 was consistent with higher mitotic activity of adipose tissue in BFMI mice. Therefore, we suggest a higher demand for PC necessary for adipose tissue growth and remodeling. This study highlights the relationship between metabolite profiles and the underlying genetics of obesity in the BFMI line.

Poor sleep quality potentiates stress-induced cytokine reactivity in postmenopausal women with high visceral abdominal adiposity

Sleep disturbance is a key behavioral risk factor for chronic medical conditions observed at high rates among overweight and obese individuals. Systemic inflammation, including that induced by stress, may serve as a common biological mechanism linking sleep, adiposity, and disease risk. To investigate these relationships, 48 postmenopausal women (mean age=61.8) completed a standardized laboratory stress task during which time blood was collected at baseline and 30, 50 and 90+ min after stressor onset to assess circulating levels of interleukin (IL)-6, IL-10, and IL-6/IL-10 ratio. Self-reported global sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) while adiposity was estimated by body mass index. Sagittal diameter was obtained in clinic to estimate visceral abdominal adiposity. Multi-level growth curve models revealed that poorer self-reported sleep quality was associated with greater stress-induced increases in IL-6/IL-10 ratio. In terms of adiposity, higher sagittal diameter, but not BMI, was associated with greater IL-6 reactivity (p's<0.05). Further, associations between sleep quality and cytokine reactivity varied as a function of sagittal diameter. Among poor sleepers (1 SD above mean of PSQI score), stress-induced increases in IL-6 and IL-6/IL-10 ratio were significantly steeper in those with high visceral adiposity (1 SD above the mean of sagittal diameter) compared to those with low visceral adiposity (1 SD below the mean of sagittal diameter). In sum, poorer sleep quality and greater visceral adiposity, separately and especially in combination, are associated with greater stress-related increases in systemic inflammation. This research may help elucidate the complex link between sleep, obesity and inflammatory disease risk.

Physical activity growth curves relate to adiposity in adolescents

PURPOSE

Findings from prospective studies on associations between physical activity and adiposity among youth are inconsistent. Our aim was to describe physical activity trajectories during secondary school and examine the association with change in adiposity in youth.

METHODS

Physical activity was measured in 20 survey cycles from 1999 to 2005; anthropometrics were measured in survey cycles 1, 12, and 19. Individual growth curves modeling moderate-to-vigorous physical activity (MVPA) and vigorous physical activity (VPA) were estimated. Estimates of initial level and rate of decline in MVPA and VPA bouts per week were included as potential predictors of body fat% and body mass index using age- and sex-specific linear regression.

RESULTS

Complete data were available for 840 and 760 adolescents aged 12-13 years at baseline, followed from survey cycles 1-12 and 12-19, respectively. Among girls, yearly declines of one MVPA and one VPA bout per week during earlier adolescence were associated with increases of 0.19 (95% confidence interval [CI], 0.02-0.36) and 0.47 (95% CI, 0.015-0.92) units of body fat%, respectively. In boys, a yearly decline of one MVPA bout per week was associated with an increase of 0.38 (95% CI, 0.05-0.70) units of body fat% during later adolescence.

CONCLUSIONS

Obesity prevention programs should include strategies to prevent declines in physical activity.

The Influence of Energetic Factors on Biomarkers of Postmenopausal Breast Cancer Risk

Strong and consistent evidence exists that physical activity reduces breast cancer risk by 10-25 %, and several proposed biologic mechanisms have now been investigated in randomized, controlled, exercise intervention trials. Leading hypothesized mechanisms relating to postmenopausal breast cancer include adiposity, endogenous sex hormones, insulin resistance, and chronic low-grade inflammation. In addition, other pathways are emerging as potentially important, including those involving oxidative stress and telomere length, global DNA hypomethylation, immune function, and vitamin D exposure. Recent exercise trials in overweight/obese postmenopausal women implicate weight loss as a mechanism whereby exercise induces favorable changes in circulating estradiol levels and other biomarkers as well. Still it is plausible that some exercise-induced biomarker changes do not require loss of body fat, whereas others depend on abdominal fat loss. We highlight the latest findings from randomized, controlled trials of healthy postmenopausal women, relating exercise to proposed biomarkers for postmenopausal breast cancer risk.

The relationship between visceral adiposity and left ventricular diastolic function: results from the Baltimore Longitudinal Study of Aging

BACKGROUND AND AIMS

It is unclear whether subcutaneous and visceral fat are differentially correlated to the decline in left ventricular (LV) diastolic function with aging. This study sought to examine the hypothesis that age-related changes in the regional fat distribution account for changes in LV diastolic function and to explore potential mediators of this association.

METHODS AND RESULTS

In this cross-sectional study, we evaluated 843 participants of the Baltimore Longitudinal Study of Aging with echocardiogram, dual-energy X-ray absorptiometry (DEXA), abdominal computed tomography (CT) and blood tests performed at the same visit. LV diastolic function was assessed by parameters of LV relaxation (E/A ratio, Em and Em/Am ratio) and LV filling pressures (E/Em ratio). Total body fat was computed by DEXA, while visceral and subcutaneous fat were determined from abdominal CT. In multivariate models adjusted for demographics, cardiovascular risk factors, antihypertensive medications, physical activity and LV mass, both visceral and subcutaneous fat were associated with LV diastolic dysfunction. When both measures of adiposity were simultaneously included in the same model, only visceral fat was significantly associated with LV diastolic dysfunction. Triglycerides and sex-hormone binding globulin, but not adiponectin and leptin, were found to be significant mediators of the relationship between visceral fat and LV diastolic function, explaining 28-47% of the association. Bootstrapping analyses confirmed the significance of these findings.

CONCLUSIONS

Increased visceral adiposity is associated with LV diastolic dysfunction, possibly through a metabolic pathway involving blood lipids and ectopic fat accumulation rather than adipokines.

Anthropometric indices and selenium status in British adults: the U.K. National Diet and Nutrition Survey

