Comparison of outcomes in adults with pediatric-onset morphea and those with adult-onset morphea: a cross-sectional study from the morphea in adults and children cohort.

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Condie, Daniel; Grabell, Daniel; Jacobe, Heidi

2014-12-01

Few studies have examined outcomes in adults with pediatric-onset morphea. The objective of the present study was to compare clinical outcomes and health-related quality of life (HRQOL) in adults with onset of morphea in childhood to those in patients with adult onset of morphea. Participants in the study were drawn from the Morphea in Adults and Children cohort and included 68 adults with pediatric-onset morphea and 234 patients with adult-onset morphea. Outcome measures included the Localized Scleroderma Cutaneous Assessment Tool (LoSCAT), physical examination findings, and HRQOL questionnaires. Adults with pediatric-onset morphea were younger, had longer disease duration, and were more likely to have the linear subtype of morphea. Patients with pediatric-onset disease were less likely to have active disease. Among patients with active disease, those with pediatric-onset morphea had less disease activity as measured by the LoSCAT. Patients with pediatric-onset disease had higher severity of disease damage when measured by the physician's global assessment of damage, but had similar levels of disease damage when measured by the Localized Scleroderma Skin Damage Index. Patients with pediatric-onset disease had more favorable HRQOL scores for all measures, all of which were statistically significantly different from those in patients with adult-onset morphea. Adults with pediatric-onset morphea differ from patients with adult-onset disease with respect to disease subtype, severity of disease activity and damage, and levels of HRQOL. Copyright © 2014 by the American College of Rheumatology.

Obesity Prevention in Older Adults.

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Volpe, Stella Lucia; Sukumar, Deeptha; Milliron, Brandy-Joe

2016-06-01

The number of older adults living in the USA, 65 years of age and older, has been steadily increasing. Data from the National Health and Nutrition Examination Survey (NHANES), 2007-2010, indicate that more than one-third of older adults, 65 years of age and older, were obese. With the increased rate of obesity in older adults, the purpose of this paper is to present research on different methods to prevent or manage obesity in older adults, namely dietary interventions, physical activity interventions, and a combination of dietary and physical activity interventions. In addition, research on community assistance programs in the prevention of obesity with aging will be discussed. Finally, data on federal programs for older adults will also be presented.

Hypoventilation improvement in an adult non-invasively ventilated patient with Rapid-onset Obesity with Hypothalamic Dysfunction Hypoventilation and Autonomic Dysregulation (ROHHAD).

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Graziani, Alessandro; Casalini, Pierpaolo; Mirici-Cappa, Federica; Pezzi, Giuseppe; Giuseppe Stefanini, Francesco

2016-01-01

Rapid-onset Obesity with Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation (ROHHAD) is a rare disease of unknown etiology, characterized by rapid-onset obesity in young children, hypoventilation, hypothalamic and autonomic dysfunction. Patients between the ages of 2 and 4 present with hyperphagia and weight gain, followed by neuro-hormonal dysfunction and central hypoventilation months or years later. Cardiac arrest may represent the fatal complication of alveolar hypoventilation and early mechanical ventilation is essential for the patient's life. In this paper, we describe a 22-year-old patient with ROHHAD syndrome who had an acute respiratory failure during nocturnal non-invasive ventilation (NIV).

Sex differences in metabolic and adipose tissue responses to juvenile-onset obesity in sheep.

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Bloor, Ian D; Sébert, Sylvain P; Saroha, Vivek; Gardner, David S; Keisler, Duane H; Budge, Helen; Symonds, Michael E; Mahajan, Ravi P

2013-10-01

Sex is a major factor determining adipose tissue distribution and the subsequent adverse effects of obesity-related disease including type 2 diabetes. The role of gender on juvenile obesity and the accompanying metabolic and inflammatory responses is not well established. Using an ovine model of juvenile onset obesity induced by reduced physical activity, we examined the effect of gender on metabolic, circulatory, and related inflammatory and energy-sensing profiles of the major adipose tissue depots. Despite a similar increase in fat mass with obesity between genders, males demonstrated a higher storage capacity of lipids within perirenal-abdominal adipocytes and exhibited raised insulin. In contrast, obese females became hypercortisolemic, a response that was positively correlated with central fat mass. Analysis of gene expression in perirenal-abdominal adipose tissue demonstrated the stimulation of inflammatory markers in males, but not females, with obesity. Obese females displayed increased expression of genes involved in the glucocorticoid axis and energy sensing in perirenal-abdominal, but not omental, adipose tissue, indicating a depot-specific mechanism that may be protective from the adverse effects of metabolic dysfunction and inflammation. In conclusion, young males are at a greater risk than females to the onset of comorbidities associated with juvenile-onset obesity. These sex-specific differences in cortisol and adipose tissue could explain the earlier onset of the metabolic-related diseases in males compared with females after obesity.

Cluster Analysis on Longitudinal Data of Patients with Adult-Onset Asthma.

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Ilmarinen, Pinja; Tuomisto, Leena E; Niemelä, Onni; Tommola, Minna; Haanpää, Jussi; Kankaanranta, Hannu

Previous cluster analyses on asthma are based on cross-sectional data. To identify phenotypes of adult-onset asthma by using data from baseline (diagnostic) and 12-year follow-up visits. The Seinäjoki Adult Asthma Study is a 12-year follow-up study of patients with new-onset adult asthma. K-means cluster analysis was performed by using variables from baseline and follow-up visits on 171 patients to identify phenotypes. Five clusters were identified. Patients in cluster 1 (n = 38) were predominantly nonatopic males with moderate smoking history at baseline. At follow-up, 40% of these patients had developed persistent obstruction but the number of patients with uncontrolled asthma (5%) and rhinitis (10%) was the lowest. Cluster 2 (n = 19) was characterized by older men with heavy smoking history, poor lung function, and persistent obstruction at baseline. At follow-up, these patients were mostly uncontrolled (84%) despite daily use of inhaled corticosteroid (ICS) with add-on therapy. Cluster 3 (n = 50) consisted mostly of nonsmoking females with good lung function at diagnosis/follow-up and well-controlled/partially controlled asthma at follow-up. Cluster 4 (n = 25) had obese and symptomatic patients at baseline/follow-up. At follow-up, these patients had several comorbidities (40% psychiatric disease) and were treated daily with ICS and add-on therapy. Patients in cluster 5 (n = 39) were mostly atopic and had the earliest onset of asthma, the highest blood eosinophils, and FEV 1 reversibility at diagnosis. At follow-up, these patients used the lowest ICS dose but 56% were well controlled. Results can be used to predict outcomes of patients with adult-onset asthma and to aid in development of personalized therapy (NCT02733016 at ClinicalTrials.gov). Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Copy number variations in "classical" obesity candidate genes are not frequently associated with severe early-onset obesity in children.

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Windholz, Jan; Kovacs, Peter; Schlicke, Marina; Franke, Christin; Mahajan, Anubha; Morris, Andrew P; Lemke, Johannes R; Klammt, Jürgen; Kiess, Wieland; Schöneberg, Torsten; Pfäffle, Roland; Körner, Antje

2017-05-01

Obesity is genetically heterogeneous and highly heritable, although polymorphisms explain the phenotype in only a small proportion of obese children. We investigated the presence of copy number variations (CNVs) in "classical" genes known to be associated with (monogenic) early-onset obesity in children. In 194 obese Caucasian children selected for early-onset and severe obesity from our obesity cohort we screened for deletions and/or duplications by multiplex ligation-dependent probe amplification reaction (MLPA). As we found one MLPA probe to interfere with a polymorphism in SIM1 we investigated its association with obesity and other phenotypic traits in our extended cohort of 2305 children. In the selected subset of most severely obese children, we did not find CNV with MLPA in POMC, LEP, LEPR, MC4R, MC3R or MC2R genes. However, one SIM1 probe located at exon 9 gave signals suggestive for SIM1 insufficiency in 52 patients. Polymerase chain reaction (PCR) analysis identified this as a false positive result due to interference with single nucleotide polymorphism (SNP) rs3734354/rs3734355. We, therefore, investigated for associations of this polymorphism with obesity and metabolic traits in our extended cohort. We found rs3734354/rs3734355 to be associated with body mass index-standard deviation score (BMI-SDS) (p = 0.003), but not with parameters of insulin metabolism, blood pressure or food intake. In our modest sample of severely obese children, we were unable to find CNVs in well-established monogenic obesity genes. Nevertheless, we found an association of rs3734354 in SIM1 with obesity of early-onset type in children, although not with obesity-related traits.

An Italian multicentre study on adult atopic dermatitis: persistent versus adult-onset disease.

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Megna, Matteo; Patruno, Cataldo; Balato, Anna; Rongioletti, Franco; Stingeni, Luca; Balato, Nicola

2017-08-01

Atopic dermatitis (AD) is a chronic, recurrent, inflammatory skin disease which predominantly affects children. However, AD may persist until adulthood (persistent AD), or directly start in adults (adult-onset AD). AD often shows a non-flexural rash distribution, and atypical morphologic variants in adults and specific diagnostic criteria are lacking. Moreover, adult AD prevalence as well as detailed data which can characterize persistent vs adult-onset subtype are scant. The aim of this study was to investigate on the main features of adult AD particularly highlighting differences between persistent vs adult-onset form. An Italian multicentre observational study was conducted between April 2015-July 2016 through a study-specific digital database. 253 adult AD patients were enrolled. Familiar history of AD was negative in 81.0%. Erythemato-desquamative pattern was the most frequent clinical presentation (74.3%). Flexural surface of upper limbs was most commonly involved (47.8%), followed by eyelid/periocular area (37.9%), hands (37.2%), and neck (32%). Hypertension (7.1%) and thyroiditis (4.3%) were the most frequent comorbidities. A subgroup analysis between persistent (59.7%) vs adult-onset AD patients (40.3%) showed significant results only regarding AD severity (severe disease was more common in persistent group, p adult-onset disease), and comorbidities (hypertension was more frequent in adult-onset group, p Adult AD showed uncommon features such as significant association with negative AD family history and lacking of association with systemic comorbidities respect to general population. No significant differences among persistent vs adult-onset subgroup were registered except for hypertension, itch intensity, and disease severity.

Residential segregation and overweight/obesity among African-American adults: A critical review

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Irma eCorral

2015-07-01

Full Text Available The relationship between residential segregation and overweight/obesity among African-American adults remains unclear. Elucidating that relationship is relevant to efforts to prevent and to reduce racial disparities in obesity. This article provides a critical review of the 11 empirical studies of segregation and overweight/obesity among African-American adults. Results revealed that most studies did not use a valid measure of segregation, many did not use a valid measure of overweight/obesity, and many did not control for neighborhood poverty. Only four (36% of the studies used valid measures of both segregation and overweight/obesity and also controlled for area-poverty. Those four studies suggest that segregation contributes to overweight and obesity among African-American adults, but that conclusion cannot be drawn with any certainty in light of the considerable methodological problems in this area of research. Suggestions for improving research on this topic are provided.

