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Query: UMLS:C0028754 (obesity)
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This study was conducted to determine the nutritional status of elderly subjects participating in a congregate meals program. Twenty-four-hour recalls, anthropometric measurements, and biochemical determinations were the criteria used to determine nutritional status of the 30 volunteers. Information regarding use of dietary supplements was also obtained. Ninety-three percent of the participants consumed diets providing at least 70 percent of the RDA for the 13 nutrients calculated. Seven percent consumed diets rated as "poor," but none of the participants consumed diets supplying less than 54 percent of the RDA. Twenty-seven percent of the sample reported daily use of dietary supplements. Height, weight, mid-arm circumference, triceps skinfold, and abdominal circumference were measured. The incidence of obesity was high, with 42 percent of the women and 78 percent of the men being over 119 percent of ideal body weight. Mid-arm circumference, triceps skinfold, and abdominal circumference data agreed with the weight-for-height data. The incidence of obesity was greater in this study than in other studies cited, and, as was not the case in other studies, the incidence of obesity was greater in men. Biochemical determinations included hemoglobin, hematocrit, serum albumin, serum folate, ascorbic acid, and vitamins A, B6, and B12. Comparison of biochemical data with accepted standards indicated that the nutritional status of the participants was adequate.
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PMID:Nutritional status of elderly participants in a congregate meals program. 721 86

During the first quarter of 1990, Xhosa-speaking nurses interviewed mothers and took anthropometric measurements of 163 children 3-6 years old living in squatter and formal housing areas of Cape Town, South Africa, to determine the nutritional status of the children. 39% of the children received less than 67% of the recommended daily allowance (RDA) of calories (i.e., deficiency) and 3% received more than 120% of the RDA. Most children were deficient in calcium (80%), iron (77%), vitamin A (64%), riboflavin (52%), niacin (53%), vitamin B6 (58%), and vitamin C (76%). Most children received more than 120% of the RDA for folic acid (68%) and for vitamin B12 (63%). Milk consumption was low (median intake, 0.5 portion vs. 2-3 portions as recommended by the department of national health and population development guidelines). The diet was also deficient in vegetables and fruit intake (1.32 vs. =or 4 portions) and fat intake (2.5 vs. =or 4 portions). Children did receive adequate portions of meat and foods from the cereal group, however. Macronutrient energy distribution fell within prudent dietary guidelines: 28.1% of energy from total fat, 63.7% from carbohydrates, and 13.2% from protein. 44.8% of children had only 2 meals with more than 600 kJ. 15 children (9.2%) had only 1 meal. 27.6% were stunted. 7.7% were underweight. 7.9% were wasted. 20.1% were obese. The undernourished children and the obese children consumed a diet low in micronutrients. These anthropometric findings indicate a population in transition--acutely and chronically undernourished children coexisting with obesity. The overall findings suggest a need to develop a nutrition and health policy to address nutrient deficit and excess.
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PMID:Nutritional status of 3-6 year-old African children in the Cape Peninsula. 785 52

Thirty-four adolescents aged 11 to 19 at the time of gastric surgery for obesity were interviewed an average of 6 years postoperatively. Patients' preoperative body mass index averaged 47; at follow-up, their body mass index averaged 32. Two thirds of the patients weighed within 9 kg of their lowest postsurgical weight at the time of follow-up; three had had additional obesity surgery. Patients reported excellent psychosocial adjustment, including improved self-esteem, social relationships, and appearance. No patient was unemployed. Patients reported poor compliance with exercise and dietary instructions. More seriously, only four patients reported taking vitamin B12, multivitamin supplements, and calcium as directed. The need for long-term patient commitment and monitoring is discussed.
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PMID:Adolescents having obesity surgery: a 6-year follow-up. 797 19

Steatosis and steatohepatitis are associated with obesity. Despite florid histological changes, patients with non-alcoholic steatohepatitis generally remain asymptomatic, and it usually runs a relatively benign course. An elevated insulin level may be important in the pathogenesis. There is a marked regression of fatty changes after weight reduction. In obese subjects the risk of developing gallstones is increased due to an increased saturation of gallbladder bile with cholesterol and possible gallbladder stasis. During weight reduction with very low calorie diets the incidence in gallstones increases probably because of an increased saturation of bile during the loss of weight. Ursodeoxycholic acid appears to be a promising prophylactic agent. Chenodeoxycholic acid is not useful for these subjects. There is controversy over whether obesity contributes to gastroesophageal reflux and gastric emptying disturbances. There are changes in gastrointestinal peptide plasma levels in obesity but it is not clear if this contributes to its development. The risk for high-risk colorectal adenomas and carcinomas is reported to be increased in obese males. Vertical banded gastroplasty and gastric bypass procedures are nowadays the surgical options for the treatment of obesity. Nutritional deficiencies, particularly of vitamin B12, folate and iron are common after gastric bypass and must be sought and treated. Dumping is another potential complication of this operation. If stenosis and gastric outlet obstruction develop endoscopic dilatation is a good therapeutic option.
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PMID:Gastrointestinal disturbances with obesity. 801 72

