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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infant feeding programs the world over have been misdirected because they consider the baby as a separate entity from the mother. Instead it is a nutritional, psychological, and biological interaction between mother and offspring. Up to 6-9 months after birth the infant can be considered a fetus with the breast replacing the placenta. Unsupplemented human milk is all that is required to sustain growth and provide good nutrition for the 1st 6 months in babies of well-nourished mothers. In poorly nourished mothers the volume and composition is surprisingly good but is often lower in calories, water soluble vitamins, Vitamin-A, calcium, and protein than the milk of well-nourished mothers. The decline in breast feeding is not only leading to nutritional disorders, infectious diseases, or infant obesity from double-feeding, it is also causing an underappreciated economic drain of millions of dollars. At present lactation amenorrhea affords more contraceptive protection than all the technological contraceptives delivered through family planning services. The continuing trend towards bottle feeding in periurban areas in developing countries will lead to population increases.
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PMID:The dyadic nature of mother and child nutrition. 1230 90

The author contends that neither behavioral nor psychological factors are responsible for obesity or overweight, but that physiological and nutritional factors are. Obesity and overweight are relevant to natural family planning because they contribute to various problems of the female reproductive system. Body fat stores estrogen, and excess body fat increases estrogen levels which creates various problems. For example, elevated estrogen levels may contribute to endometrium build-up, resulting in heavy, prolonged bleeding during menstruation or in midcycle. They may kick off a reaction, causing suppressed ovulation, premenstrual spotting, and menstrual cramps. Other possible effects of high estrogen levels are fibroid tumors, breast cancer, endometrial cancer, ovarian cancer, and amenorrhea. The consistent pressure of excess body fat on the uterus can result in uterine prolapse. Overweight may also be a symptom of a reproductive problem, e.g., ovarian failure. Hypoglycemia, including reactive hypoglycemia, caused by a diet high in sugar and white flour, plays a key role in overweight. Excessive insulin secretion in reactive hypoglycemic cases maintains high glucose levels, and the body stores the excess glucose in fat cells. Thus, a diet low in sugary foods and high in fiber-rich complex carbohydrates is the most successful way to lose weight. However, vitamins and minerals needed to maintain blood sugar levels must supplement this diet to be successful. These vitamins and minerals include the B vitamins, magnesium, and, perhaps, chromium. Iodine, vitamins A and E, zinc, and selenium help the thyroid gland operate optimally, so as to avoid excess blood sugar levels. Vitamin E, lecithin, and evening primrose oil assist the body in using fat better. Regular exercise is also important to burn excess fat. Aspartame (Nutrasweet) exacerbates hypoglycemia and is usually found in refined foods and non-foods.
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PMID:An empathetic look at overweight. 1231 98

The aim of this study was to investigate whether the absence or presence of acne or hirsutism in 248 women with polycystic ovary syndrome was associated with different clinical, endocrine, metabolic and ultrasonographic factors. Patients were divided into three groups: 96 (38.7%) without any androgenic symptoms; 94 (37.9%) with only hirsutism; and 58 (23.4%) with only acne. The cycle alterations (oligomenorrhea or amenorrhea) and the echographic ovarian morphology (polycystic or multifollicular ovaries) showed no significant differences between the three groups. Hirsutism was associated with a greater incidence of obesity and insulin resistance, with an increase of 17-hydroxyprogesterone, ovarian and adrenal androgens, 3alpha-androstanediol glucuronide, insulin, insulin-like growth factor-I and low luteinizing hormone, sex hormone binding globulins and insulin-like growth factor binding protein-1 levels. Acne was associated only with the lowest 3alpha-androstanediol glucuronide levels. Therefore, two different pathogenetic mechanisms may play a role in the onset of acne and hirsutism.
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PMID:Acne and hirsutism in polycystic ovary syndrome: clinical, endocrine-metabolic and ultrasonographic differences. 1239 56

