Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0028754 (obesity)
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Advances in genetics and molecular biology indicate that susceptibility to chronic diseases such as coronary artery disease (CAD), hypertension, diabetes, obesity, osteoporosis, alcoholism, cancer, etc., to a great extent is genetically determined. Studies have shown that 50% of the variance in plasma cholesterol concentration is genetically determined, whereas 30%-60% of the variance in blood pressure is genetically determined. For fibrinogen, an independent risk factor for CAD, 15%-50% of the variance is genetically determined. In the U.K. population the variance for the fibrinogen level is 15% whereas in the Hawaiian population, the variance is 50%, indicating significant differences between populations. Among Australians, 75% of the variance in bone density is found to be genetically determined. Genetic variation influences the response to diet. For example, individuals with ApoE4 have higher cholesterol levels and a higher risk of CAD than those with ApoE3. Additional studies show that women of the ApoE 3/2 phenotype stand to benefit the least from a high polyunsaturate: saturate (P:S) diet because of reduction in the more 'protective' high density lipoprotein cholesterol (HDL-C), whereas men of the ApoE 4/3 phenotype showed the greatest improvement in the LDL/HDL ratio. Therefore a general recommendation to increase the polyunsaturated content of the diet in order to decrease the risk for CAD is not appropriate for women with ApoE 3/2 phenotype. Thus, specific information is needed to define the optimal diet for an individual.
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PMID:Genetic variation and nutrition. 888 22

Nutrition and food science have each enhanced the development of an abundant, nutritious, safe food supply. A healthy diet should contain all of the required nutrients and sufficient calories to balance energy expenditure and provide for growth and maintenance throughout the life cycle. Importantly, dietary factors are associated with 5 of the 10 leading causes of death, including coronary heart disease, certain types of cancer, stroke, noninsulin dependent diabetes mellitus and atherosclerosis. National health care expenditures for 1990 totaled $666 billion of which 30% are related to inappropriate diet. Identification of external factors that contribute to premature death would aid preventive efforts, improve the quality of life, and reduce health care costs. Even though genetic predisposition increases susceptible people's risk for many of these chronic diseases, these conditions may be diminished or prevented by improvements in the American diet. Each stage of the life cycle has specific nutrient needs. Throughout infancy, childhood and adolescence nutrients are required to meet the growth processes as well as cognitive function. During pregnancy nutrients are required for both mother and developing infant needs. Adult nutrition focuses on tissue maintenance, nutrient and energy needs, and disease prevention. As the population of elderly increase in number and greater age, nutritional needs must be met to minimize certain disease states and assure the quality of life. Nutrition associated health risks have been identified for coronary heart disease, cancer and diabetes mellitus. Recommendations for each includes a decrease in dietary fat, awareness of caloric intake and enhancement of nutrient density including an increase in fruit and vegetables. These recommendations also impact obesity and diminish the compounding of other disease states affected by excessive body weight. Calcium intake at early ages affects development of bone density and manifestation of osteoporosis. Current gaps in knowledge are also identified that could improve health. Numerous nutrients are being examined for their regulation of specific gene expressions and in the processes of transcription and translation. To offer food products with greater nutrient density or improved functional health ingredients, modification of existing foods is needed to assure an improved diet. Policies to improve health require integration of nutrition needs with economic growth and development, agriculture and food production, processing, marketing, health care and education, and includes changing life styles and food choices. Increased research support is required to achieve national health goals with emphasis on nutrition and food sciences. Education methods must be improved to better inform consumers, to encourage food producers and manufactures to produce healthier foods, to assure training of future professionals and to provide legislators with the basis to make informed decisions. Recommendations to CFERR are identified. Improved quality and availability of nutritious foods will result in a healthier, more productive population. A decrease in the occurrence and duration of chronic disease should diminish the cost of health care and allow these resources to further benefit the nation. International concerns about undernutrition include 780 million people who are malnourished, lacking sufficient food to meet their basic nutritional needs for protein and energy, and 2 billion people who subsist on diets lacking essential nutrients needed for growth, development and physiological maintenance. National concerns about undernutrition exist based on incomplete data identified by indices of hunger and characterized by an increased demand for food assistance for women, children and the elderly. Major health problems in the US impacted by diet and nutrition include coronary heart disease, atherosclerosis, some types of cancer, non-insulin dependent diabetes mellitus, hypert
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PMID:Interrelationships of food, nutrition, diet and health: the National Association of State Universities and Land Grant Colleges White Paper. 889 67

