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Biomedical subjects

S Rössner

Publications and source records attributed to S Rössner.

At least 73 records · Page 4Linked to original sources
PubMed2000

Weight loss, weight maintenance, and improved cardiovascular risk factors after 2 years treatment with orlistat for obesity. European Orlistat Obesity Study Group.

OBJECTIVE: To determine the effect of orlistat, a new lipase inhibitor, on long-term weight loss, to determine the extent to which orlistat treatment minimizes weight regain in a second year of treatment, and to assess the effects of orlistat on obesity-related risk factors. RESEARCH METHODS AND PROCEDURES: This was a 2-year, multicenter, randomized, double-blind, placebo-controlled study. Obese patients (body mass index 28 to 43 kg/m2) were randomized to placebo or orlistat (60 or 120 mg) three times a day, combined with a hypocaloric diet during the first year and a weight maintenance diet in the second year of treatment to prevent weight regain. Changes in body weight, lipid profile, glycemic control, blood pressure, quality of life, safety, and tolerability were measured. RESULTS: Orlistat-treated patients lost significantly more weight (p<0.001) than placebo-treated patients after Year 1 (6.6%, 8.6%, and 9.7% for the placebo, and orlistat 60 mg and 120 mg groups, respectively). During the second year, orlistat therapy produced less weight regain than placebo (p = 0.005 for orlistat 60 mg; p<0.001 for orlistat 120 mg). Several obesity-related risk factors improved significantly more with orlistat treatment than with placebo. Orlistat was generally well tolerated and only 6% of orlistat-treated patients withdrew because of adverse events. Orlistat leads to predictable gastrointestinal effects related to its mode of action, which were generally mild, transient, and self-limiting and usually occurred early during treatment. DISCUSSION: Orlistat administered for 2 years promotes weight loss and minimizes weight regain. Additionally, orlistat therapy improves lipid profile, blood pressure, and quality of life.

Adult↗
PubMed2000

Social mapping of the obesity epidemic in Sweden.

OBJECTIVE: The aim of the present study is to describe the evolution of the obesity epidemic in Sweden, with specific attention to the socioeconomic gradient. DESIGN: Data from the Swedish Surveys of Living Conditions were used. Three such surveys were undertaken in 1980/81, 1988/89, and 1996/97, each of which was based on a simple random sample from the national population registry. SUBJECTS: A total of 38,284 observations are used in this analysis, including males and females aged 16-84. The sample is approximately equally divided among the 3 survey periods and by gender. MEASUREMENTS: The following body weight categories are used to describe changing prevalences: overweight (BMI>/=25), obesity (BMI>/=30) and underweight (BMI<18.5). Because body weight and heights were self-reported, recorded values were adjusted for estimating gender-specific obesity prevalences. Education was used as a proxy for socioeconomic status. RESULTS AND CONCLUSIONS: The prevalence of BMI>/=30 increased significantly over the 16-year observation period. At the time of the 1980/81 survey, the adjusted estimates were 8.8% in women and 6.6% in men, compared to 11.9% and 10.0% respectively, in 1996/97. The prevalence of BMI>/=25 was also analyzed for time trends, with specific attention to populations at risk. The largest proportionate changes occurred in women aged 16-44, among whom the prevalence of overweight doubled. The inverse educational gradient with respect to obesity is still present in both sexes, but there is no indication that it has increased in magnitude between 1980/81-1996/97.

Adolescent↗
PubMed2000

Body weight characteristics of subjects on asthma medication.

