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At least 199 records · Page 11Linked to original sources

Effect of a program of moderate physical activity on mental stress-induced increase in energy expenditure in obese women.

BACKGROUND: Energy restriction and physical activity are major components of weight reduction programs. Energy restriction is known to affect the sympathetic nervous system activity and to reduce several components of energy expenditure, including the stimulation of energy expenditure elicited by mental stress. The effect of physical activity on this parameter remains unknown. METHODS: This study was designed to assess the effect of physical training on the stimulation of energy expenditure during mental stress. Seven obese women (age 33 +/- 3 years, BMI 34.9 +/- 1.4 kg/m(2)) were studied before and after a 6 week program of aquagym (2 sessions of 50 min/week). Energy expenditure was measured by means of indirect calorimetry under hyperinsulinemic conditions before and during a 30 min mental stress. O(2) max was measured before and after physical training by means of the test of Balke. RESULTS: O(2) max was 23.4 ml/kg/min before physical training, and increased to 26.1 ml/kg/min at the completion of the training program (p<0.05). Body weight, resting energy expenditure and insulin-mediated glucose disposal [oxidative and non oxidative] were not modified after training. Mental stress increased energy expenditure by 12.3% before physical training (p<0.002 vs resting conditions) and by 12.6% after physical training (p<0.003 vs resting conditions, NS vs before physical training). CONCLUSION: Physical training per se does not alter the stimulation of energy expenditure induced by mental stress.

Adult↗

Bias in reported body weight as a function of education, occupation, health and weight concern.

Comparison of self-reported and measured weights in a working population of 2046 men and 2393 women revealed systematic underreporting of 1.3% in men and 1.7% in women. Underreporting was significantly related to weight, height, and current participation in a weight reduction program in both men and women. In men only, it was also related to age, education, history of weight-control attempts, and history of weight-related health conditions. Overall, however, these predictor variables accounted for a small fraction of the variance in underreporting and the correlation between measured and self-reported weight was very high (rs = .99). It is concluded that self-reported body weight is an excellent approximation of actual weight across a broad range of population subgroups.

Adult↗

Weight loss is correlated with an improved lipoprotein profile in obese postmenopausal women.

BACKGROUND: Changes in plasma lipid and lipoprotein distributions that occur after menopause increase the risk of cardiovascular disease in women, especially in those who are overweight. OBJECTIVE: The purpose of this study was to evaluate the impact of a nine-month weight reduction program on plasma lipids, dietary intake and abdominal fat obesity. DESIGN: A partial crossover design was used to study a weight loss treatment consisting of Phentermine hydrochloride (Fastin, SmithKline Beecham Pharmaceuticals, Philadelphia, PA) therapy plus a low energy diet (5040 kJ/d). Forty-seven obese, postmenopausal Caucasian women (BMI of 30-38 kg/m2) were randomized into two groups, both of which received drug and diet treatment over six months. However, Group I started the intervention program three months later than Group II. Plasma total, HDL and LDL cholesterol and triacylglycerol were measured, body composition was assessed by anthropometry and dual energy x-ray absorptiometry, and food frequency records were collected at four timepoints. RESULTS: Over nine months, women in Group II reduced body weight (14.4%), lowered plasma concentrations of LDL cholesterol (14% to 26%) and triacylglycerol (15%) and raised plasma HDL cholesterol concentration (15%). These plasma lipid changes decreased the total cholesterol/HDL cholesterol ratio from 4.3 to 3.2. All subjects decreased abdominal fat measurements and energy and cholesterol intakes, as well as percentage of energy derived from total and saturated fat during the study. Most subjects also increased dietary fiber consumption. CONCLUSION: Both weight loss and diet modifications are associated with an improved plasma lipid profile in obese postmenopausal women.

Adult↗

Relationship of weight loss and cigarette smoking to changes in high-density lipoprotein cholesterol.