Two New Loci for Body-Weight Regulation Identified in a Joint Analysis of Genome-Wide Association Studies for Early-Onset Extreme Obesity in French and German Study Groups

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Scherag, André; Dina, Christian; Hinney, Anke; Vatin, Vincent; Scherag, Susann; Vogel, Carla I. G.; Müller, Timo D.; Grallert, Harald; Wichmann, H.-Erich; Balkau, Beverley; Heude, Barbara; Jarvelin, Marjo-Riitta; Hartikainen, Anna-Liisa; Levy-Marchal, Claire; Weill, Jacques; Delplanque, Jérôme; Körner, Antje; Kiess, Wieland; Kovacs, Peter; Rayner, Nigel W.; Prokopenko, Inga; McCarthy, Mark I.; Schäfer, Helmut; Jarick, Ivonne; Boeing, Heiner; Fisher, Eva; Reinehr, Thomas; Heinrich, Joachim; Rzehak, Peter; Berdel, Dietrich; Borte, Michael; Biebermann, Heike; Krude, Heiko; Rosskopf, Dieter; Rimmbach, Christian; Rief, Winfried; Fromme, Tobias; Klingenspor, Martin; Schürmann, Annette; Schulz, Nadja; Nöthen, Markus M.; Mühleisen, Thomas W.; Erbel, Raimund; Jöckel, Karl-Heinz; Moebus, Susanne; Boes, Tanja; Illig, Thomas; Froguel, Philippe; Hebebrand, Johannes; Meyre, David

2010-01-01

Meta-analyses of population-based genome-wide association studies (GWAS) in adults have recently led to the detection of new genetic loci for obesity. Here we aimed to discover additional obesity loci in extremely obese children and adolescents. We also investigated if these results generalize by estimating the effects of these obesity loci in adults and in population-based samples including both children and adults. We jointly analysed two GWAS of 2,258 individuals and followed-up the best, according to lowest p-values, 44 single nucleotide polymorphisms (SNP) from 21 genomic regions in 3,141 individuals. After this DISCOVERY step, we explored if the findings derived from the extremely obese children and adolescents (10 SNPs from 5 genomic regions) generalized to (i) the population level and (ii) to adults by genotyping another 31,182 individuals (GENERALIZATION step). Apart from previously identified FTO, MC4R, and TMEM18, we detected two new loci for obesity: one in SDCCAG8 (serologically defined colon cancer antigen 8 gene; p = 1.85×10−8 in the DISCOVERY step) and one between TNKS (tankyrase, TRF1-interacting ankyrin-related ADP-ribose polymerase gene) and MSRA (methionine sulfoxide reductase A gene; p = 4.84×10−7), the latter finding being limited to children and adolescents as demonstrated in the GENERALIZATION step. The odds ratios for early-onset obesity were estimated at ∼1.10 per risk allele for both loci. Interestingly, the TNKS/MSRA locus has recently been found to be associated with adult waist circumference. In summary, we have completed a meta-analysis of two GWAS which both focus on extremely obese children and adolescents and replicated our findings in a large followed-up data set. We observed that genetic variants in or near FTO, MC4R, TMEM18, SDCCAG8, and TNKS/MSRA were robustly associated with early-onset obesity. We conclude that the currently known major common variants related to obesity overlap to a substantial degree between

Two new Loci for body-weight regulation identified in a joint analysis of genome-wide association studies for early-onset extreme obesity in French and german study groups.

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André Scherag

2010-04-01

Full Text Available Meta-analyses of population-based genome-wide association studies (GWAS in adults have recently led to the detection of new genetic loci for obesity. Here we aimed to discover additional obesity loci in extremely obese children and adolescents. We also investigated if these results generalize by estimating the effects of these obesity loci in adults and in population-based samples including both children and adults. We jointly analysed two GWAS of 2,258 individuals and followed-up the best, according to lowest p-values, 44 single nucleotide polymorphisms (SNP from 21 genomic regions in 3,141 individuals. After this DISCOVERY step, we explored if the findings derived from the extremely obese children and adolescents (10 SNPs from 5 genomic regions generalized to (i the population level and (ii to adults by genotyping another 31,182 individuals (GENERALIZATION step. Apart from previously identified FTO, MC4R, and TMEM18, we detected two new loci for obesity: one in SDCCAG8 (serologically defined colon cancer antigen 8 gene; p = 1.85x10(-8 in the DISCOVERY step and one between TNKS (tankyrase, TRF1-interacting ankyrin-related ADP-ribose polymerase gene and MSRA (methionine sulfoxide reductase A gene; p = 4.84x10(-7, the latter finding being limited to children and adolescents as demonstrated in the GENERALIZATION step. The odds ratios for early-onset obesity were estimated at approximately 1.10 per risk allele for both loci. Interestingly, the TNKS/MSRA locus has recently been found to be associated with adult waist circumference. In summary, we have completed a meta-analysis of two GWAS which both focus on extremely obese children and adolescents and replicated our findings in a large followed-up data set. We observed that genetic variants in or near FTO, MC4R, TMEM18, SDCCAG8, and TNKS/MSRA were robustly associated with early-onset obesity. We conclude that the currently known major common variants related to obesity overlap to a substantial

Experience of severe desaturation during anesthetic induction period in an obese adult patient with Prader-Willi syndrome -A case report-.

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Choi, Joon Woo; Kim, Eun-Ju; Min, Byung Woo; Ban, Jong Seouk; Lee, Sang Gon; Lee, Ji-Hyang

2012-02-01

Prader-Willi syndrome is characterized by infantile hypotonia, childhood-onset obesity, short stature, mental retardation, hyperphagia, hypogonadism. After infantile hypotonia phase, patient is prone to morbid obesity due to hyperphagia. Complications associated with morbid obesity are recognized as the main risk factors for death the lifespan of patients with Prader-Willi syndrome. We experienced desaturation and bronchospasm during arteriovenous fistula surgery in an obese adult with Prader-Willi syndrome.

Pubertal Onset in Apparently Healthy Indian Boys and Impact of Obesity.

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Surana, Vineet; Dabas, Aashima; Khadgawat, Rajesh; Marwaha, Raman Kumar; Sreenivas, V; Ganie, M Ashraf; Gupta, Nandita; Mehan, Neena

2017-01-01

Primary - to determine the age of pubertal onset in Indian boys. Secondary - (a) to assess the impact of obesity on pubertal timing, (b) to assess the relationship between gonadotropins and puberty. Cross-sectional. General community-seven schools across New Delhi. Random sample of 1306 school boys, aged 6-17 years. Anthropometric measurement for weight and height and pubertal staging was performed for all subjects. Body mass index (BMI) was calculated to define overweight/obesity. Serum luteinizing hormone (LH), follicle stimulating hormone, and serum testosterone were measured in every sixth subject. Age at pubertal onset-testicular volume ≥4 mL (gonadarche) and pubic hair Stage II. Median age of attaining gonadarche and pubarche was 10.41 years (95% confidence interval [CI]: 10.2-10.6 years) and 13.60 (95% CI: 13.3-14.0 years), respectively. No significant difference in the age of attainment of gonadarche was observed in boys with normal or raised BMI, though pubarche occurred 8 months earlier in the latter group. Serum gonadotropins and testosterone increased with increasing stages of puberty but were unaffected by BMI. Serum LH level of 1.02 mIU/mL and testosterone level of >0.14 ng/mL showed the best prediction for pubertal onset. The study establishes a secular trend of the age of onset of puberty in Indian boys. Pubarche occurred earlier in overweight/obese boys. The cutoff levels of serum LH and testosterone for prediction of pubertal onset have been established.

Polygenic risk predicts obesity in both white and black young adults.

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Benjamin W Domingue

Full Text Available To test transethnic replication of a genetic risk score for obesity in white and black young adults using a national sample with longitudinal data.A prospective longitudinal study using the National Longitudinal Study of Adolescent Health Sibling Pairs (n = 1,303. Obesity phenotypes were measured from anthropometric assessments when study members were aged 18-26 and again when they were 24-32. Genetic risk scores were computed based on published genome-wide association study discoveries for obesity. Analyses tested genetic associations with body-mass index (BMI, waist-height ratio, obesity, and change in BMI over time.White and black young adults with higher genetic risk scores had higher BMI and waist-height ratio and were more likely to be obese compared to lower genetic risk age-peers. Sibling analyses revealed that the genetic risk score was predictive of BMI net of risk factors shared by siblings. In white young adults only, higher genetic risk predicted increased risk of becoming obese during the study period. In black young adults, genetic risk scores constructed using loci identified in European and African American samples had similar predictive power.Cumulative information across the human genome can be used to characterize individual level risk for obesity. Measured genetic risk accounts for only a small amount of total variation in BMI among white and black young adults. Future research is needed to identify modifiable environmental exposures that amplify or mitigate genetic risk for elevated BMI.

Polygenic risk predicts obesity in both white and black young adults.

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Domingue, Benjamin W; Belsky, Daniel W; Harris, Kathleen Mullan; Smolen, Andrew; McQueen, Matthew B; Boardman, Jason D

2014-01-01

To test transethnic replication of a genetic risk score for obesity in white and black young adults using a national sample with longitudinal data. A prospective longitudinal study using the National Longitudinal Study of Adolescent Health Sibling Pairs (n = 1,303). Obesity phenotypes were measured from anthropometric assessments when study members were aged 18-26 and again when they were 24-32. Genetic risk scores were computed based on published genome-wide association study discoveries for obesity. Analyses tested genetic associations with body-mass index (BMI), waist-height ratio, obesity, and change in BMI over time. White and black young adults with higher genetic risk scores had higher BMI and waist-height ratio and were more likely to be obese compared to lower genetic risk age-peers. Sibling analyses revealed that the genetic risk score was predictive of BMI net of risk factors shared by siblings. In white young adults only, higher genetic risk predicted increased risk of becoming obese during the study period. In black young adults, genetic risk scores constructed using loci identified in European and African American samples had similar predictive power. Cumulative information across the human genome can be used to characterize individual level risk for obesity. Measured genetic risk accounts for only a small amount of total variation in BMI among white and black young adults. Future research is needed to identify modifiable environmental exposures that amplify or mitigate genetic risk for elevated BMI.

The association between childhood sexual and physical abuse with incident adult severe obesity across 13 years of the National Longitudinal Study of Adolescent Health

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Richardson, Andrea S.; Dietz, William H.; Gordon-Larsen, Penny

2013-01-01

Background Severe obesity has increased yet childhood antecedents of adult severe obesity are not well understood. Objective Estimate adult-onset severe obesity risk in individuals with history of childhood physical and/or sexual abuse compared to those who did not report abuse. Methods Longitudinal analysis of participants from the U.S. National Longitudinal Study of Adolescent Health (N=10,774) Wave II (1996; aged 12–22 years) followed through Wave IV (2008–09; aged 24–34 years). New cases of adult-onset severe obesity (BMI≥40 kg/m2 using measured height and weight) in individuals followed over 13 years who were not severely obese during adolescence (BMI childhood was associated with an increased risk of incident severe obesity in adulthood in non-minority females (Hazard Ratio=2.5; 1.3, 4.8) and males (Hazard Ratio=3.6; 1.5, 8.5) compared to individuals with no history of abuse. Conclusion In addition to other social and emotional risks, exposure to sexual and physical abuse during childhood may increase risk of severe obesity later in life. Consideration of the confluence of childhood abuse might be considered as part of preventive and therapeutic approaches to address severe obesity. PMID:24115589

[Epigenetics and obesity].

