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

The aim of this study was to ascertain whether overweight men and women of comparable age, body surface area and weight would display any differences in weight loss or changes in body composition while receiving identical calorie intakes. 15 men and 15 women of mean age 46.7 (26-57) years with obesity (body mass index 29-36 kg/m2) were given a reducing diet containing 700 kcal/d for 4 weeks. The two groups were identical in age, body weight and height. The change in body composition was studied by means of ultrasound and nitrogen balance. The women had thicker layers of subcutaneous fat (241 +/- 8 mm) over all parts of the body than the men (137 +/- 10 mm) (summated measurements at 14 points). Among the men body weight fell from 93.1 +/- 2.1 to 83.8 +/- 2.0 kg, but the women declined only from 92.9 +/- 2.0 to 84.7 +/- 1.9 kg. Although men achieved a greater weight loss (13%; P less than 0.001) the decrease in their subcutaneous fat layer was 33% less (to 117 +/- 9 mm) than in the women (211 +/- 8 mm). Cumulative nitrogen balance among the men was 4.7 times more negative than in women (-104 +/- 14 g versus -22 +/- 11 g); this points to accentuated muscle breakdown. More fat was mobilized in the women than in the men, chiefly from the regions of the limbs and hips.
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PMID:[Sex-specific changes in body composition during weight reduction]. 219 87

The low-energy protein diet providing 1559 kJ is the first accurately defined diet for the treatment of obesity in the CSSR. The daily amount contains 4.0 g fat, 33.0 g protein, 50.0 g carbohydrate, 5.6 g fibre and daily recommended allowances of vitamins. The diet is enriched with potassium, magnesium and iron. The low-energy protein diet was used for a period of 28 days in the treatment of 49 obese patients aged 40.49 +/- 1.39 years whose initial weight was 110.14 +/- 3.41 kg and the BMI 39.44 +/- 1.13. The therapeutic regime comprised in addition to the diet adequate physical exercise of aerobic character and training of correct eating behaviour. Four weeks treatment led to a significant decline of body weight (by 10.60 +/- 0.46 kg) and a significant drop of the BMI (by 3.65 +/- 0.16). Men lost more weight than women. In women a substantial drop of the body weight (90.5%) was due to reduction of body fat, while in men adipose tissue participated by 60.0% in the loss. During the fourth week of treatment a positive nitrogen balance was achieved, obviously due to adequate physical exercise. The waist/hip ratio was not affected by treatment in either group. The therapeutic regime influenced favourably some risk factors of ischaemic heart disease. In addition to a significant drop of the systolic and diastolic blood pressure a significant decline of total cholesterol, triacylglycerols and serum insulin occurred. There was a concurrent decline of the urinary C-peptide excretion. The therapeutic regime involving the low-energy protein diet was well tolerated by the patients. The incidence of side effects during treatment was less frequent than in treatment by intermittent fasts. No disorders of the cardiac rhythm were recorded during treatment.
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PMID:[A Czechoslovak low-energy protein diet in the treatment of obesity]. 235 13

An obese woman with respiratory failure and bilateral diaphragmatic paralysis, was studied in order to investigate the effects of weight loss on respiratory function during wakefulness and sleep. The patient was studied on 5 different occasions during which diurnal blood gas analysis, spirometry, CO2 rebreathing test, nitrogen wash-out test and a nocturnal polysomnographic study were performed. The follow-up period lasted 9 months, during which the patient progressively lost 19 kg. Progressive improvement in awake blood gas tensions (PaO2 + 21 mmHg, PaCO2 - 16 mmHg) as well as in nocturnal oxyhemoglobin saturation and transcutaneous PCO2 were observed; at the same time only minor changes in responsiveness to CO2 and in lung volumes were found. Conversely alveolar efficiency for CO2, obtained with the nitrogen wash-out test, in the supine posture increased from 81.7 to 90.5%, indicating an improvement in ventilation/perfusion ratio as a possible determinant of blood gas tension improvement during wakefulness and, as a consequence, also during sleep. We conclude that obesity is one possible cause of the occurrence of respiratory failure in bilateral diaphragmatic paralysis.
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PMID:Obesity as a possible cause of respiratory failure in bilateral diaphragmatic paralysis. Case report. 248 95

We studied the influence of lung volumes on apnoea-induced desaturation in ten subjects with sleep apnoea syndrome. Lung volumes were measured by helium dilution in the sitting and supine position and closing volume with the single-breath nitrogen washout test. To characterize the severity of apnoea-induced desaturations, we determined a desaturation curve for each patient. This curve was obtained by plotting the fall in arterial oxygen saturation (SaO2) reached at the end of each apnoea against the apnoea duration. From this curve we selected two indices: 1) the SaO2 fall following 30 s of obstructive apnoea (delta SaO2 30); and 2) the desaturation surface between 10-30 s of obstructive apnoea (DS 10-30). Both the delta SaO2 30 and the DS 10-30 were significantly correlated with the expiratory reserve volume (ERV), measured in the sitting (r = 0.77 and 0.65, respectively; p less than 0.05) and the supine positions (r = 0.96 and 0.87; p less than 0.005). A strong correlation was also observed with the difference between the supine ERV and the seated closing volume CV) (r = 0.99 with delta SaO2 30 and 0.89 with DS 10-30; p less than 0.005). Obesity influenced sitting and supine ERV values. We conclude that, among lung volumes, supine ERV and supine ERV-seated CV are the best indicators of the severity of apnoea-induced desaturation.
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PMID:Role of lung volumes in sleep apnoea-related oxygen desaturation. 270