Recent studies have raised concern over possible associations between high selenium (Se) status and excess adiposity, known to be linked to adverse cardiometabolic outcomes. Studies of Se status in relation to adiposity are scarce in the United Kingdom. This study examined cross-sectional associations of anthropometric indices with Se-status biomarkers in a nationally representative sample of 1045 (577 female, 468 male) British Caucasian adults ages 19-64 who participated in the 2000-2001 National Diet and Nutrition Survey. Median (first, third quartile) values for whole-blood glutathione peroxidase (GPx) activity and plasma and erythrocyte Se concentrations were 120.0 (103.0, 142.4) nmol mg Hb(-1) min(-1), 1.08 (0.98, 1.20) µmol/L, and 1.62 (1.38, 1.91) µmol/L, respectively. For males, values were 119.0 (100.0, 141.0) nmol mg Hb(-1) min(-1), 1.09 (0.99, 1.22) µmol/L, and 1.54 (1.34, 1.79) µmol/L, respectively; for females 121.0 (105.0, 145.0) nmol mg Hb(-1) min(-1), 1.07 (0.97, 1.18) µmol/L, and 1.71 (1.43, 1.99) µmol/L, respectively. Multivariate adjusted mean differences (95% CI) in whole-blood GPx between the highest (>30 kg/m(2)) and the lowest (<25 kg/m(2)) categories of body mass index and the highest (96.5-139.2 cm) and the lowest (52.2-78.1cm) quartiles of waist circumference (WC) were -7.9 (-13.2, -2.7) and -9.7 (-16.2, -3.2) nmol mg Hb(-1) min(-1), respectively. Difference (95% CI) in plasma Se between the third (87.5-96.4 cm) and the lowest quartiles of WC was -0.04 (-0.08, -0.03) µmol/L. Difference (95% CI) in red blood cell (RBC) Se between the highest (0.91-1.11) and the lowest (0.53-0.76) quartiles of waist-to-hip ratio (WHR) was 0.10 (0.00, 0.20) µmol/L. Similar results were observed in gender and menopausal-status subgroup analyses. The inverse association between plasma Se and WC and the positive association between RBC Se and WHR will need confirmation. The findings suggest associations between low whole-blood GPx activity and higher measures of general and central adiposity. Further experimental and randomized studies are needed to deduce the mechanisms and infer causality.

Adiposity and the relationship between vitamin D and blood pressure

OBJECTIVE

Circulating vitamin D (25OHD) concentrations are negatively associated with blood pressure (BP) but little is known about the mechanisms for this relationship. Adiposity is positively associated with BP and inversely with circulating 25OHD concentrations but no studies have assessed the relationship between plasma 25OHD and adiposity on BP. The goal of this study is to investigate if the association between plasma 25OHD and BP is mediated by adiposity.

MATERIALS/METHODS

The relationship between plasma 25OHD, systolic and diastolic BP, and adiposity [BMI, waist circumference, visceral adipose tissue (VAT)] was assessed in a multi-ethnic cross-sectional study of Aboriginal (n=151), Chinese (n=190), European (n=170), and South Asian (n=176) participants by linear regression models.

RESULTS

Plasma 25OHD concentrations were negatively associated with systolic (standardized B=-0.191, P<0.001) and diastolic BP (standardized B=-0.196, P<0.001) in models adjusted for age, sex, ethnicity, family history of CVD, smoking status, alcohol consumption, and physical activity. The negative relationship between plasma 25OHD concentrations and systolic and diastolic BP was attenuated after the addition of BMI, waist circumference, and VAT to the models, but the relationship remained significant. Plasma 25OHD concentrations accounted for 0.7% and 0.8% of the variance in systolic and diastolic BP, respectively.

CONCLUSION

These findings suggest that the relationship between vitamin D and BP is independent of adiposity. Further studies are required to determine the mechanisms by which vitamin D affects BP.

Calibration of a semi-automated segmenting method for quantification of adipose tissue compartments from magnetic resonance images of mice

OBJECTIVE

To use an automated water-suppressed magnetic resonance imaging (MRI) method to objectively assess adipose tissue (AT) volumes in whole body and specific regional body components (subcutaneous, thoracic and peritoneal) of obese and lean mice.

MATERIALS/METHODS

Water-suppressed MR images were obtained on a 7T, horizontal-bore MRI system in whole bodies (excluding head) of 26 week old male C57BL6J mice fed a control (10% kcal fat) or high-fat diet (60% kcal fat) for 20 weeks. Manual (outlined regions) versus automated (Gaussian fitting applied to threshold-weighted images) segmentation procedures were compared for whole body AT and regional AT volumes (i.e., subcutaneous, thoracic, and peritoneal). The AT automated segmentation method was compared to dual-energy X-ray (DXA) analysis.

RESULTS

The average AT volumes for whole body and individual compartments correlated well between the manual outlining and the automated methods (R2>0.77, p<0.05). Subcutaneous, peritoneal, and total body AT volumes were increased 2-3 fold and thoracic AT volume increased more than 5-fold in diet-induced obese mice versus controls (p<0.05). MRI and DXA-based method comparisons were highly correlative (R2=0.94, p<0.0001).

CONCLUSIONS

Automated AT segmentation of water-suppressed MRI data using a global Gaussian filtering algorithm resulted in a fairly accurate assessment of total and regional AT volumes in a pre-clinical mouse model of obesity.

Association between anxiety and obesity: A study of a young-adult Nigerian population

Background:

The relationship between anxiety and obesity is still debatable and seems to vary between cultures. The subject has been scarcely investigated in Nigeria, hence this study.

Materials and Methods:

A total of 1584 young-adult Nigerians (56.4% males) of mean age 21.8 ± 2.2 years were studied. Anxiety was assessed using the Beck's Anxiety Index (BAI), while obesity was determined using the bioelectrical impedance analysis (BIA) and body mass index (BMI) methods. Standard protocols were followed for all assessments and measurements. Appropriate descriptive statistics were carried out, while regression and correlation analyses (for continuous variables) and the Chi square tests (for categorical variables) were used to assess the relationship between anxiety and obesity.

Results:

The degree of adiposity of the subjects (males and females alike) classified by %BF standards did not significantly (P > 0.05) affect the proportion of the population with any degree of anxiety. The proportion of population with high anxiety (for both sexes) was similar (P > 0.05) irrespective of their BMI status. All the obese (BMI-wise only) males had low anxiety, while the proportion of thin females (in the low anxiety group) was significantly (P < 0.05) higher than that of their normal weight counterparts. There was neither a significant correlation nor a significant association (P > 0.05) between the BAI scores and the studied measures of adiposity in both male and female subjects.

Conclusion:

The low prevalence of both anxiety and obesity in the studied population may explain the observed lack of association between the studied variables. These findings do not support the “jolly fat” hypothesis.

Lean NASH: distinctiveness and clinical implication

INTRODUCTION

Non-alcoholic fatty liver (NAFL) in the absence of overweight and/or obesity, defined by the anthropometric parameter, body mass index (BMI), has been designated as 'lean NASH.' While maintaining a close pathophysiological link with metabolic syndrome (MS) and insulin resistance (IR), the presence of subtle alterations in measures of total body and regional adiposity not exceeding the designed cut-offs, are hallmarks of 'lean NASH.'

MATERIAL AND METHODS

Available literature related to non-alcoholic steatohepatitis (NASH) in lean or non-obese individuals and its pathogenesis in general published in English language journals till the time of manuscript preparation were reviewed and critically analysed.

ANALYSIS

Being a closely related but variant phenotype of NASH, its features metabolically resemble the well-characterized entity 'metabolically obese normal weight (MONW)' individuals. Apart from total body adiposity, distribution of fat in different body compartments has assumed greater pathophysiologic relevance in characterizing 'lean NASH'. Detection of NASH in stringently defined non-obese individuals, by both BMI and waist circumference indices, indicates existence of a subset of NASH in which fat compartmentalization at ectopic sites is not picked up by the anthropometric yardsticks used. Volume [Quantity] and biological behavior of the visceral and deep subcutaneous adipose tissues contribute to this variant of NASH in non-obese subjects. Genetic predisposition to IR and MS along with the environmental influences like childhood nutritional status, dietary composition and gut microbiome possibly play pathogenetic role.

