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Query: UMLS:C0020505 (hyperphagia)
 6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with idiopathic chronic intestinal pseudo-obstruction suffer from malnutrition because of inability to maintain adequate oral intake without the development of obstructive symptoms. We have successfully used central venous nutrition in two patients with this syndrome, both on a short-term and long-term home-maintenance basis. Hyperalimentation can provide adequate nutrition in patients with intestinal pseudo-obstruction until normal bowel function returns or until definitive therapy for this chronic disease is found.
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PMID:Idiopathic chronic intestinal pseudo-obstruction. Use of central venous nutrition. 10 Jun 20

There is persuasive evidence that much obesity is due to underexercising rather than overeating. In a series of randomized, controlled trials we found that sedentary men who take up jogging lose body fat in proportion to miles run, increase their energy intake, and improve their lipoprotein pattern. In a 1-year comparison of fat loss by dieting vs. fat loss by exercise without dieting, both methods were found to be effective in moderately overweight men, and both approaches raised plasma HDL cholesterol. We also demonstrated in overweight men and women losing weight on a prudent diet (low fat, low cholesterol) that adding exercise to energy restriction further increased loss of body fat and reduced waist-to-hip girth ratio, especially in men. Risk of coronary heart disease was also substantially further reduced by addition of exercise, in both sexes. These studies suggest that regular exercise is a valuable addition to dietary change for weight control and reduction of risk of chronic disease in people of all ages. In this article I shall describe studies done by our group in the past 10 years to investigate the effects of varying energy expenditures and varying caloric intakes on body composition, in particular body fat content. The intervention studies are of relatively long duration (1 or 2 years) and have been conducted in free-living men and women. Such long-term investigations are rare in children and adolescents. Although experience in adults cannot be translated directly to children, our findings may indicate profitable research directions for future obesity research in the young.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Impact of experimental manipulation of energy intake and expenditure on body composition. 835 99

Dietitians are developing a philosophy and a practice protocol of weight management. A professional philosophy of weight management addresses questions about the social, psychological, and biological spectra of weight management: Should overweight be considered in terms of size acceptance or gluttony and sloth? How should emotional overeating and obsessive restriction be managed? Should obesity be considered a chronic disease, or should the idea that health at every size is possible be espoused? A professional practice protocol addresses another set of questions: Is obesity to be viewed as a short-term and long-term health challenge? Regarding the spectrum of antiobesity agents and antidieting approaches of weight management, what professional position and individual practice will be adopted? Should professional contact with patients be continuous or aimed toward self-care? What measures of successful outcomes will be used: weight change or life quality improvement? How should professional responsibility be balanced with personal concerns about eating and health behaviors that affect body weight? What are examples of closing the gap between the vision and the reality of the roles and goals of the dietitian on a weight management team? Dietitians are translating philosophy into practice. Because dietary control alone has a record of limited success in weight loss and less success in maintaining weight loss, the dietitian's expanded role includes helping patients manage weight with coping skills, motivation techniques, physical activity, and food behavior change. The challenge is integrating functional components of practice with dietitians' unique food and nutrition skills that include selection of alternative foods, portion control, and preparing acceptable, tasty foods for lifelong weight management.
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PMID:The dietitians' philosophy and practice in multidisciplinary weight management. 978 37

Data from the Partnership for Child Development shows that nutrition problems of school children may be greater and more widespread than previously thought; its experience indicates that school-based health and nutrition programs are feasible and effective. A survey of donors and agencies reveals wide support for school health and nutrition programs. Data on iron deficiency from a database developed by the World Health Organization (WHO) indicate a higher prevalence of anemia in school-age children than in pre-school children. In school-aged children in Mongolia, the very low intake of fruit is responsible for the lower than normal values of some essential vitamins and minerals. Food-for-school programs, such as the national program in India, provide food to take home to children with high attendance records; this is used to attract the enrollment and attendance of children, particularly girls. In India, the government-funded Nutritional Support to Primary Education Programme has been successful in rural areas and will include the entire country by the end of 1998. In Indonesia, the school feeding program in designated 'poor' villages continues to be funded by the government in spite of the economic crisis there. In South Africa, a case study has shown that the use of fortified biscuits as a snack food results in the significant improvement of the micronutrient status of school children. Concerns learned from the Kenyan programs, which have suffered from a lack of funds, include the key role of parents, the safety and quality of food from vendors and hawkers, and the use of money, which was given to children for food, for drugs. Guidelines that promote healthy eating for school children in the US have been developed. Overeating, obesity, eating disorders, and the future risk of chronic disease have become problems in developed countries and among some groups of people in developing countries. In developed countries, personal preferences drive the nutritional patterns of school children, rather than the availability of food. In Nepal, a study indicates that, among children in more affluent schools, preferences are moving toward modern convenience foods of poor nutritional quality.
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PMID:Nutrition of the school-aged child. 1234 62

Obesity is a chronic disease with a worldwide increasing incidence. The mainstay of therapy consists in modification of behaviour related to obesity such as overeating and physical inactivity. When these life-style modifying attempts fail, the use of anti-obesity drugs is warranted. The two available drugs, orlistat and sibutramine, are capable of reducing body weight by 10%. Failure of these medications in a subset of patients to achieve adequate weight loss and limited overall efficacy have led to an extensive research on novel anti-obesity agents. This review presents an overview on the current drugs available as well as on potential future candidates.
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PMID:[Pharmacotherapy of obesity]. 1536 53

Obesity is a chronic disease with a worldwide increasing incidence. The mainstay of therapy consists in modification of behaviour related to obesity such as overeating and physical inactivity. When these life-style modifying attempts fail, the use of anti-obesity drugs is warranted. Public health efforts and current anti-obesity agents have not controlled the increasing epidemic of obesity, which has led to an extensive research on novel anti-obesity agents. This review presents an overview on potential future candidates.
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PMID:[Novel anti-obesity drugs]. 1573 49

