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

We report a 44-year-old woman in whom intestinal bypass for obesity at age 23 resulted in chronic malabsorption. After hysterectomy for menorrhagia due to atypical endometrial hyperplasia, the finding of myometrial lipofuscinosis led to a demonstration of vitamin E deficiency. Vitamin E supplementation led to an unexpected improvement in the unsteadiness of gait and slurring of speech of which she had also complained. We suggest that supplementation with vitamin E should be routine in all patients with persistent severe steatorrhoea.
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PMID:Symptomatic vitamin E deficiency diagnosed after histological recognition of myometrial lipofuscinosis. 765 82

Intakes of vitamin A, dietary antioxidants, and other dietary components were examined for their relation to the risk of malignant melanoma among 234 cases and 248 controls in three counties of western Washington State. Cases were drawn from persons diagnosed with melanoma between 1984 and 1987 and identified through a Seattle-Puget Sound cancer registry. Population controls were identified through random digit dialing and were randomly selected, stratified by age, sex, and county. Subjects completed a telephone interview and a mailed food frequency questionnaire asking for information on diet, demographic factors, and factors known to be associated with melanoma. Subjects were asked to estimate their food intake 7 years prior to diagnosis for cases and during a comparable time period for controls. Among data on 16 nutrients calculated from reported food intake, one significant finding emerged: Vitamin E obtained from food was inversely related to risk of melanoma (for highest quartile vs. lowest quartile, age-, education-, and energy intake-adjusted odds ratio (OR) = 0.34, 95% confidence interval (CI) 0.16-0.72; p for trend = 0.01). When intake of nutrients from food plus vitamin and mineral supplements was considered, zinc from food and supplements was associated with a decreased risk of melanoma (for highest quartile vs. lowest quartile, adjusted OR = 0.46, 95% CI 0.24-0.91; p for trend = 0.01). There was no evidence that vitamin A, preformed retinol, or carotenoids were associated with a decreased risk of melanoma or that alcohol or polyunsaturated fats were associated with an increased risk. Body mass index (weight (kg)/height (m)2) was significantly related to melanoma risk; cases were more obese than controls (for highest quartile vs. lowest quartile, age-, sex-, and education-adjusted OR = 1.90, 95% CI 1.10-3.27; p for trend = 0.02). These results provide limited support for the hypothesis that antioxidants such as vitamin E or cofactors in protection from oxidative damage such as zinc may be protective for melanoma, and they suggest that obesity should be measured in future studies of melanoma.
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PMID:Case-control study of malignant melanoma in Washington State. II. Diet, alcohol, and obesity. 816 37

Several lines of evidence support an atherogenic role for oxidized low-density lipoprotein (LDL). Previous studies have suggested that although Mexican-Americans have an increased rate of diabetes, obesity, elevated triglyceride levels, and low high-density lipoprotein (HDL) cholesterol levels, their rates of coronary heart disease (CHD) are similar or possibly lower than in non-Hispanic whites. Mexican-Americans have smaller, denser LDL than non-Hispanic whites. On the basis of this latter observation, we postulated that lipid peroxide (LPO) levels would be increased in Mexican-Americans. We examined the oxidizability of plasma in 50 Mexican-Americans and 50 non-Hispanic whites from the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease, at baseline and after coincubation with a metal-independent system (2'2'-azobis-2-amidinopropane hydrochloride [AAPH]) and a metal-dependent system (Fe2+/H2O2) of oxidation. LPO levels were measured by a modified fluorimetric assay. Vitamin E and plasma fatty acid composition were also determined. We found significantly higher LPO levels at baseline and after AAPH coincubation in Mexican-Americans than in non-Hispanic whites (baseline, 2.75 +/- .09 v 2.07 +/- .09 micromol/L, P < .001; post-AAPH, 5.49 +/- .14 v 5.07 +/-. .04 micromol/L, P = .037). However, no significant ethnic differences were seen after coincubation with Fe2+/H2O2. Diabetes and cigarette-smoking were also associated with higher LPO levels. Mexican-Americans also had lower levels of vitamin E (the predominant lipid-soluble antioxidant in plasma) than non-Hispanic whites, although these differences only partially explained the differences in susceptibility to oxidation. Plasma fatty acids were similar in Mexican-Americans and non-Hispanic whites, suggesting only small differences in diet composition. We conclude that LPO levels are higher in Mexican-Americans than in non-Hispanic whites, and that these results are only partially related to differences in vitamin E levels.
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PMID:Plasma oxidizability in Mexican-Americans and non-Hispanic whites. 869 25