CONCLUSION

The most important concern is in the principles of nomenclature within syndromes where clinical dissimilarities exist despite biological similarities. Till a uniformly acceptable pathophysiological and/or etiology-based classification emerges, the term "lean NASH" would continue to provide us an opportunity to ponder over and refine this subset of fatty liver in non-obese people and potentially significant liver disease.

Validity of the methods to assess body fat in children and adolescents using multi-compartment models as the reference method: a systematic review

OBJECTIVE

To analyze the validity of methods to assess body fat in children and adolescents using a systematic review.

METHODS

The search was conducted by two independent researchers using the MEDLINE, BioMed Central, SciELO and LILACS electronic databases. For inclusion, the articles should be written in English or Portuguese, and must have used multi-compartment models as the criterion measure of the model, with body fat measurement of whole body in non-athlete children and adolescents.

RESULTS

A preliminary search resulted in 832 studies. After all selection steps were performed, 12 articles were included. The selected studies were published between 1997 and 2010, whose samples consisted of children and adolescents with levels of relative body fat ranging from 20.7% to 41.4%. The methods used were: dual energy X-ray absorptiometry (58.3%), isotope dilution (41.6%), skinfold thickness (33.3%), hydrostatic weighing (25%), bioelectrical impedance analysis (25%), air displacement plethysmography (16.6%), and total body electrical conductivity (8.3%).

CONCLUSIONS

Based on the analysis of the studies, isotope dilution and air displacement plethysmography methods were the most reliable, despite the limited number of studies. As for clinical use or for population-based studies, the equation of Slaughter et al. (1998), which uses the triceps and subscapular skinfolds thickness, showed the best results for assessment of body fat in this population.

Bone quality and strength are greater in growing male rats fed fructose compared with glucose

Optimization of peak bone mass during adolescence is important for osteoporosis prevention. Studies in rodents and humans have demonstrated the harmful effects of sugar intake on bone health. With the high levels of sucrose in the diets of adolescents, it is necessary to understand the influence of glucose and fructose on growing bones. This study compared the effects of dietary glucose and fructose on bone formation, microarchitecture, and strength. Because of the different metabolic effects of glucose and fructose, we hypothesized that their individual effects on bone would be different. Eighteen male Sprague-Dawley rats (age, 60 days) were randomly assigned to high-fructose (n = 9; 40% fructose, 10% glucose) or high-glucose diet (n = 9; 50% glucose) for 12 weeks. Bone measurements included histology and histomorphometry of trabecular bone in the distal femur and a 3-point bending test of the whole tibia. Whole liver mass and postprandial serum glucose, insulin, and triglycerides were used to assess differences in energy metabolism between the diets. There were no differences in food intake, body weight, or visceral adiposity between groups, but fructose consumption led to heavier livers (P = .001) and elevated serum triglycerides (P = .00). The distal femurs of fructose-fed rats had greater bone volume (bone volume/total volume; P = .03), lower bone surface (bone surface/bone volume; P = .02), and thicker trabeculae (trabecular thickness; P = .01). The tibias of the fructose-fed rats also withstood a greater maximum flexure load (P = .032). These results indicate that consumption of the high-fructose diet resulted in stronger bones with enhanced microarchitecture than consumption of the high-glucose diet.

Cardiometabolic factors and disease duration in patients with Parkinson's disease

OBJECTIVE

Previous studies have reported that patients with Parkinson's disease (PD) have a favorable cardiometabolic risk profile. The aim of this study was to investigate the relationship between cardiometabolic risk factors and the duration of disease.

METHODS

One hundred and fifty patients with PD (56.7% men) were studied, measuring body mass index (BMI), waist circumference (WC), body fat percentage (BF%) by impedance, fasting glucose, serum lipids, and transaminases.

RESULTS

In sex- and age-adjusted correlation models, duration of PD was inversely related to BMI (r = -0.20; P < 0.05) and BF% (r = -0.29; P < 0.005). Using multivariable regression models (adjustments: age, gender, smoking status, levodopa dose and, alternatively, BMI, WC, or BF%), high-density lipoprotein (HDL) levels were positively correlated with disease duration (P < 0.01 for all). In models adjusted for WC and BF%, total HDL-cholesterol ratio was also inversely associated with duration of PD (P < 0.05 for both). No other association between biochemical variables and the duration of PD was found. Moreover, no dose-response effect of levodopa on metabolic risk factors was observed.

CONCLUSIONS

HDL levels and total HDL-cholesterol ratio were favorably associated with duration of PD. This factor may contribute to cardiometabolic protection in PD. The mechanisms underlying this association deserve further investigation.

Effect of adenovirus and influenza virus infection on obesity

The purpose of this review is to provide an overview of the effects of adenovirus and influenza virus infections on obesity in various experimental models. We reviewed studies that were conducted within the past 10 years and were related to virus infection and obesity prevalence. Here, we discuss a different causal relationship between adenovirus and influenza infections with obesity. Adenovirus infection can cause obesity, whereas obesity can be a risk factor for increasing influenza virus infection and increases the risk of morbidity and mortality. The prevalence of obesity due to adenovirus infections may be due to an increase in glucose uptake and reduction in lipolysis caused by an increase in corticosterone secretion. Adenovirus infections may lead to increases in appetite by decreasing norepinephrine and leptin levels and also cause immune dysfunction. The relationship between obesity and influenza virus infection could be summarized by the following features: decreases in memory T-cell functionality and interferon (IFN)-α, IFN-β, and IFN-γ mRNA expression, increases in viral titer and infiltration, and impaired dendritic cell function in obese individuals. Moreover, leptin resistance may play an important role in increasing influenza virus infections in obese individuals. In conclusion, prevention of adenovirus infections could be a good approach for reducing obesity prevalence, and prevention of obesity could reduce influenza virus infections from the point of view of viral infections and obesity.

Role of socio-cultural factors on changes in fitness and adiposity in youth: a 6-year follow-up study

BACKGROUND AND AIMS

Optimal cardio-respiratory fitness and adiposity levels are tightly related to health in youth. We analysed changes in fitness and adiposity in young individuals from two countries, and examined the role of maternal education in these changes.

METHODS AND RESULTS

A 6-year follow-up study was conducted on 483 Estonian children (9 years) and 466 Swedish children (9-10 years) and adolescents (15 years). Fitness was assessed by a maximal bike test, and total and central adiposity were indirectly estimated by skinfolds (Slaughter's equation for fat mass) and waist circumference. At follow-up, fitness and adiposity had increased in the children cohort (P ≤ 0.001), while small or no change occurred in the adolescent cohort. In the children cohort, Estonian participants had a lower increase in fitness and a higher increase in adiposity (total and central) than Swedish participants. Higher maternal education increased the odds of remaining fit (top quartile) by half and reduced the risk of remaining fat (top quartile) by half; odds ratios = 1.56 (1.00-2.43), 0.50 (0.32-0.77) and 0.61 (0.39-0.94) for fitness, total and central adiposity, respectively.