In mammals, the pleiotropic biological functions of tumor necrosis factor alpha (TNF-alpha) may include important effects on human reproductive physiology. Thus, chronic anovulation, oligo or amenorrhea, infertility, hyperandrogenism, obesity, insulin resistance and increased TNFalpha serum levels have been observed in women affected by polycystic ovary syndrome (PCOS). Whole blood short - term cell cultures (WBSC) are simple systems where the capacity to produce TNF-alpha by circulating leukocytes, mainly of the macrophage/monocyte lineage, can be accurately quantified. Given the relevance of monocytes/macrophages in the production of TNF-alpha, in this study, in a control-case approach, WBSC from women with PCOS were analyzed in their basal and lipolysaccharide (LPS)- stimulated capacity to produce the cytokine. These measurements did not correlate with the increased serum levels of the cytokine and the normal levels of cortisol, found in PCOS women. Increased serum TNF-alpha levels in PCOS women correlated positively with body mass index and negatively with insulin sensitivity. In spite of the increased serum TNF-alpha levels in PCOS women, basal and LPS stimulated production of the cytokine, by the ex vivo WBSC from these patients, were within normal values.
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PMID:Evaluation of tumor necrosis factor alpha production in ex vivo short term cultured whole blood from women with polycystic ovary syndrome. 1251 26

Polycystic ovarian syndrome is a complex problem affecting as many as 10% of a company's female work force. The condition commonly presents with symptoms of oligomenorrhea or amenorrhea, central obesity, and hirsutism. Stein (1935) first postulated the condition as cystic ovaries resulting from continuous LH stimulation. A current hypothesis is that PCOS may be two conditions--one resulting from LH and a second the result of a hyperinsulinemia. Weight loss and exercise, often difficult to maintain, can often return a woman to normal ovulatory cycles. First line pharmocotherapy includes OCs with desogestral as the progestin component. Antiandrogens such as spironolactone can be added to increase the antiandrogen effect. The occupational health nurse may be the only health care provider with whom the employee comes into contact who is able to see the impact of the syndrome over time, thus allowing the opportunity to counsel employees about long term risk reducing behaviors.
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PMID:Polycystic ovarian syndrome. A challenge for occupational health nursing. 1259 40

The standard first-line treatment for normogonadotropic anovulatory infertile patients [referred to as World Health Organization group 2 (WHO 2)] is ovulation induction using clomiphene citrate (CC) in incremental doses. Twenty to 25% of women show clomiphene-resistant anovulation (CRA), that is, they remain anovulatory even after multiple attempts with increased doses of CC. About 50% of the ovulatory CC patients conceive within six CC-induced cycles. Given the heterogeneous nature of the group, the individual prognosis (i.e., the chance of success) will vary considerably between patients. In the event an individual prognosis of each patient would be available before the start of the treatment, the overall efficiency of ovulation induction could be improved. Prognostic evidence at an individual level should use multiple patient variables, including results from previous treatments (if any). When variables are interdependent, a statistical model can be used to relate individual characteristics with the predicted outcome. Such a model will provide estimates of prognosis for individualized patient profiles, allowing new patients to profit from the experience of the cohort of previous patients used to build the model. This paper discusses the prediction of time to pregnancy following induction of ovulation with CC. This prediction was broken down in two steps, leading to two separate prognostic models. The first model predicts an intermediate outcome, the chance that the patient will be CRA (i.e., no ovulation in response to CC medication); the second model predicts the final outcome (time until pregnancy) in women who do ovulate. The CRA model was based on a prospective cohort study of 201 patients with normogonadotropic oligoamenorrheic infertility, 45 of whom were CRA (22%). It contained four predictor variables all related to the diagnosis of PCOS within the group of WHO 2: Increased free androgen index (FAI; hyperandrogenemia), elevated body mass index (BMI; obesity), greater mean ovarian volume (as an ultrasound feature of polycystic ovaries), and amenorrhea were all predictive for CRA. The second model was based on the non-CRA patients and contained two prognostic variables: increased age and oligomenorrhea were predictive for longer time to pregnancy after first ovulation with CC. Using the example of the prediction of time to pregnancy following induction of ovulation with CC, we present and discuss characteristics of good prognostic evidence for clinical use, focusing on study design, statistical analysis, evaluation, and presentation of results.
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PMID:Characteristics of the best prognostic evidence: an example on prediction of outcome after clomiphene citrate induction of ovulation in normogonadotropic oligoamenorrheic infertility. 1280 58

