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PubMed1982

Effects of excessive caloric intake and caloric restriction on body weight and energy expenditure at rest and light exercise.

The individual response to overeating and semistarvation on energy expenditure at rest and light work before and after a test meal was investigated. This response was related to the change in dry body weight, measured as weight (W) minus total body water (TBW). Experiments were performed on 9 non-obese subjects: (a) with a normal habitual energy intake; (b) (overfeeding) with an extra energy intake of 12 MJ per day for two weeks; and (c) (semistarving) with an energy intake of only 2.1 MJ per day for 2 weeks. Measurements of VO2, VCO2, W and TBW were obtained at the end of each of the three periods. It was found that the perturbation in energy intake from normal to 20-25 MJ per day increased the energy expenditure. The magnitude of this increase was highly individual and inversely related to the change in dry body weight. Energy expenditure, measured under the four standardized conditions, after 2 weeks of starvation was lower than that obtained after the preceding overeating period. This decrease was also roughly inversely related to the change in dry body weight. The results support the idea that part of the regulation of body energy content takes place by way of a change in the efficiency of energy utilization and that the response to a perturbed energy intake varies considerably between subjects.

Adult↗
PubMed2002

How reliable is length-based determination of body weight and tracheal tube size in the paediatric age group? The Broselow tape reconsidered.

BACKGROUND: The Broselow tape was designed to estimate body weight and tracheal tube size on the basis of the body length of emergency paediatric patients. The tape was validated previously in US populations. We assessed its accuracy in a sample of European children by reviewing paediatric anaesthetic charts at the Triemli City Hospital for 1999. METHODS: Age, body length and body weight measured before surgery as well as the size of the tracheal tube used were recorded. The body weight was estimated on the basis of body length using the Broselow tape and was compared with the measured weight. Tracheal tube size selections using the Broselow tape and an age-based formula were compared with the size of the tube used. RESULTS: A good correlation was found between the Broselow weight and the measured weight (r2=0.88). Bland-Altman analysis revealed a mean bias of -0.52 kg for the entire study population. For children < or = 20 kg the mean bias was -0.05 kg, and for children > 20 kg was -1.05 kg. The Broselow weight was found to be within a 10% error of the measured weight in 65% of children. Tracheal tube selection by the Broselow tape method was adequate in 55% but underestimated the actual tube size in 39%. The age-based formula matched the actual tracheal tube size in 41% of children but overestimated it in 57%. CONCLUSIONS: The Broselow tape is an accurate means to assess body weight from length in smaller children; in older children it underestimated body weight. Endotracheal tube size selection by the Broselow tape appears to match the size of the tube used better than the age-based formula. The results in a European sample of children are comparable to the US data.

Anthropometry↗
PubMed2003

Reference values for second trimester fetal and neonatal organ weights and measurements.

To establish accurate reference ranges for the entire second trimester, we documented organ weights, body weight, and linear measurements for 597 fetuses and neonates with gestational ages ranging from 12 to 26 wk. We determined the mean and standard deviation for weights and measurements at each week of gestation using the StatView trade mark SE + Graphics statistical program. The analyses revealed a linear correlation between the gestational age and, respectively, the toe-heel length, crown-rump length, and crown-heel length. Body and organ weights increase at varying rates throughout the second trimester. The data correlate well with weights and measurements previously published for the latter half of the second trimester, and extend these reference ranges to encompass the entire second trimester.

Crown-Rump Length↗
PubMed2001

Hormones, weight change and menopause.

OBJECTIVE: To determine total body weight change occurring in women at mid-life, specifically with respect to occurrence of menopause and use of estrogen. DESIGN: Retrospective analysis of body weight measurements accumulated in two cohorts of healthy women participating in studies of skeletal metabolism. SUBJECTS: Cohort 1: 191 healthy nuns enrolled in a prospective study of osteoporosis risk, aged 35-45 in 1967; cohort 2: 75 women aged 46 or older and still menstruating, enrolled in 1988 in a study of bone cell dynamics across menopause. Roughly one-third of each group received hormone replacement after menopause. MEASUREMENTS: Body weight and height, age, menstrual status and use of estrogen replacement. Cohort 1: 608 measurements at 5 y intervals spanning a period from 17 y before to 22 y after menopause; cohort 2: 1180 measurements at 6-month intervals spanning a period from 5 y prior to 5 y after menopause. RESULTS: In cohort 1 weight rose as a linear function of age (both chronological and menopausal), both before and after cessation of ovarian function, at a rate of approximately 0.43% y(-1). Neither the menopausal transition nor the use of estrogen had an appreciable effect on this rate of gain. In cohort 2 the rate of gain seemed to diminish slightly at menopause. As with cohort 1, hormone replacement (or its absence) had no appreciable effect on weight. CONCLUSIONS: The long-term, total body weight trajectory at mid-life is not influenced appreciably by either cessation of ovarian function or by hormone replacement.