CONCLUSIONS

Our data suggest that the socioeconomic situation of a country might influence key cardiovascular risk factors (fitness and adiposity), being at higher risk for a low-middle income country (Estonia) than a higher income country (Sweden). The findings stress the role of socioeconomic status, particularly maternal education, in the maintenance of healthy fitness and adiposity levels from childhood into later life. Preventive efforts have to be taken from early age.

Neighborhood safety and green space as predictors of obesity among preschool children from low-income families in New York City

BACKGROUND

Neighborhood safety, green space, walkability, and sociodemographics may influence physical activity and childhood obesity.

METHODS

Data on measured height and weight, demographic characteristics, and home ZIP code were collected from year 2004 enrollees in a means-tested preschool program in New York City. Each ZIP code was surrounded by a 400-m buffer and characterized using data from the US census, local government departments, New York Times website, and Transportation Alternatives. Linear and Poisson models were constructed using cluster robust standard errors and adjusting for child's sex, race, ethnicity, age, and neighborhood characteristics.

RESULTS

Analyses included 11,562 children ages 3-5 years living in 160 residential ZIP codes. A higher homicide rate (at the 75th vs 25th percentile) was associated with a 22% higher prevalence of obesity (95% CI for the prevalence ratio (PR): 1.05 to 1.41). A higher density of street trees (at the 75th vs 25th percentile) was associated with 12% lower prevalence of obesity (95% CI for the PR: 0.79 to 0.99). Other neighborhood characteristics did not have significant associations with childhood obesity.

CONCLUSIONS

Among preschool children from low-income families, neighborhood homicide rate was associated with more obesity and street tree density was associated with less obesity.

Fat-mass and obesity-associated gene variant and changes of body mass index from ages 3 to 13 years

OBJECTIVE

The effect of the fat-mass and obesity-associated (FTO) gene minor allele on the change of adiposity from childhood to adolescence among Asians remains unclear, and is expected to differ among the developmental stages from childhood to adolescence. We assessed the relationship between a FTO variant and changes in body mass index (BMI) between 3 and 13 years of age among Japanese.

METHODS

Subjects were 66 fifth graders (37 boys, 29 girls) enrolled in 2006 from Shunan City, Japan, and genotyped (rs1558902). Anthropometrics were measured at fifth grade and three years later at eighth grade, and data for these individuals recorded at 3 years of age by the health center were included. The effects on BMI and the BMI-standard deviation score (SDS) were analyzed after adjusting for age and sex.

RESULTS

The minor allele of FTO was positively associated with BMI and BMI-SDS among boys at an age of 10 years (β=1.779 and 0.812, respectively). The risk allele was positively associated with changes in BMI among boys between 3 and 10 years of age (β=1.656). However, negative associations with changes in BMI and BMI-SDS were found among boys between 10 and 13 years of age (β=-0.875 and -0.512, respectively).

CONCLUSION

The increment of adiposity at 10 years of age in boys might be influenced by the FTO variant, but this influence was significantly reduced at 13 years.

Relationship between lipid and hematological profiles with adiposity in obese adolescents

Background

An excess of weight including obesity have reached epidemic rates in all age groups, both in developed and developing countries. It is notable that overweight children and adolescents have a higher likelihood of becoming obese adults and to present health-related problems early in life.

Objetives

To verify associations of the lipid and hematological profiles with adiposity in obese adolescents beginning multidisciplinary weight loss therapy.

Methods

This cross-sectional study was conducted with 85 adolescents of both genders, aged 12-19 years (Tanner staging 3 or 4) and body mass index greater than the 95^th percentile. The sum of the triceps, subscapular and calf skinfolds and the waist circumference were used to estimate adiposity. Blood samples were collected from all patients after overnight fasting to analyze blood lipids (total cholesterol, high-density lipoprotein, low-density lipoprotein, very low-density lipoprotein and triglycerides), blood sugar and the hematological profile (hemoglobin, platelets and red blood cells). The Kolmogorov-Smirnov test and Spearman and Pearson correlation coefficients were used for statistical analysis with significance set for p-values ≤ 0.05.

Results

There were statistical differences between genders for red blood cells (p-value = 0.000), hemoglobin (p-value = 0.000) and platelets (p-value = 0.002). Positive correlations were found for red blood cells (p-value = 0.031) and hemoglobin (p-value = 0.024) with waist circumference. There was a negative correlation between hemoglobin and the sum of skinfolds (p-value = 0.022).

Conclusion

The results demonstrate an association between the lipid and hematological profiles and body adiposity in obese adolescents thus reinforcing the importance of treating obese adolescents early to prevent health related problems in adult life.

Evaluation of adiposity-related biomarkers as metabolic syndrome indicators

Recent studies have suggested a relationship of the increased circulating adipokines and inflammatory cytokine, and the risk of metabolic syndrome (MetS). The objective of this study was to identify adiposity-related factors that reflect MetS in order to establish early intervention targets. We performed a cross-sectional study which included 108 MetS subjects and 91 controls. Blood adiponectin, leptin, vascular-, and intercellular adhension molecules (VCAM, ICAM), monocyte chemoattractant protein 1 (MCP1), high-sensitivity C-reactive protein (hsCRP), oxidized LDL (oxLDL), tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were measured. The correlation analysis indicated that the MetS score (sum of the number of MetS risk factors) had an inverse relationship with adiponectin (p < 0.0001), and positive correlations with leptin (p < 0.05), ICAM (p < 0.01), MCP1 (p < 0.05), oxLDL (p < 0.05), TNF-α (p < 0.0001), IL-6 (p < 0.05) and hsCRP (p < 0.01). In multivariate logistic regression analyses, plasma triglyceride (TG) was independently associated with adiponectin, ICAM and TNF-α with the standardized β coefficients of -0.213, 0.197, and 0.193, respectively. Plasma HDL-cholesterol was independently associated with ICAM and hsCRP with the standardized β coefficients of -0.150 and -0.173. Adiponectin, TNF-α, and hsCRP were the most proximate markers reflecting MetS. Among MetS components, TG and HDL-cholesterol concentrations displayed the relationship with inflammatory markers measured in this study.

Mode of delivery and adiposity: Hong Kong's "Children of 1997" birth cohort

PURPOSE

To examine whether mode of delivery was associated with childhood adiposity in a developed non-Western context.

METHODS

We used generalized estimating equations to estimate the association of mode of delivery (vaginal or cesarean) with body mass index (BMI) z-score and overweight (including obesity) from 3 months to 13 years, in 7809 term birth (94% follow-up) from a population-representative Chinese birth cohort, "Children of 1997." We used multiple imputation for missing data.

