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Biomedical subjects

V Hainer

Publications and source records attributed to V Hainer.

At least 19 recordsLinked to original sources
PubMed1997

[Health risks and economic costs associated with obesity requiring a comprehensive weight reduction program].

An increasing prevalence of obesity all over the world reflects a lack of effective measures in both prevention and treatment of obesity. Obesity as a disease has been underestimated by the lay-public as well as health care providers. However, obesity represents a substantial health problem associated with a decreased quality of life. Obesity is linked to numerous chronic diseases (cardiovascular diseases, diabetes, hyperlipidemia, gout, osteoarthritis, gall-stones, and bowel, breast and genitourinary cancers) that lead to premature disability and mortality. Health risks increase with a body mass index (BMI) over 25 in individuals 19-35 years of age and with a BMI over 27 in those 35 years of age and older. Health risks also increase with an excess accumulation of visceral fat manifested as an increase in waist circumference (> 100 cm) or in waist to hip ratio (> 0.85 for females and > 1.00 for males). According to studies carried out in different countries current economic costs of obesity represent 5-8% of all direct health costs. In contrast, effective treatment of obesity results in a substantial decrease in expenditures associated with pharmacotherapy of hypertension, diabetes, hyperlipidemia and osteoarthritis. Both scientists and clinicians involved in obesity research and treatment recommend to introduce the long-term weight management programs focussing more on the overall health of the participants than the weight loss per se. Therefore, it will be necessary to establish new realistic goals in the obesity management that reflect reasonable weights and recently experienced beneficial health effects of modest (5-10%) weight loss. Comprehensive obesity treatment consisting of low fat diet, exercise, behavioral modification, drug therapy and surgical procedures requires differentiated weight management programs modified according to the degree and type of obesity as well as to current health complications present. The Czech Society for the Study of Obesity defined a comprehensive weight reduction program carried out in weight reduction clubs, out-patient obesity clinics and in specialized departments attached to the university hospitals. In order to provide an integrated knowledge from many different disciplines connected with obesity three week postgraduate course has been organized for physicians involved in obesity management. Even the most spread weight reduction clubs in our country (STOB) are supervised by the trained counselors. The main goal of different weight management programs is to find out optimal approaches leading to long-term beneficial outcome and ameliorating the variety of disorders associated with obesity.

Health Care Costs↗
PubMed1997

In vivo increase in beta-adrenergic lipolytic response in subcutaneous adipose tissue of obese subjects submitted to a hypocaloric diet.

The effects of 28 days of a very low calorie diet (382 Cal/day)) on the beta-adrenergic lipolytic response and nutritive blood flow in sc adipose tissue were investigated in vivo using the microdialysis technique in 24 obese subjects. The diet did not modify the extracellular glycerol concentrations, but increased the local nutritive blood flow (measured by the ethanol escape method). The lipolytic response and the vasodilating effect of increasing concentrations of isoprenaline (from 0.001-10 mumol/L) added to the perfusate were enhanced after 28 days of diet. Before the diet, equimolar concentrations (100 mumol/L) of dobutamine [selective beta 1-adrenoceptor (beta 1-AR) agonist], terbutaline (selective beta 2-AR agonist), and CGP 12,177 (selective beta 3-AR agonist) increased glycerol concentration in adipose tissue. The lipolytic effect of terbutaline was the greatest, and the effect of CGP 12,177 was the least marked. After 28 days of the diet, the effects of terbutaline and CGP 12,177 were not modified, whereas the effect of dobutamine was increased and reached the effect of terbutaline. The three agonists increased nutritive blood flow; this effect was not modified during the diet. In summary, this study demonstrates an increase in the in vivo lipolytic responses to isoprenaline and dobutamine during the hypocaloric diet. Furthermore, functional beta 3-AR are present in the sc adipose tissue of obese patients; however, their activation is only weakly involved in the lipolytic process in this population and is not modified by the hypocaloric diet.

Adipose Tissue↗
PubMed1997

Adipose tissue lipolysis and hormone-sensitive lipase expression during very-low-calorie diet in obese female identical twins.