A recent development in the treatment of obesity is the widespread use of very-low-calorie diets. This study assessed the response to refeeding (RF) after semistarvation (SS) in a rat model. Male Sprague-Dawley rats (440 g) were semistarved for 21 d, receiving a nutritionally complete defined formula diet at 23% of calories of control (C) rats fed ad libitum, and subsequently refed over 21 d (SS----RF). Organ weight, contents of protein and DNA, and the protein-DNA ratio were determined for the liver, pancreas, small intestine, and heart. Compared with C animals, SS----RF animals showed variable repletion of tissue protein but not of tissue DNA. The higher protein-DNA ratio shown in these organ systems suggests a cellular hypertrophic adaptive response to refeeding. A persistent reduced number of cells in ratio to protein concentration is evident despite refeeding over 21 d. Very-low-calorie diets as well as refeeding influence nitrogen economy of selected organ systems.
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PMID:Gastrointestinal and cardiac response to refeeding after low-calorie semistarvation. 281 99

A double blind placebo controlled study was carried out in 40 subjects newly referred for treatment for obesity to determine the effects of the new thermogenic beta adrenoceptor agonist BRL 26830A. The subjects were randomised to receive either BRL 26830A, 200 mg daily for two weeks then 400 mg daily, or placebo for 18 weeks, and all were instructed to follow a 3.35 MJ diet that was low in fat and high in fibre. Weight loss was 15.4 (SD 6.6) kg in subjects given BRL 26830A compared with 10.0 (5.9) kg in those given placebo (p = 0.02). The relative weight loss was 0.93 (0.39%) a week with BRL 26830A and 0.61 (0.38)% with placebo (p = 0.02). Urinary excretion of nitrogen was similar in both groups, whereas measurements of skinfold thickness indicated a 4.1 kg difference in the amount of fat lost, suggesting that weight loss with BRL 26830A was mainly from adipose and not lean tissue. BRL 26830A had no effect on resting pulse rate or pressor effects on either diastolic or systolic blood pressure. No significant differences were found between the two groups in serum cholesterol concentration, percentage of high density lipoprotein cholesterol, plasma concentrations of glucose and insulin, the ratio of glucose to insulin, serum concentrations of triiodothyronine and thyroxine, and creatinine clearance. Short term administration of BRL 26830A to six subjects who had taken the drug for 18 weeks showed that the expenditure of energy increased by 11.6% during the second hour after administration, which suggests that BRL 26830A may enhance weight loss thermogenically. BRL 26830A may be a useful drug in the treatment of obesity.
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PMID:Weight loss in obese subjects on a restricted diet given BRL 26830A, a new atypical beta adrenoceptor agonist. 289 68

Metabolic defects in obese (fa/fa) Zucker rats have previously been shown to be reversed by adrenalectomy; however, hypercorticosteronemia has not been demonstrated. We now report that the total daily excretion of corticosterone and urea nitrogen are significantly greater (P less than 0.01) in obese Zucker rats than in age-matched lean Zucker rats. This excessive excretion of corticosterone is not of autonomous adrenal origin, since dexamethasone treatment (20 micrograms/kg X day) for 2 days induced a proportionate reduction in corticosterone excretion (approximately 50%) in both obese and lean Zucker rats. Corticosterone excretion was further suppressed to levels not different from those in lean rats after 2 days of dexamethasone (40 micrograms/kg X day). Both the peak and total pituitary beta-endorphin secretion in response to an iv bolus of corticotropin-releasing factor (CRF) were diminished in obese Zuckers. The response to CRF in obese Zucker rats was dampened and superimposable on that of dexamethasone-treated lean Zucker rats, suggesting the existence of chronic hypercorticosteronemia as a component of this genetic obesity. These observations provide evidence for a compensatory alteration of the pituitary-adrenal axis. We suggest that corticosterone turnover may be increased in obese Zucker rats.
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PMID:Hypercorticosteronuria and diminished pituitary responsiveness to corticotropin-releasing factor in obese Zucker rats. 293 45

