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PubMed2006

Prematurity--another example of perinatal metabolic programming?

Low birth weight is associated with both later adult diseases such as type 2 diabetes mellitus and a number of metabolic abnormalities, the foremost of which is insulin resistance. Indeed the link between an adverse perinatal environment, manifested by low birth weight, and adult life pathology may be an early, permanent reduction in insulin sensitivity. A reduction in insulin sensitivity has been demonstrated in small for gestational age (SGA), term subjects from childhood through to adulthood. Less is known about children born premature into an adverse neonatal environment. We present data demonstrating that premature infants also have metabolic abnormalities similar to those observed in term, SGA children and that these occur irrespective of whether they are SGA or appropriate for gestational age (AGA).

Adipose Tissue↗

PubMed1988

Resistive training can reduce coronary risk factors without altering VO2max or percent body fat.

Eleven healthy, untrained males (age = 44 +/- 1 yr; range = 40 to 55 yr) were studied to determine the effects of 16 wk of high-intensity resistive training on risk factors for coronary artery disease. Lipoprotein-lipid profiles, plasma glucose and insulin responses during an oral glucose tolerance test, and blood pressure at rest were determined before and after training. The training program resulted in a 13% increase in high-density lipoprotein-cholesterol (39 +/- 2 vs 44 +/- 3 mg.dl-1, P less than 0.05), a 43% increase in high-density lipoprotein-cholesterol (7 +/- 2 vs 10 +/- 2 mg.dl-1, P less than 0.05), a 5% reduction in low-density lipoprotein cholesterol (129 +/- 5 vs 122 +/- 5 mg.dl-1, P less than 0.05), and an 8% decrease in the total cholesterol/high-density lipoprotein-cholesterol ratio (5.1 +/- 0.3 vs 4.7 +/- 0.3, P less than 0.01), despite no changes in VO2max, body weight, or percent body fat. Glucose-stimulated plasma insulin concentrations during oral glucose tolerance testing were significantly lower, and supine diastolic blood pressure was reduced (P less than 0.05) as a result of the training program. No changes in any of these variables occurred in a sedentary control group. These findings indicate that resistive training can lower risk factors for coronary artery disease independent of changes in VO2max, body weight, or body composition.

Adipose Tissue↗

PubMed2004

[Psychological project supporting weight reduction as a significant element in the prevention of secondary obesity].

Psychological factors may contribute in creating and maintaining of overweight that often results of disturbances of individual's psychosocial functioning. That is why psychological impact should be a significant element of both obesity treatment and prevention of recurrence. The article presents a project implemented in the Obesity Treatment Centre "Waga" in Katowice. The project acts as a part of a group, complex treatment process leading to weight reduction. Design, target group and the achieved results are presented as well a psychological aspects helping the process of reduction of body weight.

Body Image↗

PubMed1983

Body percept change in obese females after weight reduction therapy.

Video-image representations of body size were measured on a television monitor that was modified to give a display continuum that ranged from 50% under- to 50% over-estimation of objective size. Sixty-eight females who were undergoing weight reduction counseling were measured before and after treatment. All Ss judged themselves to be significantly more obese than they actually were, with a tendency for errors to be greatest among the more obese Ss. After therapy, more realistic estimates of their physiques ensued. A drop-out rate of 23% was recorded; the drop-outs saw themselves as significantly more obese than those who graduated from the program.

Adolescent↗

PubMed1997

Transforming growth factor beta 1 transduced mouse prostate reconstitutions: II. Induction of apoptosis by doxazosin.

BACKGROUND: To study the possible relationship between adrenergic activities and the pathogenesis of benign prostatic hyperplasia (BPH), we tested the effect of doxazosin, an alpha 1-adrenoceptor antagonist, on prostatic growth in vivo using a mouse model for BPH. METHODS: The mouse prostate reconstitution (MPR) model system with retroviral (BabeTGF-beta 1Neo) transduction of transforming growth factor beta 1 (TGF-beta 1) was used to induce focally hyperplastic BPH-like lesions and increase the number of catecholaminergic neurons. The mice were treated with daily intraperitoneal injections of doxazosin (3 mg/kg). RESULTS: Doxazosin caused a significant reduction in the wet weight of BabeTGF-beta 1-infected MPRs. The percent of PCNA-positive epithelial cells was similar in the doxazosin-treated and water only, control groups. There was a significant increase in the number of epithelial cells undergoing programmed cell death, apoptosis, in the doxazosin group (apoptotic index = 4.7 for doxazosin group vs. 3.1 for control group, P < 0.05). The doxazosin-induced apoptosis was more apparent in TGF-beta 1 transduced MPRs than BAG alpha control MPRs, and was not seen in the prostates of the adult male mice into which the MPRs were engrafted. CONCLUSIONS: Our data demonstrate a novel and potentially important biological activity of doxazosin in vivo in this mouse model of BPH.