Adult↗
PubMed2006

Comparison of weighted performance measurement and dichotomous thresholds for glycemic control in the Veterans Health Administration.

OBJECTIVE: Quality measures of glycemic control using threshold values do not assess incremental quality improvement. We compared health care system performance using weighted continuous versus dichotomous measures for glycemic control. RESEARCH DESIGN AND METHODS: We performed retrospective cross-sectional analysis of chart abstraction data on 37,142 diabetic patients from 141 Veterans Health Administration medical centers in 2000-2001. RESULTS: Subjects per facility ranged from 163 to 740 (mean 263). Mean overall HbA(1c) (A1C) was 7.58%. A continuous measure for glycemic control was calculated based on percentage of maximal quality-adjusted life-years saved (QALYsS). Overall mean facility performance using the dichotomous measure was 62% <8% A1C (range 48-75%) and 39% <7% A1C (21-57%), in comparison with 45% maximal QALYsS (31-60%). Correlation between QALYsS and A1C thresholds of <8 (0.848) and <7 (0.838) for facility rankings was excellent; correlation between facility level performance using thresholds of <8 and 7% was poor (r = 0.13, P = 0.14). Comparison of facility rankings between the <7% dichotomous measure and the QALYsS-weighted measure showed that 22% changed their ranking by > or =2 deciles with marked changes in top and bottom deciles. CONCLUSIONS: Facility rankings vary by threshold or continuous methodology. However, because significant numbers of individuals are unable to reach "optimal" target goals (thresholds) even in clinical trials with extensive exclusion criteria, we propose that a continuous measure assessing improvement toward optimal A1C, rather than a pass/fail optimal target, is both a fairer assessment clinical practice and a more accurate reflection of population health improvement.

Aged↗
PubMed2005

Measuring preference weights for American college of rheumatology response criteria for patients with rheumatoid arthritis.

OBJECTIVE: To estimate weights for health states comprising American College of Rheumatology (ACR) response and different levels of adverse events associated with rheumatoid arthritis (RA) treatments. METHODS: A survey was mailed to 748 patients with RA from southern California. In addition to several questionnaires commonly used for patients with RA, patients were instructed to evaluate 10 hypothetical health states, in which they could have an ACR response and/or adverse events due to new treatments, with a visual analog scale (VAS). Patients also evaluated their current health with a VAS question and a time tradeoff (TTO) question. Linear extrapolation was used to derive 6 more health states. The Pearson correlation coefficient was used to validate VAS and TTO results. RESULTS: A total of 487 (65%) patients returned the survey. Among the 10 health states evaluated with VAS directly, the health state in which a patient has ACR70 with no adverse events had the highest VAS weight (0.84), followed by the one having an ACR50 response with no adverse events (0.80). Correlation coefficients ranged from 0.63 for the correlation between VAS and physical component summary to -0.18 between TTO and pain and tender joint count; the correlation coefficients were all statistically significant, indicating there was convergent validity of the VAS and that VAS functioned differently from TTO in how it measured weights. CONCLUSION: VAS weights for 16 ACR response health states of patients with RA were derived. These weights could be used for cost-utility analyses of interventions for patients with RA.

Aged↗
PubMed2001

Weight loss and body mass index as predictors of HIV disease progression to AIDS in adults. Aquitaine cohort, France, 1985-1997.

OBJECTIVE: To assess the performance of weight related nutritional markers (reported involuntary weight loss greater than 10%, measured weight loss and body mass index-BMI-) in predicting HIV disease progression. DESIGN: Multirisk cohort of HIV-1 infected patients. METHOD: The three nutritional variables were studied in Cox proportional hazard models as time dependant variables. RESULTS: The sample included 2376 subjects (median follow up: 43.1 months), of those 675 experienced an AIDS defining event. After adjustment for well known prognostic factors, the reported weight loss greater than 10% tripled the risk of progression to clinical AIDS (Hazard ratio [HR] 3.0. 95% confidence interval [CI] 2.5-3.7). For measured weight loss under 5%. between 5% and 10% and greater than 10% of baseline weight compared with no weight loss, hazard ratios were respectively 1.8 (CI 1.5-2.2), 2.6 (CI 2.1-3.2) and 5.1 (CI 4.1-6.4). The relative risks of AIDS were 1.7 (CI 1.3-2.2) for BMI between 17 kg/m2 and 18.5 kg/m2, 2.6 (CI 1.7-4.0) for BMI between 16 kg/m2 and 17 kg/m2 and 4.7 (CI 3.0-7.4) for BMI under 16 kg/m2. COMMENTS: Even a limited weight loss measured at a given time during follow up increases the risk of HIV progression; moreover, a simple cross-sectionnal measure of BMI has a good predictive value for subsequent development of clinical disease.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Body mass index and prevalence of obesity changes among Kuwaitis.