Elevated fasting insulin concentrations and insulin resistance have been associated with non-insulin-dependent diabetes mellitus (NIDDM), obesity, atherosclerosis, and hypertension. Vitamin E supplementation in persons with and without NIDDM may be related to greater insulin sensitivity (SI). The cross-sectional associations of the intake of vitamins E and C with SI and insulin concentrations were evaluated among African American, Hispanic, and non-Hispanic white men and women with a wide spectrum of glucose tolerance included in the Insulin Resistance and Atherosclerosis Study (IRAS) (n = 1151). Insulin sensitivity was measured by minimal model analysis of a 12-sample, insulin-modified, frequently sampled intravenous glucose tolerance test. Nutrient intake (including vitamin supplement use) was assessed with a food-frequency questionnaire modified to include foods consumed by the three ethnic groups. Linear-regression models were used, including rank of SI and the log of fasting insulin as the outcome variables. Pearson correlation coefficients for vitamins E and C in relation to rank SI were r = 0.07 (P = 0.01) and r = 0.07 (P = 0.02), respectively. After adjustment for total energy and BMI these associations were no longer statistically significant and did not differ between ethnic groups. Results were similar when vitamins E and C were combined in categories of low and high antioxidant intake. Models replicated with log of fasting insulin as the outcome variable also did not produce significant associations with vitamins E or C. Thus, these cross-sectional analyses do not support the hypothesis of improved SI with increased intake of vitamins E and C.
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PMID:Insulin sensitivity and intake of vitamins E and C in African American, Hispanic, and non-Hispanic white men and women: the Insulin Resistance and Atherosclerosis Study (IRAS). 935 42

Poor diet and physical inactivity contribute to many chronic diseases in the United States each year. Diets low in saturated fatty acids and cholesterol and high in plant foods, i.e., fruits and vegetables, legumes and whole cereals, are protective. Physically active lifestyles are associated with lower risk of cardiovascular diseases, diabetes, obesity and some cancers. To access diet and physical activity levels in West Virginians, we conducted a study which was supported by the West Virginia Bureau for Public Health and the West Virginia University Prevention Research Center (CDC Cooperative Agreement). The purposes of this study were to estimate the proportion of the sample meeting recommendations for chronic disease prevention, and to examine if the individuals who were meeting the Surgeon General's physical activity recommendation for health are also consuming healthier diets. Our results showed that reducing saturated fatty acids and increasing consumption of folate, Vitamin E, calcium and fiber are of prime public health importance in West Virginia. Diet and activity levels were modestly related, suggesting that those who adopt a healthy diet also become more active and vice versa. Due to the cross-sectional nature of this data, it is unknown if single-strategy or dual interventions work best. Prospective studies are needed to determine optimal strategies.
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PMID:Dietary intakes and leisure-time physical activity in West Virginians. 1182 76

The author contends that neither behavioral nor psychological factors are responsible for obesity or overweight, but that physiological and nutritional factors are. Obesity and overweight are relevant to natural family planning because they contribute to various problems of the female reproductive system. Body fat stores estrogen, and excess body fat increases estrogen levels which creates various problems. For example, elevated estrogen levels may contribute to endometrium build-up, resulting in heavy, prolonged bleeding during menstruation or in midcycle. They may kick off a reaction, causing suppressed ovulation, premenstrual spotting, and menstrual cramps. Other possible effects of high estrogen levels are fibroid tumors, breast cancer, endometrial cancer, ovarian cancer, and amenorrhea. The consistent pressure of excess body fat on the uterus can result in uterine prolapse. Overweight may also be a symptom of a reproductive problem, e.g., ovarian failure. Hypoglycemia, including reactive hypoglycemia, caused by a diet high in sugar and white flour, plays a key role in overweight. Excessive insulin secretion in reactive hypoglycemic cases maintains high glucose levels, and the body stores the excess glucose in fat cells. Thus, a diet low in sugary foods and high in fiber-rich complex carbohydrates is the most successful way to lose weight. However, vitamins and minerals needed to maintain blood sugar levels must supplement this diet to be successful. These vitamins and minerals include the B vitamins, magnesium, and, perhaps, chromium. Iodine, vitamins A and E, zinc, and selenium help the thyroid gland operate optimally, so as to avoid excess blood sugar levels. Vitamin E, lecithin, and evening primrose oil assist the body in using fat better. Regular exercise is also important to burn excess fat. Aspartame (Nutrasweet) exacerbates hypoglycemia and is usually found in refined foods and non-foods.
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PMID:An empathetic look at overweight. 1231 98