Adrenergic alpha-Antagonists↗

PubMed1993

Nutritional concerns of women with breast cancer.

Health professionals should assess the nutrition information needs of women with breast cancer in order to provide appropriate services. Questionnaires were mailed to 143 Reach to Recovery volunteers who had had surgery for breast cancer, and 72% responded. The subjects were mostly concerned about and wanted information on diets for cancer prevention, low-fat diets, weight reduction, and vitamin supplements. Findings also showed the potential for excessive vitamin/mineral use among one-third of respondents and a tendency toward weight gain regardless of whether or not chemotherapy was received. The results provide direction for development of nutrition educational materials and programs for women with breast cancer.

Adult↗

PubMed1987

[Effect of multifactorial sanatorium-based preventive measures on excessive body weight].

The effects of various procedures and behavior patterns on excessive weight loss are demonstrated in males between 40 and 59 years of age in the course of a program carried out on a standard protocol at 15 sanatoria. The best effect was produced where medical recommendations on diet adjustment were followed strictly, as the reduction of caloric intake was more efficient here, as compared to other diets or exercise. Relative preventive effect was higher, after the same preventive procedures, in individuals with marginal obesity, as compared to those with marked obesity.

Adult↗

PubMed1995

Primary prevention of hypertension: a challenge for occupational health nurses.

1. About one in four adults in the United States has high blood pressure on the basis of a single evaluation. Hypertension is associated with an increased risk of developing coronary heart disease, stroke, congestive heart failure, renal insufficiency, and peripheral vascular disease. 2. Weight loss, reduced sodium intake, reduced alcohol consumption, and exercise have documented efficacy as interventions to decrease high blood pressure. A number of intervention programs in community based settings and in health care provider practice based settings have documented that behavioral change and relevant reductions in blood pressure are feasible. 3. Occupational health nurses are in unique positions to both initiate and support intervention programs. Interventions could be conducted by individual occupational health nurses as well as sponsored by corporate employers or local occupational health nursing constituencies.

Humans↗

PubMed2003

Serum bFGF levels are reduced in Japanese overweight men and restored by a 6-month exercise education.

OBJECTIVE: To investigate whether the changes in vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) concentrations before and after weight reduction in Japanese overweight men are associated with changes in body mass index (BMI), visceral, subcutaneous fat, VO(2) and work rate (WR) at ventilatory threshold (VT). DESIGN: Cross-sectional and longitudinal clinical intervention study with exercise education. SUBJECTS: In total, 30 Japanese overweight men (BMI, 29.0+/-2.2 kg/m(2)) and 31 normal-weight men (BMI, 22.5+/-1.6 kg/m(2)) at baseline were enrolled: 30 overweight men (BMI, 29.0+/-2.2 kg/m(2)) were further enrolled into a 6-month exercise program. MEASUREMENTS: Fat distribution evaluated by visceral fat (V) and subcutaneous fat (S) areas measured with computed tomography scanning at umbilical levels, angiogenic peptides including VEGF and bFGF, exercise tests at baseline and after 6 months. RESULTS: In normal-weight and overweight subjects at baseline, VEGF positively correlated with S area (r=0.350, P=0.007) but not with V area. In contrast, bFGF negatively correlated with BMI (r=-0.619, P<0.001), S (r=-0.457, P<0.001) and V areas (r=-0.466, P<0.001). By intervention with exercise education, 30 overweight subjects showed reduction in BMI (29.0+/-2.2 to 28.0+/-2.0, P<0.001), V and S areas, increase in VO(2) and WR at VT, increase in bFGF (9.21+/-5.82-21.2+/-7.04 ng/ml, P<0.001), and no change in VEGF (1.45+/-0.72-1.88+/-0.52 ng/ml, P=0.016). The stepwise multiple regression analysis revealed that DeltaBMI (beta=-6.052) and DeltaVO(2) (beta=2.806) were independently related to DeltabFGF (P<0.001) and all other variables including DeltaS area, and DeltaV area, and DeltaWR did not enter the equation at significant levels. CONCLUSION: The present study indicated a negative correlation between serum bFGF levels and BMI at baseline as well as an association of DeltaBMI and DeltaVO(2) with DeltabFGF after exercise intervention. The exercise-induced elevation of bFGF may be beneficial in the prevention of the atherosclerosis in overweight subjects.