The fact that obesity is a chronic disorder has traditionally focused experimental attention on the long-term controls of energy balance. Searches for therapeutic targets tend to concentrate on central integrative mechanisms and to largely ignore the visceral afferents and other peripheral mechanisms providing short-term controls of energy balance. Investigations of central mechanisms have yet to yield, however, any practical and effective treatments for correcting obesity. In this review, we survey some of the arguments for considering peripheral visceral afferent mechanisms as promising targets for future research on obesity. These arguments include (1) the observation that visceral afferents have the specializations, complexities, heterogeneities, and extensive distributions at key sites to provide exhaustive and dynamic feedback to control energy handling, (2) the fact that the most effective treatments yet developed for achieving long-term or permanent weight loss, namely gastroplasty and similar bariatric surgical procedures, clearly alter visceral afferent feedback from the gastrointestinal tract, and (3) experimental observations that suggest loss of visceral negative feedback can lead to overeating, positive energy balance, and obesity. Furthermore, even though excess adiposity is a disturbance in long-term energy regulation, it is instructive that obesity in the final analysis is developed, is maintained, and ultimately needs to be treated one meal at a time. When these considerations are taken in conjunction with concerns about side effects and risks that can be expected to accompany pharmacological therapies directed at central nervous system circuits, it would seem prudent to assess ways in which the feedback of visceral afferents might be enhanced or manipulated to support or synergize with other therapeutic strategies used in the management of excess energy intake.
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PMID:Obesity: should treatments target visceral afferents? 1624 69

Incorporating the Healthy Eating Index concept, we have developed a global dietary quality index, the Overall Dietary Index (ODI). We have evaluated the relationships between ODI and chronic disease in a 1998 Taiwanese Health Screening program with over 46,000 members (51.2% females) aged 19-84. However, it could not predict health status adequately. Therefore, we revised this ODI which became ODI-R (Revised). The revision added a quality evaluation for staples (whole grains) and protein-rich foods (fish and soy) and reduced the impact of dietary fat quantity. ODI-R comprises nine items with a maximal score of 100. It has 5 food categories: dairy products, protein rich foods (eggs/legumes/fish/meats), vegetables, fruits and cereals; 2 dietary fat qualities (P/S ratio and cholesterol); and 2 descriptors: dietary moderation (alcohol, salt and sugar as one item) and dietary variety. The mean ODI-R was lower than ODI (64.4 vs. 68.1 in men and 65.5 vs. 69.0 in women) and the distribution. The correlations between macronutrients and ODI-R were weaker than for ODI, especially for fat (from +/-0.52 to +/-0.07) as well as for cholesterol and all fatty acid types by degree of saturation. For dietary fiber and micronutrients, the correlations became either less negative or more positive, signaling that the ODI-R reflects food quality more appropriately than ODI in regard to micronutrients. Empirically, a subtraction scoring approach for the overeating of protein rich foods, did not meaningfully decrease ODI-R in Taiwanese elderly or children. ODI-R provides an effective measure of dietary quality over quantity.
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PMID:A global overall dietary index: ODI-R revised to emphasize quality over quantity. 1829 8

Chronic stress can affect human health through a myriad of behavioral and biochemical pathways. Tauhis review focuses on some key hormonal and metabolic pathways that appear important today. In modern society, we are faced with excessive psychological stress, as well as an epidemic of overeating, and the two together appear to have synergistic effects. Chronic stress can lead to overeating, co-elevation of cortisol and insulin, and suppression of certain anabolic hormones. This state of metabolic stress in turn promotes abdominal adiposity. Both the direct stress response and the accumulation of visceral fat can promote a milieu of systemic inflammation and oxidative stress. This biochemical environment appears to be conducive to several cell aging mechanisms, mainly dampening telomerase and leading to telomere length (TL) shortening and cell senescence. Immune cell telomere shortness is linked with many chronic disease states and earlier mortality. In this way, chronic stress may influence a variety of diseases through a biochemical cascade leading to immune cell senescence. Certain psychological temperaments at high risk of this stress cascade (mainly anxiety prone), gene-environment interactions, and potential interventions for interrupting the stress-aging cascade are discussed.
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PMID:Psychological and metabolic stress: a recipe for accelerated cellular aging? 1926 17

Across different societies, non-dominant minority groups, compared to the dominant group, often exhibit higher rates of involvement in high-risk behaviors, such as smoking, drug and alcohol use, sexual risk behaviors, overeating, and unsafe driving habits. In turn, these behaviors have a well-documented impact on chronic disease, morbidity, and mortality. Previous studies have emphasized macro-structural or micro-agentic explanations for this phenomenon. Such explanations suffer from mirror-image shortcomings, such as, by emphasizing structural barriers, macro-level explanations leave out individual agency ("the over-socialized conception of the individual"), while micro-level theories give short shrift to structural constraints that prevent individuals from engaging in health-promoting behaviors ("the under-socialized conception of the individual"). Moreover, most current theories regard individuals as passive players who are influenced by the social environment or by psychological problems, or who make "bad" choices. The current paper develops an integrated theoretical framework that incorporates structural inequalities while leaving intact the role of individual agency. According to the social resistance framework, power relations in society encourage members of non-dominant minority groups to actively engage in everyday resistance practices that include various unhealthy behaviors. The paper develops propositions from which testable hypotheses can be generated, and discusses the implications and contributions of the social resistance framework.
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PMID:Understanding high-risk behavior among non-dominant minorities: a social resistance framework. 2190 76


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