Biomedical subjects

L Lissner

Publications and source records attributed to L Lissner.

At least 55 records · Page 3Linked to original sources

PubMed1998

Familial predisposition for obesity may modify the predictive value of serum leptin concentrations for long-term weight change in obese women.

Leptin is believed to play a role in regulating food intake and body weight. The aim of this study was to examine the influence of parental history of obesity on the association between baseline serum leptin concentrations and subsequent 4-y weight changes. Changes in food intake were also considered in the analysis. Middle-aged, obese women with no obese parent (n = 25) or at least one obese parent (n = 24) were included in the analysis. At baseline, women with no parental history of obesity and women with a parental history of obesity did not differ in body mass index (in kg/m2: 41.2 and 40.2, respectively) or median leptin concentrations (40.8 and 38.8 microg/L, respectively). Four-year weight changes varied widely in both groups combined (from -30 to 24 kg). Stratified regression analysis, adjusted for age, weight, and height, revealed that high leptin concentrations predicted less weight gain (or more weight loss) in women with no obese parent (beta = -21.2, P = 0.0006) but played no significant role in predicting weight gain in women with at least one obese parent (beta = -3.8, P = 0.41). Adding changes in energy and fat intakes to the model reduced the association between leptin and weight change to nonsignificance in the women with no obese parent, indicating that the effect of leptin could be explained largely by dietary changes. In conclusion, serum leptin concentrations predict long-term weight change in obese women with no history of parental obesity, an association largely mediated by changes in food intake.

Adult↗

PubMed1998

Cardiovascular risk during early adult life. Risk markers among participants in "Live for Life" health promotion programme in Sweden.

STUDY OBJECTIVE: To study differences in cardiovascular lifestyle risk factors and biological risk markers in early adult life, with special attention to age and sex differences. Lifestyle cardiovascular risk factors included dietary habits, physical inactivity, smoking, alcohol habits, psychosocial strain, and mental stress. Biological risk markers included anthropometric variables, arterial blood pressure, and serum cholesterol concentration. DESIGN: A combined individual and community based preventive programme, including health examinations. SETTING: All communities in the County of Skaraborg in south western Sweden. PARTICIPANTS: Altogether 12,982 men and women aged 30 or 35 years who underwent health examinations over seven years. MAIN RESULTS: In both sexes, biological risk markers studied were worse in 35 year old subjects than in 30 year olds. Furthermore, a larger proportion of men aged 35 years were smokers and were physically inactive compared with 30 year old men. However, dietary habits were better in both sexes in the upper age group. At both ages there were also significant differences between men and women. Women, compared with men, had better dietary habits and lower alcohol consumption but smoked more and experienced greater mental stress and psychosocial strain. All biological risk markers were worse in men than in women at both ages studied. During the observation period, some improvement of the health profile of the participants was observed, indicating a beneficial effect of the intervention programme. CONCLUSIONS: The results indicate that the risk of cardiovascular disease, as assessed from studying lifestyle and biological risk markers, increases early in life, suggesting that preventive measures should start early.

Adult↗

PubMed1997

[New height and weight standards for the middle aged and aged. Weight increases more than height].

This article presents new weight and height data collected during three large surveys of representative middle-aged and elderly men and women from Gothenburg in 1990-93. Based on these data, weight and height tables are provided as an aid in clinical evaluation. Additionally, weights and heights collected during previous examinations in the 1970s (Läkartidningen 1981; 78: 3152-4) make it possible to describe secular changes nearly two decades later. These comparative data suggest that height and weight have increased in both men and women. However, body weight has increased more than height, resulting in an increase in mean body mass index (RMI) in most groups, with the exception of 75-year old women.

Aged↗

PubMed1997

Low-fat diets may prevent weight gain in sedentary women: prospective observations from the population study of women in Gothenburg, Sweden.