Many of the cancers common in the Western world, including colon, prostate and breast cancers, are thought to relate to dietary habits. Of the known risk factors, many will act through increasing the probability of mutation. Recognised dietary mutagens include cooked meat compounds, N-nitroso compounds and fungal toxins, while high meat and saturated fat consumption, increasing rates of obesity, and regular consumption of alcohol and tobacco are all dietary trends that could indirectly enhance the probability of mutation. However, there are significant difficulties in implementing and sustaining major dietary changes necessary to reduce the population's intake of dietary mutagens. Dietary antimutagens may provide a means of slowing progression toward cancer, and be more acceptable to the population. Consideration of genetic mechanisms in cancer development suggest several distinct targets for intervention. Strategies that reduce mutagen uptake may be the most simple intervention, and the one least likely to result in undesirable side effects. Certain (but not all) types of dietary fibres appear to reduce mutation through this mechanism, as may certain probiotics and large planar molecules such as chlorophyllin. Antioxidants have been suggested to scavenge free radicals, and prevent their interactions with cellular DNA. Small molecule dietary antioxidants include ascorbic acid, Vitamin E, glutathione, various polyphenols and carotenoids. We found a statistically significant relationship between colon cancer incidence and soil selenium status across different regions of New Zealand. Additionally, a study of middle-aged men suggested that blood selenium levels lower than 100 ng/ml were inadequate for repair or surveillance of oxidative (and other) DNA damage. We suggest that selenium will be an important antimutagen, at least in New Zealand, possibly through antioxidant effects associated with selenium's role in enzymes associated with endogenous repair of DNA damage. Modulation of xenobiotic metabolizing enzymes is well recognised as cancer-protective, and is a property of various flavonoids and a number of sulfur-containing compounds. Many fruits and vegetables contain compounds that will protect against mutation and cancer by several mechanisms. For example, kiwifruit has antioxidant effects and may also affect DNA repair enzymes. Dietary folate may be a key factor in maintenance of methylation status, while enhanced overall levels of vitamins and minerals may retard the development of genomic instability. The combination of each of these factors could provide a sustainable intervention that might usefully delay the development of cancer in New Zealand and other populations. Although there are a range of potentially antimutagenic fruits, vegetables and cereals available to these populations, current intake is generally below the level necessary to protect from dietary or endogenous mutagens. Dietary supplementation may provide an alternative approach.
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PMID:Dietary cancer and prevention using antimutagens. 1513 38

Prostate cancer is the most common neoplasm and the second cause of cancer death. It is an excellent target for primary chemopreventive strategies for the following reasons: it is highly prevalent and has a long latency period, there are identifiable risk factors and a precursor lesion and it produces a biochemical marker (serum PSA) which can serve as an intermediate end point in chemoprevention studies. The goal of primary prevention strategies is to prevent development of clinical life-threatening neoplasms in asymptomatic patients with no evidence of clinical disease. Identification of populations at risk for developing cancer is the cornerstone of chemoprevention. Well-established risk factors for prostate cancer include African-American race, older age and family history. Data on diet and obesity are less clearly defined. Since high grade prostatic intraepithelial neoplasia (PIN) is an early predictor of prostate cancer, preventive strategies focusing on men with high grade PIN are being explored. It was demonstrated that finasteride could significantly reduce prostate cancer in asymptomatic men with normal PSA and no abnormalities on rectal examination. Elevated prostaglandin levels, and upregulation of cyclooxygenase-2 (COX-2) are found in prostate cancer cell lines. There is some epidemiologic evidence that regular use of NSAIDs, which inhibit COX-2, may be associated with a lower risk of prostate cancer. In the field of nutrition, data from prospective large-scale studies demonstrated that increased consumption of lycopene-rich tomato-based foods referred to a reduction in the risk for prostate cancer. Vitamin E was also found to reduce prostate cancer risk. Prospective data showed that vitamin D has an inhibitory effect on prostate cancer development while increased calcium consumption, independent from dietary intake, might increase the risk. Dietary fat intake, particularly from animal sources, may also increase the risk for prostate cancer. Whether this effect is strictly due to the already identified compounds or to other compounds, remains to be explored. Further study will hopefully help to establish a core set of nutritional and dietary factors that can positively or negatively affect prostate cancer development, as well as a set of pharmacologic agents that can reduce the risk of prostate cancer development and/or progression in selected patients.
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PMID:[Nutrition and pharmacological treatment for prevention of prostate cancer]. 1645 Jul 27

