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

Obesity and type 2 diabetes mellitus have reached epidemic proportions in the US, and indeed, globally. While microvascular complications contribute to considerable morbidity, much of the excess mortality (around 70%) is due to macrovascular disease. Hyperglycemia has predictable toxic effects on multiple organs ('glucotoxicity') including the pancreas, where it impairs insulin secretion and insulin gene expression through mechanisms that lead to glucose densensitization and beta-cell exhaustion, eventually resulting in irreversible beta-cell failure. There is robust evidence to suggest that strict glycemic control reduces diabetic microvascular complications (retinopathy, nephropathy, and neuropathy) in both primary- and secondary-prevention settings. While unequivocal evidence that intensive glycemic control reduces the risk of death due to macrovascular disease is lacking, meta-analytic data and controlled clinical trial data suggest there may still be clinically significant lowering of the risk for macrovascular endpoints through strict glycemic control. Cardiovascular disease in a diabetic patient is a collusion of several factors besides hyperglycemia, such as hypertension, dyslipidemia, diffuse endothelial dysfunction, hypercoagulability, and inflammation. It is important to address lifestyle issues such as maintenance of ideal bodyweight, good dietary practice, smoking cessation, and regular exercise in the comprehensive risk management of a diabetic patient, in order to reduce the vascular complications. Large, ongoing clinical trials such as ACCORD (Action to Control Cardiovascular Risk in Diabetes) are likely to establish the potential benefits of glycemic control in preventing or postponing macrovascular complications of diabetes.
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PMID:The effectiveness of intensive glycemic control for the prevention of vascular complications in diabetes mellitus. 1700 87

While ruling out programmed aging, evolutionary theory predicts a quasi-program for aging, a continuation of the developmental program that is not turned off, is constantly on, becoming hyper-functional and damaging, causing diseases of aging. Could it be switched off pharmacologically? This would require identification of a molecular target involved in cell senescence, organism aging and diseases of aging. Notably, cell senescence is associated with activation of the TOR (target of rapamycin) nutrient- and mitogen-sensing pathway, which promotes cell growth, even though cell cycle is blocked. Is TOR involved in organism aging? In fact, in yeast (where the cell is the organism), caloric restriction, rapamycin and mutations that inhibit TOR all slow down aging. In animals from worms to mammals caloric restrictions, life-extending agents, and numerous mutations that increase longevity all converge on the TOR pathway. And, in humans, cell hypertrophy, hyper-function and hyperplasia, typically associated with activation of TOR, contribute to diseases of aging. Theoretical and clinical considerations suggest that rapamycin may be effective against atherosclerosis, hypertension and hyper-coagulation (thus, preventing myocardial infarction and stroke), osteoporosis, cancer, autoimmune diseases and arthritis, obesity, diabetes, macula-degeneration, Alzheimer's and Parkinson's diseases. Finally, I discuss that extended life span will reveal new causes for aging (e.g., ROS, 'wear and tear', Hayflick limit, stem cell exhaustion) that play a limited role now, when quasi-programmed senescence kills us first.
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PMID:Aging and immortality: quasi-programmed senescence and its pharmacologic inhibition. 1701 37

Heat stroke in athletes is entirely preventable. Exertional heat illness is generally the result of increased heat production and impaired dissipation of heat. It should be treated aggressively to avoid life-threatening complications. The continuum of heat illness includes mild disease (heat edema, heat rash, heat cramps, heat syncope), heat exhaustion, and the most severe form, potentially life-threatening heat stroke. Heat exhaustion typically presents with dizziness, malaise, nausea, and vomiting, or excessive fatigue with accompanying mild temperature elevations. The condition can progress to heat stroke without treatment. Heat stroke is the most severe form of heat illness and is characterized by core temperature >104 degrees F with mental status changes. Recognition of an athlete with heat illness in its early stages and initiation of treatment will prevent morbidity and mortality from heat stroke. Risk factors for heat illness include dehydration, obesity, concurrent febrile illness, alcohol consumption, extremes of age, sickle cell trait, and supplement use. Proper education of coaches and athletes, identification of high-risk athletes, concentration on preventative hydration, acclimatization techniques, and appropriate monitoring of athletes for heat-related events are important ways to prevent heat stroke. Treatment of heat illness focuses on rapid cooling. Heat illness is commonly seen by sideline medical staff, especially during the late spring and summer months when temperature and humidity are high. This review presents a comprehensive list of heat illnesses with a focus on sideline treatments and prevention of heat illness for the team medical staff.
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PMID:Heat-related illness in athletes. 1760 28