Eight pairs of obese female monozygotic twins were subjected to a 4-week, very-low-calorie diet (VLCD) that induced a decrease in mean body mass index from 32.9 +/- 1.1 to 29.7 +/- 1.1 kg/m2. Infusion of the beta-adrenergic agonist, isoproterenol, induced an increase in plasma levels of nonesterified fatty acids and glycerol that was more pronounced during than before VLCD. sc fat biopsies were obtained before and during VLCD to study adipocyte lipolysis. beta-adrenergic sensitivity was moderately improved during VLCD. Basal and stimulated lipolyses, and hormone-sensitive lipase activity and protein levels were increased during VLCD. Before VLCD, intrapair resemblance was found for basal and stimulated lipolysis rates. In response to the treatment, intrapair resemblance was observed for basal lipolysis and for lipolysis stimulated with agents acting on plasma membrane receptors. These results suggest that the increase of basal lipolysis during VLCD is caused by an increase of hormone-sensitive lipase expression. They support the notion that the genotype may play a role in regulating the changes of adipose tissue lipolysis rates observed during VLCD.

Adipose Tissue↗
PubMed1995

Body fat assessment by a new bipedal bioimpedance instrument in normal weight and obese women.

The aim of the study was to evaluate a new bioimpedance method for assessment of body fat employing bipedal electrodes instead of those attached to both upper and lower extremities. The new analyzer (TBF-105, Tanita Corp., Tokyo, Japan) enables simultaneous measurements of body weight and total body resistance in a subject standing on the stainless steel electrodes. The instrument was tested in both normal weight and obese women. Fat mass estimated by bipedal bioimpedance was highly correlated with that determined by hydrodensitometry (n = 145, r = 0.945, p < 0.001). Fat mass estimated by bipedal bioimpedance significantly correlated not only with subcutaneous fat measured as a sum of 10 skinfolds (r = 0.758, p < 0.001) but also with visceral fat determined as an area on CT scan (r = 0.780, p < 0.001). Anthropometric variables did not substantially influence the differences revealed in fat mass determined by bipedal bioimpedance and by densitometry. An overestimation of total fat mass by bipedal bioimpedance has not been revealed in severely obese individuals, even in those with higher fat accumulation in the limb region. In conclusion, our data have demonstrated that the new bioimpedance instrument employing bipedal electrodes represents a reliable tool for rapid body fat assessment in both normal weight and obese women.

Adipose Tissue↗
PubMed1995

Simple anthropometric measurements--relation to body fat mass, visceral adipose tissue and risk factors of atherogenesis.

Abdominal type of obesity is linked to risk factors of atherosclerosis and to metabolic diseases. 216 women, aged 17 to 67 years, mean age 43.1 +/- 0.76, mean weight 108.7 +/- 1.6 kg and mean BMI 39.57 kg/m2, were examined. Body composition was assessed by hydrodensitometry, fat distribution was determined by simple anthropometric measurements (waist circumference, sagittal abdominal diameter at the level L4,5, waist to hip ratio-WHR and waist to thigh ratio-WTR), by computed tomography estimating of visceral fat area and by the ultrasound assessment of visceral fat. Close correlation of visceral fat area determined by CT with the ultrasound assessment of visceral fat was found (r = 0.71). In contrast to WHR, a strong correlation of the waist circumference and sagittal abdominal diameter to total body fat content (r = 0.89, r = 0.84, respectively). Close relation of the waist circumference, sagittal abdominal diameter and WTR to visceral fat examined by ultrasound was discovered (r = 0.61, r = 0.66 and r = 0.58, respectively). The sample was divided into quintiles according to waist circumference, abdominal sagittal diameter and WHR. After adjustment for weight and age, waist circumference and sagittal abdominal diameter tend to be more closely related to the metabolic variables (total cholesterol, HDL-cholesterol, triglycerides, fasting blood glucose, fasting insulin, uric acid) and to the arterial blood pressure than WHR. In the group followed only weak relation was found between anthropometric measures of fat distribution and occurrence of diseases complicating obesity, probably as a result of a high overall fatness connected with a high content of visceral fat.

Abdomen↗
PubMed1994

[The role of oils containing triacylglycerols and medium-chain fatty acids in the dietary treatment of obesity. The effect on resting energy expenditure and serum lipids].

