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

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

The purpose of this report is to propose standards for the successful treatment of obesity. This process is somewhat arbitrary because obesity is a multifactorial disease and because standards need revision as diagnostic and treatment techniques improve. Weight loss, the classic standard of success, does not account for individual variability. Reduction in other measures of body size, such as body mass index, percentage of excess weight, and body fat, may be preferable. Improvement in known complications of obesity (diabetes mellitus, hypertension, hyperlipoproteinemia, sleep apnea, and psychosocial problems) are equally valid measures of success. Because obesity is a chronic disease, maintenance of weight loss is included as a standard of success. Response to obesity treatment varies, and thus criteria to define minimal, intermediate, and full success for each variable are necessary.
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PMID:Proposed standards for judging the success of the treatment of obesity. 836 96

Dietary, anthropometric, and chronic disease risk factors (CDRF) including blood lipids and blood pressure (BP), were measured in 91 vitamin-mineral supplement users (SU) and nonusers (NU) representing a wide range of athletic interests. Supplements were used by 46 (51%) subjects; 100% of female athletes and 51% of male athletes used supplements while none of a group of 15 control female subjects currently used supplements. Both dietary intake and energy expenditure were measured using 7-day records. Adiposity was determined from body weight, body mass index, and skinfolds. Total cholesterol, high-density lipoprotein cholesterol, serum ferritin, hemoglobin, hematocrit, zinc, copper, and vitamin C were based on 12-hour fasting blood samples. Dietary intake (excluding supplements) for SU tended to be greater than NU for vitamin C, thiamin, riboflavin, niacin, B6, B12, folate, calcium, iron and magnesium. Plasma vitamin C levels were significantly higher among SU than NU of both gender groups (p < 0.05). Although SU may exhibit additional healthy lifestyle practices, lipid profiles for many of these athletes were unfavorable with regard to CDRF.
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PMID:Vitamin-mineral supplement use and nutritional status of athletes. 846 14

The Mexican-American population of south Texas has been shown previously to have elevated frequencies of gallbladder disease, based on medical history. In the present study, ultrasonography was employed to screen 1004 randomly selected individuals aged 15 to 74 years. Among women, the frequency of previous cholecystectomy was 10.0%; the frequency of stones on ultrasound was 12.2%. In men, the respective frequencies were 1.7% and 6.3%. Highest frequencies of gallbladder disease occurred among those aged 45 years or above: 40.2% and 19.2% among women and men, respectively. Non-insulin-dependent diabetes mellitus, obesity, and hypertension were also markedly elevated in this population. Overall, more than 40% of the population had either gallbladder disease, non-insulin-dependent diabetes, obesity, or hypertension. Among those older than 45 years, 70% had one or more of these chronic conditions. Examining the associations of gallbladder disease with other chronic diseases or measures of lipids, lipoproteins, and apolipoproteins demonstrates that factors predictive of or associated with cholecystectomy are different from those for gallstones by ultrasound. Diabetes and obesity show the strongest associations with cholecystectomy among women under 45 years (women with diabetes being 6.8 times as likely to have had a cholecystectomy than those without diabetes). Testing an extensive array of lipid-related measures resulted in no clear patterns, with the possible exception of alpha-lipoprotein and related measures. That the Mexican-American population is relatively young and experiencing extremely rapid growth indicates that the burden of chronic disease in general and gallbladder disease in particular will increase dramatically in the coming years.
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PMID:An ultrasound survey of gallbladder disease among Mexican Americans in Starr County, Texas: frequencies and risk factors. 850 3

A key informant based survey was done in 1992 to enlist cases of chronic disorders in a rural area of Haryana. Thirty-nine villages selected purposely from a block were surveyed by a trained field worker. He made contacts with key informants like dais, anganwadi workers, health workers, teachers, village elders, etc, to enlist known cases of chronic disorders. In all 812 cases of chronic disease were encountered in 28844 population (28.2/1000). Prevalence of chronic disorders was more in higher age group. Males outnumbered females in younger age group and vice versa for higher age group. Asthma, poliomyelitis, mental illness/retardation were more prevalent in males while hypertension, obesity were reported more in females. Tuberculosis, diabetes, hypertension and asthma were significantly more prevalent in higher age group while poliomyelitis was reported more in children. Consultation rate was high in tuberculosis, asthma, hypertension and diabetes.
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PMID:Estimation of chronic disease load in a rural area of Haryana. 857 91

Although the disorders associated with obesity have been extensively studied, little attention has been paid to the fact that obesity is itself a chronic disease. This misunderstanding of the nature of obesity has contributed to the stigmatization of obese persons and to the use of inappropriate or inadequate treatment regimens. Although the etiology of obesity is still unclear, genetic, metabolic, and social factors are all believed to play a role in its development and progression. Behavioral therapy, exercise, very-low-calorie diets, drug therapy, and surgery affect the treatment of obesity of differing levels of severity. The regaining of weight following treatments other than surgery is very frequent, in part because periods of weight loss are rarely followed by maintenance programs. An increasing awareness of the chronic, multifactorial nature of obesity will ideally lead to the development of new long-term treatment programs that are safe and effective. Such programs are urgently needed in light of new data that show that the prevalence of obesity is increasing in the United States, as much as 30% in the last decade.
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PMID:Current views on obesity. 862 60