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Casanello, Paola; Krause, Bernardo J; Castro-Rodríguez, José A; Uauy, Ricardo

Current evidence supports the notion that exposure to various environmental conditions in early life may induce permanent changes in the epigenome that persist throughout the life-course. This article focuses on early changes associated with obesity in adult life. A review is presented on the factors that induce changes in whole genome (DNA) methylation in early life that are associated with adult onset obesity and related disorders. In contrast, reversal of epigenetic changes associated with weight loss in obese subjects has not been demonstrated. This contrasts with well-established associations found between obesity related DNA methylation patterns at birth and adult onset obesity and diabetes. Epigenetic markers may serve to screen indivuals at risk for obesity and assess the effects of interventions in early life that may delay or prevent obesity in early life. This might contribute to lower the obesity-related burden of death and disability at the population level. The available evidence indicates that epigenetic marks are in fact modifiable, based on modifications in the intrauterine environment and changes in food intake, physical activity and dietary patterns patterns during pregnancy and early years of adult life. This offers the opportunity to intervene before conception, during pregnancy, infancy, childhood, and also in later life. There must be documentation on the best preventive actions in terms of diet and physical activity that will modify or revert the adverse epigenetic markers, thus preventing obesity and diabetes in suceptible individuals and populations. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Is Adolescent-Onset First-Episode Psychosis Different from Adult Onset?

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Ballageer, Trevor; Malla, Ashok; Manchanda, Rahul; Takhar, Jatinder; Haricharan, Raj

2005-01-01

Objective: To examine whether first-episode psychosis patients with onset during adolescence (ages 15-18) differ significantly from those with young-adult onset (ages 19-30). Method: Consecutive patients presenting with first-episode psychosis (N = 242) were assessed for demographic and illness characteristics such as duration of untreated…

The association between childhood sexual and physical abuse with incident adult severe obesity across 13 years of the National Longitudinal Study of Adolescent Health.

Science.gov (United States)

Richardson, A S; Dietz, W H; Gordon-Larsen, P

2014-10-01

Severe obesity has increased, yet childhood antecedents of adult severe obesity are not well understood. Estimate adult-onset severe obesity risk in individuals with history of childhood physical and/or sexual abuse compared with those who did not report abuse. Longitudinal analysis of participants from the US National Longitudinal Study of Adolescent Health (n = 10,774) wave II (1996; aged 12-22 years) followed through wave IV (2008-2009; aged 24-34 years). New cases of adult-onset severe obesity (body mass index [BMI] ≥ 40 kg/m2 using measured height and weight) in individuals followed over 13 years who were not severely obese during adolescence (BMI childhood was associated with an increased risk of incident severe obesity in adulthood in non-minority females (hazard ratio [HR; 95% Confidence Interval] = 2.5; 1.3, 4.8) and males (HR = 3.6; 1.5, 8.5) compared with individuals with no history of abuse. In addition to other social and emotional risks, exposure to sexual and physical abuse during childhood may increase risk of severe obesity later in life. Consideration of the confluence of childhood abuse might be considered as part of preventive and therapeutic approaches to address severe obesity. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

Childhood obesity affects adult metabolic syndrome and diabetes.

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Liang, Yajun; Hou, Dongqing; Zhao, Xiaoyuan; Wang, Liang; Hu, Yuehua; Liu, Junting; Cheng, Hong; Yang, Ping; Shan, Xinying; Yan, Yinkun; Cruickshank, J Kennedy; Mi, Jie

2015-09-01

We seek to observe the association between childhood obesity by different measures and adult obesity, metabolic syndrome (MetS), and diabetes. Thousand two hundred and nine subjects from "Beijing Blood Pressure Cohort Study" were followed 22.9 ± 0.5 years in average from childhood to adulthood. We defined childhood obesity using body mass index (BMI) or left subscapular skinfold (LSSF), and adult obesity as BMI ≥ 28 kg/m(2). MetS was defined according to the joint statement of International Diabetes Federation and American Heart Association with modified waist circumference (≥ 90/85 cm for men/women). Diabetes was defined as fasting plasma glucose ≥ 7.0 mmol/L or blood glucose 2 h after oral glucose tolerance test ≥ 11.1 mmol/L or currently using blood glucose-lowering agents. Multiple linear and logistic regression models were used to assess the association. The incidence of adult obesity was 13.4, 60.0, 48.3, and 65.1 % for children without obesity, having obesity by BMI only, by LSSF only, and by both, respectively. Compared to children without obesity, children obese by LSSF only or by both had higher risk of diabetes. After controlling for adult obesity, childhood obesity predicted independently long-term risks of diabetes (odds ratio 2.8, 95 % confidence interval 1.2-6.3) or abdominal obesity (2.7, 1.6-4.7) other than MetS as a whole (1.2, 0.6-2.4). Childhood obesity predicts long-term risk of adult diabetes, and the effect is independent of adult obesity. LSSF is better than BMI in predicting adult diabetes.

Evaluation of common genetic variants identified by GWAS for early onset and morbid obesity in population-based samples

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den Hoed, M; Luan, J; Langenberg, C

2013-01-01

BACKGROUND: Meta-analysis of case-control genome-wide association studies (GWAS) for early onset and morbid obesity identified four variants in/near the PRL, PTER, MAF and NPC1 genes. OBJECTIVE: We aimed to validate association of these variants with obesity-related traits in population-based sam......BACKGROUND: Meta-analysis of case-control genome-wide association studies (GWAS) for early onset and morbid obesity identified four variants in/near the PRL, PTER, MAF and NPC1 genes. OBJECTIVE: We aimed to validate association of these variants with obesity-related traits in population......, these variants, which were identified in a GWAS for early onset and morbid obesity, do not seem to influence obesity-related traits in the general population....

Obesity: locus of control, body image, weight loss, and age-at-onset.

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Wineman, N M

1980-01-01

In a retrospective investigation designed to measure locus of control, body image, and weight loss in Overeaters Anonymous members who had childhood, adolescence, or adulthood onset of obesity, 116 subjects were grouped according to age at onset of obesity and the year they joined OA. A convenience, volunteer sample of OA members completed a demographic data questionnaire, Rotter's Social Reaction. Inventory, and Secord and Jourard's Body Cathexis Scale. Significant overweight percentage differences were not found when the three age-at-onset groups were compared. Significant differences emerged, however, for adolescent-onset group persons who were categorized as "old" members; they had a larger weight loss and were more satisfied with their body image. A positive linear relationship between greater perception of internal control and a good body image was found in the entire adulthood-onset group. Weight loss and good body image of the oldest adolescent-onset group probably was the outcome of their association with a self-help group i.e., OA. Assessment of developmental issues related to the time of initial weight gain may indicate which treatment regime would be most effective.

Temporal Discrimination: Mechanisms and Relevance to Adult-Onset Dystonia

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Antonella Conte

2017-11-01

Full Text Available Temporal discrimination is the ability to determine that two sequential sensory stimuli are separated in time. For any individual, the temporal discrimination threshold (TDT is the minimum interval at which paired sequential stimuli are perceived as being asynchronous; this can be assessed, with high test–retest and inter-rater reliability, using a simple psychophysical test. Temporal discrimination is disordered in a number of basal ganglia diseases including adult-onset dystonia, of which the two most common phenotypes are cervical dystonia and blepharospasm. The causes of adult-onset focal dystonia are unknown; genetic, epigenetic, and environmental factors are relevant. Abnormal TDTs in adult-onset dystonia are associated with structural and neurophysiological changes considered to reflect defective inhibitory interneuronal processing within a network which includes the superior colliculus, basal ganglia, and primary somatosensory cortex. It is hypothesized that abnormal temporal discrimination is a mediational endophenotype and, when present in unaffected relatives of patients with adult-onset dystonia, indicates non-manifesting gene carriage. Using the mediational endophenotype concept, etiological factors in adult-onset dystonia may be examined including (i the role of environmental exposures in disease penetrance and expression; (ii sexual dimorphism in sex ratios at age of onset; (iii the pathogenesis of non-motor symptoms of adult-onset dystonia; and (iv subcortical mechanisms in disease pathogenesis.

X-linked adult-onset adrenoleukodystrophy: Psychiatric and neurological manifestations.

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Shamim, Daniah; Alleyne, Karen

2017-01-01

Adult-onset adrenoleukodystrophy is a rare x-linked inborn error of metabolism occurring predominantly in males with onset in early 30s. Here, we report a 34-year-old male with first signs of disease in early 20s manifesting as a pure psychiatric disorder. Prior to onset of neurological symptoms, this patient demonstrated a schizophrenia and bipolar-like presentation. The disease progressed over the next 10-13 years and his memory and motor problems became evident around the age of 33 years. Subsequently, diagnostic testing showed the typical magnetic resonance imaging and lab findings for adult-onset adrenoleukodystrophy. This case highlights adult-onset adrenoleukodystrophy which may present as a pure psychiatric disturbance in early adulthood and briefly discusses the prolonged time between the onset of psychiatric symptoms and the onset of neurological disease.

Pathway discovery using transcriptomic profiles in adult-onset severe asthma

DEFF Research Database (Denmark)

Hekking, Pieter-Paul; Loza, Matt J; Pavlidis, Stelios

2017-01-01

in nasal brushings (5 signatures), sputum (3 signatures), and endobronchial brushings (6 signatures). Signatures associated with eosinophilic airway inflammation, mast cells, and group 3 innate lymphoid cells were more enriched in adult-onset severe asthma, whereas signatures associated with induced lung...... injury were less enriched in adult-onset severe asthma. CONCLUSIONS: Adult-onset severe asthma is characterized by inflammatory pathways involving eosinophils, mast cells, and group 3 innate lymphoid cells. These pathways could represent useful targets for the treatment of adult-onset severe asthma....

Impact of morbid obesity on medical expenditures in adults.

Science.gov (United States)

Arterburn, D E; Maciejewski, M L; Tsevat, J

2005-03-01

Morbid obesity (body mass index (BMI) > or =40 kg/m2) is associated with substantially increased morbidity and mortality from chronic health conditions and with poorer health-related quality of life; however, less is known about the impact of morbid obesity on healthcare expenditures. To examine the impact of morbid obesity on healthcare expenditures using a nationally representative sample of US adults. We performed a cross-sectional analysis of 16 262 adults from the 2000 Medical Expenditure Panel Survey, a nationally representative survey of the noninstitutionalized civilian population of the United States. Per capita healthcare expenditures were calculated for National Institutes of Health BMI categories, based on self-reported height and weight, using a two-part, multivariable model adjusted for age, gender, race, income, education level, type of health insurance, marital status, and smoking status. Odds of incurring any healthcare expenditure and per capita healthcare expenditures associated with morbid obesity in 2000. When compared with normal-weight adults, the odds of incurring any healthcare expenditure in 2000 were two-fold greater among adults with morbid obesity. Per capita healthcare expenditures for morbidly obese adults were 81% (95% confidence interval (CI): 48-121%) greater than normal-weight adults, 65% (95% CI: 37-110%) greater than overweight adults, and 47% (95% CI: 11-96%) greater than adults with class I obesity. Excess costs among morbidly obese adults resulted from greater expenditures for office-based visits, outpatient hospital care, in-patient care, and prescription drugs. Aggregate US healthcare expenditures associated with excess body weight among morbidly obese US adults exceeded $11 billion in 2000. The economic burden of morbid obesity among US adults is substantial. Further research is needed to identify interventions to reduce the incidence and prevalence of morbid obesity and improve the health and economic outcomes of morbidly

Overweight, Obesity, and Extreme Obesity Among Mississippi Adults, 2001?2010 and 2011?2015

OpenAIRE

Mendy, Vincent L.; Vargas, Rodolfo; Cannon-Smith, Gerri; Payton, Marinelle

2017-01-01

Introduction In 2015, about 1.5 million adults in Mississippi were overweight or obese. Obesity is associated with increased risk for diabetes and cardiovascular problems. We examined trends in the prevalence of overweight, obesity, and extreme obesity from 2001 through 2010 and 2011 through 2015. Methods We used data from the Mississippi Behavioral Risk Factor Surveillance System to analyze trends in the prevalence of overweight, obesity, and extreme obesity among adults from 2001 through 20...