Adipose Tissue↗

PubMed1983

[Generation of response functions of a NaI detector by using an interpolation technic].

A computer method is developed for generating response functions of a NaI detector to monoenergetic gamma-rays. The method is based on an interpolation between measured response curves by a detector. The computer programs are constructed for Heath's response spectral library. The principle of the basic mathematics used for interpolation, which was reported previously by the author, et al., is that response curves can be decomposed into a linear combination of intrinsic-component patterns, and thereby the interpolation of curves is reduced to a simple interpolation of weighting coefficients needed to combine the component patterns. This technique has some advantages of data compression, reduction in computation time, and stability of the solution, in comparison with the usual functional fitting method. The processing method of segmentation of a spectrum is devised to generate useful and precise response curves. A spectral curve, obtained for each gamma-ray source, is divided into some regions defined by the physical processes, such as the photopeak area, the Compton continuum area, the backscatter peak area, and so on. Each segment curve then is processed separately for interpolation. Lastly the estimated curves to the respective areas are connected on one channel scale. The generation programs are explained briefly. It is shown that the generated curve represents the overall shape of a response spectrum including not only its photopeak but also the corresponding Compton area, with a sufficient accuracy.

Gamma Rays↗

PubMed1992

A seven-year follow-up of a weight reduction programme in Finnish primary health care.

The study was carried out to assess the short- and long-term effects of a Finnish Social Insurance Institution (SII) weight reduction programme in overweight primary health care clients and the suitability of the programme for use in health centres. The treatment group consisted of 22 men and 71 women, mean body mass index (BMI) 34.3, divided into 8 subgroups. These subjects participated in a 6-week weight reduction course led by public health nurses. Afterwards, there were six follow-up sessions and weight measurements at about 2-month intervals. A control group of 20 men and 76 women, mean BMI 33.5, received no weight reduction instruction during the 1 year that they served as controls. The weights, serum and high-density lipoprotein (HDL) cholesterol levels as well as blood pressures of the subjects in both groups were measured at entry to the study and at the end of the 1-year period. At that time the treatment group showed a weight reduction of 10.9 kg in men and 5.4 kg in women. The control group showed a mean weight gain of 0.9 kg in men and 0.2 kg in women. HDL cholesterol increased in the treatment group. The blood pressure decreased significantly in the category of subjects with a weight loss exceeding 4 kg weight. At the end of the 7-year follow-up period the mean weight reduction in the treatment group was 8.7 kg in men and 3.5 kg in women. Of men 53% and of women 21% still weighed over 10 kg less than at baseline. Both the clients and public health nurses found the weight reduction programme useful and applicable to health centres, preferably with extended time. The programme has now been adopted nationwide in the Finnish primary health care system.

Adolescent↗

PubMedDate not supplied

Culturally tailored diabetes education program for Chinese Americans: a pilot study.

BACKGROUND: The prevalence of type 2 diabetes among Chinese Americans is rising, and cultural and socioeconomic factors prevent this population from achieving optimal diabetes management. OBJECTIVES: To assess the feasibility and acceptability of a culturally appropriate diabetes management program tailored to Chinese Americans with type 2 diabetes and the preliminary outcomes of the intervention. METHOD: Forty eligible subjects were recruited from the community to participate in this 10-session program developed by integrating Chinese cultural values into an established Western diabetes management program. Feasibility and acceptability of the program were evaluated by the percentage of participants meeting the course objectives and satisfaction with the program. Outcomes measures included the Diabetes Quality-of-Life (DQOL) survey, body weight, blood pressure, and HbA1c levels measured before, after, and 3 months after the intervention. RESULTS: Thirty-three participants completed all 10 sessions and the outcome measurements. Attrition rate was 17.5%. The majority of the participants understood the course content (75%) and identified and demonstrated various diabetes management skills (70% and 82.5%, respectively). All participants who completed the program were "very satisfied" with the program. With regard to the outcome variables, 43.6% of the participants lost more than 5 pounds and most had a reduction in blood pressure at 3 months after completion of the program. Mean HbA1c decreased from 7.11 to 6.12 postintervention. Significant improvements on the DQOL also were reported. DISCUSSION: Culturally tailored diabetes management may be effective in Chinese Americans with type 2 diabetes. Further study, with a larger sample size and a control group, is recommended.