The Population Study of Women in Gothenburg, Sweden is an ongoing prospective study of female residents who were recruited from the local registry in 1968-1969 when they were 38-60 years old. The data presented here were collected from 361 healthy women who underwent a baseline physical examination including a supplementary dietary history interview and returned for a second general health examination 6 years later. This report identifies a subgroup of 57 women who were sedentary during their leisure time and appear to have been particularly susceptible to gaining weight as a function of the fat content of their diets. Specifically, longitudinal analysis of body weights in the whole sample revealed a statistical interaction between leisure-time physical activity and habitual dietary fat intake (energy%), as reported at the baseline examination, in the prediction of subsequent weight change. Further stratified analysis suggested that weight changes were significantly dependent on dietary fat intake among the sedentary women only. High energy intake also predicted weight gain in the sedentary group, although the predictive value for a high-fat diet was of marginal significance after adjusting for total energy consumption. These results suggest that sedentary recreational activity plus a low-fat diet may have a combined contribution to weight change that is not equivalent to the sum of the separate effects. Such a synergy between two modifiable lifestyle factors seems highly relevant for prevention of obesity.

Adult↗

PubMed1997

Dietary intake in relation to restrained eating, disinhibition, and hunger in obese and nonobese Swedish women.

The aims of this study were to: describe dietary intakes of obese and nonobese middle-aged women using a validated food frequency questionnaire; to assess dietary restraint, disinhibition, and hunger by the three factor eating questionnaire (TFEQ) in obese and nonobese samples and determine which of the factors are independently associated with obesity; and to examine correlations between selected nutritional variables and the TFEQ factors. Subjects studied included 179 obese Swedish women (BMI > 32) and 147 nonobese population-based controls (BMI < 28). Age-adjusted mean energy intake was significantly higher in obese women (2730 +/- 78 vs. 2025 +/- 85 kcal, p < 0.0001). In absolute and relative terms, fat intake was higher and alcohol intake was lower in the obese subjects. Disinhibition was the strongest TFEQ factor independently differentiating the obese and nonobese states, i.e., after adjustment for restraint and hunger. Within the obese sample, strong associations were seen between energy intake and disinhibition (p = 0.0005) and hunger (p = 0.0004). The association between energy intake and restrained eating was negative and weaker (p = 0.04). No such associations were seen in nonobese women. Thus, using a dietary instrument that is valid and unbiased with respect to obesity, strong psychological correlates, possibly causal, of variability in energy intake were detected in middle-aged women with obesity. Disinhibition is associated with both obesity and high-energy intakes and is therefore an important factor to consider in the treatment of women with obesity.

Adult↗

PubMed1997

Relationships between changes in body composition and changes in cardiovascular risk factors: the SOS Intervention Study. Swedish Obese Subjects.

Relationships between 2-year changes in body composition (estimated from computed tomography-validated anthropometry based on sagittal trunk diameter, weight, and height), adipose tissue (AT) distribution, and cardiovascular risk factors (blood pressure, lipids, glucose, insulin, uric acid) were examined in 842 treated adults with severe obesity with weight changes from -95.5 to +30.6 kg. Although the change (delta) of visceral AT mass (expressed in % total AT) for a given change in body mass index (delta BMI) was 6-fold larger in men than in women, delta waist and delta waist/hip were similar in both sexes. In men, risk factor changes were similarly related to delta waist, delta bodyweight, and delta BMI, whereas in women, delta bodyweight seemed to be the single independent variable with the highest explanatory power. In multivariate regressions adjusted for delta BMI and baseline conditions, delta visceral AT mass was more strongly associated with risk factor changes than were delta waist and delta waist/hip. When using a three-compartment model (lean body mass, subcutaneous and visceral AT masses) plus neck and thigh girths (indicators of subcutaneous AT distribution), risk factor changes were related both to delta subcutaneous and delta visceral AT masses but not to delta lean body mass. In agreement with cross-sectional findings, delta neck was positively and delta thigh was negatively related to some risk factor changes. Thus, the use of waist as a single risk factor indicator seems less effective for epidemiological studies than the simple anthropometric measures presented here, which are able to separate the effects of visceral AT mass, subcutaneous AT mass, and subcutaneous AT distribution on metabolic parameters under both cross-sectional and longitudinal conditions.