OBJECTIVES: To compare temporal changes in BMI, overweight (BMI > 25 kg/m2) and obesity (BMI > 30 kg/m2) between two periods, among adult Kuwaitis. DESIGN: Comparison of two independent cross-sectional samples of Kuwaitis studied in 1980-81 and 1993-94. SUBJECTS: 2067 (896 men and 1171 women) and 3435 (1730 men and 1705 women) adult Kuwaitis (aged > or = 18 y), drawn from primary health care (PHC) clinics and studied for nutritional assessment and for prevalence of obesity in 1980-81 and 1993-94, respectively. MEASUREMENTS: Weight was measured in kilograms and height in meters to obtain the body mass index (BMI), which is the weight in kilograms divided by the height in meters squared (kg/m2). BMI > 25 and > 30 kg/m2 were classified as overweight and obesity, respectively. RESULTS: Mean BMI (kg/m2) increased significantly (P < 0.001) by 10.0 and 6.2% (2.5 and 1.7 kg/m2) among men and women, respectively. Prevalence of overweight and obesity (BMI > 25 and > 30 kg/m2) increased by 20.6 and 15.4% and by 13.7 and 8.4% among men and women, respectively. After controlling for sociodemographic differences between the two study periods, mean BMI was 2.0 and 1.6 kg/m2 higher in 1993-94 than in 1980-81 among men and women, respectively. Prevalence of overweight and obesity (BMI > 25 and > 30 kg/m2) also increased among both genders between the two periods (OR = 2.1, 95% CI 1.7-2.7 and OR = 1.9, 95% CI 1.5-2.4, for men and OR = 2.2, 95% CI 1.6-3.0 and OR = 1.4, 95% CI-1.0-1.9, for women). CONCLUSIONS: BMI, prevalence of overweight and obesity increased among Kuwaitis between 1980-81 and 1993-94, probably due to the effects of modernization, affluence, increased food consumption and the concomitant changes to sedentary lifestyles. The rate of temporal changes in BMI and obesity were higher, by comparison, in Kuwait than in selected other countries.

Adolescent↗
PubMedDate not supplied

n-Propanol induced microcephaly in the neonatal rat.

Neonatal rats were reared using an artificial feeding technique from postnatal day 5 through 18. On days 5, 6, 7 and 8 some animals received n-propanol in their milk formula with the remaining animals serving as controls. The propanol was given in doses similar to that of ethanol which is known to result in microcephaly using this procedure. Following the 4 day alcohol exposure, all animals received the plain milk formula until day 18, when they were decapitated and various organ weights measured. Brain weights and brain/body weight ratios were significantly decreased in the alcohol exposed group. Biochemical analysis showed the alcohol exposed group had a decreased amount of DNA in all brain areas examined. Cholesterol levels were decreased in the forebrain and cerebellar samples of the alcohol group, while protein levels were decreased only in the forebrain samples. The results suggest that exposure to n-propanol during a portion of the brain growth spurt of the neonatal rat inhibits brain development. The biochemical measures of brain growth imply n-propanol interferes with the development of the brain in a manner similar to ethanol.

1-Propanol↗
PubMed2004

Obesity among US immigrant subgroups by duration of residence.