Adult↗

PubMed1993

[Effectiveness of a community-based education program on blood pressure reduction for cardiovascular disease prevention].

To evaluate the effectiveness of lifestyle modification community-based programs on blood pressure reduction, blood pressure changes were examined according to frequency of attendance at these adult classes. The subjects were 1,017 men and women aged 40-69 who participated in a survey from 1985 to 1987, whose blood pressure was > = 140 mmHg for systolic, and/or > = 90 mmHg for diastolic and/or with antihypertensive medication use in the earlier 1981-1984 surveys. Adult classes were conducted eleven times between 1982 and 1987, emphasizing primarily reduction of salt intake, weight control if necessary, and alcohol modification. Blood pressure changes between 1981-1984 and 1985-1988 were examined in relation to the number of classes attended, stratified by antihypertensive medication use. In the group with no medication use in both surveys (n = 347), there was a significantly larger decline in systolic and diastolic blood pressures with an increase in the number of classes attended (p < 0.001). A similar trend was observed in other groups: a starting medication group (n = 198), a quitting medication group (n = 100) and a continuous medication group (n = 372). The blood pressure trend in the no medication group remained significant after controlling for age, initial blood pressure, follow-up years and the number of follow-up screenings attended. For the no medication group, there was no significant association between the number of classes attended and changes in relative weight index and alcohol intake. The proportion of persons reporting dietary modification of reduction in salt was larger, and mean 24-hour urine sodium excretion was smaller, with increasing number of classes attended in the 1985-1988 surveys. Furthermore, the proportion of persons who were able to reduce salt intake between the two survey periods was higher with an increase in the number of classes attended. Mean urine sodium excretion was smaller in those who reported reduction of salt intake than those who did not. Although this study is not a randomized controlled trial, these results suggest that a community-based education program of adult classes can be effective in reduction of blood pressure levels through modification of diet.

Adult↗

PubMed2003

Counseling for physical activity in overweight and obese patients.

Obesity has reached epidemic proportions in the United States. More than 60 percent of U.S. adults are now overweight or obese (defined as at least 30 lb [13.6 kg] overweight), predisposing more than 97 million Americans to a host of chronic diseases and conditions. Physical activity has a positive effect on weight loss, total body fat, and body fat distribution, as well as maintenance of favorable body weight and change in body composition. Many of the protective aspects of exercise and activity appear to occur in overweight persons who gain fitness but remain overweight. Despite the well-known health and quality-of-life benefits of regular physical activity, few Americans are routinely active. Results of research studies have shown that physician intervention to discuss physical activity (including the wide array of health benefits and the potential barriers to being active) need not take more than three to five minutes during an office visit but can play a critical role in patient implementation. This article describes elements of effective counseling for physical activity and presents guidelines for developing physical activity programs for overweight and obese patients.

Body Mass Index↗

PubMed1995

Effects of weight loss vs aerobic exercise training on risk factors for coronary disease in healthy, obese, middle-aged and older men. A randomized controlled trial.