RESULTS

The cesarean section rate (26%) was higher for children born in private hospitals, with lower gestational age, lower birth order, higher maternal age, higher maternal BMI, and higher family socioeconomic position. Cesarean section was not associated with BMI z-score from 3 months to 13 years (mean difference, 0.03; 95% confidence interval, -0.02 to 0.09) or overweight from 3 years to 13 years (odds ratio, 0.98; 95% confidence interval, 0.77 to 1.25) after adjusting for infant and maternal characteristics and family socioeconomic position.

CONCLUSIONS

In a non-Western developed setting, mode of delivery was not clearly associated with BMI or overweight (including obesity) into late childhood. From a public health perspective, the role of mode of delivery and its mechanistic pathway in the current burgeoning epidemic of obesity needs to be clarified.

Plasma leptin, glucose and non-esterified fatty acid variations in dromedary camels exposed to prolonged periods of underfeeding or dehydration

The involvement of plasma leptin in the adaptation of dromedary camels to harsh conditions such as food or water shortages was studied through 2 experiments. In experiment 1, fourteen female camels were either fed at 68% of maintenance energy requirements (MER) during 112d (n=4) or overfed at 134% of MER during the first 56d and then underfed at 17% of MER the next 56d (OV-UN, n=5), or underfed and then overfed for the same durations and energy intake levels (UN-OV, n=5). Weekly plasma samples showed that leptin, glucose and non-esterified fatty acid (NEFA) concentrations were significantly modulated by energy intake level. NEFA increased sharply but transiently in underfed camels of the UN-OV or OV-UN groups, whereas glucose and leptin concentrations decreased with underfeeding and increased with overfeeding with more significant effects in camels that were previously overfed or underfed, respectively. In experiment 2 twelve female camels were either normally watered (n=6) or dehydrated (n=6) during 23d and then rehydrated during 4d. Dehydration specifically increased blood hematocrit, plasma NEFA and glucose whereas leptin decreased slightly. For both experiments, leptinemia was positively related to hump adipocyte volume. Taken together these results provide new data for a better understanding of lipid and energy metabolism in camels.

The C57BL/6J Niemann-Pick C1 mouse model with decreased gene dosage has impaired glucose tolerance independent of body weight

The human Niemann-Pick C1 (NPC1) gene has been found to be associated with extreme (early-onset and morbid-adult) obesity and type 2 diabetes independent of body weight. We previously performed growth studies using BALB/cJ Npc1 normal (Npc1+/+) and Npc1 heterozygous (Npc1+/-) mice and determined that decreased Npc1 gene dosage interacts with a high-fat diet to promote weight gain and adiposity. The present study was performed using both BALB/cJ and C57BL/6J Npc1+/+ and Npc1+/- mice to determine if decreased Npc1 gene dosage predisposes to metabolic features associated with type 2 diabetes. The results indicated that C57BL/6J Npc1+/- mice, but not BALB/cJ Npc1+/- mice, have impaired glucose tolerance when fed a low-fat diet and independent of body weight. The results also suggest that an accumulation of liver free fatty acids and hepatic lipotoxicity marked by an elevation in the amount of plasma alanine aminotransferase (ALT) may be responsible for hepatic insulin resistance and impaired glucose tolerance. Finally, the peroxisome-proliferator activated receptor α (PPARα) and sterol regulatory element-binding protein-1 (SREBP-1) pathways known to have a central role in regulating free fatty acid metabolism were downregulated in the livers, but not in the adipose or muscle, of C57BL/6J Npc1+/- mice compared to C57BL/6J Npc1+/+ mice. Therefore, decreased Npc1 gene dosage among two different mouse strains interacts with undefined modifying genes to manifest disparate yet often related metabolic diseases.

Abdominal adiposity largely explains associations between insulin resistance, hyperglycemia and subclinical atherosclerosis: the NEO study

OBJECTIVE

The relative importance of insulin resistance and hyperglycemia to the development of atherosclerosis remains unclear. Furthermore, adiposity may be responsible for observed associations. Our aim was to study the relative contributions of adiposity, insulin resistance and hyperglycemia to subclinical atherosclerosis.

METHODS

In this cross-sectional analysis of the Netherlands Epidemiology of Obesity (NEO) study, a cohort of persons of 45-65 years, BMI, waist circumference (WC), fasting glucose (FPG), HbA1c and insulin concentrations were measured and the revised HOMA-IR was calculated. The carotid Intima-Media Thickness (cIMT) was measured by ultrasound. We performed linear regression analyses between standardized values of FPG, HbA1c, HOMA-IR, BMI, WC with cIMT, and subsequently included age, sex, ethnicity, education and smoking, HOMA-IR, HbA1c and FPG, BMI and WC in the models.

RESULTS

After exclusion of participants with glucose lowering therapy (n = 356) or missing data (n = 252), this analysis included 6065 participants, 43% men, and mean (SD) cIMT of 616 (92) μm. Differences in cIMT (95% CI) per SD were: FPG: 16 (10,21); HbA1c: 12 (7,16); HOMA-IR: 11 (6,16) μm. These associations attenuated after adjustments, and attenuated most strongly after adjustment for WC. Differences in cIMT (95% CI) per SD in the full model were: FPG: 4 (0,7); HbA1c: 2 (-1,5); HOMA-IR: 0 (-3,3); BMI 16 (13,19); WC: 18 (14,21) μm.

CONCLUSION

In middle-aged individuals, we observed similar contributions of insulin resistance and hyperglycemia to subclinical atherosclerosis. These contributions were largely explained by abdominal adiposity, emphasizing the importance of weight management.

Obesity, adiposity, and dyslipidemia: a consensus statement from the National Lipid Association

The term "fat" may refer to lipids as well as the cells and tissue that store lipid (ie, adipocytes and adipose tissue). "Lipid" is derived from "lipos," which refers to animal fat or vegetable oil. Adiposity refers to body fat and is derived from "adipo," referring to fat. Adipocytes and adipose tissue store the greatest amount of body lipids, including triglycerides and free cholesterol. Adipocytes and adipose tissue are active from an endocrine and immune standpoint. Adipocyte hypertrophy and excessive adipose tissue accumulation can promote pathogenic adipocyte and adipose tissue effects (adiposopathy), resulting in abnormal levels of circulating lipids, with dyslipidemia being a major atherosclerotic coronary heart disease risk factor. It is therefore incumbent upon lipidologists to be among the most knowledgeable in the understanding of the relationship between excessive body fat and dyslipidemia. On September 16, 2012, the National Lipid Association held a Consensus Conference with the goal of better defining the effect of adiposity on lipoproteins, how the pathos of excessive body fat (adiposopathy) contributes to dyslipidemia, and how therapies such as appropriate nutrition, increased physical activity, weight-management drugs, and bariatric surgery might be expected to impact dyslipidemia. It is hoped that the information derived from these proceedings will promote a greater appreciation among clinicians of the impact of excess adiposity and its treatment on dyslipidemia and prompt more research on the effects of interventions for improving dyslipidemia and reducing cardiovascular disease risk in overweight and obese patients.

