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Biomedical subjects

M Apfelbaum

Publications and source records attributed to M Apfelbaum.

At least 37 records · Page 2Linked to original sources
PubMed1990

Lack of association between dietary alcohol and HDL-cholesterol concentrations in obese women.

The relationships of alcohol intake and corpulence to HDL-cholesterol were studied in 653 women taking medical advice about body weight. The body mass index (BMI) was positively correlated with triglyceride and negatively with HDL-cholesterol. The relation between BMI and HDL-cholesterol was discontinuous. Total cholesterol, triglycerides and diastolic blood pressure were increased for alcohol intakes greater than 10 g/d regardless of body weight. Alcohol intake was associated with higher concentrations of HDL-cholesterol (P = 0.006) in non obese (BMI = 25.2 +/- 1.5 kg/m2) subjects, but not in mildly (27.3 less than or equal to BMI less than 32.3) or massively (BMI greater than or equal to 32.3) obese subjects. The fact that HDL concentrations were not associated with alcohol intake in obese patients suggests that (1) alcohol acts on the HDL pool through one of the pathways which are perturbed in obesity, possibly lipolysis, (2) obesity is one of the reasons for the differences in individual responses of HDL-cholesterol to alcohol, (3) myocardial infarction might not be inversely correlated with alcohol intake in the obese as it is in the non-obese population.

Adult↗
PubMed1990

Negative allesthesia and decreased endogenous opiate system activity in anorexia nervosa.

The combined effects of an intragastric load of glucose compared to water and of naltrexone compared to placebo were tested on preference for sucrose in six anorectic patients. While in normal subjects, glucose-induced negative allesthesia is known to disappear upon loss of weight, it persisted in anorexia nervosa (AN) despite a major weight loss; furthermore, in contrast with its effects in normoponderal subjects, naltrexone at the dose of 25 mg did not decrease the preference for sucrose nor did it enhance glucose-induced allesthesia. Basal plasma beta endorphin level determined by radioimmunoassay was higher in AN than in normal subjects (75 +/- 6.1 pmoles/l vs. 13 +/- 3.8 pmoles/l) (p less than 0.001). It is suggested that a decrease in endogenous system opiate activity might be associated with food refusal and body weight loss in anorexia nervosa.

Adolescent↗
PubMed1990

Fat-free mass estimation by the two-electrode impedance method.

In 202 healthy subjects (81 men, 121 women) aged 12-71 y, impedance (Z) was measured with a two-electrode analyzer. Fat-free mass was assessed by hydrodensitometry (FFMd). This population was randomized into two groups for cross-validation. In group 1 the relationship between ht2/Z at 1 MHz and FFMd was highly significant (r = 0.85, P less than 0.001). The equation for predicting FFMd from impedance, height2, weight, and age obtained in group 1 (r = 0.97) was applied to group 2 (r = 0.96) without reduction in r value. The accuracy of this equation was not different between men and women or between active and sedentary people. These data indicate that the two-electrode impedance method is a reliable and valid approach not only for the determination of extracellular water (as previously shown) but also for that of FFM.

Adolescent↗
PubMed1990

Obesity and iron status in menstruating women.

The relationship between iron stores and obesity in menstruating women was studied in 20 obese and 20 nonobese women matched for age and contraception. Although no difference was observed in serum iron or total-iron-binding capacity, the obese group showed significantly higher hemoglobin (137 +/- 9 vs 10 g/L, mean +/- SD; P less than 0.01), hematocrit (0.41 +/- 0.02 vs 0.39 +/- 0.03, P less than 0.05), and serum ferritin concentrations (48.0 +/- 44.3 vs 25.8 +/- 19.5 micrograms/L, P less than 0.05). There was no difference between obese and nonobese women in either the menstrual-cycle interval or the duration of the menstrual flow. Iron intake was significantly higher in the obese group (15.9 +/- 2.9 vs 14.1 +/- 2.9 mg/d, P less than 0.05). These results suggest that obese menstruating women are at low risk of depleting iron stores, possibly because of high iron intake. Iron-fortification programs might thus be undesirable in such subjects.

Adult↗
PubMed1990

Overweight treated with energy restriction and a dietary fibre supplement: a 6-month randomized, double-blind, placebo-controlled trial.