To determine the effect of weight loss on serum high-density lipoprotein cholesterol (HDL-C), we measured serum HDL-C as well as total cholesterol and triglycerides in 65 subjects 56 women and 9 men, mean age 41.1 +/- 1.5 (+/- SEM yr) before and after a weight reduction program. At entry into the program there was a significant correlation between HDL-C and several indices of overweight--relative weight, body mass index and sum of skinfold thickness. For all subjects, despite a significant weight loss of 4.5 kg or 5.8% of initial body weight and significant decrease in sum of skinfold thickness, there was no significant increase in HDL-C or correlation between changes in HDL-C and change in body weight or skinfold thickness. For women, but not men, a weak negative correlation between change in HDL-C and change in weight or percentage change in weight was observed. However, in the subset of women who were current cigarette smokers a significant (p less than 0.01) correlation was observed between change in HDL-C and change in weight (r = -0.876) and percentage change in weight (r = -0.881). Thus a modest weight loss is not usually associated with a significant increase in serum HDL-C concentration except in cigarette smoking women.

Adult↗

Correlates of obesity.

Designed to create composites of eating behavior questionnaire items and determine their relationship to an obesity index within three subsamples of participants in three Navy-sponsored weight-reduction programs (N = 1,878). After item and scale analyses were performed on questionnaire items that pertained to eating behaviors, history of weight problems, activities, and feelings about food and dieting, scores for the resultant composites were computed for individuals within the three subsamples. Results of multiple-regression analyses indicated that the strongest correlates of obesity within each subsample were the Overweight History, Food Obsession, and Activities composites; the multiple R was .49 for Marine recruits, .46 for the other male subsample, and .32 for women. The Emotional Eater composite was included in the multiple regression for the women's subsample. Personality characteristics also were found to be associated with the obesity index in the men's and women's subsamples. Future studies will examine the value of these variables as predictors of weight loss and maintenance of weight loss.

Adolescent↗

Incidence of diabetes in American Indians of three geographic areas: the Strong Heart Study.

OBJECTIVE: To estimate incidence rates of diabetes and associated risk factors among participants of the Strong Heart Study. RESEARCH DESIGN AND METHODS: Of the 4,549 Strong Heart Study participants examined at baseline, 3,638 returned for a similar examination after an average of 4 years. The 1985 World Health Organization criteria for diabetes were used to identify new diabetes cases. Rates of diabetes among participants who did not have diabetes at baseline examination were determined. The relationships between the incidence rates of diabetes and a number of risk factors measured at baseline examination were studied. RESULTS: Significant variables associated with the development of diabetes included triglycerides, obesity, fasting plasma glucose, insulin, and degree of American Indian blood among participants with NGT at baseline. For those with IGT at baseline, significant predictors included fasting plasma glucose, 2-h glucose, BMI, degree of American Indian blood, and albuminuria. CONCLUSIONS: The high incidence rates found in this study were alarming. To slow down the rapid increase of this disease in the American Indian population, preventive programs must be designed and implemented. Patients with IGT should be treated with diabetes medication or put on a rigid weight-reduction program to reduce the risk of progression to diabetes.

Aged↗

Preclinical pharmacology of fluoxetine, a serotonergic drug for weight loss.

Fluoxetine selectively inhibits serotonin uptake in vitro and in vivo and thus enhances serotonergic function, leading to a decrease in food intake beginning with the first dose and a decrease in body weight or in weight gain after multiple doses of fluoxetine. Fluoxetine and other drugs that increase serotonergic function decrease food intake with characteristics that make them attractive for use in weight reduction. In rats, for instance, fluoxetine and other serotonergic drugs suppress stress-induced eating, suppress carbohydrate consumption selectively, and suppress insulin-induced hyperphagia. Fluoxetine and other serotonergic drugs do not cause amphetamine-like behavioral stimulation in animals and have no known abuse or addiction liability. In obese yellow mice and in normal mice, as in rats, fluoxetine causes a sustained decrease in food intake and body weight. The pharmacologic effects of fluoxetine in animals suggest its potential use in weight-reduction programs in obese humans.

Animals↗

Lipid profiles of obese children and adolescents before and after significant weight loss: differences according to sex.

