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Biomedical subjects

S Rössner

Publications and source records attributed to S Rössner.

At least 109 records · Page 6Linked to original sources
PubMed1997

Changes in patients' eating behavior: in the uremic state, on continuous ambulatory peritoneal dialysis treatment, and after transplantation.

Nineteen predialysis patients (group A) were studied before and after 3 to 6 months on continuous ambulatory peritoneal dialysis (CAPD) treatment. Six patients (group B) were studied during CAPD treatment and 3 to 6 months after transplantation. Nine uremic patients (group C) were studied before and 3 to 6 months after transplantation. The patients were invited to a single test meal by means of the universal eating monitor VIKTOR. An excess portion of hash was served on a plate placed on a hidden scale that was connected to a computer registering the eating process on line. The patients filled out visual analogue scales concerning appetite and food preferences before and after the test meal. The feeling of fullness before meals was greater in patients on CAPD than in patients in the predialytic state. Transplanted patients felt less full before meals compared with their ratings during the dialysis period. The median total intake of food was lower during dialysis than after transplantation. The palatability of the food was rated lower during dialysis compared with the ratings in the uremic state. Poor appetite and low intake during dialysis is still a problem, but improves after transplantation.

Adult↗
PubMed1997

VLCD versus LCD in long-term treatment of obesity.

OBJECTIVE: To compare the long-term effects of three different programs including initial 6 weeks (V)LCD diets 420 kcal/d, 530 kcal/d, 880 kcal/d) on sustained weight loss, attrition and obesity associated conventional cardiovascular risk factors. DESIGN: Prospective, randomized clinical 52 weeks trial. Two weeks of a booster (V)LCD period after week 26. SETTING: University outpatient obesity clinic. SUBJECTS: Ninety-three middle-aged obese patients (30 men), initial mean BMI 38.7 kg/m2, age 20-65 y, from the waiting list. MAIN OUTCOME MEASURES: Weight loss pattern, attrition, reported side effects, blood pressure, blood glucose and serum lipid levels. Repeated frequent measurements up to week 26, intermittently up to final measurements at week 52. RESULTS: One year attrition (30-45%), sustained weight loss (8-15% of initial body weight) and changes in obesity associated risk parameters were similar in all three group. Fewer adverse events were reported in the LCD group. CONCLUSION: The results compare favorably with most previous reports of similar design. VLCD (420 kcal or 530 kcal/ d and LCD 880 kcal/d) were equally effective in long term treatment of obesity. The tendency to less side effects with LCD suggests that such preparations deserve further attention.

Adult↗
PubMed1997

Weight development, drop-out pattern and changes in obesity-related risk factors after two years treatment of obese men.

OBJECTIVE: To describe a combined behavioural treatment program for obese men, the 'Gustaf' study, and to evaluate treatment success by the means of weight loss, drop-out analysis and changes in metabolic risk factors. SUBJECTS: Eighty-six men, aged 43 +/- 9 y (mean +/- s.d.) and BMI 37.7 +/- 4.4 kg/m2, from the waiting list of the outpatient clinic and men directly approaching the Obesity Unit. DESIGN: Combined, behavioural modification treatment, by the means of group sessions, for one hour every week over a two year period. MAIN OUTCOME MEASURES: Weight loss and changes in risk factors after completion of one and two years study and description of treatment success in the form of changes in metabolic risk factors. RESULTS: The one year drop-out rate was 22% and the cumulative rate after two years was 34%. Mean weight decreased significantly from start (121 kg) to one year (114 kg, P < 0.001) and to two years (115 kg, P < 0.001) in completers. Several metabolic risk factors (waist and hip circumferences, systolic blood pressure, serum cholesterol and plasma insulin) remained significantly decreased after two years of treatment. The complete metabolic syndrome was diagnosed in five men at onset, but in no one after two years. There was no difference in change of metabolic risk factors after one year between the men who lost 8-12% of initial body weight and those who lost more. CONCLUSION: Sixty-six% (57/86) of the obese men who started in the 'Gustaf' program were still in the program after two years. In spite of the relatively modest weight loss, the men maintained a large proportion of this weight loss and also maintained their improved metabolic risk factor pattern.

Adult↗
PubMed1997

Lipolytic catecholamine resistance linked to alpha 2-adrenoceptor sensitivity--a metabolic predictor of weight loss in obese subjects.

