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Query: UMLS:C0028754 (obesity)
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A total of 112 patients with ischemic stroke and 115 patients of different sexes and age with dyscirculatory encephalopathy were examined for the main risk factors of cardiovascular diseases. Hypokinesia and obesity were most common in chronic vascular brain pathology whereas frequently occurring and prolonged psychoemotional overstrain, aggravated heredity and alcohol abuse promoted the occurrence of acute disorders of brain circulation. The combination of 4 and more risk factors significantly raises the probability of acute cerebral ischemia.
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PMID:[Risk factors of acute and chronic cerebral ischemia]. 215 17

Decreased activity of cholesterol 7 alpha-hydroxylase, the rate-limiting enzyme in the catabolism of cholesterol to bile acids, is known to result in increased biliary cholesterol concentration and supersaturation of bile. Supersaturation of bile by cholesterol is a necessary condition for cholesterol gallstone formation. In guinea pigs, the hepatic concentration of ascorbic acid affects the catabolism of cholesterol: hypovitaminosis C reduces cholesterol 7 alpha-hydroxylase activity. Cholesterol gallstones are frequently found in ascorbic acid-deficient guinea pigs. Risk factors for cholesterol gallstones in humans include obesity, aging, estrogen treatment, pregnancy and diabetes. Plasma ascorbic acid levels are reduced in these groups. Vegetarian diets, which typically have high ascorbic acid contents, protect against gallstones. Since ascorbic acid effects the rate-limiting step in the catabolism of cholesterol in the guinea pig and many human risk groups for cholesterol gallstones are associated with reduced ascorbic acid levels, ascorbic acid may play a contributory role in human gallbladder disease.
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PMID:Ascorbic acid and cholesterol gallstones. 845 79

Lack of physical activity and low levels of physical fitness are thought to be contributing factors to the high prevalence of obesity in African-American girls. To examine this hypothesis, we compared habitual physical activity and physical fitness in 54 African-American girls with obesity and 96 African-American girls without obesity residing in rural South Carolina. Participation in vigorous (> or = 6 METs) (VPA) or moderate and vigorous physical activity (> or = 4 METs) (MVPA) was assessed on three consecutive days using the Previous Day Physical Activity Recall. Cardiorespiratory fitness was assessed using the PWC 170 cycle ergometer test. Upper body strength was determined at two sites via isometric cable tensiometer tests. Relative to their counterparts without obesity, girls with obesity reported significantly fewer 30-minute blocks of VPA (0.90 +/- 0.14 vs. 1.3 +/- 0.14) and MVPA (1.2 +/- 0.18 vs. 1.7 +/- 0.16) (p < 0.01). Within the entire sample, VPA and MVPA were inversely associated with body mass index (r = -0.17 and r = -0.19) and triceps skinfold thickness (r = -0.19 and r = -0.22) (p < 0.05). In the PWC 170 test and isometric strength tests, girls with obesity demonstrated absolute scores that were similar to, or greater than, those of girls without obesity; however, when scores were expressed relative to bodyweight, girls with obesity demonstrated significantly lower values (p < 0.05). The results support the hypothesis that lack of physical activity and low physical fitness are important contributing factors in the development and/or maintenance of obesity in African-American girls.
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PMID:Physical activity and physical fitness in African-American girls with and without obesity. 944 42