Faster growth rate in ad libitum-fed cats: a risk factor predicting the likelihood of becoming overweight during adulthood

In human subjects, the risk of becoming overweight (OW) in adulthood is largely determined early in childhood. However, early-life factors have not been considered for feline obesity. A total of eighty colony cats, fed ad libitum, were studied; various breeds, ages and sex were included, with thirty-six (45 %) being OW and forty-four (55 %) being of ideal weight (IW). The effects of various factors (including age, sex, neuter status, breed (pure v. mixed), mean daily food intake (FI), housing status (indoor with outdoor access v. exclusively indoor) and body weight at 1 year of age (BW1y)) on weight status were assessed. Initial statistical analyses identified BW1y as the main significant variable. Body weight (BW) and FI were then assessed between 1 and 8·5 years of age, with group differences (OW v. IW) noted for BW, which increased significantly with age only in the OW group (P < 0·001). However, no difference in BW (P = 0·17) was noted when BW1y was included as a covariate in the model. FI did not change with age in either group. Finally, given the importance of BW1y, changes in BW from 3 to 12 months were then assessed with BW at 3 months of age included as a covariate. Whereas at 3 months of age, no group difference in BW was observed, a faster rate of weight gain was seen in OW cats. In conclusion, as in human subjects, the rate of growth is a key risk factor for cats becoming OW, although the factors responsible are currently not known.

Associations between Psychological Distress and Body Mass Index among Law Enforcement Officers: The National Health Interview Survey 2004-2010

OBJECTIVES

To investigate the association between psychological distress and obesity among law enforcement officers (LEOs) in the United States.

METHODS

Self-reported data on psychological distress based on six key questions were obtained from LEOs who participated in the National Health Interview Survey (2004-2010). We used Prochaska's cut-point of a Kessler 6 score ≥ 5 for moderate/high mental distress in our analysis. Mean levels of body mass index (BMI) were compared across three levels of psychological distress.

RESULTS

The average age of LEOs (n = 929) was 39.3 years; 25% were female. Overall, 8.1% of LEOs had moderate or high psychological distress; 37.5% were obese (BMI ≥ 30). Mean BMI increased with increasing psychological distress (no distress, BMI = 27.2 kg/m(2); mild distress, 27.6 kg/m(2); and moderate/high distress, 33.1 kg/m(2); p = 0.016) after adjustment for age, race, income, and education level among female officers only. Physical activity modified the association between psychological distress and BMI but only among male LEOs (interaction p = 0.002). Among male LEOs reporting low physical activity, psychological distress was positively associated with BMI (30.3 kg/m(2) for no distress, 30.7 for mild distress, 31.8 for moderate/high distress; p = 0.179) after adjustment, but not significantly. This association was not significant among males reporting high physical activity.

CONCLUSION

Mean BMI significantly increased as psychological distress increased among female LEOs. A longitudinal study design may reveal the directionality of this association as well as the potential role that physical activity might play in this association.

Does parental body mass index status modify the associations among birth weight, early growth and childhood adiposity?

OBJECTIVES

To examine the associations among birth weight, infant growth and childhood adiposity, and to test whether parental weight status modifies these associations.

METHODS

The sample was comprised of 423 participants born at term who were an appropriate size for their gestational age from the Quebec Adipose and Lifestyle Investigation in Youth (QUALITY) study, a cohort of 630 children with a parental history of obesity. Infant growth velocity from zero to two years of age was estimated using slopes from simple linear regression for weight and body mass index (BMI) Z-scores. Child anthropometrics and body composition, and parental BMI were measured from eight to 10 years of age. Associations were modelled using multiple linear regressions.

RESULTS

Increased birth weight and growth velocity independently predicted increased childhood adiposity. Effects of infant growth velocity on later adiposity were stronger with higher maternal BMI but not with higher paternal BMI. Similar interactions with birth weight were not found.

CONCLUSIONS

Early childhood measures of growth and the mother's BMI score should be included in investigations on obesity risk.

Increase in maternal adiposity and poor lipid profile is associated with oxidative stress markers during pregnancy

OBJECTIVE

This study aimed to evaluate changes in maternal adiposity and lipid profile and to correlate these parameters with Deoxyribonucleic acid (DNA) damage and total antioxidant capacity (TAC) levels among pregnant women.

METHOD

This was a longitudinal study which took place in Kelantan state, Malaysia. Fasting blood samples of 159 healthy pregnant women were collected in second and third trimesters from April 2010 until October 2011. Maternal total body fat was assessed using bioimpedance analysis method.

RESULTS

When compared to data in second trimester, pregnant women in third trimester showed significantly higher levels of total body fat (p<0.001), total cholesterol (p<0.001), triglyceride (p<0.001), LDL-C (p=0.001), DNA damage (p<0.001) and TAC (p<0.001) but a lower level of HDL-C (p<0.001). Maternal adiposity and lipid profile were positively and consistently correlated with DNA damage in second and third trimesters. Significant and positive correlations of triglyceride with TAC levels were noted in both periods indicating compensatory action against increased oxidative stress.

CONCLUSION

Normal pregnancy is associated with marked changes in lipid metabolism, prooxidant and antioxidant status. Dyslipidemia-associated oxidative stress was demonstrated with advancing gestational age. Appropriate preventive and compensatory measures should be practiced to minimize the effect of oxidative stress throughout pregnancy.

Body mass index and body fat percentage are associated with decreased physical fitness in adolescent and adult female volleyball players

BACKGROUND

The objectives of this study were to examine (a) the prevalence of overweight/obesity, and (b) the relationship between body mass index (BMI), body fat percentage (BF) and physical fitness in adolescent and adult female volleyball players.

MATERIALS AND METHODS

Adolescent (n = 102, aged 15.2 ± 2.0 year) and adult (n = 57, 25.9 ± 5.0 year) players were examined for anthropometric characteristics and body composition, and performed the physical working capacity in heart rate 170 min(-1) test, a force-velocity test, the Wingate anaerobic test (WAnT), sit-and-reach test (SAR), handgrip strength test (HST) and countermovement vertical jump (CVJ).

RESULTS

Based on international BMI cut-off points, 27.5% (n = 28) of adolescent and 12.3% (n = 7) of adult participants were classified as overweight, with the prevalence of overweight being higher in girls than in women (χ(2) = 4.90, P = 0.027). BMI was correlated with BF in both age groups (r = 0.72, P < 0.001 in girls; r = 0.75, P < 0.001 in women). Normal participants had superior certain physical and physiological characteristics than those who were overweight. For instance, normal girls and women had higher mean power during WAnT than their overweight counterparts (P = 0.003 and P = 0.009 respectively). Except for flexibility, BMI and BF were inversely related with physical fitness (e.g., BMI vs. HST r = -0.39, P < 0.001 in girls; BF vs. CVJ r = -0.45, P < 0.001 in women).

CONCLUSION

The findings confirmed the negative effect of overweight and fatness on selected parameters of physical fitness. The prevalence of overweight in adolescent volleyball players was higher than in general population, which was a novel finding, suggesting that proper exercise interventions should be developed to target the excess of body mass in youth volleyball clubs.