Several health hazards and social disabilities are associated with obesity. Increased mortality is associated with increased body weight. A high rate of mortality results from heart disease, diabetes mellitus, gallbladder disease, high blood pressure, and cancer. Physiologic cardiovascular changes occur, leading to left ventricular hypertrophy and lipid abnormalities. Hypertension, stroke, and venous stasis are increased. Pulmonary abnormalities include obstructive sleep apnea, which can be associated with secondary polycythemia and right ventricular hypertrophy. Gallstones, gallbladder disease, and accumulation of fat on the liver are significantly increased. Gout and reproductive abnormalities in women are common. Osteoarthritis of the knees and spine occur, although osteoporosis is rare. Risk for endometrial and breast cancer is increased, particularly in the presence of increased central fat. Changes in the skin include stretch marks, acanthosis negricans, hirsutism, intertrigo, and multiple papillomas. Impaired psychosocial function is manifested as social isolation, loss of job mobility, increased employee absenteeism, and economic and social discrimination.
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PMID:Health hazards of obesity. 897 52

The prevalence of diseases associated with obesity, such as cardiovascular disease and diabetes mellitus, is higher in the spinal cord injury (SCI) population. Specifically, the mortality rate for cardiovascular disease is 228% higher in the SCI population. In addition, 100% of SCI individuals have osteoporosis in the paralysed extremities. These diseases are related to physical activity level, the level of the spinal cord lesion, and time post injury. Physically active SCI men and women have above-average fat mass (16 to 24% and 24 to 32%, respectively, compared with 15% for able-bodied men and 23% for able-bodied women), while sedentary SCI individuals have 'at-risk' levels of body fat (above 25% and 32%, respectively). The proportions and densities of the 3 main constituents comprising the fat-free body (mineral, protein and water) are altered following SCI. Bone mineral content decreases by 25 to 50%, and the magnitude of reduction is dependent on the level, completeness and duration of SCI. Because of denervation resulting in skeletal muscle atrophy, total body protein reduces by 30%, and total body water relative to bodyweight decreases by 15% following SCI. Indirect methods based on 2-component body composition models assume constant proportions and densities of mineral, protein, and water in the fat-free body. As a result, prediction equations based on 2-component models yield invalid estimates of fat and fat-free mass in the SCI population. Therefore, future research needs to directly quantify the proportions and densities of the constituents of the fat-free body in the SCI population relative to age, sex, physical activity level, level of the spinal cord lesion and time post injury, and to develop equations based on multicomponent body composition models.
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PMID:Body composition of spinal cord injured adults. 901 59

The appearance of postmenopausal osteoporosis is correlated with the peak bone mass achieved during adolescence and the bone loss during adult life. The magnitude of the peak bone mass depends on genetic (race, sex, heredity), nutritional (calcium supplementation, obesity) and environmental factors as well as physical activity. Sex steroids and other hormonal factors involved in puberty, like growth hormone and insulin-like growth factors, are very important in the bone mass increase during this period. This is confirmed by studies in men with histories of constitutional delay of puberty, who have a decreased bone mineral density, and in children with precocious puberty treated with GnRH analogs, where the reduction in bone mineral density previously demonstrated seems at least completely reversible.
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PMID:[Bone mass formation in childhood and risk of osteoporosis]. 906 68

Moderate exercise for middle-aged and older adults is emerging as an important adjuvant to the treatment of many diseases. These include cardiovascular disease, diabetes, osteoporosis, osteoarthritis, insomnia, deconditioning, and (to a degree) obesity. A recent report from the United States Surgeon General recommends that most adults exercise most if not all days of the week, accumulating 180 minutes of moderate intensity exercise weekly. If your patients have been previously sedentary, encourage them to start a slow, stepwise exercise program. Ongoing support, encouragement, and follow-up can help them commit to and maintain a program of regular exercise.
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PMID:Exercise at midlife: how and why to prescribe it for sedentary patients. 915 19