Vitamin E is a natural antioxidant that has been used in animal and human studies to determine its potential in reducing cardiovascular risk; however, a detailed study in an established obese model of atherosclerosis has yet to be performed. In our current study, we show that obesity and hyperlipidemia cause a synergistic, age-related increase in urinary isoprostane levels in mice deficient in both leptin and low-density lipoprotein receptor (ob/ob;LDLR-/-). Based upon this observation, we hypothesized that vitamin E supplementation would induce potent antiatherogenic effects in this model. Lean and obese LDLR-/- mice were provided vitamin E (2000 IU/kg) in a Western-type high-fat diet for 12 weeks. Plasma lipid parameters, such as total cholesterol (TC), triglyceride (TG) and free fatty acid, were significantly higher in obese mice compared to lean mice at baseline (P<.001). Western-type diet (WD) feeding caused an increase in TC levels in all groups (P<.001); however, TG (P<.001) and free fatty acid (P<.01) were elevated only in lean mice following WD feeding. Vitamin E supplementation neither influenced any of these parameters nor reduced urinary isoprostanes in lean or obese mice. Vitamin E supplementation in ob/ob;LDLR-/- mice resulted in a trend toward a reduction in atherosclerotic lesion area (P=.10), although no differences in lesion area were noted in lean LDLR-/- animals. These data provide evidence that vitamin E supplementation is not sufficient to reduce extreme elevations in systemic oxidative stress due to hyperlipidemia and obesity and, thus, may not be cardioprotective in this setting.
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PMID:Effects of vitamin E on oxidative stress and atherosclerosis in an obese hyperlipidemic mouse model. 1678 57

Clifton Leaf, in his article "Why We're Losing the War on Cancer," presents criticisms of past research approaches and the small impact of this research thus far on producing cures or substantially extending the life of many cancer patients. It is true that gains in long-term survival for people with advanced cancers have been modest, hindered in part by the heterogeneity of tumors, which allows the cancers to persist using alternate molecular pathways and so evade many cancer therapeutics. In contrast, clinical trials have demonstrated that it is possible to reduce the incidence or improve cancer survival through prevention and early detection. Strides have been made in preventing or detecting early the four deadliest cancers in the United States (i.e., lung, breast, prostate, and colorectal). For example, 7-year follow-up data from the Breast Cancer Prevention Trial (BCPT) provides evidence that tamoxifen reduces the occurrence of invasive breast tumors by more than 40%; recent studies using aromatase inhibitors and raloxifene are also promising. The Prostate Cancer Prevention Trial (PCPT) showed that finasteride reduced prostate cancer incidence by 25%, and the ongoing Selenium and Vitamin E Cancer Prevention Trial (SELECT) is investigating selenium and vitamin E for prostate cancer prevention based on encouraging results from earlier studies. Living a healthy lifestyle, including regular physical activity, avoiding obesity, and eating primarily a plant-based diet has been associated with a lower risk of colorectal cancer. In addition, noninvasive stool DNA tests for early detection are being studied, which may lessen the reluctance of people to be screened for colorectal polyps and cancer. Behavioral and medical approaches for smoking prevention are ways to reduce the incidence of lung cancer, with antinicotine vaccines on the horizon that may help former smokers to avoid relapse. The US National Lung Screening Trial is testing whether early detection via spiral CT screening will reduce lung cancer mortality. Prevention and earlier detection offer efficient and practical strategies to reduce the cancer burden. Several of the suggestions Mr. Leaf makes, such as developing interdisciplinary collaborations and allocating resources to research earlier in the process of carcinogenesis, have become an integral strategy in the National Cancer Institute's (NCI) approach in the past decade, specifically in the realm of cancer prevention and early detection. For example, an aggressive program to identify biomarkers for earlier detection of cancer--the NCI's Early Detection Research Detection (EDRN)--has identified three promising biomarkers since its establishment in 2000. It collaborates with the National Institute of Standards and Technology and extramural scientists to develop validation standards and to identify the best technologies to use for systematic investigations. If these biomarkers can be validated, they might help to reduce cancer mortality.
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PMID:A favorable view: progress in cancer prevention and screening. 1730 81


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