Aging exacerbates obesity-induced oxidative stress and inflammation in perivascular adipose tissue in mice: a paracrine mechanism contributing to vascular redox dysregulation and inflammation

Obesity in the elderly individuals is increasing at alarming rates and there is evidence suggesting that elderly individuals are more vulnerable to the deleterious cardiovascular effects of obesity than younger individuals. However, the specific mechanisms through which aging and obesity interact to promote the development of cardiovascular disease remain unclear. The present study was designed to test the hypothesis that aging exacerbates obesity-induced inflammation in perivascular adipose tissue, which contributes to increased vascular oxidative stress and inflammation in a paracrine manner. To test this hypothesis, we assessed changes in the secretome, reactive oxygen species production, and macrophage infiltration in periaortic adipose tissue of young (7 month old) and aged (24 month old) high-fat diet-fed obese C57BL/6 mice. High-fat diet-induced vascular reactive oxygen species generation significantly increased in aged mice, which was associated with exacerbation of endothelial dysfunction and vascular inflammation. In young animals, high-fat diet-induced obesity promoted oxidative stress in the perivascular adipose tissue, which was associated with a marked proinflammatory shift in the profile of secreted cytokines and chemokines. Aging exacerbated obesity-induced oxidative stress and inflammation and significantly increased macrophage infiltration in periaortic adipose tissue. Using cultured arteries isolated from young control mice, we found that inflammatory factors secreted from the perivascular fat tissue of obese aged mice promote significant prooxidative and proinflammatory phenotypic alterations in the vascular wall, mimicking the aging phenotype. Overall, our findings support an important role for localized perivascular adipose tissue inflammation in exacerbation of vascular oxidative stress and inflammation in aging, an effect that likely enhances the risk for development of cardiovascular diseases from obesity in the elderly individuals.

Molecular mechanisms of appetite regulation

The prevalence of obesity has been rapidly increasing worldwide over the last several decades and has become a major health problem in developed countries. The brain, especially the hypothalamus, plays a key role in the control of food intake by sensing metabolic signals from peripheral organs and modulating feeding behaviors. To accomplish these important roles, the hypothalamus communicates with other brain areas such as the brainstem and reward-related limbic pathways. The adipocyte-derived hormone leptin and pancreatic β-cell-derived insulin inform adiposity to the hypothalamus. Gut hormones such as cholecystokinin, peptide YY, pancreatic polypeptide, glucagon-like peptide 1, and oxyntomodulin transfer satiety signals to the brain and ghrelin relays hunger signals. The endocannabinoid system and nutrients are also involved in the physiological regulation of food intake. In this article, we briefly review physiological mechanisms of appetite regulation.

Relation of absolute or relative adiposity to insulin resistance, retinol binding protein-4, leptin, and adiponectin in type 2 diabetes

BACKGROUND

Central fat mass (CFM) correlates with insulin resistance and increases the risk of type 2 diabetes and cardiovascular complications; however, peripheral fat mass (PFM) is associated with insulin sensitivity. The aim of this study was to investigate the relation of absolute and relative regional adiposity to insulin resistance index and adipokines in type 2 diabetes.

METHODS

Total of 83 overweighted-Korean women with type 2 diabetes were enrolled, and rate constants for plasma glucose disappearance (K(ITT)) and serum adipokines, such as retinol binding protein-4 (RBP4), leptin, and adiponectin, were measured. Using dual X-ray absorptiometry, trunk fat mass (in kilograms) was defined as CFM, sum of fat mass on the lower extremities (in kilograms) as PFM, and sum of CFM and PFM as total fat mass (TFM). PFM/TFM ratio, CFM/TFM ratio, and PFM/CFM ratio were defined as relative adiposity.

RESULTS

Median age was 55.9 years, mean body mass index 27.2 kg/m(2), and mean HbA1c level 7.12±0.84%. K(ITT) was positively associated with PMF/TFM ratio, PMF/CFM ratio, and negatively with CFM/TFM ratio, but was not associated with TFM, PFM, or CFM. RBP4 levels also had a significant relationship with PMF/TFM ratio and PMF/CFM ratio. Adiponectin, leptin, and apolipoprotein A levels were related to absolute adiposity, while only adiponectin to relative adiposity. In correlation analysis, K(ITT) in type 2 diabetes was positively related with HbA1c, fasting glucose, RBP4, and free fatty acid.

CONCLUSION

These results suggest that increased relative amount of peripheral fat mass may aggravate insulin resistance in type 2 diabetes.

Why are children living in poverty getting fatter?

In recent decades, there has been a dramatic increase in unhealthy weight for both children and adults. The Canadian standard of living has changed in favour of more easily prepared, calorie-dense foods and sedentary practices. Many family characteristics have also changed over the past 50 years. More Canadian families are living in disadvantaged situations, forecasting a host of unhealthy behaviours and attitudes in adults. The poor are not only getting poorer, they are also becoming heavier. Children from disadvantaged families seem to be leading the trend in increasing prevalence of unhealthy weight. Because they live in neighbourhoods that are perceived as unsafe, these children are likely spending more time indoors. This is associated with watching more television, which not only displaces other forms of educational and active entertainment but also places them at risk of learning inaccurate information about proper eating. Social science research helps identify factors contributing most to the rise in excess weight within this population, thus providing essential clues for effective approaches to its eradication.

Lipocalin-2: Response to a Progressive Treadmill Protocol in Obese and Normal-weight Men

Purpose

Lipocalin-2 (Lcn2), a newer adipocyte-secreted acute phase protein, was recently reported to be correlated with potential effects on obesity and inflammation. The reaction of this protein to progressive exercise has not been evaluated yet. This study was designed to compare the serum Lcn2 and high-sensitivity C-reactive protein (hs-CRP) levels after participating in an acute bout of treadmill protocol in obese and normal-weight men.

Methods

Nine obese (aged: 43.2±4.6 yrs and body mass index (BMI): 31.4±1.6 kg/m²) and 9 normal-weight (aged: 42.9±4.4 yrs and BMI: 23.03±1.7 kg/m²; mean ± SD) sedentary men selected randomly from volunteers performed a single bout of exercise according to the treadmill Bruce protocol.

Results

Before the exercise, Lcn2 level was higher in obese than normal-weight individuals (P<0.05). A significant increase in Lcn2, hs-CRP, white blood cells (WBC) and insulin resistance index was observed after the exercise in both groups (P<0.05). The level of Lcn2, hs-CRP and WBC increase was more significant in obese individuals than normal-weight subjects after the exercise (P<0.05).

Conclusions

It seems that the levels of Lcn2 and other inflammatory markers elevated in obese and normal-weight men after participating in an exhaustive progressive exercise. These changes in obese men were considerable.

Adiposity facilitates increased strength capacity in heart failure patients with reduced ejection fraction

BACKGROUND

Obesity is associated with relatively improved prognosis among heart failure (HF) patients. Mechanisms explaining this so-called "obesity paradox" have been unclear. We hypothesized that increased adiposity may contribute to increased strength capacity, and may thereby facilitate clinical benefits.

