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

District nurses deal with many overweight and obese clients on their caseloads. Many of these people have various co-morbities; their weight issues are often glossed over, prioritizing more pressing clinical issues. This however is a mistake, in this article the issue of obesity in the elderly is mapped out. It starts with looking at the reasons behind the epidemic and looking at individual factors. The elderly suffer from sarcopenia as a result of ageing which leads to changes in body morphology. If not tackled early, such changes lead to considerable increases in cardiometabolic risk. Widespread increases in BMI have been shown to promote CHD, hypertension, type 2 diabetes and certain types of cancers. Clinical depression can be a manifestation of obesity. An overview of the prevalence and non-conservative clinical management is given.
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PMID:Understanding obesity in the older person: prevalence and risk factors. 1855 67

Regular and goal-appropriate exercise is critical to improving and maintaining both health and performance. However, the frequency, intensity, duration and type of activities needed to optimise health or achieve successful sports performance will differ considerably depending on an individual's goals and capabilities. Although sport is one of many forms of exercise that can be counted towards daily physical activity, participation in sport is not necessary to meet current physical activity recommendations. The current consensus is that the minimum amount of physical activity needed to improve and maintain good health is 30 min moderate-intensity activity/d on > or = 5 d/week. The evidence supporting this consensus is based on predominantly observational evidence that performing regular aerobic (endurance)-type physical activity is associated with reduced morbidity and premature mortality from CVD, CHD, stroke and colo-rectal cancer. The exact dose needed to improve health and the slope of the dose-response gradient between physical activity and mortality for various diseases are not known, and one major limitation of the existing evidence is the lack of objective measurement of physical activity. Limited evidence indicates that a much higher dose of activity (45-90 min each day on > or = 5 d/week) may be needed to prevent overweight and obesity and to avoid weight regain in previously overweight and obese individuals. The role of resistance training and heavy domestic work in reducing morbidity and premature mortality for various diseases is unclear. As most adults do not meet current recommendations there is a critical need for innovative approaches to increase physical activity across large-scale populations.
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PMID:Conference on "Multidisciplinary approaches to nutritional problems". Symposium on "Performance, exercise and health". Exercise in improving health v. performance. 1904 Jul 81

Obesity is associated with insulin resistance, the metabolic syndrome (a clustering of three or more of increased waist circumference, blood pressure, fasting glucose and fasting plasma triacylglycerol levels and reduced HDL levels), and a marked increase in the risk of type 2 diabetes and CHD. The impact of obesity differs between individuals, particularly between men and women and between ethnic groups. For example, in South Asians, although overall obesity is less prevalent, central obesity and the metabolic syndrome are more prevalent than in Europeans and this pattern is associated with the development of type 2 diabetes and CHD at an earlier age. It is important to examine individual risk factors contributing to obesity because they may have a different impact in population subgroups. Many factors contribute to the aetiology of obesity and there is increasing evidence to suggest that altered early development is one such factor and is associated with abnormal fat accumulation, the metabolic syndrome and type 2 diabetes in later life. The present review presents this evidence and discusses some of the mechanisms that may be involved in the pathogenesis of the programming of obesity.
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PMID:Evidence for fetal programming of obesity with a focus on putative mechanisms. 1907 23

Leptin is a 16 kDa protein synthesized and secreted primarily from adipocytes. Leptin acts centrally to regulate appetite and energy expenditure and has peripheral effects to coordinate whole-body energy metabolism. Leptin acts as an energy balance and nutrient sensor; its expression and function are regulated by endocrine and dietary factors. Leptin regulates lipid metabolism, specifically lipid storage in adipocytes as well as in skeletal muscle, liver and the pancreas. Effects of leptin on tissue lipid metabolism include regulation of lipogenesis and fatty acid oxidation. Leptin resistance is a hallmark of rodent and human obesity and appears to be due to defects in leptin-receptor signalling (proximal and perhaps distal) as well as impaired leptin transport into the brain. Dietary composition, especially dietary fatty acid intake and profile, impacts on the expression of genes encoding leptin and leptin receptors as well as downstream leptin effectors. Dietary fat consumption, especially consumption of saturated fatty acids, can induce leptin resistance. Leptin has been implicated in nutritional programming during fetal and neonatal growth with long-term effects on susceptibility to obesity, diabetes and CHD in adults.
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PMID:Leptin regulation of lipid homeostasis: dietary and metabolic implications. 1907 39

Methylenetetrahydrofolate reductase (MTHFR) polymorphism may play an important role in the pathophysiology of obesity and diabetes accompanied by obesity due to its influence on plasma homocysteine levels. There are significant and sometimes very strong relationship between levels of homocysteine and several multi-system diseases including CHD and CVA. To examine the association between MTHFR gene C677T polymorphism in diabetes and obesity with serum homocysteine levels. A total of 682 subjects were recruited in four groups (Normal, obese, diabetic and obese and diabetics). MTHFR gene C677T polymorphism was detected using PCR-RFLP technique. Serum homocysteine levels were measured using HPLC. There was a significant increase in the mean serum homocysteine levels in subjects carrying TT genotype (34.6 +/- 26.5) compared to subjects carrying CC (15.1 +/- 8) or CT genotype (16.4 +/- 7.8) (P < 0.000). We found no significant differences for MTHFR allele and genotype frequencies between different groups. Our data have confirmed the association between serum homocysteine levels and MTHFR C677T genotype reported in other populations.
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PMID:Methylenetetrahydrofolate reductase gene polymorphism in diabetes and obesity. 1943 40