OBJECTIVE: Weight gain is a frequently documented side effect after long-term anti-inflammatory treatment with systemic corticosteroid drugs in patients with asthma. In recent years new types of inhaled corticosteroids have been introduced, which act locally and are more rapidly bio-transformed. Even such corticosteroids may have a detectable, clinically relevant systemic side effect on weight. The aim of this study is to investigate if there is any relationship between body weight and asthma medication. DESIGN: The relationship between asthma medication and body weight was analysed in two combined randomized samples of the adult Swedish population 16-60 y of age (n = 17,912). Multivariate logistic regression analyses were carried out to obtain estimates for (1) body mass index (BMI) indicating 'obesity' (BMI > 29.9 kg/m2) in men and women controlling for self-reported asthma medication, and (2) self-reported asthma medication controlling for BMI. In both cases we furthermore controlled for interview period, age, Swedish region, smoking habits, physical activities and level of education. RESULTS: We found no significantly higher odds for obesity in men (OR = 1.21 (0.55-2.64) or women (OR = 1.97 (0.89-4.38) on asthma medication compared to men and women with pharmacologically untreated asthma even after adjustment for smoking habits, physical activities, level of education and other related co-variables. However, we found significant positive associations between obesity and interview period, age and former smoking and inverse significant relationships with the degree of physical activity. We also found significantly higher adjusted odds for asthma, indicated by self-reported asthma medication, in women (OR = 2.74 (1.91-3.91)) but not in men (OR = 1.57 (0.96-2.56)) with BMI indicating 'obesity'. CONCLUSION: There is no strong evidence to suggest that modern pharmacological asthma treatment may contribute much to the development of obesity in either men or women on asthma medication. Adjustment for smoking habits, physical activities, level of education and other related co-variables have minor effects on these relationships. Obesity may still be an independent risk factor for asthma since we observed significantly higher odds for self-reported asthma medication in women and an almost significant relationship in men even after control for BMI and other related co-variables.

Adolescent↗
PubMed2000

Referral letters to an obesity unit--relationship between doctor and patient information.

The contents of 200 letters of referrals from physicians to a clinical obesity unit were compared with patient-reported data and analysed for concordant and discordant information. For major comorbidities (diabetes, hypertension, joint problems) concordant information was found in about 80%, whereas discordant information was found in 46% for smoking, and 66% for medication. Forty-five percent of psychological problems, described by patients, were not identified by the referring physician. The role of the referral letter as a tool in medical communication has received little attention and comparative data are generally lacking, but our data suggests that there is room for considerable improvement of the quality of the referral letter.

Adult↗
PubMed2000

Meal pattern and risk factor evaluation in one-year completers of a weight reduction program for obese men - the 'Gustaf' study.

OBJECTIVES: To evaluate changes in meal patterns and in obesity related risk factors after 1 year of treatment in obese men. DESIGN: Data from two 24-h dietary recalls, performed at base-line and after 1 year of treatment, were related to changes in medical risk factors. SETTING: Academic obesity unit. SUBJECTS: Sixty-three men, aged 44 (eight) years (mean [SD]) and Base-line Body Mass Index (BMI) 37.4 (4.6) kg m-2, who had completed 1 year of treatment. The men were subdivided by tertiles according to weight change: tertile I (n = 21), mean +0.3 kg, tertile II (n = 21), mean -5.8 kg and tertile III (n = 21), mean -14.2 kg. MAIN OUTCOME MEASURES: Weight loss, changes in meal patterns and in obesity related medical risk factors. RESULTS: The reported mean energy intake decreased after treatment in tertiles II and III by 700 (1300) kcal (P < 0.05) and 700 (900) kcal (P = 0.001), respectively. In tertile III the energy-% from fat decreased (P < 0.05) with a reciprocal increase in energy-% from protein (P < 0.05). The frequency of snacks of a low nutritional quality decreased (P < 0.01) in tertile III together with an increase in energy-% from 'hot meals of good quality' (P < 0.05). Obesity related risk factors (anthropometry, blood pressure, serum lipid concentrations, blood glucose and plasma insulin) improved in a beneficial way only in tertile III. CONCLUSIONS: The weight loss in the successful tertile III men was to a great extent explained by fewer low quality snacks but more energy from high quality meals. These changes reflected the behaviour modification strategy recommended.

Adult↗
PubMed2000

Associations of leptin, insulin resistance and thyroid function with long-term weight loss in dieting obese men.