CONTEXT: The prevalence of obesity has increased substantially since the 1980s. While immigrants are the fastest growing segment of the US population, little is known about obesity or clinician counseling about diet and exercise in this group. OBJECTIVES: To estimate the prevalence of obesity among immigrant subgroups and quantify the magnitude of the association with duration of US residence, and to describe reported diet and exercise counseling by birthplace, race, and ethnicity. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study using data from the 2000 National Health Interview Survey. MAIN OUTCOME MEASURES: Body mass index (BMI, measured as weight in kilograms divided by the square of height in meters) based on self-reported height and weight measurements, and self-reported rates of diet and exercise counseling. RESULTS: Of 32,374 respondents, 14% were immigrants. The prevalence of obesity was 16% among immigrants and 22% among US-born individuals. The age- and sex-adjusted prevalence of obesity was 8% among immigrants living in the United States for less than 1 year, but 19% among those living in the United States for at least 15 years. After adjusting for age, sociodemographic, and lifestyle factors, living in the United States for 10 to 15 and at least 15 years was associated with BMI increases of 0.88 and 1.39, respectively. The association for 15 years or more was significant for all immigrant subgroups except foreign-born blacks. Additionally, immigrants were less likely than US-born individuals to report discussing diet and exercise with clinicians (18% vs 24%, P<.001; 19% vs 23%, P<.001, respectively). These differences were not accounted for by sociodemographic characteristics, illness burden, BMI, or access to care among some subgroups of immigrants. CONCLUSIONS: Among different immigrant subgroups, number of years of residence in the United States is associated with higher BMI beginning after 10 years. The prevalence of obesity among immigrants living in the United States for at least 15 years approached that of US-born adults. Early intervention with diet and physical activity may represent an opportunity to prevent weight gain, obesity, and obesity-related chronic illnesses.

Adult↗
PubMed1993

Plasma cholesterol and depressive symptoms in older men.

In several clinical trials of interventions designed to lower plasma cholesterol, reductions in coronary heart disease mortality have been offset by an unexplained rise in suicides and other violent deaths. We have tried to find out whether depressive illness is related to low plasma cholesterol concentrations in men of 50 years and older. In 1985-87, Beck depression inventories were obtained from 1020 white men, aged 50-89 years, in the Rancho Bernardo, California, cohort. Disease history and behaviours were assessed by standard questionnaires. Plasma cholesterol and weight were measured at this time, as they had been in 1972-74. Among men aged 70 years and older, categorically defined depression was three times more common in the group with low plasma cholesterol (< 4.14 mmol/L) than in those with higher concentrations (5/31 [16%] vs 22/363 [6%]; p = 0.033). Depressive symptom scores correlated significantly and inversely with plasma cholesterol concentrations, even after adjustment for age, health status, number of chronic illnesses, number of medications, and exercise, as well as measured weight loss and change in plasma cholesterol in the previous 13 years. Our finding that low plasma cholesterol is associated with depressive symptoms in elderly men is compatible with observations that a very low total cholesterol may be related to suicide and violent death. Since cholesterol lowering in the general population is widely recommended, this observation warrants further investigation.

Aged↗
PubMed1988

Weight history and hypertension.

The relationship between weight change and hypertension was examined among men and women 25-64 years of age surveyed in the National Health and Nutrition Examination Survey (NHANES-I). Any single weight measurement (current weight, weight at an earlier age, or the difference between these two weights) was found to be a significant univariate predictor of hypertension, with current weight being most predictive. Initial weight and weight change were not associated with increased blood pressure, however, when controlling for current weight. These results do not distinguish a difference in risk of hypertension in adults with overweight or obesity of long-standing vs that of adults with overweight or obesity of more recent onset.

Adult↗
PubMed2005

Associations with weight loss and subsequent mortality risk.

PURPOSE: Studies have shown a high prevalence of weight loss in older adults is associated with an increased risk of death. We investigated this in a population-based study. METHODS: Persons living in Beaver Dam, Wisconsin, participated in a baseline examination between 1988 and 1990 (n=4926). A medical examination and standardized questionnaire were administered. Weight loss was defined as percent loss in body weight from highest lifetime weight to measured weight at baseline. RESULTS: Weight loss was associated with older age, higher rates of diseases such as diabetes, and lower baseline levels of blood pressure and serum total cholesterol. After controlling for age, medical, and lifestyle factors, both men and women had higher mortality rates over a 10+ year period for increasing categories of weight loss (hazard ratio [ 95% CI]: 1.16 [1.06, 1.27] for men and 1.23 [1.13, 1.34] for women). Increased mortality rates with increasing weight loss was shown in stratified analyses of age, body mass index (BMI) at highest weight, smoking, and disease status, but did not always reach statistical significance. Persons on weight loss diets within the year prior to baseline did not have increased mortality with increasing weight loss. CONCLUSION: The strong association between weight loss (likely involuntary) and mortality may be a useful way of estimating overall risks to longevity in populations.

Adult↗
PubMed1997

Hind III polymorphism of the lipoprotein lipase gene and plasma lipid response to low calorie diet.

