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

High-fructose corn syrup (HFCS) is a fructose-glucose liquid sweetener alternative to sucrose (common table sugar) first introduced to the food and beverage industry in the 1970s. It is not meaningfully different in composition or metabolism from other fructose-glucose sweeteners like sucrose, honey, and fruit juice concentrates. HFCS was widely embraced by food formulators, and its use grew between the mid-1970s and mid-1990s, principally as a replacement for sucrose. This was primarily because of its sweetness comparable with that of sucrose, improved stability and functionality, and ease of use. Although HFCS use today is nearly equivalent to sucrose use in the United States, we live in a decidedly sucrose-sweetened world: >90% of the nutritive sweetener used worldwide is sucrose. Here I review the history, composition, availability, and characteristics of HFCS in a factual manner to clarify common misunderstandings that have been a source of confusion to health professionals and the general public alike. In particular, I evaluate the strength of the popular hypothesis that HFCS is uniquely responsible for obesity. Although examples of pure fructose causing metabolic upset at high concentrations abound, especially when fed as the sole carbohydrate source, there is no evidence that the common fructose-glucose sweeteners do the same. Thus, studies using extreme carbohydrate diets may be useful for probing biochemical pathways, but they have no relevance to the human diet or to current consumption. I conclude that the HFCS-obesity hypothesis is supported neither in the United States nor worldwide.
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PMID:Straight talk about high-fructose corn syrup: what it is and what it ain't. 1906 36

The metabolic syndrome (MetS) is a well described cluster of interrelated risk factors for developing cardiovascular disease and type 2 diabetes. The key components of MetS are central obesity, hypertension, hyperglycaemia and dyslipidaemia. The 2005 International Diabetes Federation (IDF) consensus definition of MetS aimed to reduce confusion over criteria for MetS and to provide a simple diagnostic and clinical tool. There is considerable evidence to show that patients prescribed antipsychotic drugs are at increased risk of developing MetS. Existing clinical guidelines for metabolic screening of patients taking antipsychotics focus on diabetes rather than on the broader syndrome of MetS and are not consistent with the IDF definition of MetS. Monitoring for MetS in patients taking antipsychotics (both inpatients and outpatients) is generally poor. We present a user-friendly clinical algorithm and monitoring form, based on current evidence and using the IDF definition of MetS, to help clinicians in primary care or specialist settings to effectively monitor for MetS in these patients.
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PMID:Screening for the metabolic syndrome in patients receiving antipsychotic treatment: a proposed algorithm. 1922 Jan 77

Despite the explosion of obesogenic environment research within the last decade, consensus on what constitutes the very environment we are trying to measure has not yet been reached. This presents a major challenge towards our understanding of environmental research for obesity, and the development of a desperately needed contextualized evidence base to support action and policies for curbing this epidemic. Specifically, we lack the application of a cohesive definition or framework, which creates the potential for confusion regarding the role of the environment, misinterpretation of research findings and missed opportunities with respect to possible avenues for environmentally based interventions. This scoping review identified primary studies and relevant reviews examining factors related to body mass index, diet and/or physical activity with respect to the obesogenic environment. Using a comprehensive framework for conceptualizing the obesogenic environment, the Analysis Grid for Environments Linked to Obesity (ANGELO), we identified 146 primary studies, published between January 1985 and January 2008, that could be characterized according to the dimensions of ANGELO. Gaps in the literature were clearly identified at the level of the macro-environment, and the political and economic micro-environments, highlighting key areas where further research is warranted if we are to more fully understand the role of the obesogenic environment.
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PMID:Characterizing the obesogenic environment: the state of the evidence with directions for future research. 1949 2