OBJECTIVE: To compare the effects of weight loss vs aerobic exercise training on coronary artery disease risk factors in healthy sedentary, obese, middle-aged and older men. DESIGN: Randomized controlled trial. SUBJECTS: A total of 170 obese (body mass index, 30 +/- 1 kg/m2 [mean +/- SEM]), middle-aged and older (61 +/- 1 years) men. INTERVENTIONS: A 9-month diet-induced weight loss interventions, 9-month aerobic exercise training program, and a weight-maintenance control group. MAIN OUTCOME MEASURES: Change in body composition, maximal aerobic capacity (V02 max), blood pressure, lipoprotein concentrations, and glucose tolerance. RESULTS: Forty-four of 73 men randomized to weight loss completed the intervention and had a 10% mean reduction in weight (- 9.5 +/- 0.7 kg; P < .001), with no 22 change in VO2 max. Forty-nine of 71 men randomized to aerobic exercise completed the intervention, increased their VO2 max by a mean of 17% (P < .001), and did not change their weight, whereas the 18 men who completed in the control group had no significant changes in body composition or VO2 max. Weight loss decreased fasting glucose concentrations by 2%, insulin by 18%, and glucose and insulin areas during the oral glucose tolerance test (OGTT) by 8% and 26%, respectively (P < .01). By contrast, aerobic exercise did not improve fasting glucose or insulin concentrations or glucose responses during the OGTT but decreased insulin areas by 17% (P < .001). In analysis of variance, the decrement in fasting glucose and insulin levels and glucose areas with intervention differed between weight loss and aerobic exercise when compared with the control group (P < .05). Similarly, weight loss but not aerobic exercise increased high-density lipoprotein cholesterol levels (+ 13%) and decreased blood pressure compared with the control group. In multiple regression analyses, the improvement in lipoprotein and glucose metabolism was related primarily to the reduction in obesity. CONCLUSIONS: These results suggest that weight loss is the preferred treatment to improve coronary artery disease risk factors in overweight, middle-aged and older men.

Aged↗

PubMed2002

The effect of dietary intervention on serum lipid levels in type 2 diabetes mellitus.

Dietary therapy is the cornerstone of lipid management in patients with type 2 diabetes mellitus. The key strategies are the reduction of intake of saturated fat, trans unsaturated fat and cholesterol, and the reduction of energy intake to promote weight loss. This approach will produce significant improvements in the serum levels of low-density lipoprotein (LDL) cholesterol, triglycerides, and high-density lipoprotein (HDL) cholesterol. According to both the American Diabetes Association and the National Cholesterol Education Program (NCEP), the primary target of therapy is the serum LDL cholesterol level, with the secondary targets being non-HDL cholesterol, triglycerides, and HDL cholesterol. The recently updated guidelines of the NCEP place new emphasis on increasing soluble fiber intake to 10 to 25 g/d and adding foods fortified with plant stanols/sterols (2 g/d) as options to enhance the LDL cholesterol-lowering effect of diet.

Cholesterol, HDL↗

PubMed2005

Dietary management for older subjects with obesity.

In recent years, obesity has been recognized as a form of malnutrition in older adults and a continuing risk factor for serious health problems. Weight reduction in older adults is not as reliable a recommendation as it is for younger adults; a decreased body mass index (BMI) seems to be associated with a higher incidence of stroke, and a normal or slightly elevated BMI has been linked to greater reserve capacity. Weight loss in older adults requires strategies that consider health status, functional ability, and rational targets. Strategies may include behavior modification, dietary alterations, exercise or physical activity, and reasonable goals that do not put the individual at nutritional risk. Studies that examine different approaches to weight reduction rarely include older subjects, so it is difficult to make judgments about various interventions (surgery, exercise, drugs, or diet) and their efficacy in this population. Fad diets may be lacking in essential nutrients and may prove to be risky for elderly people. Weight loss programs for older adults should focus on maintaining adequate intake of essential nutrients while reducing calories by controlling dietary fat intake.

Aged↗

PubMed1998

How to develop a group curriculum: developing an exercise programme for overweight adults.

This paper reports on work to develop introductory exercise courses for sedentary, moderately overweight adults. The aim is to offer a safe and motivating programme of physical exercise and, through experiential learning, to encourage and facilitate increased physical activity. The core of the programme is a course of 10-20 weekly exercise classes. The classes include a variety of physical exercises adapted to the special needs of overweight adults (BMI 28-34 kg/m2) and a number of health-related fitness tests. We outline the underlying principles of the exercise courses, their structure and contents, the guidelines of instruction, and the use of formative evaluation. In addition, we report on the implementation of five weight-reduction courses and six exercise courses involving a total of 209 participants. A fairly high level of programme acceptability (in terms of attendance rates and personal commitment) and programme feasibility (in terms of acceptability, changes in personal orientation towards health and weight reduction, and satisfaction among participants) was achieved.

Adolescent↗