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Query: UMLS:C0028754 (obesity)
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Central obesity is an important risk factor for chronic disease. Its etiology remains unclear. We examined whether anger and hostility, ie, psychological attributes that influence cardiovascular morbidity and mortality, prospectively predict central visceral obesity across 13 years. Visceral adipose tissue (VAT) was determined by x-ray computed tomography (CT) at the L4-L5 disc space in a population-based sample of 157 postmenopausal Healthy Women Study participants. Standardized tests were completed to measure separately trait anger (anger frequency and intensity), style of anger expression (holding anger in and expressing it outwardly), and hostile (mistrustful) attitudes. The higher the VAT score, the higher the trait anger and anger-out scores measured 13 years earlier (Ps < .04) and the higher the concurrent hostile attitudes score (P < .02). Moreover, the higher the VAT score, the greater the increase in trait anger over the study period (P < .03). Trait anger and hostility predicted VAT independent of fasting insulin levels, although both predicted an increase in fasting insulin over time. Women were categorized into three groups according to the distribution of the average percent increase in trait anger and in weight across the study period, respectively. The mean VAT scores increased with the likelihood of being in the highest tertile of increasing trait anger (means: 129.1, 131.1, and 155.8, P < .048) and in the highest tertile of increasing weight (means: 122.4, 131.1, and 162.2, P < .003). The association between a high trait anger score and VAT remained significant, controlling for weight gain. We conclude that hostile attributes, fasting insulin, and weight gain in midlife may contribute to the development of VAT in healthy Caucasian women.
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PMID:Anger, hostility, and visceral adipose tissue in healthy postmenopausal women. 1048 55

Advances in genetics are occurring at a pace that challenges our ability to understand and respond to the implications. Soon we will be able to define more precisely the molecular mechanisms underlying human health and disease; subdivide diseases and conditions (e.g., obesity) that are clinically indistinguishable into more distinct entities, thereby improving our ability to choose rational preventive and treatment measures; identify genotypic markers that predict metabolic responses to dietary interventions; stratify the population into groups at higher or lower risk for chronic diseases such as cancer, thus allowing dietary intervention to be appropriately targeted; and develop dietary recommendations that take into account genetically determined taste preferences. Dietetics leaders, teachers, practitioners, and researchers must act now to ensure that dietetics professionals are prepared for practice in this new era. In this article we introduce the Human Genome Project, review the fundamentals of molecular genetics, discuss genetics and disease risk, and define and give examples of diet-gene interactions. We also discuss issues relevant to dietary counseling of healthy people with genetic susceptibility to chronic disease. To foster the growth of knowledge regarding this new biology among dietitians, The American Dietetic Association should take the following steps: require course work on diet-gene interactions and include human genetics as a topic area on dietetic registration examinations, form a practice group on this topic, develop an Internet-based communication and information hub for dietetics professionals, sponsor a session on human genetics at annual meetings, begin a dialogue regarding a new practice specialty in diet and genetic counseling, and encourage a health care system in which personal counseling on diet-gene interactions is valued and reimbursed.
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PMID:The genetic revolution: change and challenge for the dietetics profession. 1057 Jun 79