The SILASTIC ring vertical gastric bypass (SRVGBP) has evolved as the rational operation to control obesity. The operation consists of a proximal vertical gastric pouch < 30 cc in size. The pouch is banded with a 5.5-cm SILASTIC ring, and this functions as the stoma which does not stretch and is large enough to allow patients to eat all varieties of food, including vegetables and meats, with minimal incidence of postprandial emesis. The continuity of the gastrointestinal tract is formed with a Roux-en-Y gastroenterostomy with each limb about 60 cm long. The bypass of the gastroduodenal axis causes decreased digestion and thus decreased absorption of fats and carbohydrates, resulting in comparably more weight loss than seen in the standard restrictive gastroplasty. The dumping experienced in this operation, which prevents patients from becoming sweet eaters and thus provides long-term weight maintenance, is not as severe as in the regular gastric bypass with a dilatable stoma. In trained hands, the morbidity and mortality from this operation is comparable to that seen in the simple restrictive gastroplasty. The complications due to this operation include staple line breakdown, marginal ulcers, stenosis, incisional hernia, dumping, and iron, vitamins A, B12, D, and E deficiencies. These deficiencies are correctable by oral or parenteral supplements as necessary. This operation yields a 90% or higher success rate (> 40% excess weight loss) in the treatment of morbid obesity [corrected].
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PMID:SILASTIC ring vertical banded gastric bypass for the treatment of obesity: two years of follow-up in 84 patients [corrected]. 816 87

A short period of fasting leads, in the mouse, to usually reversible damage to chondrocytes and in patients with rheumatoid arthritis often to a temporary improvement. Slight hypo-alimentation and a low-caloric diet reduce the spontaneous development of osteo-arthritis in the mouse, whereas a high-caloric diet promotes the disease. In man, mice, and, in particular, fattened animals, obesity is often associated with forms of osteo-arthritis. In such cases, it may be assumed that metabolic damage to cartilage is involved as well as damage due to weight-bearing forces. Elderly people, i.e., persons with a predisposition to osteo-arthritis, often suffer from a generalized vitamin deficiency. Vitamins E, B2, and C have been shown to exert an inhibitory effect on osteo-arthritis in animals, and it has been found that supplementation therapy, particularly with vitamin E and the combination of vitamins B1, B6, and B12, can exert a beneficial effect on the symptomatology of human degenerative joint disease. Mineral deficits in calcium, zinc and selenium (Kashin-Beck disease; endemic osteo-arthritis deformans) can provoke skeletal damage in humans and animals. On the other hand, calcium, iron, and copper have been reported to give rise to storage diseases, in some cases with involvement of articular cartilage. There have been indications that chondrotoxic damage may result from food contaminants. So far very little is known about the influence of phytopharmacodynamic substances (other than derivatives of rutin and rhein) on osteo-arthritis. The large gaps in our knowledge of the chondrotropic properties of the constituents of food and common stimulants underline the need for further investigations.
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PMID:[Potential influence of nutrition with supplements on healthy and arthritic joints. II. Nutritional quantity, supplements, contamination]. 821 18

Dietary, anthropometric, and chronic disease risk factors (CDRF) including blood lipids and blood pressure (BP), were measured in 91 vitamin-mineral supplement users (SU) and nonusers (NU) representing a wide range of athletic interests. Supplements were used by 46 (51%) subjects; 100% of female athletes and 51% of male athletes used supplements while none of a group of 15 control female subjects currently used supplements. Both dietary intake and energy expenditure were measured using 7-day records. Adiposity was determined from body weight, body mass index, and skinfolds. Total cholesterol, high-density lipoprotein cholesterol, serum ferritin, hemoglobin, hematocrit, zinc, copper, and vitamin C were based on 12-hour fasting blood samples. Dietary intake (excluding supplements) for SU tended to be greater than NU for vitamin C, thiamin, riboflavin, niacin, B6, B12, folate, calcium, iron and magnesium. Plasma vitamin C levels were significantly higher among SU than NU of both gender groups (p < 0.05). Although SU may exhibit additional healthy lifestyle practices, lipid profiles for many of these athletes were unfavorable with regard to CDRF.
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PMID:Vitamin-mineral supplement use and nutritional status of athletes. 846 14

