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Query: UMLS:C0028754 (obesity)
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The purpose of this study was to explore the expressive capacities of our psychosomatic patients. We invited them to represent their illness in a drawing through the design test. Following this, we investigated 43 patients affected with bronchial asthma, 30 patients affected with refractory massive obesity and compared them with a control group of 25 'normal' subjects (medical students in a situation where stress and anxiety were strongly suspected as they were awaiting to sit for an examination in the Medical School). The two patient groups showed quite relevant differences as to their own expressive modalities in the use of metaphor and metonymy, which are considered as the graphic representation means of the illness.
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PMID:Representation of psychosomatic disturbances: metaphor and metonymy. 362 85

A two-fold approach was used to investigate the association between fatness and fitness of girls 7 to 17 years of age: first, age-specific correlations between fatness and measures of health-related and motor fitness, and second, comparisons of fitness levels of girls classified as fat and lean. A representative sample of 6700 between 7 to 17 years was surveyed. Adiposity (fatness) was estimated as the sum of five skinfolds (biceps, triceps, subscapular, suprailiac, medial calf). Physical fitness included health-related items (step test, PWC170, the sit and reach, sit-ups and leg lifts, flexed arm hang) and motor performance items (standing long jump, vertical jump, arm pull strength, flamingo stand, shuttle run, plate tapping). Age-specific partial correlations between fatness and each fitness item, controlling for stature and weight, were calculated. In addition, in each age group the fattest 5% (presumably the obese) and the leanest 5% were compared on each fitness test. After controlling for stature and weight, subcutaneous fatness accounts for variable percentages of the variance in each fitness item. Estimates for health-related fitness items are: cardiorespiratory endurance-step test (3% to 5%) and PWC170 (0% to 16%), flexibility-sit and reach (3% to 8%), functional strength-flexed arm hand (6% to 17%) and abdominal strength-sit-ups/leg lifts (1% to 8%). Corresponding estimates for motor fitness items are more variable: speed of limb movement-plate tapping (0% to 3%), balance-flamingo stand (0% to 5%), speed and agility-shuttle run (2% to 12%), static strength-arm pull (4% to 12%), explosive strength-standing long jump/vertical jump (11% to 18%). At the extremes, the fattest girls have generally poorer levels of health-related and motor fitness.
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PMID:Fatness and physical fitness of girls 7 to 17 years. 762 70

259 primary school children (average age 9.2 years) were randomly selected from three groups of children whose weights-for-height were 90-110% (normal 111), > 110-120% (over weight 25), and > 120% (obesity 123) of reference values for Bangkok children. They underwent physical fitness tests which included measurement of speed (50 meters run), flexibility (sit-reach), abdominal strength and endurance (30 seconds sit-up), vital capacity (spirometer), and indirect maximum oxygen uptake (VO2 max-submaximal bicycle ergometer). The results showed that all physical fitness tests were statistically significantly different (p < 0.05) between groups, except for flexibility in boys. But for the girls, only 50 meters run, sit-up and VO2 max showed statistically significant differences (p < 0.05). In the comparison of physical fitness tests between sexes, normal weight boys did better than girls (p < 0.05) for all tests except flexibility. There were no statistically significant differences between sexes in overweight and obese children. This study demonstrated that physical fitness of obese children was worse than that of normal children in both sexes, especially as measured by 50 meters run, sit-up and VO2 max tests. Thus, promotion of exercise in obese children should be stimulated to develop better physical fitness and weight reduction. In comparison of physical fitness between the sexes, boys had better physical fitness than girls, significant in the normal weight group only. There is no definite explanation as to why increase in weight results in no difference of physical fitness between sexes. Lifestyle, physical skills, and genetic determinants should be considered for interpretation of physical fitness.
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PMID:Physical fitness of obese school children in Hat Yai, southern Thailand. 785 56

Endoscopic techniques through umbilical and mons pubis ports have provided a method to plicate rectus muscle diastasis without skin resection. Limited or no skin excision is performed. Major series have included only women. The criteria for patient selection for endoscopic abdominoplasty include a protuberant abdomen caused by rectus muscle diastasis with minimal actual or potential skin laxity. There should not be significant intra-abdominal obesity. Extra-abdominal familial fat deposits may be part of the abdominal aesthetic deformity. In most women, rectus muscle diastasis because of pregnancy, obesity, or aging is associated with actual or potential skin laxity of the abdomen and lateral trunk. Endoscopic abdominoplasty in these women would produce mediocre early results and poor aging potential for the future. There are a limited number of women who are reasonable candidates for the endoscopic approach. In contrast, rectus muscle diastasis without skin laxity is a common finding in men older than 30 to 40 years of age. There may be a history of weight fluctuations, weightlifting, or full-excursion sit-up exercises, which may lead to progressive separation of the rectus muscles over time. Other etiologic factors include chronic or intermittent abdominal distension, advancing age, or familial weakness of the abdominal musculofascial tissues. Endoscopically assisted abdominoplasty was performed in four male patients with good to excellent results at 4 to 18 months. Minor complications occurred in half the patients but were successfully treated without re-operation. Men with prominent abdominal contours who are diet- and exercise-resistant should be examined both for familial fat deposits and for significant rectus muscle diastasis. Contouring of the male abdomen may be the primary indication for endoscopically assisted abdominoplasty.
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PMID:Rectus muscle diastasis in males: primary indication for endoscopically assisted abdominoplasty. 958 6