Several recent epidemiological studies have shown an increase in breast cancer risk among women who have elevated plasma levels of testosterone, reduced levels of sex hormone-binding globulin (SHBG), and hence elevated levels of bioavailable androgens and estrogens not bound to SHBG. This endocrine profile is generally associated with obesity and chronic hyperinsulinemia, of which it is most likely a result. Lack of physical activity, obesity, and a diet rich in rapidly digestible carbohydrates and poor in fibre favour the development of insulin resistance and hyperinsulinemia. The elevated insulin levels, in turn are related to decreases in plasma and tissue levels of IGFBP-1 and IGFBP-2 (insulin-like growth factor-binding proteins), and this may increase the availability of insulin-like growth factor-I (IGF-I) to its receptors. Like insulin, IGF-I also inhibits the hepatic synthesis of SHBG, whereas both hormones stimulate the ovarian synthesis of sex steroids. Moreover, insulin and IGF-I can both enhance the development of breast tumours, through their cognate receptors within the mammary tissue. Taken together, these observations lead to the hypothesis that breast cancer risk may be increased in women with elevated plasma insulin levels, and/or with elevated levels of bioactive IGF-I. Hyperinsulinemia and an increased IGF-I bioactivity could thus be an important physiological link between a western lifestyle, overnutrition, a hyperandrogenic sex steroid profile, and increased breast cancer risk. Prospective cohort studies will be needed to test this hypothesis, and to study in greater detail the possible relationships of breast cancer risk with plasma levels of IGF-I and IGFBPs. Confirmation of a relationship of breast cancer risk with plasma insulin levels, on the one hand, or with total plasma IGF-I, on the other hand, could open up new perspectives for breast cancer prevention, either by changes in dietary intake patterns and physical activity, or by the use of certain chemopreventive drugs.
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PMID:[Plasma insulin, IGF-I and breast cancer]. 1130 43

Lack of physical activity is a known determinant of obesity. Unfortunately, children become less and less active as they reach and progress through adolescence. This behavior leads to detrimental effects on body composition and other components of health-related physical fitness. Various types of exercise and activities have different effects on fitness, body composition, and metabolic state. For a physician to recommend activities or sports and exercise type, he or she should examine and discuss the patients fitness and physique goals to maintain their enthusiasm and promote lifelong physical activity benefits.
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PMID:Physical activity, exercise, and sedentary activity: relationship to the causes and treatment of obesity. 1252 88

HEALTH ISSUE: Overweight and obesity have been recognized as major public health concern in Canada and throughout the world. Lack of physical activity, through its impact on energy balance, has been identified as an important modifiable risk factor for obesity. Physical activity and obesity are also important risk factors for a variety of chronic diseases. This chapter provides an overview of the current state of physical activity and overweight/obesity among Canadian women. KEY FINDINGS: For all ages combined more women (57%) than men (50%) are physically inactive (energy expenditure <1.5 KKD). Physical activity increases as income adequacy and educational level decrease. Physical inactivity also varies by ethnicity. The prevalence of both overweight (BMI 25.0 - 29.9 kg/m2) and obese (BMI >/= 30 kg/m2) Canadian women has increased 7% since 1985. Obesity increases with age and is highest among women reporting low and lower middle incomes and lower levels of education. The prevalence of obesity is highest among Aboriginal women and men (28% and 22% respectively). DATA GAPS AND RECOMMENDATIONS: There is currently no surveillance system in Canada to monitor the level of physical activity among children, those performing activity at work, at school or in the home. There is a gap in the knowledge surrounding socio-cultural and ecological determinants of physical activity and obesity and the associations of these to chronic disease among women and minority populations. Multi-sectoral policy interventions that act to decrease the broad systemic barriers to physical activity and healthy weights among all women are needed.
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PMID:Physical Activity and Obesity in Canadian Women. 1534 69

Lack of physical activity and obesity represent important public health problems. The objectives of the current study is to evaluate the effects of a counseling intervention (the PACE protocol) conducted by general practitioners and designed to motivate persons who are overweight or obese to increase their levels of physical activity. The counseling was offered 145 patients with a BMI > or =27 who were seen between May 2002 and April 2003 in the offices of 10 general practioners. The intervention, which lasted 3-5 minutes, was conducted during routine visits, based on the Prochaska-DiClemente model of behavioral change. Changes in the motivation of the patients to engage in physical activity and actual changes in levels of activity were measured, as were BMI and abdominal circumference. The median followup was 9 months. Among the 145 eligible patients, 103 (71%) agreed to particpate. Six months following the counselling, there was a significant change in both the motivational status and physical activity of the group, and they experienced significant decreases in BMI and abdominal circumference. Counseling using the PACE model appears to positively influence levels motivation and of physical activity in those patients who agreed to participate. Further studies should be conducted to evaluate the effectiveness of this strategy in other settings and the public health benefits of such counseling.
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PMID:[Promoting physical activity in overweight and obese patients: counseling in primary care from Italy (Cesena, 2002--2003)]. 1569 4

