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

The problem of obesity in children must be taken seriously and treated aggressively. The long-term psychological, social, and medical consequences of childhood obesity can be quite serious. Behavior modification has shown new promise compared to the discouraging results of traditional approaches such as inpatient starvation, the use of appetite suppressants, and dietary counseling. The behavioral program involves a systematic approach to nutrition, exercise, eating patterns, attitudes, and family support.
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PMID:Confronting obesity in children: behavioral and psychological factors. 646 94

The Leeds facility for in vivo neutron activation analysis has been modified and calibrated for the simultaneous measurement of nitrogen, potassium, sodium, chlorine, phosphorus and calcium in obese patients weighing up to 210 kg. The effects of body size and shape were incorporated into the calibration by measuring 14 anthropomorphic phantoms of known composition representing individual patients being treated for obesity. The phantoms were constructed from tissue substitutes representing lean, skeletal and adipose tissues, arranged to simulate the distributions of the corresponding tissues within the patients, as visualised by CT scanning. The precision of the method, determined by measuring a single phantom ten times over a period of ten weeks, is between two and three per cent for all elements except calcium, for which it is 11.3%. Accuracy is estimated to be similar to precision. The procedure has been used to study changes in body composition of patients undergoing therapeutic starvation.
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PMID:Multi-element analysis of the obese subject by in vivo neutron activation analysis. 646 4

A new FAO report on how to estimate the energy and protein requirements of individuals is imminent and has direct application to the management of obese patients. Energy needs, although variable form individual to individual, are reasonably stable unless gross overfeeding or prolonged semi-starvation occurs; unconscious appetite control is surprisingly important. No longer will energy needs be expressed per kg body weight, a reference point difficult to apply to obese subjects anyway. There are now equations for estimating basal metabolic rate (BMR) these can be appled to obese subjects to give BMR in MJ per day; for kcal from kJ divide by 4.184. The equations apply to all races although north Europeans and Americans tend to have high values and Indians low. An obese patient has a higher BMR than a normal person of the same height. Lean body mass is increased in obesity so some long term loss is inevitable with slimming and accounts for the persistent fall in BMR on weight loss. Energy and protein needs are just the beginning of dietary management. Obese patients are prone to cardiovascular and gall bladder disease. A low fat diet is important and a polyunsaturated: saturated ratio (P:S) of 0.5 to 1.0 is appropriate: higher ratios will exacerbate cholestasis in the biliary tract which can be precipitated by weight loss. New evidence suggests that cereal fibre intake is important for preventing secondary bile salt recycling from the colon with its effect on biliary cholesterol saturation. Therefore long term high cereal (not bran) fibre intakes are as important in obese patients as is a low fat diet. High carbohydrate diets produce a slightly higher metabolism rate than iso-energetic diets. Low sugar diets lead to slightly lower energy intakes. Trace element deficient diets can lead to obesity so the obese patient and his family should be advised and shown how to permanently adjust to a 'prudent' diet. The short term approach to management is usually a waste of time.
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PMID:Dietary aspects of obesity. 651 54

The problem of obesity in children must be identified early and treated seriously. The long-term psychological, social, and medical consequences of childhood obesity can be quite serious. Behavior modification has shown new promise compared to the discouraging results of traditional approaches such as inpatient starvation, the use of appetite suppressants, and dietary counseling.
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PMID:A comprehensive treatment plan for obese children and adolescents: principles and practice. 657 Nov 56