Adipose Tissue↗

PubMed1997

Are elevated aminotransferases and decreased bilirubin additional characteristics of the metabolic syndrome?

Abnormal liver tests, as well as morphological changes in the liver, are frequent among obese patients. Other frequent disturbances are visceral fat accumulation, insulin resistance, non-insulin-dependent diabetes mellitus (NIDDM), hypertriglyceridemia, and hypertension; these are set of aberrations known as the metabolic syndrome. In order to investigate a possible relationship between the metabolic syndrome and impaired liver status we examined associations between liver tests, metabolic variables (insulin, glucose, and triglycerids), body composition and nutrition in 1,083 men (BMI 28.8-63.8 kg/m2) and 1,367 women (BMI 26.7-68.0 kg/m2) in the ongoing intervention study of Swedish Obese Subjects (SOS). Standard biochemical techniques were used to assess liver status and metabolic variables. Lean body mass (LBM) and masses of visceral and subcutaneous adipose tissue (AT) were estimated by means of computed tomography (CT) calibrated anthropometric equations. In both genders aspartate aminotransferase and alanine aminotransferase were, or tended to be, positively correlated to fasting serum insulin, visceral AT (women), and alcohol intake. In women, the aminotransferases were also correlated with fasting blood glucose. In both genders alkaline phosphatase was, or tended to be, positively associated with visceral AT, insulin (women), and glucose. Bilirubin was negatively correlated to insulin and visceral AT in men and women. Additional multivariate analyses indicated that alcohol had less explanatory power than serum insulin for the examined liver tests, especially among women. These results suggest that pathological liver tests in the obese may represent an expression of the metabolic syndrome.

Adipose Tissue↗

PubMed1997

VLCD plus dietary and behavioural support versus support alone in the treatment of severe obesity. A randomised two-year clinical trial.

OBJECTIVES: To determine whether 12 initial weeks on a Very Low Calorie Diet (VLCD) included in a two-year support program is associated with better long term weight loss maintenance than a dietary and behavioural support program alone. Additionally, to identify characteristics associated with successful treatment or attrition, which can be used in selecting individuals likely to respond to VLCD-programs. DESIGN: Randomised clinical trial. SETTING: Two Swedish out-patient clinics. SUBJECTS: 113 obese men and women aged 37-58 y, body mass index (BMI) > 32.0 kg/m2, participating in the Swedish Obese Subjects-(SOS) study. INTERVENTIONS: One group received VLCD for 12 initial weeks plus regular dietary and behavioural support over two years while the other group received two years of the same supportive program only. MAIN OUTCOME MEASURE: Weight loss after two years treatment. RESULTS: Both treatment groups maintained highly significant weight losses at two years but the initial VLCD-treatment appeared to have given no significant long term benefit compared to the supportive program. Examination of selected demographic, psychosocial and dietary characteristics showed that the VLCD-approach was more effective than the supportive strategy alone in men and possibly in individuals sharing household with only one person. High initial hunger-score was associated with attrition, irrespective of treatment. CONCLUSION: A VLCD-program including long term dietary and behavioural support is a successful treatment for some severely obese subjects, especially men. Further research should be directed towards matching treatments to individuals in order to improve the high recidivism rates generally following weight loss attempts.

Adult↗

PubMed1997

The Prospective Population Study of Women in Gothenburg, Sweden, 1968-69 to 1992-93. A 24-year follow-up study with special reference to participation, representativeness, and mortality.