The prevention of coronary artery disease is based on the control of several factors associated with a disease or clinical condition and suspected to play a pathogenetic role, defined as 'risk factors'. Smoking is a powerful risk factor for coronary artery disease, with risk of events increasing in relation to the number of cigarettes smoked daily. Smoking cessation is associated within 3-4 years, with a significant reduction in cardiovascular risk. Hyperlipidaemia is a powerful predictor of coronary disease with a strong, independent, continuous and graded positive association between cholesterol levels and risk of coronary events. Several large studies have shown the benefit of cholesterol reduction, and there is clear evidence of the efficacy of statins in the reduction of events in primary and secondary prevention. Hypertension is a significant, strong and independent risk factor for coronary artery disease morbidity and mortality and the reduction of events and mortality by antihypertensive treatment is well documented. Obesity is associated with an increase in all-cause mortality and cardiovascular mortality, with a particularly high risk for subjects with central obesity. Central obesity is also part of the so-called 'metabolic X syndrome' including insulin resistance, which appears to be associated with a particularly high risk of coronary artery disease. Type 1 and type 2 diabetes mellitus are associated with an increased risk of cardiovascular disease, especially in women. Several studies have shown that good metabolic control and multifactorial risk factor reduction significantly lower the coronary risk in these patients. Recent evidence is accumulating that some clotting factors (fibrinogen, factor VII, von Willebrand factor) and fibrinolytic factors (t-PA and PAI-1) are associated with an increased risk of coronary artery disease. The European Concerted Action on Thrombosis (ECAT) showed that the levels of fibrinogen, von Willebrand factor antigen, and t-PA antigen are independent predictors of subsequent coronary syndromes in patients with angina pectoris, and that low fibrinogen is associated with a low risk of events despite high cholesterol levels. Post-menopausal status is associated with increased risk of coronary artery disease, particularly when menopause is premature (before the age of 45) or abrupt (surgical). There is strong, thought not yet completely definite evidence that post-menopausal hormone replacement therapy may significantly reduce the risk of events and improve survival. Hyperhomocysteinaemia is an emerging risk factor independently associated with an increased risk of coronary artery disease, cerebral vascular disease, and peripheral vascular disease. The administration of vitamin B6, B12 or folate seems to be useful and is currently under further evaluation. Recently, attention has been focused on the correlation between coronary artery disease and genetic factors, such as ACE gene polymorphism or the gene polymorphism for the IIIa-moiety of the platelet fibrinogen receptor IIb-IIIa. In primary prevention, control of the major risk factors mainly in patients with clustered factors will substantially reduce the risk of ischaemic events. Secondary prevention of CHD is based on: aggressive behavioural advice, blood pressure reduction in hypertensives, good metabolic control of diabetes, and cholesterol reduction. Aspirin, beta-blockers, ACE inhibitors, and oral anticoagulants, may be useful in selected patients.
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PMID:Classical risk factors and emerging elements in the risk profile for coronary artery disease. 951 44

This article reviews the nutritional requirements of puberty and the clinical assessment of nutritional status, and discusses the nutritional risks imposed by vegetarian diets, pregnancy, and athletic involvement. Energy (calories) and protein are essential in pubertal development. Adolescent females require approximately 2200 calories/day, whereas male adolescents require 2500-3000 calories/day. Additional intake requirements include fat, calcium, iron, zinc, vitamins, and fiber. The clinical assessment of nutritional status begins with obtaining a good diet history of the patient and this could be offered by the body mass index. Nutritional deficiencies and poor eating habits established during adolescence can have long-term consequences, including delayed sexual maturation, loss of final adult height, osteoporosis, hyperlipidemia, and obesity. As for vegetarian adolescents, nutritional risks include lack of iodine, vitamin B12, vitamin D, and some essential fatty acids. In addition, substances in some grains reduce gut absorption, thus increasing mineral deficiencies. Pregnancy may also be a risk factor for poor nutrition during adolescence. A pregnant adolescent has different nutritional needs because she is still growing. Among adolescent athletes many are turning to nutritional supplements in an attempt to improve athletic performance. A balanced, varied diet provides adequate calories and nutrition to meet the needs of most adolescents. They also have greater water needs than do adult athletes. Details on adolescent health concerns are further discussed in this article.
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PMID:Nutrition in the adolescent. 1003 86

Homocysteine is a sulphur-containing amino acid formed during metabolism by one of two pathways by remethylation and transsulfuration. Altered homocysteine metabolism may be implicated as a factor in atherosclerosis, cerebrovascular disease or peripheral vascular disease. It is postulated that homocysteine may damage endothelial cells or acts as a direct causal factor in the thromboembolic process. Several studies have reported that there are a number of factors that may influence levels of homocysteine in humans. Serum homocysteine levels may be associated with low levels of folate, vitamin B6 and vitamin B12. These studies showed that serum homocysteine levels were higher in men and older adults, and some showed that there was a direct relationship between homocysteine and cigarette smoking, diabetes, obesity, and hypertension. Subjects who consume larger amounts of coffee were also noted to have higher serum homocysteine levels. Several cross-sectional, case-control, and cohort studies have linked homocysteinaemia with cardiovascular disease morbidity and mortality. In the Framingham Heart Study, the cohort study in Tromso, Norway, and the Atherosclerosis Risk in Communities (ARIC) Study, homocysteine levels were found to be higher in adults with asymptomatic or symptomatic coronary artery disease. In the British Regional Heart Study, homocysteine levels were found to be significantly higher in patients with stroke. Thus, there are suggestions that vitamin therapy and alteration of lifestyle habits such as cigarette smoking may lower homocysteine levels. There may be less coronary heart disease morbidity and mortality with lower homocysteine levels.
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PMID:Homocysteine and atherosclerotic disease: the epidemiologic evidence. 1056 72


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