Hepatic mitochondrial function was studied in lean and obese Zucker rats in the fed state and at 3 and 6 days of starvation. No significant differences in state 3 mitochondrial oxidative rates were found due to obesity or starvation. Palmitoylcarnitine utilization rates in mitochondria were unaffected by obesity or starvation; however, when expressed per gram liver weight, they were lower in the obese rats due to the decreased amount of mitochondrial protein per gram liver. For palmitoylcarnitine oxidation and acetoacetate and citrate production, the patterns were the same: per milligram mitochondrial protein, both lean and obese rates were equivalent; per total liver, the obese rates were higher; per gram liver, the obese rates were lower. Mitochondrial carnitine palmitoyltransferase specific activity was higher in fed obese than in lean rats and remained higher during starvation. The results indicate that mitochondrial capacity to oxidize fatty acids and to produce keto acids is not affected by genetic obesity or starvation. The differences in fatty acid oxidation and keto acid production that have been observed in hepatocytes and perfused liver might be explained by decreased mitochondrial protein per unit weight of liver or hepatocytes in obese rats.
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PMID:Hepatic mitochondrial function in lean and obese Zucker rats. 661 63

The HDL-cholesterol level was found to decrease during the first week of therapeutic starvation in hyperlipoproteinaemic (hypertriglyceridaemic), diabetic (non-insulin dependent) patients. The possible causes of the finding are discussed, and the view is expressed that the fall in HDL given no cause for discontinuing the caloric restriction or starvation as the therapeutic measures in obesity.
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PMID:Serum lipids during starvation in obesity. 666 42

Muscles of genetically-obese animals exhibit decreased binding of and metabolic responses to insulin. Muscle protein catabolism was investigated by measuring the activity of alkaline, myofibril-bound protease in male (ob/ob) mice, fed ad libitum, or fasted for 5 d. Enzyme activity in the isolated myobrillar fraction was determined by the degradation of 14C-globin. Compared to the lean siblings, protease activity in the obese mice was 2.0, 1.5 and 1.3-fold higher in gastrocnemius, diaphragm and soleus muscle respectively, but without change in heart. The higher protease activity in gastrocnemius, diaphragm and soleus was associated with a parallel decrease in the weight and protein mass of the muscles. The muscles of obese mice also showed a 3 to 4-fold increase in triglyceride and a 2-fold increase in glycogen content. After 5-d starvation, the activity of protease rose in the gastrocnemius of obese mice only 1.5 fold, while it increased as much as 4 and 2 fold in gastrocnemius and diaphragm, respectively, in the lean mice. There was no significant change in heart enzyme activity. After 5-d starvation, serum insulin in obese mice fell markedly but remained still higher than that in ad libitum fed lean mice. Insulin-dependent serum metabolites, as well as adipose tissue lipoprotein lipase and hepatic enzymes related to lipogenesis and gluconeogenesis were consequently much less affected in obese mice and the prevalence of adequate insulin supply appeared to be the cause for lack of significant effect on muscle protease activity in fasting obese mice. It is suggested, therefore, that the induction of myofibrillar protease in obesity is linked to the decrease in cellular responsiveness to insulin and may also be interrelated with the intracellular metabolic adjustments to the enhanced muscle lipid availability.
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PMID:Increased protease activity in muscles of obese- (ob/ob) mice. 676 Dec 89

Mice were found to convert acetone to lactate at appreciable rates. The conversion of acetone to gluconeogenic precursors could provide additional glycolytic intermediates that would allow the more complete utilization of lipid stores and increase survival time during starvation. In mice that were starved for 3 days or were provided with acetone in the drinking water the acetone-metabolizing pathway was induced to levels severalfold normal. Mice heterozygous for obesity-producing mutations, either obese (ob/+) or diabetes (db/+), showed induction of the activity of this pathway to a significantly higher degree than did homozygous normal (+/+) mice of the same strain. This more effective conversion of acetone to lactate exhibited by heterozygous mice could account for their prolonged survival on a starvation regimen compared to that of normal homozygotes. The rate-limiting step in the pathway appears to be the conversion of acetone to a hydroxylated derivative. The enzyme system effecting this conversion is an NADPH-requiring microsomal oxygenase found in the liver.
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PMID:Acetone metabolism in mice: increased activity in mice heterozygous for obesity genes. 692 21