OBJECTIVE: To describe the fourth phase of the Prospective Population Study of Women in Gothenburg, Sweden, with special reference to participation and survival. DESIGN: Prospective population study. SETTING: City of Gothenburg with about 430,000 inhabitants. PARTICIPANTS: 1462 participants and 128 refusers aged 38-60 years at the time of the initial study in 1968-69, 282 women who were sampled but not invited to the study in 1968-69, and 266 women participating since 1980-81 and 32 women for the first time in 1992-93. MAIN OUTCOME MEASURES: Participation rate, survival, anthropometric and metabolic characteristics. RESULTS: The participation rate throughout the study period was high. The participants were mainly characteristic of women of the same ages in the general population even after 24 years. The mortality after 24 years was higher in non-participants than in participants, while there was no difference in survival between women who were invited and women who were not invited to the study. CONCLUSIONS: The initial participants were mainly characteristic of the general population, also after a long follow-up period. The long-term survival was lower in initial refusers than in initial participants.

Adult↗

PubMed1996

[Obese individuals underestimate their food intake--which food groups are under-reported?].

The purpose of the study was to examine the distribution of macronutrient density patterns in relation to obesity. This was done in a sample of 323 Danish men and women aged 35-65 years, selected randomly from a larger population sample of adult Danes. Dietary reporting bias of energy and protein intake, in relation to body fat percentage, was assessed by comparing intake data from a diet history interview with data estimated from PABA-validated 24-hour nitrogen excretion and estimated 24-hour energy expenditure. The results of the study showed that degree of obesity was positively associated with protein underreporting of total energy and protein, whereas compared with total energy reported, protein was overreported by the obese subjects. These associations were evident despite control for gender, age and smoking (p = 0.0003). In conclusion, errors in dietary reporting of protein seem to occur disproportionately with respect to total energy, suggesting a differential reporting pattern of different foodstuffs. Although, on average, all subjects over-reported energy percent from protein, over-reporting was most common in obese. It may therefore be speculated that snack type foods are preferentially forgotten when dietary omission occurs in obese individuals. The results of the present study seem in agreement with the general assumption that obese subjects tend to specifically under-report fat and sugar-rich foods, rather than generally under-report their total intake. These results may have wide implications for the interpretation of studies of diet and comorbidities to obesity.

Adult↗

PubMed1996

Physical activity levels and changes in relation to longevity. A prospective study of Swedish women.

In 1968-1969, a population-based sample of Swedish women aged 38-60 years was recruited for a health survey, and 20-year survival was later ascertained from national registries. Occupational and leisure-time physical activity data from the baseline and 6-year follow-up examinations were evaluated in relation to all-cause mortality among 1,405 women who were initially free of major diseases. In comparison with being inactive, the mortality relative risk associated with being somewhat active was 0.28 (95% confidence interval 0.17-0.46) for occupational activity and 0.56 (95% confidence interval 0.39-0.82) for leisure-time activity. Being in the most active occupational or leisure activity category further decreased mortality risk to a minor extent. A within-subject decrease in leisure activity over 6 years was also a significant risk factor for all-cause mortality (relative risk = 2.07, relative to no change), although there was no evidence of a benefit from increasing physical activity levels. Since exclusion of early endpoints did not affect the associations in any significant way, underlying illness is unlikely to have played a major role in these analyses. It is concluded that decreases in physical activity as well as low initial levels are strong risk factors for mortality in women, and that their predictive value persists for many years.

Adult↗

PubMed1996

Reproductive history in relation to relative weight and fat distribution.

OBJECTIVE: To investigate the relationship between reproductive history and body composition. DESIGN: Prospective population study in Sweden. SUBJECTS: 1462 randomly selected women representing five separate age cohorts (38, 46, 50, 54 and 60 at the 1968-1969 baseline examination) have been followed longitudinally. MEASUREMENTS: Relative weight, fat distribution, and fat cellularity were related to menarche, parity, lactation, menopause and oestrogen medication. RESULTS: Age of menarche did not show any association with subsequent fat distribution, nor did length of lactation time. On the other hand parity was positively associated to total as well as central obesity, and lactation time was positively associated to abdominal fat cell diameter. Premenopausal women showed higher mean body weight and hip circumference than postmenopausal women of the same age. Change from pre- to postmenopausal status was associated with increase of waist circumference as well as reduction of hip circumference, resulting in an increased waist-hip ratio (WHR). Oestrogen replacement suggested some postponement of this increase. CONCLUSION: Parity and menopause are the reproductive factors most associated with gradual changes in body fat distribution. Oestrogen medication seems to play an additional role in diminishing waist circumference increase and could thus contribute to decreased cardiovascular morbidity in women.