Lipidomics Reveals Associations of Phospholipids With Obesity and Insulin Resistance in Young Adults.

Science.gov (United States)

Rauschert, Sebastian; Uhl, Olaf; Koletzko, Berthold; Kirchberg, Franca; Mori, Trevor A; Huang, Rae-Chi; Beilin, Lawrence J; Hellmuth, Christian; Oddy, Wendy H

2016-03-01

Obesity and related diseases have become a global public health burden. Identifying biomarkers will lead to a better understanding of the underlying mechanisms associated with obesity and the pathways leading to insulin resistance (IR) and diabetes. This study aimed to identify the lipidomic biomarkers associated with obesity and IR using plasma samples from a population-based cohort of young adults. The Western Australian Pregnancy Cohort (Raine) study enrolled 2900 pregnant women from 1989 to 1991. The 20-year follow-up was conducted between March 2010 and April 2012. Participants and Samples: Plasma samples from 1176 subjects aged 20 years were analyzed using mass spectrometry-based metabolomics. Associations of analytes with markers of obesity and IR including body mass index, waist circumference, homeostasis model assessment (HOMA-IR), and insulin were examined. Analyses were stratified by body mass index and adjusted for lifestyle and other factors. Waist circumference was positively associated with seven sphingomyelins and five diacylphosphatidylcholines and negatively associated with two lysophosphatidylcholines. HOMA-IR was negatively associated with two diacylphosphatidylcholines and positively with one lysophosphatidylcholine and one diacylphosphatidylcholine. No significant association was found in the obese/overweight group of the HOMA-IR model. In the normal-weight group, one lysophosphatidylcholine was increased. A possible discriminative effect of sphingomyelins, particularly those with two double bonds, and lysophosphatidylcholines was identified between subjects with normal weight and obesity independent of low-density lipoprotein cholesterol and high-density lipoprotein cholesterol concentrations. Our results suggest weight status-dependent mechanisms for the development of IR with lysophosphatidylcholine C14:0 as a key metabolite in nonobese IR.

Depression Risk in Young Adults With Juvenile- and Adult-Onset Lupus: Twelve Years of Followup.

Science.gov (United States)

Knight, Andrea M; Trupin, Laura; Katz, Patricia; Yelin, Edward; Lawson, Erica F

2018-03-01

To compare major depression risk among young adults with juvenile-onset and adult-onset systemic lupus erythematosus (SLE), and to determine demographic and health-related predictors of depression. Young adults with SLE ages 18-45 years (n = 546) in the Lupus Outcomes Study completed annual telephone surveys from 2002-2015, including assessment of depression using the Center for Epidemiologic Studies Depression Scale (CES-D), and self-report measures of sociodemographics and health characteristics. Juvenile-onset SLE was defined as age adult-onset SLE. Older age, lower educational attainment, and physical function, higher disease activity, and a history of smoking were associated with an increased depression risk. Juvenile-onset SLE patients had a higher risk of major depression across all educational groups. Young adults with SLE, particularly those with juvenile-onset disease, are at high risk for major depression, which is associated with increased disease activity, poorer physical functioning, and lower educational attainment. Early depression intervention in young adults with SLE has the potential to improve both medical and psychosocial outcomes. © 2017, American College of Rheumatology.

Poor Heart Rate Recovery Is Associated With the Development of New-Onset Atrial Fibrillation in Middle-Aged Adults.

Science.gov (United States)

Sabbag, Avi; Berkovitch, Anat; Sidi, Yechezkel; Kivity, Shaye; Ben Zekry, Sagit; Beinart, Roy; Segev, Shlomo; Glikson, Michael; Goldenberg, Ilan; Maor, Elad

2016-12-01

To investigate the association between heart rate recovery (HRR) and new-onset atrial fibrillation (AF) in middle-aged adults. Heart rate recovery was calculated using the exercise stress test in 15,729 apparently healthy self-referred men and women who attended periodic health screening examinations between January 2000, and December 2015. All participants completed the maximal exercise stress test according to the Bruce protocol and were followed clinically on a yearly basis for a median of 6.4±4 years. The primary end point was new-onset AF. Participants were grouped according to HRR at 5 minutes, dichotomized at the median value (age, male sex, obesity resting heart rate, and ischemic heart disease were all associated with increased AF risk in a univariate Cox regression model (Pnew-onset AF during long-term follow-up in middle-aged adults. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Two Sides of the Same Coin: Pediatric-Onset and Adult-Onset Common Variable Immune Deficiency.

Science.gov (United States)

Sanchez, Lauren A; Maggadottir, Solrun Melkorka; Pantell, Matthew S; Lugar, Patricia; Rundles, Charlotte Cunningham; Sullivan, Kathleen E

2017-08-01

Common variable immunodeficiency (CVID) is a complex, heterogeneous immunodeficiency characterized by hypogammaglobulinemia, recurrent infections, and poor antibody response to vaccination. While antibiotics and immunoglobulin prophylaxis have significantly reduced infectious complications, non-infectious complications of autoimmunity, inflammatory lung disease, enteropathy, and malignancy remain of great concern. Previous studies have suggested that CVID patients diagnosed in childhood are more severely affected by these complications than adults diagnosed later in life. We sought to discern whether the rates of various infectious and non-infectious conditions differed between pediatric-diagnosed (ages 17 or younger) versus adult-diagnosed CVID (ages 18 or older). Using the United States Immunodeficiency Network (USIDNET) database, we performed a retrospective analysis of 457 children and adults with CVID, stratified by age at diagnosis. Chi-squared testing was used to compare pediatric versus adult groups. After correcting for multiple comparisons, we identified few statistically significant differences (p ≤ 0.0004) between pediatric and adult groups. Pediatric-onset CVID patients had more frequent diagnoses of otitis media, developmental delay, and failure to thrive compared with adult-onset CVID patients. Adult CVID patients were more frequently diagnosed with bronchitis, arthritis, depression, and fatigue. Diagnoses of autoimmunity, lymphoma, and other malignancies were higher in adults but not to a significant degree. Serum immunoglobulins (IgG, IgA, and IgM) and lymphocyte subsets did not differ significantly between the two groups. When complications of infections and co-morbid conditions were viewed categorically, there were few differences between pediatric-onset and adult-onset CVID patients. These results suggest that pediatric CVID is not a distinct phenotype. Major features were comparable across the groups. This study underscores the need for

Early Onset Childhood Obesity and Risk of Metabolic Syndrome

Centers for Disease Control (CDC) Podcasts

This podcast features Lorena Pacheco, a doctoral student at the University of California San Diego and one of the winners of PCD's 2017 Student Research Paper Contest. Lorena answers questions about her winning research, which focuses on the relationship between early onset obesity as a risk factor for increased metabolic syndrome in Chilean children.

Gender-Associated Impact of Early Leucine Supplementation on Adult Predisposition to Obesity in Rats

Directory of Open Access Journals (Sweden)

Nora López

2018-01-01

Full Text Available Early nutrition plays an important role in development and may constitute a relevant contributor to the onset of obesity in adulthood. The aim of this study was to evaluate the long-term impact of maternal leucine (Leu supplementation during lactation on progeny in rats. A chow diet, supplemented with 2% Leu, was supplied during lactation (21 days and, from weaning onwards, was replaced by a standard chow diet. Then, at adulthood (6 months of age, this was replaced with hypercaloric diets (either with high-fat (HF or high-carbohydrate (HC content, for two months, to induce obesity. Female offspring from Leu-supplemented dams showed higher increases in body weight and in body fat (62% than their respective controls; whereas males were somehow protected (15% less fat than the corresponding controls. This profile in Leu-females was associated with altered neuronal architecture at the paraventricular nucleus (PVN, involving neuropeptide Y (NPY fibers and impaired expression of neuropeptides and factors of the mTOR signaling pathway in the hypothalamus. Interestingly, leptin and adiponectin expression in adipose tissue at weaning and at the time before the onset of obesity could be defined as early biomarkers of metabolic disturbance, predisposing towards adult obesity under the appropriate environment.

Gender-Associated Impact of Early Leucine Supplementation on Adult Predisposition to Obesity in Rats

Science.gov (United States)

López, Nora; Sánchez, Juana; Palou, Andreu; Serra, Francisca

2018-01-01

Early nutrition plays an important role in development and may constitute a relevant contributor to the onset of obesity in adulthood. The aim of this study was to evaluate the long-term impact of maternal leucine (Leu) supplementation during lactation on progeny in rats. A chow diet, supplemented with 2% Leu, was supplied during lactation (21 days) and, from weaning onwards, was replaced by a standard chow diet. Then, at adulthood (6 months of age), this was replaced with hypercaloric diets (either with high-fat (HF) or high-carbohydrate (HC) content), for two months, to induce obesity. Female offspring from Leu-supplemented dams showed higher increases in body weight and in body fat (62%) than their respective controls; whereas males were somehow protected (15% less fat than the corresponding controls). This profile in Leu-females was associated with altered neuronal architecture at the paraventricular nucleus (PVN), involving neuropeptide Y (NPY) fibers and impaired expression of neuropeptides and factors of the mTOR signaling pathway in the hypothalamus. Interestingly, leptin and adiponectin expression in adipose tissue at weaning and at the time before the onset of obesity could be defined as early biomarkers of metabolic disturbance, predisposing towards adult obesity under the appropriate environment. PMID:29329236

Does early-onset multiple sclerosis differ from adult-onset form in Iranian people

Directory of Open Access Journals (Sweden)

Fereshteh Ashtari

2010-01-01

Full Text Available Background: Few studies have attempted to delineate the clinical profile of multiple Sclerosis (MS among people of Asia. This study sought to identify the characteristics of early-onset Multiple Sclerosis (EOMS comparison to adult-onset form (AOMS in Isfahan, IRAN. Methods: This prospective study was conducted on 104 youths with multiple sclerosis beginning before the age of 16 years and 123 patients with adult-onset multiple sclerosis. Patients were observed for a mean period of 5 years. The common presenting symptoms, MRI finding, course of disease and disability score were compared between the two groups. Results: The mean onset age of disease in youths and adults were 14 ± 1.9 and 27.7 ± 8.06 years, respectively. Female/male ratio was 4.47:1 in EOMS and 3.92:1 in AOMS, this ratio was 7:1 in early childhood MS (≤ 10 year. The most common presenting symptom was optic neuritis in the EOMS group and paresthesia in AOMS. Optic neuritis was common in AOMS too, but brainstem/cerebellar signs were more common in EOMS than AOMS. Seizure occurred more frequently in EOMS than in the AOMS group (12.6% vs. 1.6%, respectively, p < 0.001. MRI showed that brainstem plaques were more prevalent in the EOMS compared with the AOMS group. Conclusions: It was concluded that early-onset MS does not significantly differ from adult form in terms of major clinical manifestation and course of disease, however Seizure is more common in EOMS, and brainstem and cerebellar symptoms as presenting symptom are more common.

Modeling the clinical and economic implications of obesity using microsimulation.