The purpose of this investigation was to determine the possible relationships between anthropometrical and health-related fitness parameters in obese middle-aged women. Twenty one obese (BMI > 27 kg/m2) and 12 control (BMI < 27 kg/m2) middle-aged females (35-45 yrs) participated in this investigation. Three series of anthropometrical measurements on the right side of the body were taken according to the O-scale physique assessment system. The Heath-Carter anthropometric somatotyping method was used and the ratio of waist to hip circumferences was calculated. The body composition was measured using bioelectrical impedance method (Bodystat-500, UK). The following health-related fitness tests used were: dynamic sit-up, hand grip, sit-and-reach, single leg balance and plate tapping. Physical working capacity (PWC) was measured using single ergometer test. Obese women possessed significantly higher (p < 0.05) values for skinfold, girth and breadth measurements. While the differences in somatotype indices were not statistically significant (p > 0.05) between obese and control groups, the transformation of somatotype characteristics to the effect sizes (ESs) revealed that these differences were large (ectomorphy: ES = 1.73; endomorphy: ES = 1.64; mesomorphy: ES = 1.71). Relative aerobic fitness (VO2max/kg, calculated from PWC) and dynamic sit-up were higher (p < 0.05) in control subjects, while obese women presented significantly higher values for hand grip strength. The thicker skinfold thicknesses increased the absolute value of PWC in obese group (r = 0.39-0.57; p < 0.05). In contrast, the thinner skinfold thicknesses in suprailiac and mid-thigh significantly increased the absolute value of PWC in control women. There were only a few significant correlations between girth and breadth measures, and health-related fitness parameters. In addition, somatotype characteristics seldom influenced the results of health-related fitness tests. Stepwise multiple regression analysis demonstrated that health-related fitness test items were more dependent on the anthropometrical parameters in obese than in control women.
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PMID:Anthropometric and health-related fitness characteristics in middle-aged obese women. 1009 24

Despite the widespread assessment of physical fitness in occupational medicine and health services, only a few validity studies have been made of the fitness tests used in relation to job demands. The purpose of this study was to assess the physical fitness of female home care workers (n = 132) in relation to age and to evaluate whether the fitness tests used predict work ability over a 5-year period of follow-up. Muscle endurance declined by 18% to 37%, and isometric muscle strength by 10% to 18%, from the youngest (21 to 35 years) to the oldest (45 to 59 years) age group. The proportion of those subjects who could be classified below the average age-related fitness categories according to the maximal oxygen consumption was highest (50%) for the 21-to-35 age group. The logistic regression model showed that obesity (odds ratio [OR] = 7.51) and poor results on the sit-up (OR, 8.9), balance (OR, 6.5), and weight-lifting (OR, 4.6) tests predicted the highest risk for reduced work ability, according to the work ability index used in the 5-year follow-up. Moreover, average results for the trunk side-bending test (OR, 4.6), poor results for the squatting test (OR, 3.8), poor knee extension strength (OR, 4.2), and the average maximal oxygen consumption (l.min-1) (OR, 3.1) indicated a high risk for reduction in work ability. The physical fitness tests were strongly associated with the physical demands of home care work and were relevant for the evaluation of work-related fitness among home care workers.
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PMID:Age-related physical fitness and the predictive values of fitness tests for work ability in home care work. 1151 56