Several studies have indicated that depressive states may lead to hypokinesia with diminished metabolic rate and energy use. Hypokinesia associated with certain eating behaviors may lead to an unfavorable energy balance that can contribute to the emergence and prevalence of obesity among children and adults. The purpose of the present study was to examine the possibility of reducing depression inventory scores in female adolescents with third-degree obesity while testing the effectiveness of different exercise programs in reducing anxiety and depression scores. The sample consisted of 40 female subjects (mean age 16 +/- 1.56 years) divided into 4 groups (aerobic training, anaerobic training, leisure activities, and control). Subjects had a body mass index of 95% or more in relation to the 50th percentile. The aerobic program consisted of three ergometric bicycle sessions per week over a 3-month period (12 weeks) and the activities were prescribed after determining the anaerobic ventilatory threshold (VO2 threshold). Anaerobic training was based on the Wingate anaerobic power test. The leisure program consisted of a varied range of activities (games, exercises, etc.). A nutritionist interviewed the members of these two groups and the control group every week in order to adapt them to the nutritional guidelines proposed for the study. The study showed that all three programs (aerobic exercise, anaerobic exercise and leisure activities) were effective in reducing body mass. However, we found a significant reduction when analyzing the depression scores only for aerobic exercise (18.9 +/- 9.33 to 10.6 +/- 9.56 or 43.9%) but no significant alterations for anaerobic exercise (11.36 +/- 5.23 to 9.63 +/- 4.78 or 15.22%) and leisure (17.28 +/- 7.55 to 15.07 +/- 7.54 or 12.78%), thus indicating that in principle this type of activity could be included to improve emotional well-being of obese adolescent girls.
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PMID:Effects of type of physical exercise and leisure activities on the depression scores of obese Brazilian adolescent girls. 1625 39

Obesity and its associated morbidities and mortalities are the effects of imbalance between energy intake and expenditure. The healthcare burden for the treatment of obesity is significantly high, due to increased risk of secondary chronic diseases such as hypertension and associated co-morbidities such as diabetes and cardiovascular disease. Lack of physical activity, high fat diets and sedentary life styles are major factors contributing to obesity. However, genetic predisposition and ethnicity are increasingly found to cause obesity. Till date, approved therapeutics have addressed excess energy intake by acting on central neural circuits that regulate feeding or on peripheral mechanisms to reduce nutrient absorption from the gut. These approaches have met with moderate success; and recently with safety concerns, leaving an unmet medical need for effective and safe pharmacotherapy for obesity thereby posing a significant challenge to pharmaceutical industry. Potential antiobesity drugs, which are being investigated by different companies, can be classified in 4 broad categories: 1) Agents that primarily decrease appetite through central action; 2) Agents that primarily increase metabolic rate or affect metabolism through peripheral action; 3) Agents that act on gastrointestinal tract; and 4) Agents that not only affect obesity but also overall Metabolic Syndrome. The current review will deal mainly with different molecules, which are under development for the above-mentioned targets and also their potential benefits and disadvantages.
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PMID:Antiobesity therapy: emerging drugs and targets. 1671 87

Hypokinesia is not an independent risk factor of ischemic heart disease (IHD) but it contributes to progression of this disease because of a positive correlation with such risk factors as arterial hypertension, dislipoproteinemia, obesity, hyperinsulinism, diabetes mellitus type 2. This dictates the necessity to add exercise to pharmacotherapy of IHD. Combined treatment of IHD including bicycle exercise in the free load regimen significantly improves cardiac pump function--a 32.0 and 34.7% mean rise in stroke index and ejection fraction in patients under 60 years of age, respectively. The above rise does not depend on the initial condition of hemodynamics. There are cases when the increase is the highest in patients with the least baseline indices showing the presence of adaptive reserves which realize in physical training. The patients treated had no complications. Thus, use of the above bicycle exercise in IHD patients can be recommended for hospital rehabilitation.
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PMID:[Bicycle exercise in the free load regimen and hemodynamics in inpatients with ischemic heart disease]. 1714 51


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