BACKGROUND: Childhood obesity has been associated with elevated serum levels of total cholesterol, triglycerides, and low-density lipoproteins (LDLs). We observed the lipid profiles of obese female subjects versus obese male subjects before and after significant weight loss. METHODS: We studied 29 girls and 21 boys enrolled in a multidisciplinary weight reduction program. RESULTS: Measures were taken at enrollment and at 10 weeks. Significant improvements were observed for changes in percentage of ideal body weight and total cholesterol and triglyceride levels. In addition, LDL decreased significantly in girls but not in boys. CONCLUSIONS: A combination of diet, behavior modification, and exercise, is an effective instrument for lowering total cholesterol and triglyceride levels in obese children. In addition, girls tend to be more susceptible to a decrease in LDL level, which might result in an increased cardiovascular protective effect.

Adolescent↗

Overweight: assessment and management issues.

Obesity is associated with an increased risk of coronary artery disease, hypertension, diabetes, hypercholesterolemia, cancer and other conditions. Although generalized obesity is associated with increased risk, the android pattern of body fat distribution may be a more sensitive predictor of coronary artery disease. A gradual weight reduction program, including adherence to a low-fat, calorie-restricted diet and participation in daily exercise, is the best approach to reduce weight and body fat.

Diet, Reducing↗

Effects of a multidisciplinary weight loss intervention on body composition in obese adolescents.

OBJECTIVE: To investigate if a multidisciplinary weight loss program in adolescents suffering severe obesity allows adequate growth and development and avoid lean mass loss. DESIGN: A total of 55 adolescents (33 girls and 22 boys) suffering severe obesity were enrolled in an interdisciplinary weight reduction program lasting 6-12 months. Progressive submaximal physical activity was performed and national dietary allowances for adolescents with low levels of physical activity energy were provided. MEASUREMENTS: Total and segmental body composition was assessed by means of dual-energy X-ray absorptiometry. RESULTS: The mean height significantly increased (P<0.001). The mean body mass index (BMI) dropped in boys from 34.5+/-3.2 to 25.5+/-2.3 kg/m(2) and in girls from 38.4+/-4.1 to 28.4+/-4.1 kg/m(2). Height increased according to the expected pattern (P<0.001). Total lean mass (LM) did not vary and was positively correlated to pubertal development in both sexes before and after weight loss. Steepest drop in fat mass (FM) was observed in the trunk (-63.2+/-10.1% in boys and -51.5+/-11.4% in girls). Decrease in BMI and FM was tightly correlated in both sexes. However, slopes significantly differed (P<0.0005) so that a decrease of 1 kg/m(2) in BMI corresponded to a decrease of 3.92 kg in FM in girls and of 5.44 kg in boys. In each sex, FM at baseline and duration of the treatment were the main determinants of the decrease in FM. CONCLUSION: During adolescence, despite a major weight loss, adequate growth and preservation of LM can be achieved. Weight loss kinetics markedly differs between boys and girls. Low-calorie diets are unnecessary to achieve a marked reduction of severe obesity during puberty.

Absorptiometry, Photon↗

Calorie requirements in weight loss: an estimate based on self-reported food intake in middle-aged men.

Twenty-eight men participating in a weight reduction program self-recorded foods eaten and calorie consumption for a 15-week period. These food records were examined to estimate calorie needs during weight loss as a function of age, entry weight, height and physical activity level. Only entry weight was significantly associated with calorie need. A predictive equation for calorie need is offered for setting individual calorie intake goals for patient-assessed calorie intake.

Body Weight↗

Hepatic insulin clearance increases after weight loss in obese children and adolescents.

BACKGROUND: Obesity is a rapidly increasing health problem among US youth. Hyperinsulinemia is associated with obesity and has been found to be a contributory factor for the development of cardiovascular disease in the obese. It has been suggested that hyperinsulinemia of obesity is a result of increased insulin secretion caused by insulin resistance. However, it has been shown in adults that decreased hepatic insulin clearance (HIC) is the primary cause of hyperinsulinemia in this population. METHODS: We studied 15 obese children and adolescents (11 F, 4 M; 8.6 to 18.1 years) before and 10 weeks after their enrollment in a multidisciplinary weight reduction program, which included a protein-sparing modified fast, a moderate intensity progressive exercise program, and a behavior-modification intervention. RESULTS: All patients lost weight (P < 0.05). Measurements of immunoreactive insulin (IRI) and C-peptide reactivity (CPR) were performed before the program and at 10 weeks. IRI levels dropped significantly, whereas CPR levels did not change. CPR/IRI molar ratios, considered an indirect estimation of HIC, rose significantly after weight loss. CONCLUSIONS: Our data suggest that hyperinsulinemia seen in obese children and adolescents is caused by decreased HIC. The cause for this decrease remains unknown, but it is reversible upon weight loss.