Adipose Tissue↗

PubMed1996

The 'Green Keyhole' nutritional campaign in Sweden: do women with more knowledge have better dietary practices?

INTRODUCTION: In 1989 the National Food Administration in Sweden introduced a food-marking symbol called the 'Green Keyhole'. The aim of the campaign is to help consumers make lowfat, high-fibre food choices. OBJECTIVE: To describe the knowledge of the Green Keyhole symbol in a general female population, and to examine whether knowledge is associated with reported intake of dietary fat and fibre. SUBJECTS: 616 randomly selected women were examined and interviewed. METHODS: Intakes of dietary fat and fibre were analysed in relation to knowledge of the Green Keyhole symbol. Knowledge was assessed by means of an open-ended question. RESULTS: 62% of the women adequately understood the meaning of the Green Keyhole. These women were significantly younger (P < 0.0001). Mean body mass index (kg/m2+/-s.e.m.) was significantly higher among the women with more knowledge of the Green Keyhole symbol than those with less knowledge: 26.4 +/- 0.2 vs 25.6 +/- 0.2, (P = 0.002). There were no major differences in total fat intake or total fibre intake between the women with less and more knowledge. However the ratios of polyunsaturated fatty acids to saturated fatty acids and fibre intake per 4200 kJ (1000 kcal) were higher (P = 0.05 and P = 0.03, respectively) and intake of saturated fatty acids was lower (P = 0.05) in the diet among women with better knowledge. CONCLUSIONS: The female population described here understands the campaign but their dietary behaviours do not appear to conform to the low-fat message.

Aged↗

PubMed1996

Weight change in relation to intake of sugar and sweet foods before and after weight reducing gastric surgery.

OBJECTIVE: To test the hypothesis that a diet containing many sweet foods is associated with poor weight loss after gastroplasty. SUBJECTS AND METHODS: 375 severely obese subjects followed for 2 y after vertical banded gastroplasty or gastric banding; 34 subjects followed after gastric bypass. RESULTS: Total energy and all macronutrients were reduced 2 y after surgery. Sweet foods were less reduced than other foods, resulting in a relative increase of sugar intake. At 2 y a high relative intake of sugar and fat was associated with a low energy intake and a large weight reduction in the gastroplasty group. In the highest quartile of mono+disaccharide intake (> 142 g) weight loss was 29.9 kg compared to 25.1 kg in lowest quartile (> 72 g). Absolute and relative sugar intake before surgery did not predict weight outcome. At 6 months, i.e. during a period of active weight reduction, energy intake was significantly related to weight loss. CONCLUSION: Gastroplasty patients who continue selecting sweet foods appear to maintain lower energy intakes and lose more weight. However the associations are unlikely to be causal but probably indicative of changes in other aspects of the diet, eg exclusion of regular meals. Since large weight losses are most likely to be associated with low quality diets these results highlight the need for supplementation therapy of gastroplasty patients. Finally the lack of association between presurgical sugar intake and subsequent weight loss brings into question the surgical practice of selectively assigning sweet eaters to gastric bypass.

Adult↗

PubMed1995

Dietary underreporting by obese individuals--is it specific or non-specific?