Science.gov (United States)

Su, W; Huang, J; Chen, F; Iacobucci, W; Mocarski, M; Dall, T M; Perreault, L

2015-01-01

The obesity epidemic has raised considerable public health concerns, but there are few validated longitudinal simulation models examining the human and economic cost of obesity. This paper describes a microsimulation model as a comprehensive tool to understand the relationship between body weight, health, and economic outcomes. Patient health and economic outcomes were simulated annually over 10 years using a Markov-based microsimulation model. The obese population examined is nationally representative of obese adults in the US from the 2005-2012 National Health and Nutrition Examination Surveys, while a matched normal weight population was constructed to have similar demographics as the obese population during the same period. Prediction equations for onset of obesity-related comorbidities, medical expenditures, economic outcomes, mortality, and quality-of-life came from published trials and studies supplemented with original research. Model validation followed International Society for Pharmacoeconomics and Outcomes Research practice guidelines. Among surviving adults, relative to a matched normal weight population, obese adults averaged $3900 higher medical expenditures in the initial year, growing to $4600 higher expenditures in year 10. Obese adults had higher initial prevalence and higher simulated onset of comorbidities as they aged. Over 10 years, excess medical expenditures attributed to obesity averaged $4280 annually-ranging from $2820 for obese category I to $5100 for obese category II, and $8710 for obese category III. Each excess kilogram of weight contributed to $140 higher annual costs, on average, ranging from $136 (obese I) to $152 (obese III). Poor health associated with obesity increased work absenteeism and mortality, and lowered employment probability, personal income, and quality-of-life. This validated model helps illustrate why obese adults have higher medical and indirect costs relative to normal weight adults, and shows that medical costs

Predicting adult obesity from childhood obesity: a systematic review and meta-analysis.

Science.gov (United States)

Simmonds, M; Llewellyn, A; Owen, C G; Woolacott, N

2016-02-01

A systematic review and meta-analysis was performed to investigate the ability of simple measures of childhood obesity such as body mass index (BMI) to predict future obesity in adolescence and adulthood. Large cohort studies, which measured obesity both in childhood and in later adolescence or adulthood, using any recognized measure of obesity were sought. Study quality was assessed. Studies were pooled using diagnostic meta-analysis methods. Fifteen prospective cohort studies were included in the meta-analysis. BMI was the only measure of obesity reported in any study, with 200,777 participants followed up. Obese children and adolescents were around five times more likely to be obese in adulthood than those who were not obese. Around 55% of obese children go on to be obese in adolescence, around 80% of obese adolescents will still be obese in adulthood and around 70% will be obese over age 30. Therefore, action to reduce and prevent obesity in these adolescents is needed. However, 70% of obese adults were not obese in childhood or adolescence, so targeting obesity reduction solely at obese or overweight children needs to be considered carefully as this may not substantially reduce the overall burden of adult obesity. © 2015 World Obesity.

Relation between Childhood Obesity and Adult Cardiovascular Risk

Directory of Open Access Journals (Sweden)

Darren M. Allcock

2009-01-01

Full Text Available The incidence of overweight and obesity is rising at an alarming pace in the pediatric population, just as in the adult population. The adult comorbidities associated with this risk factor are well-recognized and are being further elucidated continually. Additionally, we are gradually developing a better understanding of the risks of overweight and obesity among children while they are still young. However, there is now a growing body of evidence showing that childhood obesity not only leads all too frequently to adult obesity, but is in itself a risk factor for cardiometabolic syndrome and resultant cardiovascular risk in adulthood. If current trends continue, the problem of pediatric overweight and obesity will become of unmanageable proportions once these individuals reach adulthood. Future research efforts toward understanding this complex problem will need to focus on those overweight and obese children who later went on to change their metabolic course and become normal-weight adults.

The diagnostic challenge of Adult-onset Still's disease | Rostamipour ...

African Journals Online (AJOL)

The diagnostic challenge of Adult-onset Still's disease. ... Elevated serum ferritin level is not yet considered as a criteria for diagnosis of AOSD in Yamaguchi criteria, however, there are several studies which have demonstrated a strong ... Keywords: Adult Onset Still's Disease; Fever of Unknown Origin, serum ferritin ...

Adult onset sporadic ataxias: a diagnostic challenge

Directory of Open Access Journals (Sweden)

Orlando Graziani Povoas Barsottini

2014-03-01

Full Text Available Patients with adult onset non-familial progressive ataxia are classified in sporadic ataxia group. There are several disease categories that may manifest with sporadic ataxia: toxic causes, immune-mediated ataxias, vitamin deficiency, infectious diseases, degenerative disorders and even genetic conditions. Considering heterogeneity in the clinical spectrum of sporadic ataxias, the correct diagnosis remains a clinical challenge. In this review, the different disease categories that lead to sporadic ataxia with adult onset are discussed with special emphasis on their clinical and neuroimaging features, and diagnostic criteria.

Early-life exposures predicting onset and resolution of childhood overweight or obesity.

Science.gov (United States)

Kerr, Jessica A; Long, Catherine; Clifford, Susan A; Muller, Joshua; Gillespie, Alanna N; Donath, Susan; Wake, Melissa

2017-10-01

To determine which of multiple early-life exposures predict onset or resolution of overweight/obesity during a 9-year period. Design : longitudinal cohort from three harmonised community-based cohorts enriched for overweight and obesity. Early-life exposures : child-gestational age; delivery; birth weight; breast feeding; solids introduction; baseline body mass index (BMI); waist circumference; diet; activity; global, physical and psychosocial health. Mother-baseline BMI; education; age; neighbourhood disadvantage; concern for child's weight. Outcome : change in BMI category. Analyses : adjusted logistic regression. On average, the 363 children (57% retention) were 6 and 15 years old at baseline and follow-up. Children were classified as 'never' overweight/obese (38%), 'resolving' overweight/obese (15%), 'becoming' overweight/obese (8%) or 'always' overweight/obese (39%). Compared with 'never overweight/obese' children, odds of 'becoming overweight/obese' were greater with higher child (OR 2.33, 95% CI 1.02 to 5.29) and maternal BMI (OR 1.18, CI 1.07 to 1.31), and lower with higher maternal education (OR 0.09, CI 0.02 to 0.34). Compared with 'always overweight/obese' children, odds of 'resolving overweight/obese' were lower with higher maternal BMI (OR 0.87, CI 0.78 to 0.97), and higher with better child physical health (OR 1.06, CI 1.02 to 1.10) and higher maternal age (OR 1.11, CI 1.01 to 1.22) and education (OR 4.07, CI 1.02 to 16.19). Readily available baseline information (child/maternal BMI, maternal age, education and child health) were the strongest predictors of both onset and resolution of overweight/obesity between the primary school and adolescent years. Perinatal, breastfeeding and lifestyle exposures were not strongly predictive. Results could stimulate development of algorithms identifying children most in need of targeted prevention or treatment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under

Adult-onset nemaline myopathy presenting as respiratory failure.

LENUS (Irish Health Repository)

Kelly, Emer

2008-11-01

Nemaline myopathy is a rare congenital myopathy that generally presents in childhood. We report a case of a 44-year-old man who presented with severe hypoxic hypercapnic respiratory failure as the initial manifestation of nemaline myopathy. After starting noninvasive ventilation, his pulmonary function test results improved substantially, and over the 4 years since diagnosis his respiratory function remained stable. There are few reported cases of respiratory failure in patients with adult-onset nemaline myopathy, and the insidious onset in this case is even more unusual. This case highlights the varied presenting features of adult-onset nemaline myopathy and that noninvasive ventilation improves respiratory function.

New function for an old enzyme: NEP deficient mice develop late-onset obesity.

Directory of Open Access Journals (Sweden)

Matthias Becker

Full Text Available BACKGROUND: According to the World Health Organization (WHO there is a pandemic of obesity with approximately 300 million people being obese. Typically, human obesity has a polygenetic causation. Neutral endopeptidase (NEP, also known as neprilysin, is considered to be one of the key enzymes in the metabolism of many active peptide hormones. METHODOLOGY/PRINCIPAL FINDINGS: An incidental observation in NEP-deficient mice was a late-onset excessive gain in body weight exclusively from a ubiquitous accumulation of fat tissue. In accord with polygenetic human obesity, mice were characterized by deregulation of lipid metabolism, higher blood glucose levels, with impaired glucose tolerance. The key role of NEP in determining body mass was confirmed by the use of the NEP inhibitor candoxatril in wild-type mice that increased body weight due to increased food intake. This is a peripheral and not a central NEP action on the switch for appetite control, since candoxatril cannot cross the blood-brain barrier. Furthermore, we demonstrated that inhibition of NEP in mice with cachexia delayed rapid body weight loss. Thus, lack in NEP activity, genetically or pharmacologically, leads to a gain in body fat. CONCLUSIONS/SIGNIFICANCE: In the present study, we have identified NEP to be a crucial player in the development of obesity. NEP-deficient mice start to become obese under a normocaloric diet in an age of 6-7 months and thus are an ideal model for the typical human late-onset obesity. Therefore, the described obesity model is an ideal tool for research on development, molecular mechanisms, diagnosis, and therapy of the pandemic obesity.

Late-onset ADHD in adults: milder, but still dysfunctional.

Science.gov (United States)

Karam, Rafael G; Bau, Claiton H D; Salgado, Carlos A I; Kalil, Katiane L S; Victor, Marcelo M; Sousa, Nyvia O; Vitola, Eduardo S; Picon, Felipe A; Zeni, Gregory D; Rohde, Luis A; Belmonte-de-Abreu, Paulo; Grevet, Eugenio H

2009-04-01

The requirement in classificatory systems that some impairment from attention-deficit/hyperactivity disorder (ADHD) symptoms starts before 7 years of age (age of onset of impairment criteria - AOC) has been harshly criticized. Although there is evidence that late-onset ADHD is a valid diagnosis, little is known about the role of age of onset of impairment on the clinical profile of adult patients. The diagnoses of 349 adults with ADHD followed DSM-IV criteria. ADHD and oppositional defiant disorder (ODD) were evaluated with the K-SADS-E, and other comorbidities with the SCID-IV and the MINI. Subjects were divided in early and late-onset groups (age of onset of impairment between 7 and 12 years old). The effect of age of onset over clinical and demographic characteristics was tested by regression models. Late-onset subjects were diagnosed later (P=0.04), had a lower frequency of problems with authority and discipline (P=0.004), and lower scores in SNAP-IV (Pactivities (P=0.03). On the other hand, late-onset patients presented a higher prevalence of comorbid general anxiety disorder (GAD) (P=0.01). Both groups had a similar profile in the remaining comorbidities and sociodemographic characteristics. This study provides initial evidence that adults with late-onset ADHD have less severity, lower frequency of externalizing symptoms and increased comorbidity with GAD, but similar profile in other comorbidities. In addition, the data suggest that late-onset patients have a higher probability of delayed diagnosis despite the significant impairment of their condition.

Disability associated with obesity, dynapenia and dynapenic-obesity in Chinese older adults.