Adolescent↗

Effect of weight change on bone mass in female adolescents.

The purpose of this study was to examine changes in bone mineral density/bone mineral content (BMD/BMC) in obese female adolescents (Tanner stages 2 to 4) pursuing a weight reduction program. This was a prospective pilot clinical investigation involving 92 obese females screened to meet inclusion criteria and required to participate in a 6-month weight loss intervention. Baseline, 6 months, and 12 months measurements were taken for total body/lumbar spine BMD/BMC and percentage body fat. Survey instrumentation included the following: calcium food frequency/24-hour dietary recall, physical activity, and psychological assessments for anxiety/self-esteem. Changes in bone measurements were compared with changes in body weight measurements using multiple linear regression. Other potentially confounding variables analyzed included bone area, calcium intake, baseline Tanner stage, activity level, and height. Total body/lumbar spine BMD/BMC changes were found to be most significantly correlated with weight changes in the subject population. Although mean weight increased, the rate of increase per a given height velocity slowed to an appropriate height for weight ratio. Individuals who lost weight did not lose BMD/BMC; however, the rate of growth declined when compared with all study subjects whose bone growth rate was consistent with normal weight female adolescents. In this study, weight changes were strongly related to bone measurement changes in an obese adolescent female population. Dietitians counseling obese young girls are encouraged to emphasize the importance of a healthy weight loss program with optimal calcium intake and inclusive of weight-bearing exercises.

Absorptiometry, Photon↗

[Dietetic-hygienic measures in the control of arterial hypertension in obese females].

Since the evidence to data suggest that some obese person respond well to non-pharmacological measures, the aim of this study was to examine the extent of body weight reduction necessary to reduce blood pressure to normal values. A group of 250 obese women with hypertension (blood pressure measurements over 160/95) and an overweight of at least 20 per cent excess of ideal weight was included in the study. The patients were advised to take well balanced low-calorie (about 1000 kcal/day) diet containing 66 g proteins, 140 g carbohydrates, 13 g fat and 0.5 g salt. They were advised to increase daily physical activities. Low-calorie diets were used to decrease body weight in groups of patients with changed of unchanged antihypertensive drug therapy, also. Decrease in body weight resulted in significant decrease in blood pressure; over two-thirds of complaint patients achieve normal blood pressure with a loss of only 5-10 per cent of their weight excess even if at this point they were still overweight. In the group receiving no drug therapy 78 per cent reached normal blood pressure, 76 per cent in the patients whose antihypertensive treatment had to be modified during the study and 63 per cent in the group receiving unchanged drug therapy. It was concluded that weight reduction program (diet and physical activity) can be a possible approach to treat hypertension without drugs and patients can attain normotension long before achieving the ideal weight.

Adult↗

Self-esteem, internal-external locus of control, and their relationship to weight reduction.

One hundred sixteen women participated in a 10-week weight reduction program and lost on the average of 7 kg. Family-related variables and two personality constructs, self-esteem and Internal-External Locus of Control (I-E Loc), were examined as predictors for success in weight loss. Principal findings were: (a) Subjects with low self-esteem scores lost significantly less weight than subjects with medium and high scores (4.3 kg vs. 8.7 and 6.4, respectively); (b) No significant differences were recorded between Internals and Externals with regard to weight reduction; and (c) Family-related variables, marriage and number of children, did not directly affect weight loss, but their effect was observed within the three self-esteem and the two I-E Loc groups.

Adult↗

The DIET study: long-term outcomes of a cognitive-behavioral weight-control intervention in independent-living elders. Dietary Intervention: Evaluation of Technology.