BACKGROUND: Treatment of obesity with strict reducing diets is as a rule associated with the development of energetic efficiency manifested among others also by a decline of energy expenditure. The objective of the trial was to test whether addition of oils containing triacylglycerols with medium-chain fatty acid can prevent this decline and whether their administration can affect the lipid spectrum. METHODS AND RESULTS: Sixty obese patients were served for a four-week period of hospitalization at the obesitology unit a low-energy diet REDITA (Promil Co., N. Bydzov) providing 1596 kJ, 37 g protein, 50 g carbohydrate and 3 g fat. Part of the treatment was regular aerobic exercise, behavioural therapy to teach correct dietary habits and physical activity; physical activity was monitored by means of pedometers. From this group during the 3rd and 4th week 11 patients with similar characteristics were separated (age, body weight, BMI and energy expenditure at rest) as in the basic group. These patients were given daily 15 ml oil containing triacylglycerols with medium-chain fatty acids, MCT OIL (Mead Johnson, Evansville), providing 545 kJ. The resting energy expenditure was assessed in all patients every morning on fasting, immediately after awakening, using indirect calorimetry and it was corrected with regard to the respiratory quotient and excretion of catabolic nitrogen. The body composition was assessed at the beginning and at the end of the trial by hydrostatic weighing. Administration of oil containing triacylglycerols with medium-chain fatty acids (MCT OIL) prevented the decline of the resting energy expenditure (130.0 +/- 9.2 kJ/kg lean body mass/day, as compared with 126.5 +/- 7.2 kJ/kg lean body mass/day in the basic group: the difference is statistically not significant). Although addition of oil increased the energy intake by 545 kJ/day, the drop of body weight and BMI was comparable with that in the group of obese patients who did not receive the oil (10.3 +/- 1.1 kg vs. 10.6 +/- 0.5 kg). While during administration of the oil the resting energy expenditure did not change (5.97 +/- 0.30 kJ/min. vs. 5.24 +/- 0.58 kJ/min.), in obese patients who were only on the strict reducing diet it declined from 5.45 +/- 0.18 kJ/min. to 4.44 +/- 0.22 kJ/min. (p < 0.01). The significant drop of total cholesterol achieved by dietotherapy alone (5.41 +/- 0.21 mmol/l vs. 6.26 0.20 mmol/l before treatment) was not affected by administration of oil (4.86 +/- 0.28 mmol/l vs. 5.69 +/- 0.35 mmol/l before treatment). HDL-cholesterol, on the other hand, declined only in obese patients with dietotherapy (1.40 +/- 0.04 mmol/vs. 1.22 +/- 0.04 mmol/l after treatment, p < 0.01). The triacylglycerol values declined significantly in both groups (p < 0.01). CONCLUSIONS: It appears that administration of thermogenetically acting triacylglycerols with medium-chain fatty acids can prevent diet-induced energetic efficiency and can improve the long-term success of dietotherapy of obese patients.

Adult↗
PubMed1994

[Body weight fluctuation in obese women and atherogenesis risk factors].