The effects of starvation and refeeding and of obesity on pancreatic alpha2- and beta-cell responses to glucose or tolbutamide were studied with the isolated rat or mouse pancreas perfused with an amino acid mixture in the presence and absence of glucose. It was observed that the physiological adaptation to a regimen of fasting and realimentation and to obesity differed greatly in the two types of endocrine cells. Whereas beta-cells of rats showed a dramatic reduction of glucose- and tolbutamide-stimulated insulin release during starvation that was reversed by refeeding, alpha2-cells preserved their response to stimulators and inhibitors during this experimental manipulation. Amino acid stimulation of glucagon release occurred equally well with the pancreas from fed and starved rats and was suppressed efficiently by glucose and tolbutamide in both nutritional states. Surprisingly, the rate of onset of glucose suppression of alpha2-cells was significantly higher in the fasted than in the fed state. This glucose hypersensitivity was apparent 2 d after after food deprivation and had disappeared again on the 2nd d of refeeding. In the pancreas from animals starved for 3 d, glucose and tolbutamide suppression of alpha2-cells took place in the absence of demonstrable changes of insulin release. In the isolated perfused pancreas taken from the hyperphagic obese hyperglycemic mouse (C57 Black/6J; ob/ob), the observed rate of insulin secretion as a result of a combined stimulus of amino acids and glucose and of glucagon release stimulated by amino acids was about four times higher than achieved by the pancreas of lean controls. However, glucose was unable to suppress the alpha2-cells in the pancreas of obese animals, in spite of the hypersection of the beta-cells, again in contrast to the alpha2-cells of controls that were readily inhibited by glucose. These data imply that the acute suppression of alpha2-cells by glucose is largely independent of a concomitant surge of extracellular insulin levels and that the adaptation of the islet organ to starvation leads to decreased glucose sensitivity of beta-cells, which contrasts with an improved glucose responsiveness of alpha2-cells. However, hyperphagia, which is assumed to be the primary abnormality in the ob/ob mouse, leads to overproduction of insulin and glucagon by the pancreas while greatly reducing the alpha2-cell sensitivity to glucose. An attempt is made to incorporate these data on starvation, refeeding, and obesity, as well as previous results with experimental diabetes, in a comprehensive picture describing a regulative principle underlying the glucose responsivness of alpha2-cells.
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PMID:Adaptations of alpha2- and beta-cells of rat and mouse pancreatic islets to starvation, to refeeding after starvation, and to obesity. 698 16

Glucagon secretion was studied in rats with electrolytic lesions of the bilateral ventromedial hypothalamic area (VMH-L) under various experimental conditions. The results obtained are as follows: 1. The basal plasma level of immunoreactive glucagon (IRG) was lowered in VMH-L rats 5 and 10 weeks after the operation. Plasma IRG levels after 24-hour starvation and during the arginine load were more significantly decreased in the VMH-L rats than in the control group. 2. The basal plasma level of immunoreactive insulin (IRI) showed significant positive correlations with body weight and Lee's index in these rats. The basal plasma level of IRG showed significant negative correlations with body weight, Lee's index and basal plasma IRI level. 3. In response to the arginine load, the plasma IRI level was significantly increased in VMH-L rats immediately after the operation, and the plasma IRG level was more significantly decreased in VMH-L rats 1 week after the operation than in the control group. 4. The response of plasma IRG to the arginine load was also lowered more in VMH-L rats than in rats pair-fed for 4 weeks after the operation. 5. 15 weeks after the operation, there was no significant difference in response of plasma IRI and IRG to the subcutaneous injection of epinephrine between VMH-L and control rats. These findings indicate that hypoglucagonemia in the VMH-L rats was induced by various factors, such as disorder of the autonomic nervous system, excessive insulin release, etc. The impairment of glucagon secretion may contribute to the development of obesity observed in rats with VMH-lesions.
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PMID:[Studies on glucagon secretion in obese rats with hypothalamic lesions (author's transl)]. 700 30


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