OBJECTIVE: The weight loss achieved during treatment with very-low-calorie diets (VLCD) varies between individuals. The aim of this study was to investigate whether interindividual variations in catecholamine-induced lipolysis are of importance for the rate of weight loss during VLCD. DESIGN: Prospective study. SUBJECTS: Twenty-eight obese, but otherwise healthy and drug-free women aged 20-57 y with BMI 33.3-47.5 kg/m2 were investigated before entering a four week weight reduction program with a calorie-restricted diet. MEASUREMENTS: A subcutaneous adipose tissue biopsy was obtained from the abdominal area. Isolated fat cells were prepared and incubated in vitro with agents acting on lipolysis at defined steps in the lipolytic cascade. Glycerol release was measured and used as a lipolytic index. Following the biopsy, the subjects underwent a four week VLCD treatment. RESULTS: The decrease in body weight in the whole group ranged between 4.8 and 13.5 kg. Dietary compliance was ascertained by daily measurements of urine-ketones and regular interviews and was satisfactory in all subjects throughout the study. Based on percent body weight reduction, the material was divided into two equally sized groups, classified as rapid or slow weight losers. The rapid weight losers were 10-fold more sensitive to the lipolytic effect of noradrenaline (P = 0.04) and 10-fold less sensitive (P = 0.002) to the antilipolytic effect induced by the alpha 2-adrenoceptor agonist clonidine than the slow weight losers. In the whole material, weight loss was significantly correlated (adjusted r2 = 0.25) with alpha 2-adrenoceptor sensitivity. CONCLUSION: Rapid weight loss during VLCD is associated with increased adipocyte lipolytic sensitivity to catecholamines due to decreased alpha 2-adrenoceptor sensitivity, which in turn may promote lipid mobilization. It appears that variations in alpha 2-adrenoceptor sensitivity in adipocytes may be predictive of weight loss during VLCD.

Adenosine Deaminase↗
PubMed1997

Is walking for exercise too exhausting for obese women?

OBJECTIVES: As exhaustion and pain during walking seem to be common problems among obese women, we decided to analyse the relative oxygen cost (% VO2max) in obese women during level walking. SUBJECTS: Fifty-seven obese female outpatients, 44.1 +/- 10.7 y, BMI 37.1 +/- 3.4 kg.m-2. METHODS: Walking tests at a self-selected, comfortable speed were performed indoors. Speed was measured with a speedometer, oxygen consumption (VO2) with the argon-dilution method and oxygen cost was estimated. Heart rate was measured; perceived exertion and pain were assessed with Borg's Category Ratio scale, CR10. Maximum oxygen uptake (VO2max/kg) was predicted from a submaximum bicycle ergometry test. RESULTS: The women walked more slowly, 70.9 +/- 5.6 m.min-1 (P < 0.0001), and had higher VO2, 1.2 +/- 0.2 l.min-1 (P < 0.001), than normals. A majority experienced exertion and some experienced pain. Their VO2max/kg, 21.2 +/- 5.0 ml.kg-1.min-1, was less than for normals (P < 0.0001). The mean % VO2max during walking was 56%, which was higher than in normal subjects 36% (P < 0.0001). Significant correlations between % VO2max and VO2max/kg (P < 0.0001), heart rate during walking (P = 0.0009) and age (P = 0.0081), respectively, were found. CONCLUSION: Very low VO2max/kg in obese women, rather than severe obesity per se, seems the most important factor to cause high % VO2max during walking. This might explain why many obese women perceive the exertion to be excessive and cannot follow the advice of their clinicians to exercise through long and brisk walks.

Adult↗
PubMed1997

Long-term effects of a very low calorie diet (Nutrilett) in obesity treatment. A prospective, randomized, comparison between VLCD and a hypocaloric diet+behavior modification and their combination.

OBJECTIVES: To compare weight loss on a balanced hypocaloric diet to that of a Very Low Calorie Diet (VLCD) after two months of treatment and to further compare 26 months of weight maintenance and safety with or without VLCD assistance in obese patients. DESIGN: Prospective, randomized, controlled intervention trial, initially with two and later with three parallel groups. SETTING: Swedish University out-patient obesity clinic. SUBJECTS: Eighty-one obese patients of both gender with a BMI > or = 30 kg/m2 from the waiting list participated in a structured weight reduction + weight maintenance programme. INTERVENTION: Twenty-seven patients (group A) were randomized to a balanced diet of 6720 kJ/d (1600 kcal/d) during the whole treatment period. The other patients (n = 54) were randomized to VLCD (Nutrilett) 1764 kJ/d (420 kcal/d) diet during the first two months. The VLCD treated patients were rerandomized after the initial treatment to the well balanced hypocaloric diet (6720 kJ/d) with (group C) or without (group B) 1 MJ of VLCD to be taken during the evening. MAIN OUTCOME MEASURES: During the first two-month period, the mean body weight loss in the VLCD group was 18.9 +/- 7.1 kg compared to 7.2 +/- 4.8 kg in the diet treated group, with a similar relative fat loss assessed by bioimpedance of 68% and 76% respectively. The maintained weight loss in all groups after 28 months of treatment was 10.9 +/- 10.2 kg in the 52% who completed the programme. Weight losses and drop-out rates were similar in all three groups. CONCLUSIONS: Twenty-four months weight maintenance and drop out rates are independent of whether the initial treatment commences with VLCD or a hypocaloric diet. One MJ nutrition powder taken freely does not affect 24 months weight maintenance on a hypocaloric (6.7 MJ/d) diet.