BACKGROUND: Hitherto published experimental and clinical studies provide controversial findings as regards the relations of risk factors of atherogenesis and ischaemic heart disease and variations of body weight. The objective of the present study was to find out whether variations of body weight in women with severe obesity influence the incidence of some other risk factors of atherogenesis. METHODS AND RESULTS: Two groups of obese women were examined. The group described as "weight cyclers" comprised 29 women where repeated variations of body weight were recorded, whereby at least two cycles of weight loss and subsequent gain were higher than 10 kg. The mean age of the group was 40.6 +/- 1.6 years, the body weight 113.0 +/- 4.2 kg, the body mass index (BMI) 39.88 +/- 1.48, the mean number of weight cycles (< 10 kg) was 2.38 +/- 0.11. The second group described as "non-weight cyclers" comprised 55 women whose body weight change, with the exception of pregnancy, at the age above 20 years did not exceed 5 kg. The mean age of this group of women was 38.5 +/- 2.1 years, the body weight 110.4 +/- 2.9 kg and BMI 39.31 +/- 0.98. The anthropometric indicators--ratio of lean body mass, the waist/hip ratio, the waist/thigh ratio, the sagittal diameter at the L4/L5 level did not differ in the two groups: an exception was only the centralization index which differed at the borderline of statistical significance (p < 0.05). The values of other risk factors are as follows: (the first figure refers to the "weight cyclers"). Systolic blood pressure 135.0 +/- 2.5 mmHg and 135.9 +/- 2.4 mmHg resp., diastolic blood pressure 86.1 +/- 1.7 mmHg and 86.2 +/- 1.5 mmHg resp., fasting serum insulin (IRI) 22.2 +/- 3.5 mU/l and 26.2 +/- 2.4 mU/l resp., the fasting blood sugar level 5.30 +/- 0.17 mmol/l and 5.48 +/- 0.16 mmol/l, total cholesterol 5.29 +/- 0.17 mmol/l and 5.53 +/- 0.13 mmol/l, HDL-cholesterol 1.40 +/- 0.05 mmol/l and 1.30 +/- 0.04 mmol/l, triacylglycerols 1.92 +/- 0.22 mmol/l and 2.10 +/- 0.22 mmol/l. The serum concentrations of free fatty acids (at 7.00 a.m., 1.00 p.m., 9 p.m.) did not differ in the two groups: 0.790 +/- 0.058 mmol/l and 0.772 +/- 0.060 mmol/l at 7.00 a.m., 0.621 +/- 0.066 mmol/l and 0.641 +/- 0.051 mmol/l resp. at 1.00 p.m., 0.730 +/- 0.066 mmol/l and 0.810 +/- 0.061 mmol/l resp. at 9.00 p.m. CONCLUSIONS: The increased flow of free fatty acids from intraabdominal fat depots is considered to be one of the factors mediating metabolic complications in the android type of obesity. Therefore the absence of any difference in fasting free fatty acid levels in both groups of investigated obese women suggests that variations in body weight do not participate in the increased risk of development of metabolic complications in women with severe obesity. Marked variations in body weight in women with severe obesity do not influence the incidence of the risk factors of atherogenesis.

Adult↗
PubMed1992

Effect of 4-wk treatment of obesity by very-low-calorie diet on anthropometric, metabolic, and hormonal indexes.

One-month treatment of obese patients (body mass index, 39.44 +/- 0.94, measured in kg/m2) with a very-low-calorie diet (VLCD) resulted in a significant weight loss, which was higher in men than in women. In contrast, the decrease of percent fat content was higher in gynoid obese women than in men or women with android fat distribution. In females fat mobilization was depressed at the thigh region where a substantially lower percent decrement of thigh skinfold thickness was demonstrated in comparison with males. VLCD treatment positively affected blood pressure and concentrations of total cholesterol, triglyceride, insulin, and cortisol. Total cholesterol-high-density-lipoprotein (HDL) cholesterol ratio remained unchanged and HDL cholesterol in serum significantly declined. Indexes of body fat distribution were not significantly influenced by the short-term treatment by VLCD except waist-hip ratio, which declined in android obese females. VLCD does not decrease a tolerance of physical exercise, as the metabolic response to submaximal workload on a cycle ergometer as well as the responses of cortisol, growth hormone, and prolactin remained unchanged after the treatment.

Adipose Tissue↗
PubMed1992

Body-fat distribution and serum lipids during the long-term follow-up of obese patients treated initially with a very-low-calorie diet.

To evaluate a long-term efficacy of very-low-calorie-diet (VLCD) treatment, 42 obese patients were reexamined 1 y after the initiation of the weight reduction by VLCD treatment for 1 mo. All the subjects participating in the long-term outpatient weight-reduction regime were divided into weight losers and regainers according to the weight change achieved at the end of 1-y follow-up. A final body weight decrease in weight losers was followed by a significant decline of total cholesterol-high-density-lipoprotein (HDL) cholesterol ratio together with significant rise of serum HDL cholesterol whereas almost all skinfold thicknesses declined. In weight regainers the sum of 10 skinfold thicknesses was the same at the end of follow-up as at the beginning of VLCD treatment, but body fat distribution was shifted towards the gynoid type when individual skinfold thicknesses were assessed. However, among the generally employed indexes of body fat distribution only waist-thigh ratio significantly decreased in weight losers. Nonsignificant differences in serum concentrations of total cholesterol, HDL cholesterol, and triglycerides between weight regainers and weight losers at the end of long-term follow-up suggest that some kind of adherence to weight reduction regime including physical exercise may favorably affect the lipid profile as well as body fat distribution independently on the body weight regained.

