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

We used population-based data from the Province of Manitoba's universal health insurance plan to compare the cholecystectomy experience of Native Americans and non-Natives from 1972 to 1984. The age-adjusted cholecystectomy rates for Native females were higher than for non-Native females with the peak rate occurring at age 30-39 for Native Americans and at age 60-69 for non-Natives. The rates for males were three times lower than for females and did not differ between Natives and non-Natives. Native Americans were more likely readmitted to hospital for surgical complications than non-Natives and this held true after controlling for age, sex, rural versus urban residence, teaching versus non-teaching hospital, multiple discharge diagnoses or complex versus simple cholecystectomy (relative odds 1.46, 95 per cent confidence interval 1.17, 1.18). The explanation for the relatively high rates of cholecystectomy among Native American females may be related to high rates of known risk factors for gallstone disease (such as obesity and high parity). However, the higher rates of surgical complications require further study.
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PMID:Ethnic variation in cholecystectomy rates and outcomes, Manitoba, Canada, 1972-84. 272 72

To assess the risk factors for symptomatic gallstones, 88,837 women in the Nurses' Health Study cohort (age range, 34 to 59 years) were followed for four years after completing a detailed questionnaire about food and alcohol intake in 1980. A total of 433 cholecystectomies and 179 cases of newly symptomatic, unremoved gallstones, diagnosed by ultrasonographic examination or x-ray films, were reported during the four-year follow-up. The age-adjusted relative risk for very obese women, who had a Quetelet index of relative weight (weight in kilograms divided by the square of the height in meters) of more than 32 kg per square meter, was 6.0 (95 percent confidence interval, 4.0 to 9.0), as compared with women whose relative weight was less than 20 kg per square meter. For slightly overweight women (relative weight, 24 to 24.9 kg per square meter), the relative risk was 1.7 (95 percent confidence interval, 1.1 to 2.7). Overall, we observed a roughly linear relation between relative weight and the risk of gallstones. Among the 59,306 women whose relative weight was less than 25 kg per square meter, a high energy intake (greater than 8200 J per day), as compared with a low energy intake (less than 4730 J per day), was associated with an increased incidence of symptomatic gallstones (relative risk, 2.1; 95 percent confidence interval, 1.4 to 3.3), and an alcohol intake of at least 5 g per day was associated with a decreased incidence as compared with abstention (relative risk, 0.6; 95 percent confidence interval, 0.4 to 0.8). Parity did not appear to be an important risk factor after an adjustment was made for relative weight. These data support a strong association between obesity and symptomatic gallstones and suggest that even moderate overweight may increase the risk.
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PMID:Weight, diet, and the risk of symptomatic gallstones in middle-aged women. 230 Jan 12

Obesity is widely recognized as a risk factor for gallstones. However, to the authors' knowledge, only one study has examined the effect of body fat distribution on the prevalence of gallbladder disease. Mexican Americans are a population characterized by both a high prevalence of gallbladder disease and an unfavorable body fat distribution. The authors examined whether central adiposity (as measured by the ratio of subscapular-to-triceps skinfold) was related to clinically evident gallbladder disease in 1,202 Mexican Americans and 908 non-Hispanic whites in the San Antonio Heart Study from 1979 to 1982. After adjustment for overall adiposity (as measured by body mass index) and the ratio of subscapular-to-triceps skinfold, an increased prevalence of gallbladder disease was still observed in Mexican-American women. Both body mass index and the ratio of subscapular-to-triceps skinfold were positively and independently associated with gallbladder disease in women, while in men, body mass index, but not the subscapular-to-triceps skinfold ratio, was associated with gallbladder disease. Central adiposity is also related to the adverse pattern of cardiovascular risk factors observed in women with gallbladder disease.
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PMID:Central adiposity and gallbladder disease in Mexican Americans. 291 52