When considering the history of exercise physiology, authors begin with Hippocrates and the "Golden Age" of Greece before mentioning Galen and the contributions from Rome. However, this approach has omitted the information from the ancient civilizations of India which flourished before and during the emergence of Mycenaen cultures. Specifically ignored have been 1) the tridosa doctrine (humoral theory), which as early as 1500 B.C., emphasized that disease occurred because of a displacement of one or more of the three humors, with health being achieved when the humors were in equilibrium and 2) the perspective of Susruta (Sushruta) who was a 600 B.C. physician who included exercise in his prescriptions to prevent and treat diseases. Susruta not only advocated exercise to maintain equilibrium among the humors, notably kapha, he promoted exercise to minimize the consequences of obesity and diabetes. To be effective, exercise had to be daily and moderate in intensity and never excessive or to exceed the half-maximum limit for exhaustion, because disease or even death could ensue. It is concluded that Susruta's concepts pertaining to chronic exercise and to the health benefits of exercise were "remarkably modern" and that future authors on the history of exercise physiology should include contributions from ancient India.
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PMID:Susruta of India, an unrecognized contributor to the history of exercise physiology. 1835 81

This study aimed to determine whether vital exhaustion (VE) was associated with BMI cross-sectionally and after 3 and 6 years of follow-up. Extant data from the Atherosclerosis Risk in Communities (ARIC) study were used to examine the relationship between VE and BMI among 13,727 white and African-American adults cross-sectionally (baseline) and longitudinally (3 and 6 years later). We used adjusted and nonadjusted general linear regression models. Associations with excess weight gain (>or=5.0%) were also examined using logistic regression. Results showed that BMI was significantly higher among both white and African-American men and women in the highest VE quartile compared to those with no VE. Similarly, high VE at baseline was associated with higher BMI 3 and 6 years later, although VE was not able to predict future BMI after adjusting for baseline BMI. Baseline VE predicted future excess weight gain in white men and women, but not in African Americans. These results suggest that reducing VE levels may play an important role in reducing the prevalence of obesity. High VE was associated with higher current BMI (all races) and excess weight gain (whites only). Although high VE predicted future weight gain without baseline BMI adjustment, the magnitude of change in BMI over time was similar among those with low and high VE; suggesting that any relationship between VE and BMI was already established at baseline. Assessment of VE and BMI over time would help to elucidate uncertainties between the temporal nature of the relationship between them.
Obesity (Silver Spring) 2008 Jul
PMID:Obesity and vital exhaustion: analysis of the Atherosclerosis Risk in the Communities study. 1845 77

Genetic mutations resulting in obesity and type 2 diabetes mellitus (T2D) are described for both inbred and outbred mice. However, no known mouse model completely recapitulates human T2D and its comorbidities. We identified a cohort of obese, male, outbred Swiss-Webster (SW) mice as polyuric, polydipsic, glucosuric, and hyperglycemic. Prevalence of glucosuria in the SW colony reached 60% (n=70) in males 8 weeks to 6 months of age. Despite severe obesity in some females, no females were diabetic. Pathologic findings in affected males included cachexia, dilated gastrointestinal tracts with poor muscular tone, pancreatic islet degeneration and atrophy with compensatory metaplasia and/or neogenesis, bacterial pyelonephritis, membranous glomerulopathy, and late-onset hepatic tumors with macrosteatosis, microsteatosis, and hydropic change in aged males. Serum insulin correlated with blood glucose in a nonlinear pattern, suggestive of islet exhaustion. Circulating leptin levels showed a weak inverse correlation with glucose. Diabetic males were bred with obese colony females to produce 20 male and 20 female offspring. Prevalence of diabetes in male offspring was 80% (16/20) with a median age of onset of 18 weeks. By contrast, no diabetic females were identified, despite being significantly more obese than males. Male predominance is likewise a feature of T2D in humans. To our knowledge, this is the first documentation of hepatocellular carcinoma and islet metaplasia and/or neogenesis in a spontaneous outbred mouse model of T2D. The SW availability and histopathologic features represent a promising new model for the study of T2D.
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PMID:Obesity and non-insulin-dependent diabetes mellitus in Swiss-Webster mice associated with late-onset hepatocellular carcinoma. 1866 86

The objective of this study was to investigate the effect of long-term exercise training on concentrations of five hormones related to appetite and insulin resistance in overweight adolescents. In addition, we were interested in the relationships of these hormones with each other and with anthropometric and/or cardiovascular disease marker changes. Participants were >or=the 85th percentile for BMI for age and sex and participated in an 8-month supervised aerobic training program. Anthropometrics, cardiovascular fitness assessment, and fasting blood samples were taken pre- and post-training. Glucose, insulin, total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, leptin, active ghrelin, total peptide YY (PYY), adiponectin, and resistin concentrations were measured. The participants increased their time to exhaustion on an incremental treadmill test and decreased both percent body fat and blood triglyceride concentrations. Total PYY concentration increased and resistin concentration decreased after long-term exercise training, which are favorable outcomes. Leptin concentrations were related to weight, percent body fat, waist circumference, and triglyceride concentrations pre- and post-training. The changes in resistin concentrations were related to the changes in triglyceride concentrations. We conclude that long-term exercise training has beneficial effects for overweight adolescents with respect to PYY and resistin, hormones related to appetite and insulin sensitivity.
Obesity (Silver Spring) 2009 Jun
PMID:Long-term exercise training in overweight adolescents improves plasma peptide YY and resistin. 1924 79