Adipose Tissue↗
PubMed1990

[Anthropometric study of obese patients].

The authors give an account of anthropometric examinations in obese patients. These methods are used not only for quantitative assessment of the degree of obesity but also to define the body fat distribution. The predominant body fat distribution in the upper body half on the chest and abdomen is typical for android obesity and is, contrary to gynoid obesity, a serious health risk as regards cardiovascular diseases and metabolic complications. The authors describe methods of assessment of body circumference and skinfolds. The degree of obesity is assessed from the body mass index (BMI) and the percentage of total body fat calculated from skinfolds measured by means of a caliper. The type of body fat distributions is usually expressed by the waist/hip ratio or by the ratio between the subscapular skinfold thickness and the skinfold above the tricept ("index of centralization"). Recently some authors advise to calculate by anthropometry also the amount of visceral fat which is a significant risk factor of cardiovascular and metabolic complications of obesity.

Adipose Tissue↗
PubMed1990

[The effect of euphylline on energy expenditure in obese patients during treatment with a reducing diet].

The energy economy induced by a reducing diet and manifested by a reduced energy output at rest threatens greatly the long-term success of reducing regimes. The authors investigated the effect of a four-week therapy of obese patients by a low energy protein diet with an energy value of 1560 kJ on the resting metabolic rate (RMR), the serum concentration of thyroid hormones and TSH and on the Achilles tendon reflex time. Four weeks' treatment with a low energy protein diet caused a significant drop of the energy output at rest in the control group of obese men (by 17.5%), as well as in the control group of obese women (by 16.9 per cent). In the group of obese women who were given during the last two weeks of treatment depot methyl xanthine derivative, Euphilline (Byk Gulden), the energy output at rest did not decline as a result of dietetic treatment and the decline of the BMI was significantly higher than in the control group of obese women, although the two groups did not differ in the initial BMI, mean age and the degree of physical activity during treatment. With the exception of the control group of men where the serum triiodothyronine level declined, in the investigated obese subjects no significant changes of the investigated thyroid function parameters were recorded. The syndrome of low T3 thus does not participate in a substantial way in the drop of the metabolism at rest during treatment with a low energy protein diet, obviously due to the intake of 50 g carbohydrate per day.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Best's calipers modified for examinations of obese patients].

Assessment of the skinfold thickness in obese patients by means of a caliper makes it possible to determine the percentage of total body fat and provides information on the distribution of subcutaneous body fat and thus to characterize the type of obesity. In more severe obesity it is not possible to differentiate reliably by means of classical calipers larger skinfolds, in particular the subscapular and abdominal skinfold which thus makes these anthropometric examinations useless. A newly developed modification of the Best caliper makes it possible to measure reliably the majority of skinfolds in obese subjects as the arm of the caliper can be shifted to a range as high as 90 mm. Best's caliper provides, in contrary to others, the possibility to set a constant pressure when measuring the skinfold. In the discussion the authors draw attention to some methodological problems and the clinical importance of examining obese subjects by means of a caliper.

Anthropometry↗
PubMed1990

[A Czechoslovak low-energy protein diet in the treatment of obesity].

The low-energy protein diet providing 1559 kJ is the first accurately defined diet for the treatment of obesity in the CSSR. The daily amount contains 4.0 g fat, 33.0 g protein, 50.0 g carbohydrate, 5.6 g fibre and daily recommended allowances of vitamins. The diet is enriched with potassium, magnesium and iron. The low-energy protein diet was used for a period of 28 days in the treatment of 49 obese patients aged 40.49 +/- 1.39 years whose initial weight was 110.14 +/- 3.41 kg and the BMI 39.44 +/- 1.13. The therapeutic regime comprised in addition to the diet adequate physical exercise of aerobic character and training of correct eating behaviour. Four weeks treatment led to a significant decline of body weight (by 10.60 +/- 0.46 kg) and a significant drop of the BMI (by 3.65 +/- 0.16). Men lost more weight than women. In women a substantial drop of the body weight (90.5%) was due to reduction of body fat, while in men adipose tissue participated by 60.0% in the loss. During the fourth week of treatment a positive nitrogen balance was achieved, obviously due to adequate physical exercise. The waist/hip ratio was not affected by treatment in either group. The therapeutic regime influenced favourably some risk factors of ischaemic heart disease. In addition to a significant drop of the systolic and diastolic blood pressure a significant decline of total cholesterol, triacylglycerols and serum insulin occurred. There was a concurrent decline of the urinary C-peptide excretion. The therapeutic regime involving the low-energy protein diet was well tolerated by the patients. The incidence of side effects during treatment was less frequent than in treatment by intermittent fasts. No disorders of the cardiac rhythm were recorded during treatment.

