Genome-wide meta-analysis identifies 11 new loci for anthropometric traits and provides insights into genetic architecture

Approaches exploiting trait distribution extremes may be used to identify loci associated with common traits, but it is unknown whether these loci are generalizable to the broader population. In a genome-wide search for loci associated with the upper versus the lower 5th percentiles of body mass index, height and waist-to-hip ratio, as well as clinical classes of obesity, including up to 263,407 individuals of European ancestry, we identified 4 new loci (IGFBP4, H6PD, RSRC1 and PPP2R2A) influencing height detected in the distribution tails and 7 new loci (HNF4G, RPTOR, GNAT2, MRPS33P4, ADCY9, HS6ST3 and ZZZ3) for clinical classes of obesity. Further, we find a large overlap in genetic structure and the distribution of variants between traits based on extremes and the general population and little etiological heterogeneity between obesity subgroups.

Occupational burnout, eating behavior, and weight among working women

BACKGROUND

Eating behavior affects weight and thus the development of obesity. Studies on the effect of occupational burnout (exhaustive fatigue, cynicism, and lost occupational self-respect caused by chronic work stress) on eating behavior are lacking.

OBJECTIVE

The objective was to investigate associations between occupational burnout, eating behavior, and weight among working women.

DESIGN

A total of 230 working women participated in a randomized controlled intervention trial (Nuadu) that aimed at changing the health behaviors of those with health risks. We assessed eating behavior using the Three-Factor Eating Behavior Questionnaire 18 and burnout using the Bergen Burnout Indicator 15 at both baseline and 12 mo. Body weight and percentage body fat were also measured at baseline and at 12 mo. The intervention and control groups were combined and divided by burnout and weight-change variables.

RESULTS

Women experiencing burnout at baseline had significantly higher scores in emotional eating (EE; P = 0.002) and uncontrolled eating (UE; P = 0.001) than did those without burnout. A significant difference was found between the change in UE from baseline to 12 mo in those with and without burnout (P = 0.05). UE decreased significantly among those without burnout at baseline (P < 0.001).

CONCLUSIONS

Those experiencing burnout may be more vulnerable to EE and UE and have a hindered ability to make changes in their eating behavior. We recommend that burnout should be treated first and that burnout and eating behavior should be evaluated in obesity treatment.

Motivators and barriers to exercise among adults with a high risk of type 2 diabetes--a qualitative study

PURPOSE

Type 2 diabetes (T2D) can be prevented through lifestyle changes. Regular exercise for more than 4 hours per week, combined with weight loss and changes in dietary habits reduces the incidence of T2D. The aim of this study was to describe motivators and barriers to exercise among adults with a high risk of T2D.

METHODS

Altogether, 74 subjects participated in a study on the Effectiveness and Feasibility of Activating Counseling Methods and Videoconferences in Dietary Group Counseling of Subjects with high risk of T2D. The qualitative data were gathered from video-recorded group counselling sessions and were analysed using content analysis.

RESULTS

Enjoyment from exercise, social relationships related to exercise, encouragement from others, benefits to health, and the aim of weight control motivated subjects to exercise. The wish to join people with an active lifestyle, admiration of active friends and willingness to serve as an example for children reflected why exercise was an important value in life. The barriers to exercise were weather/season, health problems, lack of time, work-related factors and lack of interest.

CONCLUSIONS

Adults with high risk of T2D experienced many individually meaningful motivators. They experienced few barriers to exercise and highlighted the motivators. Thus, we present that they had a positive attitude towards increasing exercise during participation to counselling. The results can be used when developing counselling methods because they provide concrete content for counselling discussion such as importance of work-related factors, family exercise, time management skills and social support for regular exercise.

Using pictures as vignettes to assess stages of change in weight management

Aims: To evaluate the association between descriptions of the stage of change in weight management (using pictures as vignettes) and the changes in the restriction of amount of food and body weight. The goal is to develop counselling methods for helping people to change their lifestyles. Methods: A total of 74 people at high risk of type 2 diabetes participated in six months of group counselling. The data were collected through questionnaires and video-recordings at the beginning and the end of the counselling process, and were analyzed using both deductive content analysis and statistical analysis. Results: Most of the participants were at the contemplation stage at the beginning of the study, and nearly half were at the action stage at six months. There were associations between progression in the lifestyle change process, the restriction of food amount, and weight changes. Judging from this, the descriptions of the change process of weight management using pictures were well made, because the change process progressed in parallel with the changes in weight and restriction of the amount of food eaten. Conclusions: Assessing the stages of change in weight management by using pictures as vignettes is easy to carry out, and feasible. The descriptions of the stages of change were parallel with the changes in restriction of food and changes in weight.