OBJECTIVE: The aim of the present study was to identify predictors of weight loss in obese men participating in a 2-year behaviour modification programme. DESIGN: Longitudinal, clinical intervention study of a behaviour modifying weight loss program. SETTING: University Hospital, Stockholm, Sweden. SUBJECTS: Forty-four obese men (age, 42.7 +/- 1.1 years: BMI, 37.1 +/- 0.6 kg m(-2), mean +/- SEM) followed for 2 years. INTERVENTIONS: Behaviour modification weight loss programme. MAIN OUTCOME MEASURES: Associations between plasma leptin and thyroid function tests, insulin resistance by homeostatic model assessment (HOMA), dietary recall and anthropometrically determined body composition. RESULTS: At baseline, there were significant correlations between plasma leptin and body mass index (BMI), fat-free mass (FFM) and insulin resistance. Median weight loss over 2 years was 4.9 kg (range, -27.2 to +11.9). Baseline serum leptin concentrations adjusted for BMI (leptin/BMI ratio) were significantly correlated with 2-year weight change (r = 0.34, P = 0.04). A subset of seven of the 44 men gained weight over the 2 years. These 'gainers' differed significantly in initial leptin/BMI ratio (0.62 +/- 0.07) compared with the 37 'losers' (0.42 +/- 0.03, P < 0.05). In a multiple regression model, baseline leptin, insulin and age predicted 22% of the variance in weight change with no additional significant contribution from BMI, FFM, waist:hip ratio, thyroid function tests or energy intake. There was a strong correlation between the change in leptin concentrations and the change in insulin resistance from baseline to 2-year follow-up (r = 0.54; P < 0.001). CONCLUSION: Baseline plasma leptin concentrations predicted long-term weight loss. Inappropriate leptin secretion or disposal, corrected for BMI, was associated with failure to maintain weight loss in obese men in a behaviour modification weight loss programme.

Adult↗
PubMed2000

Fat intake and food choices during weight reduction with diet, behavioural modification and a lipase inhibitor.

OBJECTIVE: To study the composition of fat intake and fat-rich meals consumed during a trial in which obese subjects were treated with a lipase-inhibitor or placebo, with emphasis on food choices and eating hours. DESIGN: Patients were instructed to record all food and drink taken for four days prior to each dietician visit. The food diaries from all scheduled 15 treatment visits were analysed for nutritional content and composition and for temporal distribution. All meals containing 25 g of fat were defined as fat-rich. SUBJECTS: Twenty-eight women and six men, mean age 45.2 +/- 10.9 (SD) years with a mean body mass index of 37.3 +/- 3.3 (SD) kg m-2 at the beginning of the study. RESULTS: Fat intake, both as absolute weight and as energy % was generally higher in the placebo group but no significant trend over time could be seen. Fat rich meals were increased by 59% towards the end of the study. Most fat rich meals were eaten at lunch and dinner. Cooking fat, fatty sauces, meat dishes and cheese contributed to the major proportion of fat, both for placebo and drug treated subjects. No major changes were seen in food choice over time. CONCLUSION: A lipase inhibitor may affect the amount of fat ingested but does not seem to change major sources of fat. The typical fat-rich meal consumed by these subjects was a meat dish, consumed in the evening.

Analysis of Variance↗
PubMed2000

Lessons from obesity management programmes: greater initial weight loss improves long-term maintenance.

It is a common belief that weight loss achieved at a slow rate is better preserved than if the weight is lost more rapidly. However, the literature shows that initial weight loss is positively, not negatively, related to long-term weight maintenance. There is evidence from randomised intervention trials to support that a greater initial weight loss induced without changes in lifestyle (e.g. liquid formula diets or anorectic drugs) improves long-term weight maintenance, providing it is followed by a 1-2 years integrated weight maintenance programme consisting of lifestyle interventions involving dietary change, nutritional education, behaviour therapy and increased physical activity. In conclusion, we find evidence to suggest that a greater initial weight loss as the first step of a weight management programme may result in improved sustained weight maintenance.

Appetite Depressants↗
PubMed2000

Eating behavior in Prader-Willi syndrome, normal weight, and obese control groups.

OBJECTIVE: Hyperphagia in Prader-Willi syndrome (PWS) is hypothesized to be due to hypothalamic dysfunction; thus the study of individuals with PWS might illustrate how hypothalamic dysfunction affects eating behavior. The aim of this study was to document the microstructure of the eating behavior in patients with PWS and to compare it with that of members of obese and normal weight control groups of the same age. STUDY DESIGN: Nine subjects with PWS (age, 10 +/- 4 years), 20 normal weight subjects (age, 12 +/- 3 years), and 20 obese subjects (age, 12 +/- 4 years) were served an excess lunch meal (hash) on a hidden scale built into a table and connected to a computer. The plate of food is placed on top of the scale, and when the food is eaten, the change in food weight is registered continuously. An eating curve is displayed online. After the meal, the eating data are fitted to a polynomial, and the computer calculates the amount of food eaten, time of consumption, eating rate (initial and total), and rate of deceleration. RESULTS: Subjects with PWS were found to have a longer duration of eating (P =.04) and a slower initial eating rate (P =. 01) compared with members of both obese and normal weight groups. In subjects with PWS, 56% of the eating curves were non-decelerating (linear or accelerating) compared with 10% of the normal weight group and 30% of the obese group (P =.02). CONCLUSION: The microstructure of the eating behavior in subjects with PWS differs from that of members of obese and normal weight control groups. Thus the eating behavior found in subjects with PWS might be due to decreased satiation rather than increased hunger.