Several new problems in obesitology were pointed out in this book and commented with respect to experiments and experiences of our working group. The problem of the low triiodothyronine (T3) syndrome was treated in chapter 2. The decrease of serum T3 and increase of serum reverse T3 in obese subjects was induced by several factors, namely by fasting. A resistance to administered thyroxine and triiodothyronine was observed in these patients. This energy saving mechanism is at variance with slimming regimens. The prevention and treatment of this awkward complication was discussed. The next chapter (3) is concerned with the hormonal and metabolic effects of diet and motor activity in the course of slimming regimens. The different effects of diet and motor activity on epinephrine and norepinephrine in obese subjects were similar to those obtained by other investigators in nonobese humans. A great importance was attributed to an increased plasma level of cortisol in obese and nonobese subjects in the course of different forms of motor activity and related to a different intensity of exercise. Parallel to several of these experiments, beta-endorphin, thyroid hormones and glucagon were also estimated. It was suggested that motor activity for exercising subjects should not lead to an enhanced secretion of cortisol in view of the health deteriorating effects of increased cortisolemia and in view of an already stimulated secretion of this hormone in obese subjects on basal conditions. Vice versa, a decreased cortisolemia should be obtained in obese subjects treated with an appropriate motor activity and diet. It has been shown that diet without motor activity reduced the level of plasma androgens but in cooperation with motor activity, the level of androgens remained unaltered in the course of the reducing regimen. The conservation of a normal or even higher level of androgens is probably prerequisite for a positive nitrogen balance observed in the course of a combined slimming regimen, while diet without motor activity led in the studied conditions to a negative nitrogen balance. Chapter 4 was devoted to the role of motor activity in slimming regimens. In view of the metabolic effects of motor activity and the clinical late effects of obesity (osteoarthritis of the knees, hips and spine, arterial hypertension, overload of the cardiovascular system, diabetes mellitus etc.), a selection of motor activities was proposed. According to our long experience, we do not recommend jogging, running, jumping and all sports leading to collisions of players.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:New trends in obesitology. 307 25

To determine predictors of postoperative morbidity in elective cholecystectomy patients, the authors examined prospectively the consequences of age, sex, active and past smoking, respiratory history, obesity, type of surgical incision, and preoperative pulmonary function, upon the incidence of postoperative pulmonary complications and length of hospitalization. They identified 31 (14.8%) complications in 209 patients; 21 had atelectasis, 8 purulent bronchitis, and 2 pneumonia. These patients averaged 1.5 days longer in the hospital (p less than 0.001 by analysis of variance) than control patients. Abnormal spirometry (MEFV) and the single-breath nitrogen test (SBN2) were significant predictors of postoperative pulmonary complications (p less than 0.001 by discriminant analysis method). Active smoking and history of respiratory disease were associated with abnormal small airway function (p less than 0.001 by chisquare test), but did not predict postoperative morbidity. By analysis of variance, only a reduction in preoperative FVC emerged as predictive of prolonged hospitalization (p less than 0.001). These results were used to determine if the selection of patients by preoperative pulmonary function testing permits more cost-effective administration of respiratory therapy (RT) services. Neither the MEFV nor SBN2 had sufficient specificity to enhance the cost effectiveness of postoperative RT.
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PMID:Can postoperative pulmonary complications after elective cholecystectomy be predicted? 312 67

We evaluated the safety and efficacy of a highly supplemented controlled low-energy (1764 kJ [420 kcal]) diet in the treatment of non-insulin-dependent diabetes and obesity. Six obese, diabetic women ranging from 143% to 297% of ideal body weight were studied in a metabolic ward for 48 days. The subjects ingested a weight-maintenance diet during an eight-day control period followed by 40 days of an experimental diet containing 1764 kJ (420 kcal) of a mixture of protein (43% of energy intake), carbohydrates (51%), and fat (6%), supplemented with minerals, trace elements, and vitamins. The subjects were monitored for balances of nitrogen and minerals, as well as for the appearance of cardiac arrhythmias by 24-hour electrocardiographic recordings. Weight loss was rapid and sustained and averaged 10.1% +/- 0.8% over 40 days. Fasting plasma glucose levels declined from 16.2 +/- 1.9 mmol/L (293 +/- 36 mg/dL) to 6.9 +/- 0.8 mmol/L (126 +/- 16 mg/dL) by day 35. Similarly, hemoglobin A1c levels fell from 0.11 +/- 0.009 (11.2% +/- 0.9%) to 0.8 +/- 0.001 (8.2% +/- 1.1%). Urinary C-peptide levels declined from 62.2 +/- 15.6 nmol/48 h to 20.0 +/- 5.9 nmol/48 h by days 39 to 40 and paralleled the decline in plasma glucose values, the majority of which occurred in the first seven days. Concentrations of serum cholesterol and triglycerides decreased. Balances for nitrogen, potassium, and magnesium were negative at -1.7 g/24 h, -2.2 mEq/24 h, and -2.9 mg/dL, respectively. Blood pressure decreased without orthostasis. Resting metabolic rate fell a mean of 18% but remained within normal limits. Triiodothyronine levels also declined. Twenty-four-hour ambulatory electrocardiographic readings disclosed no significant bradyarrhythmia or tachyarrhythmia for any patient. These studies, based on a limited number of subjects, demonstrate that a highly supplemented controlled low-energy diet is a safe and efficacious treatment for diabetes and obesity, leading to significant decreases in weight, blood pressure, and levels of plasma glucose and plasma lipids. Such diets may be the optimal initial treatment of moderate to markedly obese patients with non-insulin-dependent diabetes.
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PMID:The safety and efficacy of a controlled low-energy ('very-low-calorie') diet in the treatment of non-insulin-dependent diabetes and obesity. 335 7


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