Adult↗
PubMed1990

[A low-energy protein diet--its effect on lipid and protein metabolism].

The Czechoslovak low-energy protein diet contains 1559 kj per day, incl. 33.0 g protein, 50 g carbohydrate, 4.0 g fat, 6.0 g fibre and recommended vitamin and mineral allowances. The diet was administered to 75 subjects with a mean age of 39.88 +/- 1.21 years and a body weight of 112.57 +/- 2.89 kg, and a body weight index (BMI) of 39.44 +/- 0.94, for 28 days. During treatment the body weight declined by 9.67 +/- 0.41 kg and the BMI by 3.74 +/- 0.20. At the same time there was a significant decline of the total cholesterol (p less than 0.001), LDL cholesterol (p less than 0.001), HDL cholesterol (p less than 0.01) and triacylglycerols (p less than 0.05). In 20 subjects with hyperlipidaemia similar changes of the total cholesterol and LDL cholesterol were recorded, while the decrease of HDL cholesterol (p less than 0.001) and triacylglycerols (p less than 0.001) was more marked. The nitrogen balance became during the fourth week on the diet positive (+0.64 g), there was a transitory decline of the total protein concentration. The serum amino acid concentration did not change significantly with the exception of isoleucine, the level of which increased. The serum immunoglobulin concentration did not change significantly. It may be concluded that the low-energy protein diet has a favourable impact on the lipid metabolism, without a marked negative effect on the protein metabolism.

Adult↗
PubMed1989

[The effect of a short-term reducing regimen on hormonal secretion in obese patients].

A twelve-day reducing regime involving exercise and a reducing diet (2.5 MJ/day), led in 23 obese women to an average loss of body weight of 4.52 +/- 0.35 kg. The loss of adipose tissue during the reducing regime was greater than the total loss of body weight, obviously due to proliferation of lean body mass as a result of exercise. Concurrently a significant decline of the mean morning concentration of thyroxine, triiodothyronine, C-peptide and STH in serum was recorded, while the concentration of TSH, cortisol, prolactin, LH and FSH increased insignificantly and the concentration of insulin and testosterone declined insignificantly. Exercise thus did not prevent a decline of triiodothyronine induced by the low energy diet. The exercise in the morning did not cause a stress conditioned increase of the secretion of cortisol, prolactin and STH at the onset and at the end of the reducing regime. From the metabolic aspect the favourable absence of the stimulating action of exercise on cortisol secretion is due to the character of motor activity (40-50% VO2max). The absence of a stress conditioned rise of prolactin during exercise prevents the inhibiting action of prolactin on gonadal functions. The reducing regime has also a favourable effect on insulin secretion, as on the 12th day of the reducing regime there was a significant decline of the serum level of immunoreactive insulin in the course of exercise.

Adult↗
PubMed1989

Very low energy formula diet in the treatment of obesity.

A new very low energy formula diet containing 1560 kJ (373 kcal) per day was employed in the treatment of 49 obese patients. The treatment, of 4 weeks duration, included aerobic physical exercise and behavioural intervention. This kind of therapy resulted in a significant decrease (P less than 0.001) of both weight (-10.60 +/- 0.46 kg) and body mass index (-3.36 +/- 0.16). The fat stores represented 90.5 per cent of weight loss in women and 60.0 per cent of weight loss in men. The first very low energy formula diet produced in Czechoslovakia proved to be an efficient and safe tool for the treatment of obesity, positively affecting high blood pressure, lipid and carbohydrate metabolism in the absence of serious side-effects.

Adult↗