Gallstone disease has been recognized to be linked to others metabolic disorders such as obesity, atherosclerosis, hyperlipidemia and diabetes. Previous studies demonstrated a close relationship between abnormal eating habits and gallstone disease. The total caloric intake should be calculated on each individual energy requirement and should be restricted in over-weight patients. The diet should contain approximately 15-20% of the daily calories from proteins, 30-35% from fat (mainly vegetable fat for the higher content in polyunsaturated fat) and 40-55% from carbohydrate (especially complex carbohydrate). In addition the nutritional plan should consist of adequate amount of minerals and vitamins and the fiber consumption should be increased to 30-40 g/day. Finally, at last the Authors recommends (6279-8372 Kj- a regular subdivision of the meals (small and frequent) dressed in the very natural wag.
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PMID:[The dietary problem in cholelithiasis and patients at risk]. 295 22

Technological advances have reduced and refined man's plant food intake and consequently brought about an unprecedented decline in his consumption of dietary fibre (DF). The emergence of certain diseases selectively in regions which have been affected the most by this dietary change has led to an enhanced awareness of the functions of DF. DF is a heterogeneous group of substances which resist digestion by the endogenous enzymes of the human gut, although they are fermented to a substantial extent by the bacterial flora of the large intestine. Chemically, DF essentially consists of nonstarch polysaccharides and lignin, and its major constituents are cellulose, hemicelluose, lignin and pectin. The physiological effects of DF are attributable largely to its physicochemical properties. DF primarily affects gastrointestinal (GI) function; its effects are observable at all stages from ingestion through defaecation. It restricts caloric intake, shows gastric and small intestinal transit, and affects the activity of digestive enzymes and release of GI hormones. Its overall impact is to reduce apparent digestibility of nutrients marginally but consistently. In the large intestine, DF accelerates transit, supports bacterial growth and serves to hold water. As a result, the faecal weight and water content increase, and the transit time generally becomes shorter. Secondary to its GI effects, DF attenuates postprandial glycaemia and has long term effects on glucose tolerance and lipoprotein metabolism. These effects have important implications in the aetiopathogenesis of constipation and its sequelae including diverticulosis, cholesterol gallstones, colorectal cancer, obesity, diabetes mellitus and atherosclerosis. DF has traditionally been used therapeutically for constipation; now its use in diabetes is also well established. Our appreciation of the role of DF in human nutrition has undergone a major change in the last two decades. From a redundant constituent of plant foods, it has now moved to the position of an essential nutrient, the deficiency of which seems to have serious consequences.
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PMID:Dietary fibre: consensus and controversy. 301 Mar 80

Recent studies of vegetarian diets and their effects on morbidity and mortality are reviewed. Vegetarian diets are heterogeneous as are their effects on nutritional status, health, and longevity. Mortality rates are similar or lower for vegetarians than for nonvegetarians. Risks of dietary deficiency disease are increased on vegan but not on all vegetarian diets. Evidence for decreased risks for certain chronic degenerative diseases varies. Both vegetarian dietary and lifestyle practices are involved. Data are strong that vegetarians are at lesser risk for obesity, atonic constipation, lung cancer, and alcoholism. Evidence is good that risks for hypertension, coronary artery disease, type II diabetes, and gallstones are lower. Data are only fair to poor that risks of breast cancer, diverticular disease of the colon, colonic cancer, calcium kidney stones, osteoporosis, dental erosion, and dental caries are lower among vegetarians. Reduced risks for chronic degenerative diseases can also be achieved by manipulations of omnivorous diets and lifestyles.
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PMID:Health aspects of vegetarian diets. 304 2

A total of 2,584 healthy residents in the Yaeyama District of Okinawa, Japan, were investigated in 1984 to determine the prevalence of gallstone disease and its associated factors. Diagnosis of gallstone disease was assessed by real-time ultrasonography. For participants over 20 years of age, obesity index and serum levels of total cholesterol and triglycerides were measured. Overall prevalence of gallstone disease was 3.2%. Prevalence increased with age from 0% under 19 years of age to 11.4% over 70 years of age and was higher in females (4.0%) than in males (2.5%). The results of the logistic regression analysis indicated that age and fatty liver were significant predictors of gallstone disease. The results of the automatic interaction detector analysis indicated that age and fatty liver were strong factors associated with gallstone disease and that prevalence was highest in females over age 50 with fatty liver.
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PMID:Prevalence of gallstone disease in a general population of Okinawa, Japan. 234 64