Pedometer use among adults at high risk of type 2 diabetes, Finland, 2007-2008

INTRODUCTION

A pedometer helps adults exercise more, but sedentary adults need instruction and advice to be motivated to use one. We conducted this qualitative study to describe the experiences of participants at high risk of type 2 diabetes who began using a pedometer.

METHODS

A total of 74 people at high risk of type 2 diabetes participated in 6 months of group counseling. From April 2007 to April 2008, we collected data through questionnaires, theme interviews (n = 22) and video recordings of counseling sessions. From October 2007 through June 2008, we analyzed the data.

RESULTS

Pedometers were useful tools for observing levels of exercise, setting personal goals for walking, and helping evaluate whether daily goals were met. Negative experiences were associated with functional failures, pedometers' unsuitability for exercise other than walking, and the goal of 10,000 steps, which some participants considered too high.

CONCLUSION

Sedentary adults can be motivated to use a pedometer if we inform them that regular users find it a useful instrument for increasing their level of exercise. These adults should set realistic goals for walking and receive adequate instructions for using pedometers.

The effect of eating behavior on weight loss and maintenance during a lifestyle intervention

OBJECTIVE

To investigate the effects of intensive counseling on eating behavior and weight loss and maintenance and their associations.

METHODS

A randomized weight loss counseling intervention with follow-up of 18 months, conducted between 2002-2004 at Oulu University Hospital, Finland included obese adults (n=82, body mass index >27 kg/m(2)). Subjects were randomized into 1) intensive counseling and 2) short-term counseling. Forty-nine subjects who completed the study were included. Eating behavior was repeatedly assessed by the Three Factor Eating Questionnaire-18 and Binge Eating Scale.

RESULTS

Eating behavior improved in both groups. Effect of counseling was -5.0+/-5.7 kg compared with -2.4+/-2.5 kg in the control group (p<0.05 between the groups) during the first 6 months. At 18 months the weight loss results were -2.6+/-6 kg and -0.7+/-3.5 kg, respectively (NS). Success in weight loss maintenance is associated with improved eating behavior (p<0.05). By contrast, failure in weight loss is associated with high scores of uncontrolled eating and binge eating symptoms at the baseline (p<0.05).

CONCLUSIONS

Both intensive and short-term interventions improved eating behavior and weight loss but there was no difference between the two modes of intervention. The association between the improvement of eating behaviour and the success of weight loss suggests a causal relationship which however should be confirmed in a prospective study focusing specifically on this aspect.

Impact of intensified dietary therapy on energy and nutrient intakes and fatty acid composition of serum lipids in patients with recently diagnosed non-insulin-dependent diabetes mellitus

Compliance with dietary recommendations and the effect of intensified dietary therapy on energy and nutrient intakes and fatty acid composition of serum lipids were studied in 86 obese subjects (aged 40 to 64 years) with recently diagnosed non-insulin-dependent diabetes mellitus (NIDDM). After three months of basic education, the subjects were randomly separated into an intervention group (n = 40) and a conventional treatment group (n = 46). Members of the intervention group participated in 12 months of intensified education; those in the conventional group visited local health centers. Compliance with dietary instructions was monitored through food records. Intensified dietary therapy resulted in greater weight loss, better metabolic control, and a less atherogenic lipid profile than conventional treatment. Intake of energy and saturated fatty acids tended to decline in the intervention group. A higher percentage of patients in the intervention group had a total fat intake of 30% of energy or less after 15 months (32.5% [12 of 38] vs 17.4% [8 of 46]). Similarly, more patients in the intervention group had a saturated fatty acid intake of 10% or less of total energy intake at the end of the study (35.0% [13 of 38] vs 8.7% [4 of 46]). The mean dietary cholesterol intake was within recommendations in both groups at the end of the study. The relative percentage of linoleic acid of serum lipids increased significantly and the relative percentage of palmitic acid of serum triglycerides, phospholipids, and cholesterol esters decreased in the intervention group. These changes indicate that intensified dietary therapy improved the quality of fat in the diet of patients with NIDDM.

Changes in hedonic responses to sweet and fat in recently diagnosed non-insulin-dependent diabetic patients during diet therapy

A study was undertaken to find out how the hedonic responses to, and reported liking and consumption of, sweet and fat foods change during the first months of diet therapy of recently diagnosed patients with non-insulin-dependent diabetes mellitus. The patients were 12 women and 19 men aged 40-65 years. The methods used consisted of hedonic rating tests and summated scales which measured overall tendencies to like and consume fatty and sweet foods. These measurements were made three times at intervals of six weeks. At the same time clinical measurements, weight and glycaemic control were recorded. Hedonic ratings of sweet juices decreased during three months of therapy, but hedonic responses to fatty food items (cheese, milk) remained practically unchanged. After three months of diet therapy the diabetic subjects liked fatty and sweet foods less and consumed them less frequently, which was the aim of the diet therapy. At the same time their metabolic control improved markedly, too.