Current body mass index (BMI) norms for children and adolescents are developed from a reference population that includes obese and slim subjects. The validity of these norms is influenced by the observed secular increase in body weight and BMI. We hypothesized that the performance of children in health-related physical fitness tests would be negatively related to increased BMIs, and therefore fitness tests might be used as criteria for developing a more appropriate set of BMI norms. We evaluated the existing data from a nation-wide fitness survey for students in Taiwan (444 652 boys and 433 555 girls) to examine the relationship between BMI and fitness tests. The fitness tests used included: an 800/1600-m run/walk; a standing long jump; bent-leg curl-ups; and a sit-and-reach test. The BMI percentiles developed from the subgroup whose test scores were better than the 'poor' quartile in all four tests were compared with those of the whole population and linked to the adult criteria for overweight and obesity. The BMIs were significantly related to the results of fitness testing. A total of 43% of students had scores better than the poorest quartile in all of their tests. The upper BMI percentile curves of this fitter subgroup were lower than those of the total population. The 85th and 95th BMI percentile values of the fitter 18-year-old-students (23.7 and 25.5 kg m(-2) for boys; 22.6 and 24.6 kg m(-2) for girls) linked well with the adult cut-off points of 23 and 25 kg m(-2), which have been recommended as the Asian criteria for adult overweight and obesity. Hence, the BMI norms for children and adolescents could be created from selected subgroups that have better physical fitness. We expect that the new norms based on this approach will be used not only to assess the current status of obesity or overweight, but also to encourage activity and exercise.
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PMID:Approaching healthy body mass index norms for children and adolescents from health-related physical fitness. 1216 76

The X-ray crystal structure of the human constitutive androstane receptor (CAR, NR1I3)/retinoid X receptor alpha (RXRalpha, NR2B1) heterodimer sheds light on the mechanism of ligand-independent activation of transcription by nuclear receptors. CAR contains a single-turn Helix X that restricts the conformational freedom of the C-terminal AF2 helix, favoring the active state of the receptor. Helix X and AF2 sit atop four amino acids that shield the CAR ligand binding pocket. A fatty acid ligand was identified in the RXRalpha binding pocket. The endogenous RXRalpha ligand, combined with stabilizing interactions from the heterodimer interface, served to hold RXRalpha in an active conformation. The structure suggests that upon translocation, CAR/RXRalpha heterodimers are preorganized in an active conformation in cells such that they can regulate transcription of target genes. Insights into the molecular basis of CAR constitutive activity can be exploited in the design of inverse agonists as drugs for treatment of obesity.
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PMID:A structural basis for constitutive activity in the human CAR/RXRalpha heterodimer. 1561 Jul 35

Non-exercise activity thermogenesis (NEAT) is the energy expenditure of all physical activities other than volitional sporting-like exercise. NEAT includes all the activities that render us vibrant, unique, and independent beings such as working, playing, and dancing. Because people of the same weight have markedly variable activity levels, it is not surprising that NEAT varies substantially between people by up to 2000 kcal per day. Evidence suggests that low NEAT may occur in obesity but in a very specific fashion. Obese individuals appear to exhibit an innate tendency to be seated for 2.5 hours per day more than sedentary lean counterparts. If obese individuals were to adopt the lean "NEAT-o-type," they could potentially expend an additional 350 kcal per day. Obesity was rare a century ago and the human genotype has not changed over that time. Thus, the obesity epidemic may reflect the emergence of a chair-enticing environment to which those with an innate tendency to sit, did so, and became obese. To reverse obesity, we need to develop individual strategies to promote standing and ambulating time by 2.5 hours per day and also re-engineer our work, school, and home environments to render active living the option of choice.
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PMID:Non-exercise activity thermogenesis: the crouching tiger hidden dragon of societal weight gain. 1643 8

In westernized countries the sedentary lifestyle in conjunction with a hypercaloric diet has caused an increase in the number of obese adults. Moreover, recent studies suggest that the prevalence of overweight in children increased during the last decade. However, the literature has to be interpreted with some caution since the majority of epidemiological studies examining health, fitness, and obesity rely on self-reported data rather than measurements. A further limitation is that most studies examine either physical activity or nutrition, only few deal with both aspects simultaneously. In the present study we analyzed both aspects in more than 58,000 persons aged between 17 and 26 years. All of them were applicants for the German Bundeswehr, which accepts only volunteers with school leaving certificates and a body mass index (BMI) below 30 kg . m (-2). The admitted subjects performed a Physical-Fitness-Test (PFT) consisting of 5 simple sport tests (shuttle run, sit-ups, push-ups, standing jump, Cooper test). For 23 000 subjects additional measurements of body height and body weight as well as information about their education level were available. These data were combined with the PFT results. We found large deficits in the physical fitness of young adults: More than 37 % of the participants failed to pass the PFT, with failure rates of the male volunteers increasing significantly since 2001. While the female volunteers showed virtually constant body weight and BMI, the corresponding values of men increased monotonously between the age of 17 and 26 years. Physical fitness was positively, BMI negatively correlated with education level. The present findings suggest that body weight increases and fitness decreases in non-obese young adults in Germany. Despite the correlations between BMI and physical fitness the terms "overweight" and "physically unfit" should not be regarded as synonyms.
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PMID:Physical performance, body weight and BMI of young adults in Germany 2000 - 2004: results of the physical-fitness-test study. 1687 92


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