METHODS AND RESULTS

In a controlled, cross-sectional study, adults aged ≥ 50 years with HF with reduced ejection fraction (HFREF) (LVEF ≤ 40%) were compared to age matched controls. Body composition was determined by dual-energy X-ray absorptiometry (DXA). Aerobic (cardiopulmonary exercise testing), maximum strength (one repetition maximum [1RM]), and power (submaximal resistance/time) were assessed. 70 adults (31 HFREF, 39 controls; mean age 66.2 ± 9.6 years) were studied. Peak oxygen consumption (VO2) (15.4 ± 4.2 vs. 23.4 ± 6.6 ml O2 · kg(-1) · min(-1), p<0.0001), 1RM (154.8 ± 52.0 vs. 195.3 ± 56.8 kg, p<0.01) and power (226.4 ± 99.2 vs. 313.3 ± 130.6, p<0.01) were lower in HFREF vs. controls. 1 RM correlated with total fat (r=0.56, p<0.01), leg fat (r=0.45, p<0.05) and arm fat (r=0.39, p<0.05) in HFREF. Moreover, among HFREF patients with a high (≥ 30 kg/m(2)) body mass index (BMI), 1RM and fat mass were significantly greater than those with lower (<30 kg/m(2)) BMIs. Correlations between 1 RM and total fat (r=0.65, p<0.05) and leg fat (r=0.64, p<0.05) were particularly notable in the high BMI subgroup.

CONCLUSION

Increased adiposity correlates with relatively greater strength in HFREF patients which may explain some of the clinical benefits that result from obesity.

Comparing Height-Adjusted Waist Circumference Indices: The Fels Longitudinal Study

OBJECTIVES

While researchers are increasingly recognizing the importance of adjusting waist circumference (WC) for height, no standard has yet been established. In this study we contrast three standard methods for indexing WC by height (using height, root-height and height-squared) via comparisons with age-specific optimal indices.

STUDY DESIGN AND SETTING

Measurements from 722 male and 746 female Caucasian participants in the Fels Longitudinal Study were used. The three standard waist-circumference indices (as well as an optimal index) were determined for ages 2 through 18, and for every decade thereafter to 70 years of age. Pearson correlations were used to assess the suitability of all indices.

RESULTS

The three standard indices remain correlated with the original WC measures, though each was associated with height at some ages. Waist-to-height ratio is suitable for some childhood ages (boys: 5 - 9, 13 - 16; girls: 4 - 7, 9, 11 - 14) but not for adult ages; Root-height works well mostly for older teenage children and adults but not in early childhood and adolescence; Height-squared is nowhere suitable. In both men and women, the optimal indexing factor ranged between root-height and height-squared in childhood, and is close to root-height in adulthood.

CONCLUSIONS

No one index is most suitable, as WC indexed by root-height is suitable for use with measurements from teenage children and adults, while waist-to-height ratio is generally suitable for use in children. WC indexed by height-squared is nowhere suitable.

Association of adiposity with pulse pressure amongst gujarati Indian adolescents

BACKGROUND AND AIM

The current study was conducted to determine the effect of adiposity on vascular distensibility in Gujarati Indian adolescents as research indicating the pathogenesis of hypertension among overweight and/or obese Indian adolescents is scant and ethnic differences exist in the pathogenesis of hypertension

MATERIALS AND METHODS

A cross-sectional study was conducted on 488 Gujarati Indian adolescents of 16-19 years age group. Adiposity was assessed in terms of BMI, Body Fat %, Fat Mass, Fat Mass Index and Waist Circumference. Arterial blood pressure was recorded and pulse pressure (PP) was calculated using the standard equation based on the difference between systolic blood pressure (SBP) and diastolic blood pressure (DBP). Pearson's correlation coefficient was determined to find the association between the markers of adiposity and SBP, DBP and PP.

RESULT

A significant positive correlationship was found between adiposity and PP in boys. However, no significant correlationship was found between adiposity and PP in girls.

CONCLUSION

An increase in total as well as visceral adiposity is probably associated with a decrease in vascular distensibility in the Gujarati Indian adolescent boys but not in girls, thus indicating a protective role of female sex hormone estrogen which has been shown earlier to protect the vasculature from atherosclerosis, endothelial dysfunction which occurs with increase in adiposity.

The Role of Overweight and Obesity in the Cardiorenal Syndrome

The presence of a group of interactive maladaptive factors including hypertension, insulin resistance, metabolic dyslipidemia, obesity, microalbuminuria, and/or reduced renal function constitute the cardiorenal metabolic syndrome (CRS). Overweight, obesity, and chronic kidney disease (CKD) have grown to pandemic proportions in industrialized countries during the past decade. The fact that these interactive factors promote heart and renal disease has been documented in large population-based studies. Obesity seems to be the driving force behind the development of heart disease and CKD and therefore the CRS. The relationship between overweight/obesity and kidney disease begins in early childhood and appears to be related to overconsumption of high-fructose corn syrup and insufficient physical activity. Today, 13 million children are obese, and over 70% of these children are likely to become obese adults. Indeed, approximately 30% of male and 34% of female adults in the United States are obese. This lifestyle-related epidemic will be a major societal medical and economic problem that will accentuate the current epidemic of CKD in the United States and other industrialized and emerging industrialized countries. In this article, we will review the potential mechanisms by which obesity and other metabolic abnormalities interact to promote heart and progressive kidney disease.

Diet-induced obesity in two C57BL/6 substrains with intact or mutant nicotinamide nucleotide transhydrogenase (Nnt) gene

The C57BL/6J (B6/J) male mouse represents a standard for diet-induced obesity (DIO) and is unique in expressing a loss-of-function nicotinamide nucleotide transhydrogenase (Nnt) gene. This mutation was associated with a marked reduction in glucose-stimulated insulin secretion from B6/J islets in vitro and moderately impaired glucose clearance in vivo. To assess the contribution of this Nnt mutation, we compared DIO responsiveness of Nnt-mutant B6/J males to Nnt wild-type C57BL/6NJ (B6/NJ) males over a 14-week period of feeding a high-fat (60% of calories) diet. Initial mean body weights at 6 weeks did not distinguish the substrains and both substrains were DIO-sensitive. However, B6/J males outgained the B6/NJ males, with a significant 3 g higher mean body weight at 20 weeks accompanied by significant increases in both lean and fat mass. Mean nonfasting serum glucose over time was also significantly higher in B6/J males, as was impairment of glucose tolerance assessed at 8 and 20 weeks of age. Serum leptin, but not insulin, was significantly higher in B6/J males over time. Potential contributions of the wild-type Nnt gene were demonstrable on a lower fat diet (10% of calories) where a significantly greater weight gain over time by B6/NJ males was correlated with a significantly higher serum insulin. In conclusion, DIO developed in response to 60% fat feeding regardless of Nnt allele status. Contribution of the B6/J-unique Nnt mutation was most evident in response to 10% fat feeding that resulted in reduced serum insulin and weight gain compared to B6/NJ males.