OBJECTIVE: To assess the effects of a low calorie diet on plasma lipids according to the Hind III polymorphism of the lipoprotein lipase (LPL) gene in overweight patients. DESIGN: Diet intervention study (25% restriction in energy intake during 2.5 months) in relation to genetic factors. SUBJECTS: 115 unrelated patients (77 women and 38 men) recruited on the basis of 120% of ideal body weight. MEASUREMENTS: Body weight, body mass index, blood lipids and lipoproteins, at entry and after 2.5 months, determination of LPL Hind III genotypes. RESULTS: On spontaneous diet, lipid and lipoproteins differed significantly between Hind III genotypes. Homozygous subjects for the presence of the Hind III cutting site, H2H2, had significantly higher plasma and VLDL triglyceride and apolipoprotein B concentrations than subjects carrying H1 allele. H2H2 subjects reduced their VLDL-triglyceride and apolipoprotein B concentrations more than H1 carriers, in such a way that differences in lipid levels according to genotypes were no more significant after diet. The magnitude of the decrease in triglycerides was positively correlated with the initial concentration but, among hypertriglyceridemic subjects, H2H2 still had the largest decrease in plasma and VLDL-triglycerides. CONCLUSION: The genetic variation at the LPL gene locus affects the response of serum lipid levels to caloric restriction. Overweight subjects with the H2H2 genotype of the LPL Hind III polymorphism are predisposed to hypertriglyceridemia but they are good responders to diet in terms of lipid levels.

Adult↗
PubMed1998

Correlates of body weight in the 1994 National Population Health Survey.

OBJECTIVE: This study examines three specific questions about obesity and overweight, using a nationally representative sample of Canadians. Are sociodemographic and lifestyle behaviors associated with body weight? Is body weight correlated with specific health outcomes? Has the prevalence of obesity in Canada changed since 1978? METHODS: Secondary data analysis of a cross-sectional survey. SAMPLE: This study uses the 1994 National Population Health Survey (NPHS) by Statistics Canada. It is a stratified random sample of 19600 Canadians across all provinces. RESULTS: The results show that age, gender, education, birth place and region, are significantly associated with obesity. When a lower criterion is used for overweight and obesity (body mass index, BMI > or = 25), dummy variables for marital status and occupation are also significant. Second, obesity is associated with poorer self-rated health, high blood pressure, heart disease, diabetes, arthritis, respiratory and stomach problems. For those respondents who have a BMI score of 25 or greater, there is also an association with stroke. Finally, it is unclear whether the prevalence of obesity has changed. However, there appears to be a systematic difference between studies using actual height and weight measurements (anthropometric) vs self-reported measurements. CONCLUSIONS: Weight can be considered a modifiable risk factor and reductions in the prevalence of obesity should reduce the risk of specific chronic conditions. Provincial variations in the prevalence of obesity (BMI > or = 27) and overweight and obesity (BMI > or = 25) suggest that collapsing provinces into regions may obscure important inter-provincial differences in body weight. More research is required to assess whether or not obesity is decreasing in Canada. Some of the limitations of self-reported data are discussed.

Adult↗
PubMed2005

A genome-wide scan for quantitative trait loci linked to obesity phenotypes among West Africans.

OBJECTIVE: To identify quantitative trait loci (QTL) for three obesity phenotypes: body mass index (BMI), fat mass (FM) and percent body fat (PBF) in West Africans with type 2 diabetes (T2DM). DESIGN: An affected sibling pair (ASP) design, in which both siblings had T2DM. Obesity was analyzed as a quantitative trait using a variance components approach. SUBJECTS: Sib-pairs affected with T2DM from the Africa America Diabetes Mellitus (AADM) study, comprising 321 sibling pairs and 36 half-sibling pairs. MEASUREMENTS: Weight was measured on an electronic scale to the nearest 0.1 kg, and height was measured with a stadiometer to the nearest 0.1 cm. Body composition was estimated using bioelectric impedance analysis (BIA). Genotyping was carried out at the Center for Inherited Disease Research (CIDR) with a panel of 390 trinucleotide and tetranucleotide repeats. RESULTS: The obesity-related phenotype showing the strongest linkage evidence was PBF on chromosome 2 (LOD 3.30 at 72.6 cM, marker D2S739). Suggestive linkage to FM was found on chromosomes 2 (LOD 2.56 at 80.4 cM) and 5 (LOD 2.25 at 98 cM, marker D5S1725). The highest LOD score for BMI was 1.68 (chromosome 4, 113.8 cM). The areas of linkage for the three phenotypes showed some clustering as all three phenotypes were linked to the same regions of 2p13 and 5q14, and our study replicated linkage evidence for several regions previously reported in other studies. CONCLUSION: We obtained evidence for several QTLs on chromosome 2, 4 and 5 to three obesity phenotypes. This study provides data on the genetics of obesity in populations that are currently under represented in the global effort directed at understanding the pathophysiology of excess adiposity in free living individuals.

Adipose Tissue↗