Symptomatic cholesterol gallstone disease occurs because of the combination of a number of biochemical and physiologic defects: formation of supersaturated bile, nucleation, crystal retention, stone growth, and gallbladder inflammation. There are several possible explanations for the high prevalence of supersaturated bile in the Western adult human as compared to other adult mammals. First, the human liver is defective in converting cholesterol to bile acids; the majority of cholesterol is eliminated as cholesterol. Second, the large flux of cholesterol in vesicular form is not matched by a large flux of recycling bile acids. Third, humans live sedentary lives and voluntarily reduce their caloric requirement to prevent obesity. Low caloric intake decreases the circulation of bile acids (including the flux through the hepatocyte). Fourth, the human species is a defective bile secretor in terms of biliary volume (microliter/kg-min) compared to other mammals. This is because human enterohepatic circulation of bile acids is "sluggish" and because bile acid-independent flow is also lower than in all other mammals. The accumulation of deoxycholic acid, a secondary bile acid formed in the colon, appears to cause secretion of bile that is supersaturated in cholesterol, and may also contribute. Five additional risk factors explain why cholesterol gallstone disease is so prevalent. First, the human species has a gallbladder, and the irregular meal pattern of humans may be responsible for prolonged storage of bile. Second, bile from cholesterol gallstone patients nucleates cholesterol more rapidly. Third, defective gallbladder contraction is associated with cholesterol gallstone disease in the majority of gallstone patients. Fourth, the healthy gallbladder absorbs cholesterol and desaturates bile--protective functions that may be lost with chronic cholecystitis. Finally, the presence of gallstones stimulates mucous secretion, which traps cholesterol crystals.
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PMID:Pathogenesis of cholesterol gallstones. 306 78

Obesity clearly increases the risk of gallstone formation. The role of nucleating factors may be most decisive in transforming merely saturated bile into a gallstone-forming solution. Weight loss in the short run may promote stone formation but in the long run may be beneficial if it is maintained. UDCA appears to be a promising prophylactic agent against gallstone formation during weight loss regardless of whether it is achieved by diet alone, by jejunoileal bypass, or by gastric restriction surgery.
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PMID:Hepatobiliary effects of obesity and weight-reducing surgery. 306 8

Biliary cholesterol saturation indices (SI's) were measured in fasting duodenal bile from (i) obese and non-obese individuals with and without cholesterol gallstones, (ii) obese individuals undergoing weight reduction and (iii) obese gallstone patients receiving chenodeoxycholic acid (CDCA) therapy. Biliary lipid secretion rates were also measured in three obese subjects before and during 11 days starvation. The mean SI in fifteen non-obese controls (0.89 +/- SEM 0.06) was significantly lower than that in the twenty-four obese without (1.14 +/- 0.07; P less than 0.01), and in the twenty-nine non-obese with gallstones (1.30 +/- 0.05; P less than 0.001) while in sixteen obese gallstone patients, the mean SI of 1.55 +/- 0.06 was significantly higher than that seen in the other three groups (P less than 0.01-0.001). Although fifteen obese subjects lost 15% of their initial body weight during dieting, this did not change their SI's consistently. However in three obese individuals, total starvation did reduce the SI's and significantly lowered the biliary cholesterol secretion rate. Ten obese gallstone patients responded to 15.8 +/- 0.3 mg CDCA kg-1 day-1 by developing unsaturated fasting duodenal bile (SI 0.89 +/- 0.04). A further increase in CDCA dose to 19.0 +/- 0.7 mg kg-1 day-1, as a result of reducing body weight, was more effective in lowering SI's (0.75 +/- 0.06, range 0.51-1.0) than that achieved by increasing the dose to 18.9 +/- 0.46 mg kg-1 day-1 through more capsules per day (SI 0.89 +/- 0.03, range 0.67-1.25). These studies show that (i) biliary cholesterol SI's are greater when obesity and gallstones occur together than in either obesity or gallstones alone, and (ii) although weight loss in obese individuals does not consistently alter biliary cholesterol SI's, it may be beneficial in obese patients receiving CDCA therapy for gallstone dissolution.
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PMID:Effect of obesity and weight reduction on biliary cholesterol saturation and the response to chenodeoxycholic acid. 308 8


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