University students' dietary habits have been criticised for their nutritional inadequacy and faddism. Kuwait University students may face the risk of obesity because of affluence and modernization and the dynamic changes in their level of physical activity and caloric intake. This promoted a study of a random sample of 842 Kuwait University students for dietary and socioeconomic factors associated with obesity. Weight and height were measured to calculate the body mass index (BMI), which is the weight in kilograms divided by the height in meters squared (kg/m2). Obesity was classified into grade 1 and 2 (BMI > 25 and > 30 kg/m2). The associated factors studied and obtained through questionnaires included gender, age, marital status, parental obesity, education and occupation, dieting, last dental and health check-up, year of study, number of siblings (total, brothers and sisters), eating in between meals, high school and college GPA and major, exercising, number of regular meals eaten, obese relatives, those living at home, and servants, highest desired degree, birth order, having a chronic disease, countries prefer visiting, family income, governorate, and socioeconomic status (SES). Grade 1 and 2 obesity were found to be 32.0 and 8.9%, respectively. Factors that were found to be significantly associated with obesity included gender, age, marital status, obesity among parents, dieting, last physical check-up, year of study, number of brothers, sisters and regular meals eaten and high school GPA. Logistic regression analysis revealed that the same factors significantly contributed to the development of obesity except the last four. The level of obesity among Kuwait University students is high. Obesity is a risk factor for a variety of chronic diseases. There is a need to address the challenge of instituting measures that would reduce the future ill-effects of obesity on young adults. It is widely believed that during the young adult years many important health habits are formed and set. It is at this stage (or earlier) that wellness and self-care programming for college students is essential and worthy of being explored and its efficacy assessed.
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PMID:Obesity among Kuwait University students: an explorative study. 1067 42

Obesity has been on the increase among people of the Arabian Gulf countries. Overweight and obesity among 18-29-year-old Kuwaiti men increased by 23.4 and 14.8% respectively, between 1980 and 1993. The objective of the present study was to explore factors associated with overweight and obesity in a sample of 515 Kuwaiti college men studied in 1997. Weight and height were measured. The index of adiposity used was the BMI, which is the weight (kg) divided by the height (m) squared (kg/m2). The men were classified as overweight (BMI > 25 kg/m2) or obese (BMI > 30 kg/m2). The associated factors obtained through questionnaires included age, marital status, governorate, number of siblings, suffering from a chronic disease, subjects' parental obesity, education and occupation, number of major meals eaten, eating between meals, family income, number of servants, number of people living at home, exercising, last dental and physical check-up, dieting, year of study, highest desired degree after college, countries preferred for visiting, and socio-economic status. The results of the study revealed that 38.5 and 11.1% of the students were overweight and obese respectively. Factors that were found to be significantly associated with overweight and obesity among the men included age, marital status, last dental check-up, exercising, subjects' parental obesity, dieting and year of study. Logistic regression analysis of significant associated factors revealed that the same factors contributed to the development of overweight and obesity.
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PMID:Dietary and socio-economic factors associated with obesity among Kuwaiti college men. 1067 9

Obesity is a chronic disease with a poor therapeutical outcome. Well-defined education of the patient and conservative treatment are the basics of therapy. Nevertheless, one should always be aware of the possibility of surgical intervention. In the following, the diagnostical and therapeutical procedures concerning obesity will be described in order to allow a reasonable indication of surgical intervention.
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PMID:[Obesity: when does the internist recommend surgery?]. 1076 52

The most rapidly growing segment of the United States population is the geriatric group, especially those above 75 years of age. Hypertension, diabetes mellitus, and dyslipidemia increase with advancing years in Westernized, industrialized societies such as the United States. These disorders contribute significantly to strokes and myocardial infarctions and associated morbidity and mortality in our elderly population. The increase in these chronic disease processes with aging is related, in part, to increasing obesity, reductions in physical activity, and medications that predispose to these conditions (ie, nonsteroidal inflammatory agents and hypertension). Hypertension in the elderly is characterized by high peripheral vascular resistance/reduced cardiac output, impaired baroflex sensitivity, relatively greater systolic pressures, increased blood pressure variability, and a propensity to salt sensitivity. Type 2 diabetes in the elderly is related to alterations in body composition (ie, increased central adiposity and decreased lean body mass) and to reduced physical activity. There is an increasing body of evidence that aggressive treatment of hypertension and dyslipidemia in the elderly results in comparable, if not greater, reductions in cardiovascular morbidity and mortality in the elderly as in younger counterparts.
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PMID:Hypertension, hormones, and aging. 1081 Oct 49