OBJECTIVE: To examine the distribution of patterns of macronutrient density in relation to obesity. DESIGN: Cross sectional. SETTING: Denmark. SUBJECTS: 323 men and women aged 35-65 years, selected randomly from a larger population sample of Danish adults. MAIN OUTCOME MEASURE: Bias in dietary reporting of energy and protein intake in relation to percentage body fat, assessed by comparison of data from an interview on dietary intake with data estimated from 24 hour nitrogen output, validated by administering p-aminobenzoic acid, and estimated 24 hour energy expenditure. RESULTS: Degree of obesity was positively associated with underreporting of total energy and protein, whereas compared with total energy reported, protein was overreported by the obese subjects. CONCLUSION: Errors in dietary reporting of protein seem to occur disproportionately with respect to total energy, suggesting a differential reporting pattern of different foods. Although, on average, all subjects showed a greater underreporting of energy than of protein, this was most common in the obese subjects. Snack-type foods may be preferentially forgotten when obese people omit food items in dietary reporting. These results seem to agree with the general assumption that obese people tend to underreport fatty foods and foods rich in carbohydrates rather than underreport their total dietary intake. These results may have implications for the interpretation of studies of diet and comorbidities related to obesity.

4-Aminobenzoic Acid↗

PubMed1995

Body compartment and subcutaneous adipose tissue distribution--risk factor patterns in obese subjects.

The purpose of this study was to investigate whether upper body obesity and/or visceral obesity are related to cardiovascular risk factors among severely obese subjects, phenomena that have previously been reported in more heterogeneous body weight distributions. 2450 severely obese men and women aged 37 to 59 years, with a body mass index of 39 +/- 4.5 kg/m2 (mean +/- SD) were examined cross-sectionally. Eight cardiovascular risk factors were studied in relation to the following body composition indicators: four trunk and three limb circumferences, along with weight, height and sagittal trunk diameter. From the latter three measurements lean body mass (LBM, i.e., the non-adipose tissue mass) and the masses of subcutaneous and visceral adipose tissue were estimated by using sex-specific prediction equations previously calibrated by computed tomography. Two risk factor patterns could be distinguished: 1. One body compartment-risk factor pattern in which the subcutaneous adipose tissue (AT) mass and, in particular, the visceral AT mass were positively related to most risk factors while the lean body mass was negatively related to some risk factors. 2. One subcutaneous adipose tissue distribution- risk factor pattern in which the neck circumference was positively and the thigh circumference negatively related to several risk factors. It is concluded that lean body mass (LBM), visceral and subcutaneous adipose tissue masses as well as neck and thigh circumferences, used as indices of subcutaneous adipose tissue distribution, are independently related to cardiovascular risk factors in severely obese men and women.

Adipose Tissue↗

PubMed1995

Dietary fat intake and weight gain in women genetically predisposed for obesity.

The influence of dietary fat intake on subsequent change in body mass index (BMI) of adult women was examined while taking into account predisposition for obesity. A representative population sample of 361 Swedish women aged 38-60 y was first examined in 1968-1969 and followed up 6 y later. Dietary intake was estimated by diet history interview, and parental fatness was assessed by questionnaire. Women already overweight with > or = 1 obese parent were considered predisposed to obesity. When total energy intake, smoking habits, physical activity, and menopausal status were controlled for in regression analysis, high dietary fat intake was significantly associated with a 6-y gain in BMI only the predisposed women (P = 0.003), but not among obese women with lean parents, or lean women with or without obese parents. High dietary fat intake may have an obesity-promoting effect in women with a genetic predisposition.

Adult↗

PubMed1995

The dietary fat: carbohydrate ratio in relation to body weight.

A review of the contemporary dietary surveys indicates that the percentage of energy derived from fat is, in general, positively associated with total energy consumption and obesity. However, dietary carbohydrate tends to show the opposite trend. Epidemiological and experimental evidence suggest that the fat: carbohydrate ratio affects body weight through energy surfeits facilitated by the high energy density and palatability of fat. Biological mechanisms for an effect of this dietary ratio on the regulation of body weight have been the topic of much recent research. In this context the fat: carbohydrate ratio might be of particular importance in individuals with an inherited susceptibility to obesity.

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