Adolescent↗
PubMed2000

Secretion of tumor necrosis factor-alpha shows a strong relationship to insulin-stimulated glucose transport in human adipose tissue.

Some animal models suggest that tumor necrosis factor (TNF)-alpha is a key component in obesity-linked insulin resistance because it inhibits insulin receptor signaling and glucose transport in insulin-sensitive tissues. However, in vivo data in humans have given conflicting results regarding the relationship between circulating TNF-alpha levels and insulin sensitivity. In the present study, the potential local role of TNF-alpha on insulin action in human subcutaneous adipose tissue was studied in 42 obese women (BMI 39+/-10 kg/m2). We found a strong inverse correlation between adipose TNF-alpha secretion and maximum insulin-stimulated glucose transport in adipocytes that was independent of fat cell volume, age, and BMI (P < 0.001, r = 0.58). As much as one-third of the variation in insulin-stimulated glucose transport could be accounted for by variations in TNF-alpha secretion. There was no significant correlation (r = 0.11) between secretion of adipose plasminogen activator inhibitor 1 and glucose transport. Furthermore, subcutaneous adipose tissue of 4 obese women (BMI 40+/-4) incubated with TNF-A for 24 h showed a one-third concentration-dependent inhibition of insulin-stimulated glucose transport (P < 0.01). In conclusion, adipose TNF-alpha may be an important specific and local factor in adipose tissue that influences the ability of insulin to stimulate glucose transport in human fat cells, at least in obese women.

Adipose Tissue↗
PubMed1999

Open randomised trial of intermittent very low energy diet together with nicotine gum for stopping smoking in women who gained weight in previous attempts to quit.

OBJECTIVE: To determine whether attempts to prevent weight gain will increase success rates for stopping smoking. DESIGN: 16 week, open, randomised study with 1 year follow up. SETTING: Obesity unit. SUBJECTS: 287 female smokers who had quit smoking before but started again because of weight concerns. INTERVENTION: Combination of a standard smoking cessation programme with nicotine gum and a behavioural weight control programme including a very low energy diet. A control group was treated with the identical programme but without the diet. MAIN OUTCOME MEASURE: Sustained cessation of smoking. RESULTS: After 16 weeks, 68/137 (50%) women had stopped smoking in the diet group versus 53/150 (35%) in the control group (P=0.01). Among these women, weight fell by mean 2.1 (95% confidence interval 2.9 to 1.3) kg in the diet group but increased by 1.6 (0.9 to 2.3) kg in the control group (P<0.001). After 1 year the success rates in the diet and control groups were 38/137 (28%) and 24/150 (16%) respectively (P<0.05), but there was no statistical difference in weight gain. CONCLUSIONS: Combining the smoking cessation programme with an intervention to control weight helped women to stop smoking and control weight.

Chewing Gum↗
PubMed1999

An advanced culture method for generating large quantities of highly pure dendritic cells from mouse bone marrow.

As dendritic cells (DC) are rare populations in all organs, their generation from hematopoietic precursors in large quantities has proven critical to study their biology. From murine bone marrow about 5 x 10(6) cells at 70% purity are obtained per mouse after 8 days of culture with GM-CSF. We have improved this standard method and routinely achieve a 50-fold higher yield, i.e., 1-3 x 10(8) immature and mature DC per mouse at 90-95% purity. The major modifications were: (i) the avoidance of any active depletion of bone marrow cell subpopulations to circumvent loss of precursors, (ii) a lower plating density of bone marrow cells, (iii) a prolonged culture period of 10-12 days, (iv) the reduction of the GM-CSF dose from day 8 or 10 onwards to reduce granulocyte contaminations. The final non-adherent population at day 10-12 constitutes a mixture of immature and mature DC. Further maturation of DC could be induced by high doses of LPS or TNF-alpha for the last 24 h, where 50-70% of the non-adherent fraction represented mature DC with high levels of NLDC-145, CD86 and CD40. This method allows by simple means the generation of high numbers of murine DC with very low B cell or granulocyte contaminations. It will be valuable to study DC biology notably at the molecular level.

Animals↗