Physical inactivity increases the risk for heart disease, diabetes, colon cancer, high blood pressure, obesity, osteoporosis, muscle and joint disorders, and symptoms of anxiety and depression. However, approximately one third of adults in the United States report no leisure-time physical activity, and rates of inactivity have been higher in January than in June. Among adults, the prevalence of leisure-time physical inactivity is highest among those who are older, Hispanic, and residing in southern states. A national health objective for the year 2000 is to reduce to < or = 15% the proportion of persons reporting no leisure-time physical activity (objecive 1.5). To assist in monitoring efforts to achieve this objective, CDC analyzed data from the 1994 Behavioral Risk Factor Surveillance system (BRFSS) and estimated for each month the proportion of adults from selected demographic groups who reported no leisure-time physical activity. The findings indicate seasonal patterns in the prevalence of reported leisure-time physical inactivity; however, monthly rates of inactivity were higher and more stable among older persons, Hispanics, and residents of southern states.
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PMID:Monthly estimates of leisure-time physical inactivity--United States, 1994. 915 73

In epidemiology of osteoporosis, obesity is to be considered one of its protecting factors. However there are in the literature discordant opinions: some authors describe a protective effect of obesity on the trabecular bone, others on the cortical one, others no effects at all and others finally a positive influence on both the trabecular and the cortical bone. However, only few studies on obesity's impact on bone metabolism are available. Bone mineral density at forearm and serum osteocalcin levels, a specific and sensitive marker of bone turn-over, in a group of postmenopausal obese women with those of a nonobese control group were compared. Obese women showed higher densitometric measurements than nonobese, but only the values of the third distal site of forearm resulted higher in a significant way. Serum osteocalcin values were similar between the two groups but the obese women showed a greater dispersion of the values (8.15 +/- 4.96 ng/ml) compared to nonobese (8.35 +/- 1.63 ng/ml). This high variability suggests an heterogeneity of bone turn-over in obese subjects and could explain the discordant results of the literature.
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PMID:Serum osteocalcin levels in postmenopausal obese women. 917 3

Over the last century there has been a trend toward an earlier onset of menarche attributed to better nutrition and body fatness. With the discovery of the obesity gene and its product, leptin, we reexamined this hypothesis from a new perspective. As delayed menarche and leanness are considered risk factors for osteoporosis, we also evaluated the relation between leptin and bone mass. Body composition and serum leptin levels were measured, and the timing of menarche was recorded in 343 pubertal females over 4 yr. Body composition was measured by dual x-ray absorptiometry, and leptin by a new RIA. All participants were premenarcheal at baseline (aged 8.3-13.1 yr). Leptin was strongly associated with body fat (r = 0.81; P < 0.0001) and change in body fat (r = 0.58; P < 0.0001). The rise in serum leptin concentration up to the level of 12.2 ng/mL (95% confidence interval, 7.2-16.7) was associated with the decline in age at menarche. An increase of 1 ng/mL in serum leptin lowered the age at menarche by 1 month. A serum leptin level of 12.2 ng/mL corresponded to a relative percent body fat of 29.7%, a body mass index of 22.3, and-body fat of 16.0 kg. A gain in body fat of 1 kg lowered the timing of menarche by 13 days. Leptin was positively related to bone area (r = 0.307; P < 0.0001) and change in bone area (r = 0.274; P < 0.0001). A critical blood leptin level is necessary to trigger reproductive ability in women, suggesting a threshold effect. Leptin is a mediator between adipose tissue and the gonads. Leptin may also mediate the effect of obesity on bone mass by influencing the periosteal envelope. This may have implications for the development of osteoporosis and osteoarthritis.
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PMID:Leptin is inversely related to age at menarche in human females. 932 46

Female reproductive hormones cause breast cancer. Long-term use of postmenopausal hormones increases the risk of breast cancer. The apparent survival advantage seen in women diagnosed with breast cancer while taking postmenopausal hormones may be due to the hormone-responsive nature of their tumors, diagnosis at an earlier stage, or other biases. Thus, the data indicating a survival advantage do not specify what the policies were on the use of hormones after diagnosis. Substantial evidence from studies of obesity confirms the association of higher estrogen levels with poorer prognosis. Tamoxifen (Nolvadex), acting as an antiestrogen in breast tissue, increases the likelihood of survival, as does oophorectomy in premenopausal women. Given these data, women diagnosed with breast cancer should use hormones sparingly. Alternatives to hormone therapy should be used for long-term prevention of heart disease and osteoporosis.
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PMID:Estrogen replacement therapy for breast cancer patients. 959 75


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