Science.gov (United States)

Yang, Ming; Ding, Xiang; Luo, Li; Hao, Qiukui; Dong, Birong

2014-02-01

Whether the combination of obesity and low muscle strength (dynapenic-obesity) would cause greater impairment of the activities of daily living (ADL)/instrumental activities of daily living (IADL) than obesity alone and low muscle strength alone (dynapenia) remains unclear. The aim of this study was to reveal the possible independent and additive effects of dynapenia and obesity on ADL/IADL disability in an older Chinese population. A cross-sectional study, including 616 community-dwelling older adults, was conducted in China from 2010 to 2012. Based on the World Health Organization Asian Criteria of Obesity and handgrip strength tertiles, 4 independent groups were identified as follows: nondynapenia/nonobesity, dynapenia alone, obesity alone, and dynapenic-obesity. The Katz Index of Independence in ADL was used to assess ADL disability, whereas 6 IADL items of the Older Americans Resources and Services (OARS) multidimensional functional assessment questionnaire were used to assess IADL disability. The prevalence of ADL and IADL disability was 21.1% and 28.9% in the dynapenic-obesity group, 15.5% and 22.6% in the dynapenia alone group, 13.1% and 19.6% in the obesity alone group, and 11.9% and 12.9% in the nondynapenia/nonobesity group, respectively. After adjusting for the covariates, in comparison with the dynapenic-obesity group, the adjusted odds ratios (95% confidence interval) for ADL disability were 0.36 (0.13-0.73) in the nondynapenia/nonobesity group, 0.51 (0.20-0.78) in the dynapenia-alone group, and 0.40 (0.11-0.61) in the obesity-alone group. The corresponding data for IADL disability were 0.55 (0.20-0.93), 0.82 (0.39-0.98), and 0.61 (0.30-0.91), respectively. Dynapenia, obesity, and dynapenic-obesity were associated with an increased risk of ADL/IADL disability. Dynapenic-obesity was associated with a greater risk of ADL/IADL disability in comparison with dynapenia or obesity alone. Copyright © 2014 American Medical Directors Association, Inc

Higher Midazolam Clearance in Obese Adolescents Compared with Morbidly Obese Adults

NARCIS (Netherlands)

Rongen, van A.; Brill, M.J.E.; Vaughns, J.D.; Välitalo, P.A.J.; Dongen, van E.P.A.; Ramshorst, van B.; Barrett, J.S.; Anker, van den J.N.; Knibbe, C.A.J.

2017-01-01

The clearance of cytochrome P450 (CYP) 3A substrates is reported to be reduced with lower age, inflammation and obesity. As it is unknown what the overall influence is of these factors in the case of obese adolescents vs. morbidly obese adults, we studied covariates influencing the clearance of the

Exploring single nucleotide polymorphisms previously related to obesity and metabolic traits in pediatric-onset type 2 diabetes.

Science.gov (United States)

Miranda-Lora, América Liliana; Cruz, Miguel; Aguirre-Hernández, Jesús; Molina-Díaz, Mario; Gutiérrez, Jorge; Flores-Huerta, Samuel; Klünder-Klünder, Miguel

2017-07-01

To evaluate the association of 64 obesity-related polymorphisms with pediatric-onset type 2 diabetes and other glucose- and insulin-related traits in Mexican children. Case-control and case-sibling designs were followed. We studied 99 patients with pediatric-onset type 2 diabetes, their siblings (n = 101) without diabetes, 83 unrelated pediatric controls and 137 adult controls. Genotypes were determined for 64 single nucleotide polymorphisms, and a possible association was examined between those genotypes and type 2 diabetes and other quantitative traits, after adjusting for age, sex and body mass index. In the case-pediatric control and case-adult control analyses, five polymorphisms were associated with increased likelihood of pediatric-onset type 2 diabetes; only one of these polymorphisms (CADM2/rs1307880) also showed a consistent effect in the case-sibling analysis. The associations in the combined analysis were as follows: ADORA1/rs903361 (OR 1.9, 95% CI 1.2; 3.0); CADM2/rs13078807 (OR 2.2, 95% CI 1.2; 4.0); GNPDA2/rs10938397 (OR 2.2, 95% CI 1.4; 3.7); VEGFA/rs6905288 (OR 1.4, 95% CI 1.1; 2.1) and FTO/rs9939609 (OR 1.8, 95% CI 1.0; 3.2). We also identified 16 polymorphisms nominally associated with quantitative traits in participants without diabetes. ADORA/rs903361, CADM2/rs13078807, GNPDA2/rs10938397, VEGFA/rs6905288 and FTO/rs9939609 are associated with an increased risk of pediatric-onset type 2 diabetes in the Mexican population.

Differences between asthma-COPD overlap syndrome and adult-onset asthma.

Science.gov (United States)

Tommola, Minna; Ilmarinen, Pinja; Tuomisto, Leena E; Lehtimäki, Lauri; Haanpää, Jussi; Niemelä, Onni; Kankaanranta, Hannu

2017-05-01

Differences between asthma-COPD overlap syndrome (ACOS) and adult-onset asthma are poorly understood. This study aimed to evaluate these differences in a clinical cohort of patients with adult-onset asthma, as a part of the Seinäjoki Adult Asthma Study (SAAS).188 patients were diagnosed with adult-onset asthma and re-evaluated 12 years after diagnosis. They were divided into three groups based on smoking history and post bronchodilator spirometry values: 1) never- and ex-smokers with obstructive (forced expiratory volume in 1 s (FEV 1 )/forced vital capacity (FVC) ≥0.7) patients with ≥10 pack-years; and 3) ACOS patients with ≥10 pack-years and FEV 1 /FVC obstructive patients with ≥10 pack-years smoking history, respectively. ACOS patients also showed reduced lung function, higher remaining bronchial reversibility and a higher number of comorbidities.This study shows distinct differences in diffusing capacity, blood neutrophil and IL-6 levels, bronchial reversibility, lung function and comorbidities between ACOS and adult-onset asthma. The present findings should be considered in the comprehensive assessment of adult asthma patients. Copyright ©ERS 2017.

Body height and weight of patients with childhood onset and adult onset thyrotoxicosis.

Science.gov (United States)

Takamatsu, J; Kobe, N; Ito, M; Ohsawa, N

1999-03-01

The present study has compared body height and weight of thyrotoxic female patients of childhood onset and adult onset. The body height of 141 out of 143 (99%) adult-onset thyrotoxic patients was within the range of mean +/- 2SD for the age-matched general Japanese female population. On the other hand, in 42 patients with childhood-onset thyrotoxicosis, 6 (14%) had their height being greater than the mean + 2SD of general population, and 34 (81%) were taller than the mean value. In 86 patients with siblings, 42 (49%) were at least 2 cm taller than their sisters, and 26 (30%) were more than 2 cm shorter than their sisters. The body weight of 27 out of 42 (68%) patients younger than 20 years was not decreased but was even greater than the mean value for the age-matched general population. The results indicate that excessive thyroid hormone in vivo enhances body height in humans. The increased body weight in some young patients suggests that enhanced dietary intake due to increased appetite in hyperthyroidism has overcome the energy loss with increased metabolism.

Trends of obesity and abdominal obesity in Tehranian adults: a cohort study

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Mirmiran Parvin

2009-11-01

Full Text Available Abstract Background Considering the increasing trend of obesity reported in current data, this study was conducted to examine trends of obesity and abdominal obesity among Tehranian adults during a median follow-up of 6.6 years. Methods Height and weight of 4402 adults, aged 20 years and over, participants of the Tehran Lipid and Glucose Study (TLGS, were measured in 1999-2001(phase I and again in 2002-2005(phase II and 2006-2008 (phase III. Criteria used for obesity and abdominal obesity defined body mass index (BMI ≥ 30 and waist circumference ≥ 94/80 cm for men/women respectively. Subjects were divided into10-year groups and the prevalence of obesity was compared across sex and age groups. Results The prevalence of obesity was 15.8, 18.6 and 21% in men and 31.5, 37.7 and 38.6% in women in phases I, II and III respectively (p Conclusion This study demonstrates alarming rises in the prevalences of both obesity and abdominal obesity in both sexes especially in young men, calling for urgent action to educate people in lifestyle modifications.

Psychological and Behavioral Risk Factors for Obesity Onset in Adolescent Girls: A Prospective Study

Science.gov (United States)

Stice, Eric; Presnell, Katherine; Shaw, Heather; Rohde, Paul

2005-01-01

Because little is known about risk factors for obesity, the authors tested whether certain psychological and behavioral variables predicted future onset of obesity. The authors used data from a prospective study of 496 adolescent girls who completed a baseline assessment at age 11-15 years and 4 annual follow-ups. Self-reported dietary restraint,…

Association of Obesity with Onset of Puberty and Sex Hormones in Chinese Girls: A 4-Year Longitudinal Study.

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Lingling Zhai

Full Text Available To examine the influence of childhood obesity on the early onset of puberty and sex hormones in girls.Healthy girls with different percentages of body fat at baseline (40 obese, 40 normal, and 40 lean were recruited from three elementary schools in Shenyang, China. These girls (mean age 8.5 years were also matched by height, school grade, Tanner stage, and family economic status at baseline. Anthropometry, puberty characteristics, and sex hormone concentrations were measured at baseline and at each follow-up visit. The generalized estimating equation model and analysis of variance for repeated measures using a generalized linear model were used to determine the differences in puberty characteristics and sex hormones among three groups.Over 4 years, mean age of breast II onset was earlier among obese girls (8.8 years than normal girls (9.2 years and lean girls (9.3 years. The prevalence (% of early-maturation in the obese, normal, and lean groups was 25.9%, 11.1%, and 7.4%, respectively. Obesity was associated with an increased risk for breast stage II (year 2: RR, 6.3; 95% CI, 1.9-21.1 and year 3: RR, 6.9; 95% CI, 0.8-60.1. None of the girls experienced menarche in the first year; however, by the fourth year 50.0% of obese girls had menarche onset, which was higher than normal weight (27.5% and lean girls (8.1%. The mean estradiol level increased with age in the obese, normal, and lean groups. The mean estradiol concentration was higher in obese girls than in normal and lean girls throughout the 4-year period (P<0.05.Childhood obesity contributes to early onset of puberty and elevated levels of estradiol in girls.

Altered characteristics of balance control in obese older adults.

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Melzer, Itshak; Oddsson, Lars I E

2016-01-01

Obesity is one of the most significant epidemiological trends of the last decades. Recently it was found that obese individuals show postural instability. Balance control mechanisms in obese older adults were less studied. Therefore we aimed to investigate the effect of obesity on balance control mechanisms in older adults. Parameters from Stabilogram-Diffusion Analysis (SDA) and measures from summary statistics of foot centre-of-pressure (COP) displacements along the anterior-posterior (AP) and mediolateral (ML) directions in eyes open and eyes closed conditions were used to characterize postural control in 22 obese (30-postural control process in obese older adults. A greater sway displacement before closed-loop feedback mechanisms are called into play was seen in the ML direction that may lead to a higher risk of instability and fall events. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Adult Onset Still's Disease and Rocky Mountain Spotted Fever

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Paul Persad

2010-01-01

Full Text Available Adult Still's Disease was first described in 1971 by Bywaters in fourteen adult female patients who presented with symptoms indistinguishable from that of classic childhood Still's Disease (Bywaters, 1971. George Still in 1896 first recognized this triad of quotidian (daily fevers, evanescent rash, and arthritis in children with what later became known as juvenile inflammatory arthritis (Still, 1990. Adult Onset Still's Disease (AOSD is an inflammatory condition of unknown etiology characterized by an evanescent rash, quotidian fevers, and arthralgias. Numerous infectious agents have been associated with its presentation. This case is to our knowledge the first presentation of AOSD in the setting of Rocky Mountain Spotted Fever. Although numerous infectious agents have been suggested, the etiology of this disorder remains elusive. Nevertheless, infection may in fact play a role in triggering the onset of symptoms in those with this disorder. Our case presentation is, to our knowledge, the first case of Adult Onset Still's Disease associated with Rocky Mountain spotted fever (RMSF.