There is a growing interest in evolutionary models of human adiposity. Frequent reference has been made to 'thrifty genes' or 'thrifty phenotypes', referring to a variety of metabolic or behavioural traits that in one or the other way imply frugality in the expenditure or storage of energy. However, there is confusion over how the strategy of thrift has been incorporated into human biology. At the broadest level, humans represent a thrifty species relative to other mammals, indicating that metabolic adaptations had a crucial role in the emergence of the Homo lineage, in particular in buffering reproduction from ecological stochasticity. In contemporary humans, some variability in adiposity may be attributable to genotypes systematically favoured in certain ecological settings. Genetic variability is also present within populations, and may be considered bet hedging (distributing risk across offspring to increase parental fitness). Bet hedging is an alternative to genetic drift for accounting for genetic variability in the absence of strong selective pressures. Contrasting with genetic variability emerging over the long-term, thrifty phenotypes represent a response to short-term ecological variability. Physiological plasticity allows the emergence of variability across the life course in response to ecological cues experienced directly or by very recent ancestors. Finally, cultural norms or individual preferences allow voluntary behavioural manipulation of thrift in individuals. Overall, there is a range of factors and processes both favouring and opposing thrifty genes, which may reflect moderate bet hedging rather than systematic adaptation. Plasticity protects the genome from selective pressures by tailoring the organism to ongoing ecological conditions. The fact that obesity can occur in different individuals through different genotypes, life histories and behaviours indicates that different treatments are also likely to be required.
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PMID:Thrift: a guide to thrifty genes, thrifty phenotypes and thrifty norms. 1975 75

Mask ventilation is the most fundamental skill in airway management. In this review, we summarize the current knowledge about difficult mask ventilation (DMV) situations. Various definitions for DMV have been used in the literature. The lack of a precise standard definition creates a problem for studies on DMV and causes confusion in data communication and comparisons. DMV develops because of multiple factors that are technique related and/or airway related. Frequently, the pathogenesis involves a combination of these factors interacting to cause the final clinical picture. The reported incidence of DMV varies widely (from 0.08% to 15%) depending on the criteria used for its definition. Obesity, age older than 55 yr, history of snoring, lack of teeth, the presence of a beard, Mallampati Class III or IV, and abnormal mandibular protrusion test are all independent predictors of DMV. These signs should, therefore, be recognized and documented during the preoperative evaluation. DMV can be even more challenging in infants and children, because they develop hypoxemia much faster than adults. Finally, difficult tracheal intubation is more frequent in patients who experience DMV, and thus, clinicians should be familiar with the corrective measures and management options when faced with a challenging, difficult, or impossible mask ventilation situation.
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PMID:Difficult mask ventilation. 1992 95

As the prevalence of obesity continues to rise in society, an increasing number of patients undergoing non-bariatric surgery will be obese. Obesity is known to increase morbidity and mortality in the general population and thus is perceived as a risk factor for adverse post-surgical outcomes. This association is not clear-cut, however, and there is a lack of consensus in the literature on the risk between obesity and specific complications, in particular relating to infection, wound healing, respiratory and venous thromboembolism. The paucity of studies, as well as a lack of consistency of definition of obesity, with an over-reliance on body mass index rather than body composition analysis, may underlie this confusion. Emerging concepts position central/visceral adipose tissue as potentially key to the pathogenesis of the comorbidities associated with obesity, thus this article reviews emerging research investigating the association between visceral obesity, the metabolic syndrome and resulting post-operative complications. It is hypothesized that the state of chronic inflammation and dysmetabolism observed in visceral obese patients negatively influences post-operative outcomes and represents a potential target for pharmaconutrition. The need for further research investigating the influence of visceral adiposity on immune function post surgery and its impact on post-operative morbidity and mortality is highlighted.
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PMID:Obesity and post-operative complications in patients undergoing non-bariatric surgery. 2002 95

The disorder now known as the "metabolic syndrome "was first recognized 50 years ago, but the use of various definitions led to confusion over its real nature. The metabolic syndrome is directly linked to android obesity, which reflects insulin resistance; it lies at the root of all associated risk factors and is a forerunner of type 2 diabetes. Screening is based on systematic waist measurement, taking ethnic origin into account. This pragmatic approach avoids the uncertainties generated by different definitions and is less restrictive than a simple diagnosis of the metabolic syndrome. Non drug treatment of android obesity is inexpensive and effective but may be difficult to apply, owing to a number of social issues.
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PMID:[Obesity and the metabolic syndrome: a new epidemic]. 2012 Jan 60

As the pandemic of 2009 H1N1 influenza A virus progressed, more patients required hospitalisation. The objective of this study is to describe the characteristics and clinical course of hospitalised patients with 2009 H1N1 virus infection in Chile. This was a prospective, observational study of 100 consecutive hospitalised patients with RT-PCR-confirmed 2009 H1N1 influenza A, admitted to Puerto Montt General Hospital (Puerto Montt, Chile). Information was obtained regarding contact history, demographics, laboratory values and clinical course. The primary reason for hospitalisation was pneumonia, in 75% of patients. Rapid influenza A test was positive in 51% of patients. Prior exposure to 2009 H1N1 virus was documented in 21% of patients. Clinical failure, documented in 18% of cases, was characterised by respiratory failure and acute respiratory distress syndrome. Failure was more common in patients with obesity, tachypnoea, confusion and multilobar infiltrates. When evaluating a patient hospitalised with influenza-like illness, a negative rapid test for influenza A or negative contact with a suspected case should not alter physicians' considerations regarding the likelihood of 2009 H1N1 virus infection. Patients with 2009 H1N1 virus infection with obesity, tachypnoea, confusion and multilobar infiltrates should be closely monitored since they are at high risk for clinical failure.
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PMID:Characteristics of hospitalised patients with 2009 H1N1 influenza in Chile. 2018 21