It is becoming increasingly evident that the low serum levels of testosterone experienced by aging men are associated with increased all-cause mortality from CHD and other vascular disorders. Achieving a normal physiological testosterone concentration through the administration of testosterone therapy has been shown to provide beneficial effects on the pathophysiological markers and clinical symptoms of CHD. Many of the factors involved in the atherosclerotic process are interlinked with other, increasingly prevalent pathological conditions such as obesity, the metabolic syndrome (MetS), type 2 diabetes and erectile dysfunction, suggesting that testosterone therapy has potentially wide-ranging health benefits. As the number and scope of testosterone substitution and androgen deprivation studies increases and evidence accumulates, it is timely to assess available data and this review summarises the current understanding of the effects of testosterone on cardiovascular risk factors with particular emphasis on the relevance of testosterone treatment.
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PMID:The effects of testosterone on risk factors for, and the mediators of, the atherosclerotic process. 1946 9

Diagnosis of acute coronary syndrome (ACS) in elder patients encounters difficulty due to age-specific features of CHD resulting from a number of physiological and pathological changes associated with aging. This study was designed to analyse the structure of risk factors and clinical signs of ACS based on the examination of 176 patients of different age groups. It turned out that the number of risk factors and concomitant disorders grows with age. The occurrence and significance of certain risk factors (smoking, obesity) tends to change in the opposite direction. Old and very old patients show increased frequency of subtle and atypical forms of ACS. This together with variable ECG features on tribute to the difficulty of diagnosis.
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PMID:[Risk factor structure and specific clinical features of acute coronary syndrome in aged and elderly patients]. 1970 84

The aim of the work was to evaluate the prevalence of cardiac rhythm and conductance disturbances in patients with early manifestations of metabolic syndrome (MS). 24-hour ECG monitoring was undertaken in 105 patients meeting AHA/NHLBI (2005) MS criteria and in 79 healthy subjects. Exclusion criteria were the presence of diabetes mellitus, CHD, and obesity (body mass index > 40 kg/m2). MS was associated with an increased number of supraventicular extrasystoles (628.9 +/- 49.5 vs 415.9 +/- 57.9, p < 0.05) and ventricular extrasystoles (34.4 +/- 9.9 vs 11.8 +/- 6.5 for paired ones and 9.5 +/- 3.7 vs 2.2 +/- 4.0 for group ones, p < 0.05), higher frequency of tachyarrhythmia (supraventicular tachycardia: 18.1 vs 7.6%, p < 0.05; atrial fibrillation: 9.5 vs 2.5, p < 0.05; sinus node arrest: 6.7 vs 0%, p < 0.05). Regression analysis revealed significant correlation between arrhythmias and the number of components of the disease. It is concluded that cause-and-effect relationship between MS and cardiac rhythm disturbances is apparent at the early stage of the disease.
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PMID:[Rhythm and conductivity disorders in patients at the initial stages of metabolic syndrome]. 1970 87

The aim of this study was to measure plasma leptin level in patients with bronchial asthma (BA) and compare it with clinical features of the disease. It included 21 healthy subjects, 9 patients with extrapulmonary allergy, and 18 with partially controllable BA. Plasma leptin was measured by ELISA. Patients with BA showed a much higher leptin level and its significant difference depending on body mass index. Correlation analysis revealed significant correlation between leptin level and degree of eosinophilia in peripheral blood and phlegm, epidermal and iatrogenic sensitization, per os glucocorticoid therapy, concomitant pathology, such as type 2 diabetes, thyroid diseases, cardiological problems (CHD, hypertensive disease), and their complications (acute myocardial infarction, stroke). The reported phenomenon of elevated plasma leptin level in BA patients and its correlation with a number of clinical features open up a possibility for further investigation into the role of obesity in BA pathogenesis and its progress, for the search of new ways to manage the disease.
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PMID:[Plasma leptin level in patients with bronchial asthma]. 1970 89

A community based cross sectional survey was carried out to study the prevalence of the risk factors for CHD and identify the high-risk groups in the rural community. 924 subjects of 30 years and above were investigated using structured, pre-tested schedule. Coronary risk factors were assessed. Statistical analysis was done by using Chi square test for prevalence of coronary risk factors in the age and sex groups. The prevalence of coronary risk factors ranged from 5.4 to 41.3%. Tobacco use, alcohol consumption, truncal obesity and sedentary life style were significantly prevalent among males. Whereas truncal obesity and hypertension among females. Behaviour change communication strategies targeting these high risk factors need to be emphasized to lower CHD related morbidity burden in the community.
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PMID:Prevalence of coronary risk factors in a rural community of Andhra Pradesh. 1980 33


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