Pre-adult versus adult onset major depressive disorder in a naturalistic patient sample: the Leiden Routine Outcome Monitoring Study.

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van Noorden, M S; Minkenberg, S E; Giltay, E J; den Hollander-Gijsman, M E; van Rood, Y R; van der Wee, N J; Zitman, F G

2011-07-01

Pre-adult onset of major depressive disorder (MDD) may predict a more severe phenotype of depression. As data from naturalistic psychiatric specialty care settings are scarce, we examined phenotypic differences between pre-adult and adult onset MDD in a large sample of consecutive out-patients. Altogether, 1552 out-patients, mean age 39.2 ± 11.6 years, were diagnosed with current MDD on the Mini-International Neuropsychiatric Interview Plus diagnostic interview as part of the usual diagnostic procedure. A total of 1105 patients (71.2%) had complete data on all variables of interest. Pre-adult onset of MDD was defined as having experienced the signs and symptoms of a first major depressive episode before the age of 18 years. Patients were stratified according to the age at interview (20-40/40-65 years). Correlates of pre-adult onset were analysed using logistic regression models adjusted for age, age squared and gender. Univariate analyses showed that pre-adult onset of MDD had a distinct set of demographic (e.g. less frequently living alone) and clinical correlates (more co-morbid DSM-IV - Text Revision diagnoses, more social phobia, more suicidality). In the multivariate model, we found an independent association only for a history of suicide attempts [odds ratio (OR) 3.15, 95% confidence intervals (CI) 1.97-5.05] and current suicidal thoughts (OR 1.81, 95% CI 1.26-2.60) in patients with pre-adult versus adult onset MDD. Pre-adult onset of MDD is associated with more suicidality than adult onset MDD. Age of onset of depression is an easy to ascertain characteristic that may help clinicians in weighing suicide risk.

Molecular screening of the ghrelin gene in Italian obese children: the Leu72Met variant is associated with an earlier onset of obesity.

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Miraglia del Giudice, E; Santoro, N; Cirillo, G; Raimondo, P; Grandone, A; D'Aniello, A; Di Nardo, M; Perrone, L

2004-03-01

To test whether ghrelin variants could play a role in modulating some aspects of the obese phenotype during childhood. We screened the ghrelin gene in 300 Italian obese children and adolescents (mean age 10.5+/-3.2 y; range 4-19 y) and 200 controls by using the single-strand conformation polymorphism and the restriction fragment length polymoprhism analysis. No mutations were detected with the exception of two previously described polymorphisms, Arg51Gln and Leu72Met. For both variations, allelic frequencies were similar between patients and controls. Interestingly, we showed that the Leu72Met polymorphism was associated with differences in the age at obesity onset. Patients with the Met72 allele became obese earlier than homozygous patients for the wild Leu72 allele. The logrank test comparing the plots of the complement of Kaplan-Meier estimates between the two groups of patients was statistically significant (Pghrelin variations cause the obesity due to single-gene mutations. The Leu72Met polymorphism of the ghrelin gene seems to play a role in anticipating the onset of obesity among children suggesting, therefore, that ghrelin may be involved in the pathophysiology of human adiposity.

Smoking habits and obesity in young adults.

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Zimlichman, Eyal; Kochba, Ilan; Mimouni, Francis B; Shochat, Tzippora; Grotto, Itamar; Kreiss, Yitshak; Mandel, Dror

2005-07-01

The aim of this work was to study the association between obesity and smoking habits in young adults. Specifically, we tested the hypothesis that obesity does not prevent young adults from smoking and conversely smoking does not protect against obesity. Trained nurses interviewed participants concerning demographic data and health behaviors such as smoking. At the time of the interview, weight and height were measured. Data were analyzed retrospectively. A representative sample of Israel Defense Force (IDF) personnel upon discharge from compulsory service, usually at the age of 20-21 years. Overall, 29 745 participants were included during the 13-year study (16,363 males and 13,382 females). Smoking rates were higher among obese participants than among overweight and non-obese participants (34.9%, 37.1%, 43.6% for non-obese, overweight and obese, respectively; P < 0.001). Mean number of cigarettes smoked per day were also higher among smokers that were obese and overweight compared to the non-obese (15.2 +/- 9.2, 15.6 +/- 10.7, 18.0 +/- 9.8, respectively; P < 0.001). Overweight and obesity were associated with the father's lower academic educational level. In logistic regression analysis, obesity, year of study and parental academic education were correlated independently with smoking (P < 0.001). The positive association between obesity and smoking suggests that obesity is not a deterrent to smoking and also that smoking does not help to prevent obesity.

Unusual radiological findings of adult-onset pulmonary tuberculosis

International Nuclear Information System (INIS)

Lee, Yong Chul; Lee, Jong Beum; Kim, Sue Hyun

1987-01-01

Usual chest radiographic findings in pulmonary tuberculosis are well described in radiologic literatures for both primary and postprimary phases of disease. During the last decade, many authors have enumerated the unusual manifestations of pulmonary tuberculosis in adult population. These unusual findings usually have been involved in the frequent failure of both radiologist and clinician to recognize that tuberculosis could be the cause of a abnormal chest radiograph in patients who are finally and surprisingly proven to have tuberculosis. Authors have evaluated 249 patients who were admitted and newly proven to have adult-onset pulmonary tuberculosis at Chung-Ang University Hospital from January, 1985 to December, 1986. Unusual findings were noted in 76 (30.5%) of the 249 patients with adult-onset pulmonary tuberculosis. These unusual findings most frequently could be seen in 3rd decades and showed no sex difference in incidence. A broad spectrum of abnormal findings including usual and unusual abnormalities were procedure by adult-onset pulmonary tuberculosis. The unusual radiographic findings were arbitrarily classified. Pleural effusion without parenchymal disease (10.0%), unusual location of infiltrate (5.6%) and atelectasis (3.2%) were relatively common. Hilar and / or mediastinal lymphnode enlargement (1.6%), cavity without parenchymal infiltrates (1.6%), septic lung-like infiltrates (1.6%), completely clear lungs (1.2%), miliary infiltrates (1.2%), fibrocalcific scar-like infiltrates (1.2%), masslike density (1.2%) and rheumatoid lung-like infiltrates (1.2%) were occasionally noted. Pneumothorax without parenchymal disease (0.4%) and bron chocutaneous fistula (0.4%) are. The recognition of these unusual findings could further improve the detection and diagnosis of adult-onset pulmonary tuberculosis

Rapid-onset obesity, hypoventilation, hypothalamic dysfunction, autonomic dysregulation and neuroendocrine tumor syndrome with a homogenous enlargement of the pituitary gland: a case report.

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Aljabban, Lama; Kassab, Lina; Bakoura, Nour Alhuda; Alsalka, Mohammad Fayez; Maksoud, Ismaeil

2016-11-22

Rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation syndrome is a rare pediatric disorder with a variable sequence of clinical presentations, undefined etiology, and high risk of mortality. Our patient presented an unusual course of the disease accompanied by a homogenous mild enlargement of her pituitary gland with an intact pituitary-endocrine axis which, to the best of our knowledge, represents a new finding in rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation syndrome. We present a documented case of a 4 years and 8-month-old Syrian Arabic girl with a distinctive course of signs and symptoms of rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation syndrome accompanied by mature ganglioneuroma in her chest, a homogenous mild enlargement of her pituitary gland, generalized cortical brain atrophy, and seizures. Three months after her first marked symptoms were noted she had a sudden progression of severe respiratory distress that ended with her death. The findings of this case could increase our understanding of the pathogenetic mechanisms of rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation, and place more emphases on pediatricians to consider rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation syndrome whenever early rapid onset of obesity, associated with any malfunction, is observed in children. This knowledge could be lifesaving for children with rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation syndrome.

Successful Treatment of Adult-Onset Erythromelalgia with Steroid Pulse and Pregabalin

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Aya Kakizaki

2012-11-01

Full Text Available Adult-onset erythromelalgia (EM is a rare disease characterized by episodic bouts of burning pain and erythema for which the optimal therapy is unclear. In this report, we describe a 68-year-old Japanese woman with adult-onset EM. Intravenous administration of methylprednisolone sodium succinate 1,000 mg/day dramatically improved her pain as evaluated by the visual analog scale. Although the patient’s pain gradually developed again, it could be controlled with pregabalin. Our present case might suggest a possible, optimal therapy for adult-onset EM.

Treatment and outcome of adult-onset neuroblastoma.

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Suzuki, Maya; Kushner, Brian H; Kramer, Kim; Basu, Ellen M; Roberts, Stephen S; Hammond, William J; LaQuaglia, Michael P; Wolden, Suzanne L; Cheung, Nai-Kong V; Modak, Shakeel

2018-03-25

Adult-onset neuroblastoma is rare and little is known about its biology and clinical course. There is no established therapy for adult-onset neuroblastoma. Anti-GD2 immunotherapy is now standard therapy in children with high-risk neuroblastoma; however, its use has not been reported in adults. Forty-four adults (18-71 years old) diagnosed with neuroblastoma between 1979 and 2015 were treated at Memorial Sloan Kettering Cancer Center. Five, 1, 5 and 33 patients had INSS stage 1, 2, 3 and 4 diseases, respectively. Genetic abnormalities included somatic ATRX (58%) and ALK mutations (42%) but not MYCN-amplification. In the 11 patients with locoregional disease, 10-year progression-free (PFS) and overall survival (OS) was 35.4 ± 16.1% and 61.4 ± 15.3%, respectively. Among 33 adults with stage 4 neuroblastoma, 7 (21%) achieved complete response (CR) after induction chemotherapy and/or surgery. Seven patients with primary refractory neuroblastoma (all with osteomedullary but no soft tissue disease) received anti-GD2 antibodies, mouse or humanized 3F8. Antibody-related adverse events were similar to those in children, response rate being 71.4%. In patients with stage 4 disease at diagnosis, 5-year PFS was 9.7± 5.3% and most patients who were alive with disease at 5 years died of neuroblastoma over the next 5 years, 10-year OS being only 19.0 ± 8.2%. Patients who achieved CR after induction had superior PFS and OS (p = 0.006, p = 0.031, respectively). Adult-onset neuroblastoma appeared to have different biology from pediatric or adolescent NB, and poorer outcome. Complete disease control appeared to improve long-term survival. Anti-GD2 immunotherapy was well tolerated and might be beneficial. © 2018 UICC.

A genome-wide association meta-analysis identifies new childhood obesity loci

DEFF Research Database (Denmark)

Bradfield, Jonathan P; Taal, H Rob; Timpson, Nicholas J

2012-01-01

Multiple genetic variants have been associated with adult obesity and a few with severe obesity in childhood; however, less progress has been made in establishing genetic influences on common early-onset obesity. We performed a North American, Australian and European collaborative meta...

Adult obesity, disease and longevity in Mexico.

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Palloni, Alberto; Beltrán-Sánchez, Hiram; Novak, Beatriz; Pinto, Guido; Wong, Rebeca

2015-01-01

To obtain estimates of the effects of overweight and obesity on the incidence of type 2 diabetes (T2D) and adult mortality. We use three waves (2000, 2002, 2012) of the Mexican Health and Aging Survey (MHAS).We employ parametric hazard models to estimate mortality and conventional logistic models to estimate incidence of T2D. Obesity and overweight have a strong effect on the incidence of T2D;this, combined with the large impact of diabetes on adult mortality, generates increases in mortality that translate into losses of 2 to 3 years of life expectancy at age 50. If increasing trends in obesity in Mexico continue as in the past, progress in adult survival may be slowed down considerably and the incidence of T2D will continue to increase.