Determining valid zygosity is a basic and important requirement in a twin study, because misdiagnosing zygosity leads to biased results. The Healthy Twin Study has collected data from adult like-sex twins and their families since 2005. In the study, a questionnaire to determine zygosity was developed comprising four questions; one concerning the degree of resemblance, and three concerning the degree of confusion by the resemblance. Among 2,761 individuals (624 twin pairs) of twin and their families, 406 pairs of twins (mean age 38.3, 63.5% women) with both questionnaire and genotype information were selected to examine the validity of the zygosity questionnaire using 16 short tandem repeat markers. We first determined individual zygosity including undetermined category, and then decided the zygosity of a twin pair using a decision tree. Sensitivity of questionnaire diagnosis was 98.8% for monozygotic (MZ) and 88.9% for dizygotic (DZ) twins, and positive predictive value was 97.2% for MZ and 95.0% for DZ. When we compared correctly and wrongly diagnosed twin pairs, misdiagnosed DZ twins (nine pairs) showed striking similarity in stature or obesity even exceeding that of true MZ twins. Our finding suggests that a parsimonious questionnaire method of diagnosing the zygosity will be useful, and adding physical or physiological measurements to a questionnaire of zygosity diagnosis will either confound the correct diagnosis or reduce the efficiency of the study compared with using questionnaire alone or with introducing genotyping.
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PMID:Validity of the zygosity questionnaire and characteristics of zygosity-misdiagnosed twin pairs in the Healthy Twin Study of Korea. 2047 20

The results of numerous investigations on the impact of obesity on renal insufficiency conducted in recent years introduce certain dilemmas about their mutual agreement. Some studies suggest that obesity is negatively correlated with the terminal phase of renal failure. On the other hand, other research has shown that reducing the index of body weight of patients with renal disease improves glomerular filtration. Even more confusion comes from findings indicating that metabolic syndrome in non-diabetic renal disease sufferers increases the risk of occurrence and progression of chronic renal disease. However, some research results suggest that obesity is positively correlated with survival of patients on dialysis, i.e., the higher the index of body weight the lower the mortality rate, especially with extremely obese patients. Reverse epidemiology is a term for the medical hypothesis which holds that the influence of obesity and high body weight indexes may be protective and associated with greater survival of obese patients on haemodialysis. A high serum creatinine concentration is a direct consequence of low rates of glomerular filtration and is inversely correlated with mortality rate. However, observations that high creatinine concentrations before haemodialysis treatment are a predictor of survival may be explained by the fact that they are also the direct consequence of increased muscle mass and a higher dietary protein intake. Thus, improvement of their nutritive state might delay progression and diminish the complications expected for patients suffering from kidney insufficiency. The requirements for daily protein intake by dialysis patients are not clear enough, while a hyperprotein diet may be a significant source of uraemic toxins, phosphate and H(+)-ion, which would be detrimental for their health. Some research has indicated that obesity of dialysis patients is not linked to increased risk of cardiovascular diseases in contrast to the general population. On the other hand, a low body mass index and additional parameters of malnutrition are strong independent indicators of mortality rate in dialysis patients. Although, there is a substantial amount of data that support a protective role for obesity, some authors question the existence of the obesity paradox. They do not oppose the results of that research, but suggest that obese individuals are actually protected in the short-term while later on they are liable to higher mortality risks than people of normal body weight. The role of obesity is undisputed as a significant mortality factor in the general population. Nevertheless, some well-designed studies have confirmed that obesity has a protective influence on patients treated by chronic dialysis procedures. This is not to suggest that obesity is recommended as a model for a higher survival rate in those patients, but the role of 'uraemic adipose tissue' and probable additional factors that might result in a lower mortality rate should be considered.
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PMID:Obesity in renal failure--health or disease? 2065 10


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