The polycystic ovary syndrome (PCOS) is characterized by increased secretion of LH, insulin and androgens. The main clinical complaints of women with PCOS include: oligo- or amenorrhea, dysfunctional uterine bleeding, hirsutism, obesity and/or anovulatory infertility. The first line treatment for these problems include: 1) estrogen-progestin therapy for oligomenorrhea and dysfunctional uterine bleeding; 2) estrogen-progestin therapy and/or antiandrogens for hirsutism; 3) lifestyle changes such as diet and exercise for obesity and 4) weight loss or clomiphene for anovulatory infertility. However, clinical trials have indicated that metformin is effective second line therapy when first line therapy has not been effective, is not acceptable to the patient or is medically contraindicated. The addition of metformin to the armamentarium of the gynecological endocrinologist represents an important advance.
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PMID:Metformin for the treatment of the polycystic ovary syndrome. 1497 11

This study was performed to investigate the serum levels of bisphenol A (BPA), an endocrine disruptor, in women with ovarian dysfunction and obesity. Fasting serum samples were obtained from 19 non-obese and 7 obese women with normal menstrual cycles: 7 patients with hyperprolactinemia, 21 patients with hypothalamic amenorrhea, and 13 non-obese and 6 obese patients with polycystic ovary syndrome (PCOS). BPA was measured by an enzyme-linked immunosorbent assay. BPA was detected in all human sera. Serum BPA concentrations were significantly higher in both non-obese and obese women with polycystic ovary syndrome (1.05 +/- 0.10 ng/ml, 1.17 +/- 0.16 ng/ml; p<0.05, respectively) and obese normal women (1.04 +/- 0.09 ng/ml, p<0.05) compared with those in non-obese normal women (0.71 +/- 0.09 ng/ml). There was no difference among women with hyperprolactinemia, women with hypothalamic amenorrhea, and non-obese normal women. There were significant positive correlations between serum BPA and total testosterone (r = 0.391, p<0.001), free testosterone (r = 0.504, p<0.001), androstenedione (r = 0.684, p<0.001), and DHEAS (r = 0.514, p<0.001) concentrations in all subjects. These findings show that there is a strong relationship between serum BPA and androgen concentrations, speculatively due to the effect of androgen on the metabolism of BPA.
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PMID:Positive relationship between androgen and the endocrine disruptor, bisphenol A, in normal women and women with ovarian dysfunction. 1511 66

Obesity is increasing rapidly among women all over the world, and more women in fertile ages become overweight and obese. Among all other problems, women who are obese have higher rates of amenorrhoea and infertility. Obese women have a higher risk of complications during pregnancy such as hypertensive diagnoses and gestational diabetes, and delivery complications such as higher rates of caesarean sections and prolonged time of delivery. The aim of this article is to review the consequences of being obese during the reproductive life of a woman.
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PMID:Effects of obesity on women's reproduction and complications during pregnancy. 1524 82

Recent international agreement on the definitions of polycystic ovary syndrome (PCOS) has helped to clarify the clinical approach to diagnosis of PCOS. However, in the precise assessment of an individual patient it is still necessary for a detailed history of menstrual disorder (especially oligo- and amenorrhoea and anovulatory dysfunctional uterine bleeding), infertility or miscarriage, hyperandrogenism (mainly acne, hirsutism and scalp hair loss, distinguished from virilization) and obesity supplemented by the demonstration of polycystic ovaries on transvaginal ultrasound scanning. Assessment of endocrine changes in serum levels of luteinizing hormone, follicle stimulating hormone, oestradiol and prolactin, plus appropriate measures of circulating androgens (especially total and free testosterone, sex hormone binding globulin, 17 hydroxy-progesterone, dehydro-epiandrosterone sulphate and sometimes a 24-hour urinary free control) might help in further defining the abnormalities. Assessment of ovulatory status, obesity (body mass index and waist-hip ratio) and insulin resistance (oral glucose tolerance test with serum insulin levels) are also important in most cases. PCOS is a highly variable condition and investigation and management needs to be individualized. Long-term follow-up is also to a great extent dictated by the constellation of symptoms and clinical features of individual patients, but potential long-term hazards should be defined and patients warned of these.
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PMID:Current recommendations for the diagnostic evaluation and follow-up of patients presenting with symptomatic polycystic ovary syndrome. 1538 Jan 49


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