Adult↗
PubMed1997

Reduced food intake after jejunoileal bypass: a possible association with prolonged gastric emptying and altered gut hormone patterns.

The object of this study was to examine whether eating behavior, food preference, gastric emptying, and gut hormone patterns are altered after jejunoileal bypass (JIB) in patients with severe obesity. Eight obese [mean (+/- SD) body mass index (BMI; in kg/m2) 42.9 +/- 4] subjects were studied prospectively before and 9 mo after JIB with eight age- and sex-matched normal-weight control subjects. Total energy intake, data from the universal eating monitor (VIKTOR), eating motivation measured by visual analog scales, a food-preference checklist, a forced-choice list, solid-phase gastric emptying, and postprandial concentrations of cholecystokinin, motilin, and neurotensin were studied. BMI was reduced by 29% after JIB. Compared with normal subjects, the JIB patients showed a reduced desire to eat, decreased hunger, and reduced prospective consumption before a test meal. After surgery, obese subjects selected fewer food items and showed a reduced preference for high-carbohydrate and high-fat items before a test meal. There was a trend from an accelerated toward a decelerated eating pattern in obese subjects after JIB. After JIB, gastric emptying of obese subjects was slowed and similar to that in control subjects. Obese subjects had lower postprandial cholecystokinin concentrations that were lower than those of control subjects both before and after JIB. Postprandial concentrations of neurotensin were higher after JIB. We conclude that after JIB, the desire to eat and preference for high-carbohydrate and high-fat items is reduced, resulting in decreased energy intake. That gastric emptying is prolonged and gut hormone patterns are altered with low postprandial plasma cholecystokinin and high neurotensin plasma concentrations may at least partly account for these observations.

Adult↗
PubMed1997

An android body fat distribution in females impairs the pregnancy rate of in-vitro fertilization-embryo transfer.

To assess if the waist:hip ratio (WHR) is associated with the pregnancy rate (PR) in in-vitro fertilization (IVF) and embryo transfer, waist and hip girths, in addition to height, weight, body mass index (BMI), indications for IVF, PR and other related variables, were measured in 220 women undergoing IVF-embryo transfer. Three variables were significantly negatively associated with PR; high age, smoking and WHR >0.80. Women with WHR between 0.70-0.79 had a PR of 29.9% as compared to 15.9% in women with WHR >0.80 [odds ratio 0.42, 95% confidence interval (CI) 0.2-0.9, P = 0.03]. There were no correlations between BMI and PR, nor were there any significant differences for the indications for IVF-embryo transfer, number of oocytes or oocyte fertilization rate, cleavage rate and number of embryos transferred. The association between a low PR and WHR >0.80 remained unchanged after adjustment for age, BMI, smoking, indication for IVF, parity and number of embryos transferred. In IVF-embryo transfer, fertilization is a laboratory and clinically controlled process, until the embryo is transferred to the uterus. Possible reasons for our finding of a decreased PR in women with an android body fat distribution include a different endocrinological and biochemical milieu for the oocyte in the growing follicle, oocytes of poor quality, or endometrial changes due to hormonal dysfunction.

Adipose Tissue↗
PubMed1997

Weight gain in pregnancy.

Pregnancy and body weight development are intertwined in complicated patterns. Of the obese patients at our Obesity Unit, 73% had retained > 10 kg in connection with a pregnancy. For the general population the effect of a pregnancy on future weight development is surprisingly difficult to predict. In the Stockholm pregnancy and weight development study the estimated mean weight retention associated with a pregnancy and estimated 1 year after delivery was 0.5 kg but ranged from -12 to +26 kg. Weight increase during pregnancy was the strongest predictor for sustained weight retention 1 year later. Pre-pregnancy weight did not predict the weight development outcome. The lactation pattern had only a minor influence on weight development. Smoke cessation was an important predictor for sustained weight increase. More weight retention was observed in those women who reported an unfavorable change in lifestyle as regarded eating habits, meal patterns and physical activity. The eventual body weight after pregnancy seems to be more determined by the changes associated with that particular pregnancy than with the lifestyle before.

Female↗
PubMed1997

Defining success in obesity management.

Obesity is an exploding epidemic in the Western world, with severe consequences for the individual as well as being a burden to society. An increased awareness about the threat of obesity to health and life is therefore essential. Weight normalization is not necessary to achieve significant health benefits. Sustained moderate weight reduction has important effects on morbidity, probably affects mortality, and certainly affects psychosocial aspects of life. New realistic standards to define success should be developed.

Adult↗