Data on self-perceived health in relation to relative body weight from the nationally representative adult Swedish population (12988 men and 13414 women) obtained from Statistics Sweden were analysed. The results are adjusted for age, socio-economic groups, self-reported chronic disease and marital status. Obesity was associated with 40% higher prevalence of severe pains from several joints in men and women and higher consumption of analgetics (OR = 1.6, 95% CI 1.2-2.2, in men, OR = 1.9, 95% CI 1.6-2.3, in women). Overweight and more often obese subjects reported physical impairment and in particular reduced mobility (OR = 1.9, 95% CI 1.5-2.5 in obese men and OR = 2.4, 95% CI 2.0-2.9 in obese women). Intake of vitamins was 20-40% significantly lower in overweight and obese than in normal weight subjects; the intake of iron pills was 60% lower in obese women. Dental status was worse in overweight and obese subjects. Dentures were found more often in overweight (OR = 1.5, 95% CI 1.3-1.7) and obese women (OR 2.2, 95% CI 1.9-2.7) in comparison to those with normal weight. Underweight was associated with adverse self-perceived health with regard to all these indicators. Our findings suggest that already moderate overweight in particular in women results in reduced mobility and physical impairment.
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PMID:Obesity and self-perceived health in Sweden. 868 Apr 65

Criteria for the evaluation of new drugs to treat obesity are important as guides for designing clinical trials to test these agents. These criteria must be developed in relation to the realities of obesity, which is a chronic disease associated with morbidity and mortality that is increased by visceral fat deposits. The observation that patients regain weight after stopping drug treatment for obesity argues for the proposition that drugs work only when taken and NOT that the drugs are ineffective. The analogy between the development of treatments for obesity to those for the treatment of hypertension is used to highlight potential areas for new developments. Several features of an ideal drug for the treatment of obesity are suggested. Criteria for evaluating new drugs include both primary and secondary endpoints. The primary endpoint for an anti-obesity drug should be weight loss, possibly by category of success. Losses of total body fat or visceral fat might be alternative primary endpoints. Secondary endpoints include reduction in risk factors for associated diseases and improvement in the quality of life. In trials where vigorous placebo designs including highly aggressive behavior modification or very-low-calorie diets were used, it may be difficult or impossible to detect a response to a drug.
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PMID:Evaluation of drugs for treating obesity. 869 40

Pulmonary embolism is the third most common acute cause of death in the United States. There are approximately 500,000 cases annually in this country, leading to death in 50,000. Subjective symptoms and objective findings can oftentimes be confusing and nonspecific. A pulmonary embolism is defined as an occlusion of one or more pulmonary vessels by material that has traveled there from outside of the lung and is usually caused by a dislodged thrombus that originated in the deep veins of the legs or pelvis. Risk factors include older age, prior thromboembolism, immobility, cancer, chronic disease, congestive heart failure, pelvic and lower extremity surgery, varicosities, obesity, and oral contraception. This article will discuss current modalities that are used in the evaluation of deep venous thromboembolism and pulmonary embolism and include ventilation/perfusion scan, ultrasonography, impedance plethysmography, pulmonary angiography, and newer tests including D-dimer assays and spiral computed tomography. Medical management including simple and complex decision making, anticoagulation, and thrombolytic therapy will also be discussed. An ounce of prevention is worth a pound of gold--identification of risk factors and the use of appropriate therapeutic measures can reduce an individual's risk for deep venous thromboembolism and pulmonary embolism.
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PMID:Clinical diagnosis and management of the patient with deep venous thromboembolism and acute pulmonary embolism. 871 Feb 57

The aim of this study was to compare the quality of life of patients under home mechanical ventilation (HMV) for restrictive lung disease, with the quality of life of patients with chronic obstructive pulmonary disease (COPD), having similar decrease in forced expiratory volume in one second (FEV1), but not receiving HMV. Sixteen patients who were receiving intermittent HMV (six post-tuberculosis, four post-poliomyelitis, two neuromuscular diseases, two kyphoscoliosis, two obesity-hypoventilation syndromes) were compared to 15 COPD patients who were receiving only usual conservative treatment, including long-term oxygen therapy. Dyspnoea scores, anxiety, depression, and psychosocial scores, as well as a panel of functional parameters were measured. The two groups did not differ in terms of functional impairment. However, patients under HMV had much better scores for anxiety, depression, and adjustment to illness than COPD patients. Scores for dyspnoea at rest were also better in the HMV group, but showed no relationship to quality of life. In spite of a cumbersome and intrusive type of treatment, patients under home mechanical ventilation for predominantly restrictive lung disease were found to have a better quality of life than chronic obstructive pulmonary disease patients under conservative therapy. In the first group, a longer history of coping with a chronic disease and the perception that medical intervention is effective may in part account for this difference.
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PMID:Quality of life of patients under home mechanical ventilation for restrictive lung diseases: a comparative evaluation with COPD patients. 876 89


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