Fifty-four percent of American adults are overweight. Obesity is a chronic disease associated with a number of conditions, such as diabetes, heart disease, hypertension, certain types of cancers, and breathing problems. The direct and indirect costs related to obesity exceed $70 billion annually. Because of the many cost and quality issues related to obesity, national attention is turning toward the special needs of this population. Strategies to restructure therapeutic intervention with attention to risk management, economic implications, and patient satisfaction are important considerations when managing the obese patient.
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PMID:Restructuring the therapeutic environment to promote care and safety for the obese patient. 1086 13

Respiratory syncycial virus (RSV) is the first cause of acute lower respiratory tract infection in Chilean infants. A significant impact of nutrition on clinical course of these infections has been described. In order to analyze the association between nutritional status (NS) and clinical course of infants hospitalized with acute lower respiratory tract infection due to RSV, 130 infants (mean age 5.8 +/- 4.9 m) without chronic diseases, admitted to hospital with confirmed RSV infection, were studied. Clinical course of disease was assessed (hospitalization days and days with oxygen therapy) according to nutritional status on admission (weight/length (W/L), ratio, arm muscle area, lymphocyte count and albumin), antropometrics changes, and hospital dietary intake. On admission prevalence of malnutrition by W/L (z score) was 1%, 14% overweight and 8% were obese. Median value of hospitalization days was 5 d (2-29 d) and days receiving oxygen was 3 d (0-19 d). Longer admission were observed in fasted patients than in those who were fed everyday (Wilcoxon and Log-rank test, 8 d vs 5 d; P < 0.01). Obese children (Wilcoxon and Log-rank test, 5 d vs. 3d in normal patients; P < 0.05), and patients not fed enterally (Wilcoxon and Log-rank test, 7 d vs. 3 d; P < 0.01) required oxygen for longer time. Fasting and severity of illness (Tal score) were correlated variables (X2 0.001). The multivariate analysis showed an association of Tal score and NS on admission, with days receiving oxygen therapy. We conclude that obesity is a risk factor for worse clinical course of acute lower respiratory tract infection in Chilean infants with RSV infection and without chronic disease.
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PMID:[Nutritional status and clinical evolution of hospitalized Chilean infants with infection by respiratory syncytial virus (RSV)]. 1088 96

Previous epidemiological studies have demonstrated relationships between individual nutrients and glucose intolerance and type 2 diabetes, but the association with the overall pattern of dietary intake has not previously been described. In order to characterize this association, 802 subjects aged 40-65 years were randomly selected from a population-based sampling frame and underwent a 75 g oral glucose-tolerance test. Principal component analysis was used to identify four dietary patterns explaining 31.7% of the dietary variation in the study cohort. These dietary patterns were associated with other lifestyle factors including socio-economic group, smoking, alcohol intake and physical activity. Component 1 was characterized by a healthy balanced diet with a frequent intake of raw and salad vegetables, fruits in both summer and winter, fish, pasta and rice and low intake of fried foods, sausages, fried fish, and potatoes. This component was negatively correlated with central obesity, fasting plasma glucose, 120 min non-esterified fatty acid and triacylglycerol, and positively correlated with HDL-cholesterol. It therefore appears to be protective for the metabolic syndrome. Component 1 was negatively associated with the risk of having undiagnosed diabetes, and this association was independent of age, sex, smoking and obesity. The findings support the hypothesis that dietary patterns are associated with other lifestyle factors and with glucose intolerance and other features of the metabolic syndrome. The results provide further evidence for the recommendation of a healthy balanced diet as one of the main components of chronic disease prevention.
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PMID:A cross-sectional study of dietary patterns with glucose intolerance and other features of the metabolic syndrome. 1088 14

Obesity is a chronic disease that affects a substantial number of Americans. Obesity significantly increases a person's risk of cardiovascular diseases and morbidity. Modification of lifestyle behaviors that contribute to obesity (e.g., inappropriate diet and inactivity) is the cornerstone of treatment. Behavior modification involves using such techniques as self-monitoring, stimulus control, cognitive restructuring, stress management and social support to systematically alter obesity-related behaviors. In addition, adjunctive pharmacotherapy can play an important role in the routine medical management of obesity.
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PMID:Successful management of the obese patient. 1089 33


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