Fifty-two (41 females, 11 males) overweight patients, mean body mass index (BMI) = 29.3, were treated for 6 months in a randomized, double-blind, placebo-controlled, parallel group design. The treatment consisted of an energy restricted diet and a dietary fibre supplement amounting to 7 g/day. After treatment the weight reduction in the fibre-treated group, 5.5 +/- 0.7 kg, was significantly higher than that of the placebo group, 3.0 +/- 0.5 kg (P = 0.005). Both groups were normotensive and comparable commencing treatment, 126.5/75.6 +/- 2.0/1.3 mm Hg versus 126.7/78.7 +/- 2.5/1.6 mm Hg. The treatment changed blood pressure non-significantly. Hunger feelings using visual analogue scales (VAS) were significantly reduced from 139.8 +/- 8.2 cm to 118.3 +/- 7.0 cm in the fibre-treated group, whereas a significant increase from 129.5 +/- 6.9 cm to 146.9 +/- 8.8 cm (P less than 0.02) was seen in the placebo group. Side-effects were predominantly gastrointestinal and equally distributed in the two groups. It is concluded that a dietary fibre supplement is of value in the management of overweight, enhancing weight loss and decreasing hunger feelings.

Adult↗
PubMed1990

Circadian rhythm of energy intake and corpulence status in adults.

The relationship between circadian distribution of energy intake and corpulence was studied in 1312 subjects seeking medical advice for their weight. The corpulence categories (non-obese, mildly obese and massively obese) were defined on the basis of NHANES II. Food consumption was assessed through the dietary history method. The 24 h energy intake increased with corpulence. The lunch represented higher (P less than 0.001) proportions of daily intake in mildly and in massively obese than in non-obese. The reverse occurred for the breakfast (P less than 0.001). The relationships of corpulence with breakfast and lunch persisted after adjustment for nutrient intake. No difference was found for dinner and extra-prandial food intake. Such data suggests several behavioural and/or metabolic hypothesis.

Adult↗
PubMed1989

International trial of long-term dexfenfluramine in obesity.

In a randomised, placebo-controlled, double-blind study, 822 obese patients of both sexes were given either dexfenfluramine (dF), 15 mg twice daily (404), or placebo (418) in addition to a calorie-restricted diet for 1 year. Patients in both groups lost weight significantly in the first 6 months; after 6 months dF patients had a higher cumulative mean weight loss. Dropout rates were lower in dF patients than in placebo patients, mainly because of dissatisfaction with weight loss in the latter group. More than twice as many dF patients as placebo patients achieved a given weight loss; but more dF patients than placebo patients had transient side-effects (tiredness, diarrhoea, dry mouth, polyuria, and drowsiness).

Adult↗
PubMed1989

Effects of a low dose of naltrexone on glucose-induced allesthesia and hunger in humans.

In order to study the effects of a low dose of the opioid antagonist naltrexone on ingestive behavior for sucrose in humans, preference for sucrose solutions and feelings of hunger were scored on visual analogical scale by 14 healthy subjects with or without naltrexone. Effects of intragastric glucose load or water, and naltrexone (25 mg) or placebo were tested. At this low dose, naltrexone alone had a slight effect on allesthesia, and it produced a strong potentiation of glucose-induced allesthesia.

Adult↗
PubMed1989

[Anorexia nervosa: absence of sensitivity to nutritional protein markers. Study of 23 patients and comparison to a paired group with colonic Crohn's disease].

One of the most important therapeutic goal in anorexia nervosa is to define with the patient a body weight to obtain. To do so, objective criteria are needed. For this purpose, we studied in a longitudinal way, 9 nutritional parameters in 23 patients with anorexia nervosa, as compared with 23 age - and sex - matched patients with Crohn's disease: body weight, tricep's skinfolds, mid-arm muscle circumferences; serum albumin, prealbumin, transferrin, hemoglobin, cholesterol; urinary creatinine and calcium, magnesium, zinc and copper serum levels and urinary outputs. Despite losses of body weight, of lean body mass and of fatty mass higher in patients with anorexia nervosa than in those with Crohn's disease, the former had higher nutritional protein's serum levels than the latter. These nutritional protein markers were not in anorexia nervosa different from normal values. In anorexia patients, zinc and copper serum levels and urinary outputs were very low. This study suggests that nutritional protein markers of hepatic synthesis are not sensitive markers for malnutrition evaluation and can not be used to follow renutrition efficacy.

Adult↗
PubMed1989

A positive correlation between energy intake and body mass index in a population of 1312 overweight subjects.

The energy intake (EI) of 1312 overweight subjects was assessed using the research dietary history method. EI was positively associated with overweight--as expressed by the body mass index (BMI)--in both males and females. Such findings are at variance with earlier reports of low dietary intakes in the obese and of an inverse relationship between EI and BMI. This discrepancy could be related to the dietary-interviews method used and/or to differences in the degree of motivation of the obese subjects in the various studies. On the other hand, our results are consistent with the positive relationship between energy expenditure (EE) and BMI previously reported in the literature and with the expected EE of our subjects.

Adult↗
PubMed1989

Energy expenditure economy induced by decrease in lean body mass in anorexia nervosa.