OBJECTIVE: To describe the long-term outcomes of a cognitive-behavioral weight-control intervention implemented in a community-based sample of independent-living, older adults. DESIGN: A quasi-experimental design was used to compare an intervention community with a wait-listed control community. Comparisons between the communities were made at 40 weeks (J Am Diet Assoc. 1994;94:37-42). The controlled trial ended at 40 weeks; then both communities received 2 years of intervention. Two-year data from both communities were combined and are presented in this article. Three-year outcome data from the initial intervention community were available and are also presented. SUBJECTS: A total of 247 overweight (> 4.5 kg of age-adjusted weight), older (mean age = 71 years) adults in 2 independent-living retirement communities participated in the study. INTERVENTION: The Dietary Intervention: Evaluation of Technology (DIET) study consisted of an intensive 10-week psychoeducational approach focused on lifestyle change, followed by a less intensive 2-year phase focusing on relapse prevention and maintenance of lifestyle changes. OUTCOME MEASURES: Physiologic and behavioral variables were analyzed at baseline and at 2 years after baseline. This article reports the combined 2-year outcome data from both retirement communities. Results of an additional follow-up 1 year after intervention was withdrawn are reported for the initial intervention community. STATISTICAL ANALYSIS: A within-subjects repeated measures analysis of variance design was used to test for significant changes in weight and lipid values over time. RESULTS: At 2 years, 70% of those who started the intervention remained actively enrolled. This group showed significant decreases in body mass index (-1.2, P < .001) and glucose level (-0.80 mmol/L, P < .001). Although high-density lipoprotein cholesterol (HDL-C) levels had increased at 40 weeks after baseline, this was not maintained at 2 years. At the 3-year follow-up, changes in body mass index and glucose level were maintained. APPLICATIONS/CONCLUSIONS: The purpose of this article was to describe the long-term outcomes of a community-based weight-reduction intervention for older adults. The findings may be of interest to clinicians who design community or worksite weight-reduction programs. Although the intervention was designed to be a low-intensity program, attrition over the length of the study was still problematic. Nevertheless, our follow-up study indicates that this intervention was efficacious in maintaining reductions in weight and glucose levels for overweight older adults for 3 years.

Activities of Daily Living↗

Sex differences in weight loss among adults with type II diabetes mellitus.

The treatment of choice for Type II or non-insulin-dependent diabetes mellitus is a behavioral program for the management of weight. However, compliance with this lifelong dietary regimen is often poor. In the current investigation male and female adults with diagnosed Type II diabetes were randomly assigned to either a behavior modification, a cognitive modification, a cognitive-behavior modification, or a control group. Patients were evaluated in terms of weight, percentage of body fat, and glycosylated hemoglobin measures. Men lost significantly more weight than women and subjects in the behavior modification group lost more weight and demonstrated greater decreases in diabetes control than subjects in the cognitive-behavior modification, cognitive, and control groups. A significant interaction indicated that diabetic men may benefit more from behavioral weight reduction programs than diabetic women. Several explanations for these findings are considered.

Adult↗

Weight reduction regresses left ventricular mass regardless of blood pressure level in obese subjects.

The effects of weight reduction on left ventricular mass in obese normotensive and hypertensive subjects were investigated. Previous studies have shown that weight reduction in hypertensive (HT) obese patients is associated with decreased left ventricular mass (LVM) and decreased blood pressure (BP). This study was performed to examine whether weight reduction would also regress LVM in normotensive (NT) obese subjects and to clarify the mechanisms of these effects if they occurred. A weight-reduction program consisted of mild exercise and mild hypocaloric intake. M-mode echocardiography was performed to estimate the LVM. After the 12-week intervention, the mean reductions in body weight (BW) in the NT (n = 11) and HT (n = 11) groups were 4.9 kg (p < 0.005) and 4.6 kg (p < 0.0005), respectively. Systolic, diastolic, and mean BP were significantly reduced by 13, 9, and 11 mm Hg, respectively, in the HT group. By contrast, no significant changes in systolic, diastolic, or mean BP were observed in the NT group. LVM was significantly reduced from 176 +/- 26 gm to 159 +/- 26 gm (p < 0.05) in the HT group and from 167 +/- 33 gm to 145 +/- 34 gm (p < 0.02) in the NT group. These results suggest that weight reduction in obese subjects by mild exercise and mild hypocaloric intake can lead to a reduction in LVM, regardless of whether the subjects have normal or high blood pressure.

Adult↗