Dietary restriction and increased physical activity are recommended for obesity treatment. Very low carbohydrate diets are used to promote weight loss, but their effects on physical function and exercise tolerance in overweight and obese individuals are largely unknown. The aim of this study was to compare the effects of a very low carbohydrate, high fat (LC) diet with a conventional high carbohydrate, low fat (HC) diet on aerobic capacity, fuel utilization during submaximal exercise, perceived exercise effort (RPE) and muscle strength. Sixty subjects (age: 49.2+/-1.2 years; BMI: 33.6+/-0.5 kg/m2) were randomly assigned to an energy restricted (approximately 6-7 MJ, 30% deficit), planned isocaloric LC or HC for 8 weeks. At baseline and week 8, subjects performed incremental treadmill exercise to exhaustion and handgrip and isometric knee extensor strength were assessed. Weight loss was greater in LC compared with HC (8.4+/-0.4% and 6.7+/-0.5%, respectively; P=0.01 time x diet). Peak oxygen uptake and heart rate were unchanged in both groups (P>0.17). Fat oxidation increased during submaximal exercise in LC but not HC (P<0.001 time x diet effect). On both diets, perception of effort during submaximal exercise and handgrip strength decreased (P<or=0.03 for time), but knee extensor strength remained unchanged (P>0.25). An LC weight loss diet shifted fuel utilization toward greater fat oxidation during exercise, but had no detrimental effect on maximal or submaximal markers of aerobic exercise performance or muscle strength compared with an HC diet. Further studies are required to determine the interaction of LC diets with regular exercise training and the long-term health effects.
Obesity (Silver Spring) 2009 Oct
PMID:Effects of a low carbohydrate weight loss diet on exercise capacity and tolerance in obese subjects. 1937 24

Previous studies suggested that hypoxia and exercise may have a synergistic effect on cardiovascular and metabolic risk factors. We conducted a single blind study in overweight to obese subjects to test the hypothesis that training under hypoxia (HG, n = 24, FiO(2) = 15%) results in similar or even greater improvement in body weight and metabolic risk markers compared with exercise under normoxia (NG, n = 21, FiO(2) = 21%). After an initial metabolic evaluation including incremental exercise testing, subjects trained in normoxic or hypoxic conditions thrice weekly over a 4-week period at a heart rate corresponding to 65% of maximum oxygen uptake (VO(2max)). The experimental groups were similar at the start of the investigation and weight stable during the training period. Subjects in the hypoxia group trained at a significantly lower workload (P < 0.05). Yet, both groups showed similar improvements in VO(2max) and time to exhaustion. Respiratory quotient and lactate at the anaerobic threshold as well as body composition improved more in the hypoxia group. We conclude that in obese subjects, training in hypoxia elicits a similar or even better response in terms of physical fitness, metabolic risk markers, and body composition at a lower workload. The fact that workload and, therefore, mechanic strain can be reduced in hypoxia could be particularly beneficial in obese patients with orthopedic comorbidities.
Obesity (Silver Spring) 2010 Jan
PMID:Influences of normobaric hypoxia training on physical fitness and metabolic risk markers in overweight to obese subjects. 1954 14

At least 60 min of daily physical activity (PA) are recommended for weight control, a target achieved by only 3% of obese (OB) women. The purposes of this study were to examine (i) the affective responses of normal-weight (NW), overweight (OW), and OB middle-aged sedentary women to exercise of increasing intensity and (ii) the relationship of affective responses to self-efficacy and social physique anxiety. The women participated in a graded treadmill protocol to volitional exhaustion while providing ratings of pleasure-displeasure and perceived activation each minute. The Activation Deactivation Adjective Check List (AD ACL) was also completed before and after exercise. The affective responses of NW and OW women did not differ. However OB women gave lower pleasure ratings during the incremental protocol and reported lower Energy scores immediately after the protocol. Social physique anxiety, but not self-efficacy, was inversely related to pleasure and energy. The lower levels of pleasure and energy experienced by OB than nonobese women could account in part for their dramatically low levels of PA participation. Modifying the cognitive antecedents of social physique anxiety might be a useful intervention strategy.
Obesity (Silver Spring) 2010 Jan
PMID:Affective responses to increasing levels of exercise intensity in normal-weight, overweight, and obese middle-aged women. 1955 79


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