In anorexia nervosa, the low energy input associated with the classic overactivity during the malnourished state needs a sparing of energy expended at rest and also during physical activity. Therefore, we measured energy expenditure, both at rest and during moderate bicycling exercise (30W, 6 min), in 11 adult anorectic patients (weight 35.15 +/- 4.30 kg, mean +/- s.d.) at the beginning of their treatment and again after a mean weight gain of about 8.4 kg. During the malnourished state, the resting energy expenditure (REE) was lower than that predicted according to Harris and Benedict (P less than 0.001). Although it was significantly increased after weight gain (P less than 0.05), the REE per kg of lean body mass remained unchanged after repletion. The total oxygen consumption related to exercise remained unchanged after refeeding (2114 +/- 487 ml/15 min, basal vs 2168 +/- 394 ml/15 min, repletion) (n.s.). Thus in anorexia nervosa, weight loss and malnutrition did not induce economy either in energy expended at rest per unit of lean body mass nor in the energy expended in moderate cycling activity.

Adolescent↗
PubMed1988

Delayed gastric emptying in anorexia nervosa is improved by completion of a renutrition program.

The effects of renutrition on gastric emptying and upper gastrointestinal symptoms were evaluated in 14 anorexia nervosa patients before and after weight gain. A double-isotope technique was used to measure gastric emptying of both the solid and the liquid phases of the meal. Upper gastrointestinal symptoms were frequent before renutrition, occurring in 78% of the patients. Among these symptoms, nausea, vomiting and gastric fullness were correlated well with slowing in gastric emptying of both solid and liquid phases of the meal, which was demonstrated, respectively, in 10 (71%) and nine (64%) of the 14 patients. For the 11 patients who subsequently gained body weight, we observed, without any pharmacological treatment, an improvement of gastric emptying of both solid and liquid phases of the meal in eight (73%) and seven (64%) patients, respectively. Gastric emptying was unchanged in the three other patients who gained very little weight during the time of the study. As gastric emptying improved, so did nausea, vomiting, and gastric fullness. In three patients who had initially gained weight, nausea and gastric fullness recurred, associated again in all cases with a delay in gastric emptying. In conclusion, in anorexia nervosa, delayed gastric emptying, which is a frequent feature and which is well correlated with some of the upper digestive complaints, can return to normal without any pharmacological treatment. In this improvement, psychological assistance may play a role, together with the correction of the malnutrition.

Adolescent↗
PubMed1988

Low high density lipoprotein-2 concentrations in obese male subjects.

In this study we have compared the lipoprotein patterns, in particular HDL subfractions, of 34 obese men to those of 34 normoponderal normolipemic men, matched for age and use of tobacco. Obesity was associated with increased VLDL concentrations in only half the subjects. HDL concentrations in all obese subjects were lower than in matched controls. The decrease was most marked in the HDL2 subfraction in which cholesterol and protein contents were decreased by 50%; it was independent of triglyceride levels and not related to the severity of overweight. Moreover, while HDL2 was negatively correlated with BMI (P less than 0.01) when both populations were considered together, the correlation disappeared when calculated separately within each population, suggesting a threshold effect. The low levels of HDL2 might result from discretely altered lipolysis, not sufficient to cause an elevation in fasting triglyceridemia. In this case, HDL2 should prove to be a sensitive index of lipolytic efficiency.

Adult↗
PubMed1988

Association of apolipoprotein epsilon 4 allele with hypertriglyceridemia in obesity.

Hypertriglyceridemia is the most frequent lipid abnormality associated with obesity. Genetic polymorphism of apolipoprotein E (apoE) has been demonstrated to influence lipid levels. We wanted to assess the role of apoE alleles in the hypertriglyceridemias of the obese population. The apoE phenotypes and lipid status were investigated in a population of 172 obese French subjects. The frequencies of phenotypes E4/3, E4/4 and E4/2 were 29.7%, 8.1% and 2.1%, respectively, in a subgroup with triglycerides greater than or equal to 200 mg/dl (n = 37) versus 14.2%, 2.7% and 0.9% in the normolipidemic subgroup (p less than 0.005). The odds ratio of hypertriglyceridemia was 3.15 for obese subjects with epsilon 4; 27.7% of hypertriglyceridemias could be attributed to epsilon 4 allele. It is concluded that the genetic polymorphism of apoE modulates the effects of obesity on lipids and lipoproteins and that allele epsilon 4 increases the risk of obesity-induced hypertriglyceridemia.

Adult↗
PubMed1988

[Feeding behavior disorders in man].

Diagnosis of anorexia nervosa is easily made using symptom lists. It is mandatory to check that the weight loss is due to no somatic cause. The prevalence of bulimia and syndromes associating bulimia and anorexia is increasing considerably. In these latter syndromes, while not in typical anorexia, major affective disorders are often found. Endocrinological abnormalities are numerous. However the part of denutrition itself in these abnormalities is not clear. Pathogenesis of these eating disorders remains mysterious. But most probably, the endogenous opioid system is involved, at least in their perpetuation.

Anorexia↗