Very long chain acyl-coenzyme A dehydrogenase deficiency with adult onset

DEFF Research Database (Denmark)

Smelt, A H; Poorthuis, B J; Onkenhout, W

1998-01-01

Very long chain acyl-coenzyme A (acyl-CoA) dehydrogenase (VLCAD) deficiency is a severe disorder of mitochondrial beta-oxidation in infants. We report adult onset of attacks of painful rhabdomyolysis. Gas chromatography identified strongly elevated levels of tetradecenoic acid, 14:1(n-9), tetrade......Very long chain acyl-coenzyme A (acyl-CoA) dehydrogenase (VLCAD) deficiency is a severe disorder of mitochondrial beta-oxidation in infants. We report adult onset of attacks of painful rhabdomyolysis. Gas chromatography identified strongly elevated levels of tetradecenoic acid, 14:1(n-9......), tetradecadienoic acid, 14:2(n-6), and hexadecadienoic acid, 16:2(n-6). Palmitoyl-CoA and behenoyl-CoA dehydrogenase in fibroblasts were deficient. Muscle VLCAD activity was very low. DNA analysis revealed compound heterozygosity for two missense mutations in the VLCAD gene. The relatively mild clinical course may...... be due to residual enzyme activity as a consequence of the two missense mutations. Treatment with L-carnitine and medium chain triglycerides in the diet did not reduce the attacks of rhabdomyolysis....

A genome-wide association meta-analysis identifies new childhood obesity loci

NARCIS (Netherlands)

Bradfield, Jonathan P.; Taal, H. Rob; Timpson, Nicholas J.; Scherag, Andre; Lecoeur, Cecile; Warrington, Nicole M.; Hypponen, Elina; Holst, Claus; Valcarcel, Beatriz; Thiering, Elisabeth; Salem, Rany M.; Schumacher, Fredrick R.; Cousminer, Diana L.; Sleiman, Patrick M. A.; Zhao, Jianhua; Berkowitz, Robert I.; Vimaleswaran, Karani S.; Jarick, Ivonne; Pennell, Craig E.; Evans, David M.; St Pourcain, Beate; Berry, Diane J.; Mook-Kanamori, Dennis O.; Hofman, Albert; Rivadeneira, Fernando; Uitterlinden, Andre G.; van Duijn, Cornelia M.; van der Valk, Ralf J. P.; de Jongste, Johan C.; Postma, Dirkje S.; Boomsma, Dorret I.; Gauderman, W. James; Hassanein, Mohamed T.; Lindgren, Cecilia M.; Magi, Reedik; Boreham, Colin A. G.; Neville, Charlotte E.; Moreno, Luis A.; Elliott, Paul; Pouta, Anneli; Hartikainen, Anna-Liisa; Li, Mingyao; Raitakari, Olli; Lehtimaki, Terho; Eriksson, Johan G.; Palotie, Aarno; Dallongeville, Jean; Das, Shikta; Deloukas, Panos; McMahon, George

Multiple genetic variants have been associated with adult obesity and a few with severe obesity in childhood; however, less progress has been made in establishing genetic influences on common early-onset obesity. We performed a North American, Australian and European collaborative meta-analysis of

A genome-wide association meta-analysis identifies new childhood obesity loci

NARCIS (Netherlands)

Bradfield, J.P.; Taal, H.R.; Timpson, N.J.; Scherag, A.; Lecoeur, C.; Warrington, N.M.; Hypponen, E.; Holst, C.; Valcarcel, B.; Thiering, E.; Salem, R.M.; Schumacher, F.R.; Cousminer, D.L.; Sleiman, P.M.A.; Zhao, J.; Berkowitz, R.I.; Vimaleswaran, K.S.; Jarick, I.; Pennell, C.E.; Evans, D.M.; St Pourcain, B.; Berry, D.J.; Mook-Kanamori, D.O.; Hofman, A.; Rivadeneira, F.; Uitterlinden, A.G.; van Duijn, C.M.; van der Valk, R.J.P.; de Jongste, J.C.; Postma, D.S.; Boomsma, D.I.; Gauderman, W.J.; Hassanein, M.T.; Lindgren, C.M.; Mägi, R.; Boreham, C.A.G.; Neville, C.E.; Moreno, L.A.; Elliott, P.; Pouta, A.; Hartikainen, A.-L.; Li, M.; Raitakari, O.; Lehtimäki, T.; Eriksson, J.G.; Palotie, A.; Dallongeville, J.; Das, S.; Deloukas, P.; McMahon, G.; Ring, S.M.; Kemp, J.P.; Buxton, J.L.; Blakemore, A.I.F.; Bustamante, M.; Guxens, M.; Hirschhorn, J.N.; Gillman, M.W.; Kreiner-Møller, E.; Bisgaard, H.; Gilliland, F.D.; Heinrich, J.; Wheeler, E.; Barroso, I.; O'Rahilly, S.; Meirhaeghe, A.; Sørensen, T.I.A.; Power, C.; Palmer, L.J.; Hinney, A.; Widen, E.; Farooqi, I.S.; McCarthy, M.I.; Froguel, P.; Meyre, D.; Hebebrand, J.; Järvelin, M.J.; Jaddoe, V.W.V.; Smith, G.D.; Hakonarson, H.; Grant, S.F.A.

2012-01-01

Multiple genetic variants have been associated with adult obesity and a few with severe obesity in childhood; however, less progress has been made in establishing genetic influences on common early-onset obesity. We performed a North American, Australian and European collaborative meta-analysis of

Obesity and dissociable forms of impulsivity in young adults.

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Chamberlain, Samuel R; Derbyshire, Katherine L; Leppink, Eric; Grant, Jon E

2015-10-01

Obesity is one of the leading causes of preventable morbidity and mortality, and young people are increasingly affected. The aim of this study was to examine relationships between obesity and dissociable forms of impulsivity in young adults. A group of young adults (511) was recruited from city areas in the United States using media advertisements. These young adults were administered careful and extensive clinical and neurocognitive assessment in order to quantify different aspects of impulsivity (behavioral/phenomenological-, cognitive-, and personality-related measures). Associations between obesity and impulsivity were explored using multivariate analysis of variance and discriminant function analysis. 10.8% of the sample was obese, and 21.5% was overweight. Compared to controls, subjects with obesity showed significantly elevated rates of maladaptive gambling behaviors, monetary amounts lost to gambling, nicotine consumption, impulsive action (prolonged stop-signal reaction times in the Stop-Signal Test), and impulsive decision-making (reduced modulation of behavior as a function of risk in the Cambridge Gamble Test). Even accounting for potential confounding variables, obesity was significantly predicted by female gender, older age, more maladaptive gambling behaviors, and worse inhibitory control (stop-signal reaction times). Obesity is associated with several dissociable forms of impulsivity in young people, especially gambling and impulse dyscontrol. Family doctors should screen for gambling problems in obese young adults. Successful treatment of nicotine dependence in young obese people is likely to require intensive weight management support. Neuropsychological deficits relating to impulsivity occur in obese people in early adulthood, and may represent vulnerability markers rather than being due to chronic untoward metabolic effects on brain function.

Lifelong doubling of mortality in men entering adult life as obese

DEFF Research Database (Denmark)

Zimmermann, E; Holst, C; Sørensen, T I A

2011-01-01

The association between obesity in adults and excess morbidity and mortality is well established, but the impact of being obese in early adulthood on health throughout adult life needs elucidation. We investigated the all-cause mortality until 80 years of age in men starting adult life as obese....

Adult-onset Rasmussen encephalitis associated with focal cortical dysplasia.

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Hohenbichler, Katharina; Lelotte, Julie; Lhommel, Renaud; Tahry, Riëm El; Vrielynck, Pascal; Santos, Susana Ferrao

2017-12-01

Rasmussen encephalitis is a rare, devastating condition, typically presenting in childhood. Cases of adult-onset Rasmussen have also been described, but the clinical picture is less defined, rendering final diagnosis difficult. We present a case of adult-onset Rasmussen encephalitis with dual pathology, associated with focal cortical dysplasia and encephalitis. We interpreted the Rasmussen encephalitis to be caused by severe and continuous epileptic activity due to focal cortical dysplasia. The best therapeutic approach for such cases remains unclear.

Adult onset glycogen storage disease type II (adult onset Pompe disease): report and magnetic resonance images of two cases

International Nuclear Information System (INIS)

Del Gaizo, Andrew; Banerjee, Sima; Terk, Michael

2009-01-01

Glycogen storage disease type II (GSDII), also referred to as Pompe disease or acid maltase deficiency, is a rare inherited condition caused by a deficiency in acid alpha-glucosidase (GAA) enzyme activity. The condition is often classified by age of presentation, with infantile and late onset variants (Laforet et al. J Neurology 55:1122-8, 2000). Late onset tends to present with progressive proximal muscle weakness and respiratory insufficiency (Winkel et al. J Neurology 252:875-84, 2005). We report two cases of biopsy confirmed adult onset GSDII, along with key Magnetic Resonance (MR) images. (orig.)

Contribution of Common Genetic Variants to Obesity and Obesity-Related Traits in Mexican Children and Adults

Science.gov (United States)

Villalobos-Comparán, Marisela; Villarreal-Molina, Teresa; Romero-Hidalgo, Sandra; López-Contreras, Blanca; Gutiérrez-Vidal, Roxana; Vega-Badillo, Joel; Jacobo-Albavera, Leonor; Posadas-Romeros, Carlos; Canizalez-Román, Adrián; Río-Navarro, Blanca Del; Campos-Pérez, Francisco; Acuña-Alonzo, Victor; Aguilar-Salinas, Carlos; Canizales-Quinteros, Samuel

2013-01-01

Background Several studies have identified multiple obesity-associated loci mainly in European populations. However, their contribution to obesity in other ethnicities such as Mexicans is largely unknown. The aim of this study was to examine 26 obesity-associated single-nucleotide polymorphisms (SNP) in a sample of Mexican mestizos. Methods 9 SNPs in biological candidate genes showing replications (PPARG, ADRB3, ADRB2, LEPR, GNB3, UCP3, ADIPOQ, UCP2, and NR3C1), and 17 SNPs in or near genes associated with obesity in first, second and third wave GWAS (INSIG2, FTO, MC4R, TMEM18, FAIM2/BCDIN3, BDNF, SH2B1, GNPDA2, NEGR1, KCTD15, SEC16B/RASAL2, NPC1, SFRF10/ETV5, MAF, PRL, MTCH2, and PTER) were genotyped in 1,156 unrelated Mexican-Mestizos including 683 cases (441 obese class I/II and 242 obese class III) and 473 normal-weight controls. In a second stage we selected 12 of the SNPs showing nominal associations with obesity, to seek associations with quantitative obesity-related traits in 3 cohorts including 1,218 Mexican Mestizo children, 945 Mexican Mestizo adults, and 543 Indigenous Mexican adults. Results After adjusting for age, sex and admixture, significant associations with obesity were found for 6 genes in the case-control study (ADIPOQ, FTO, TMEM18, INSIG2, FAIM2/BCDIN3 and BDNF). In addition, SH2B1 was associated only with class I/II obesity and MC4R only with class III obesity. SNPs located at or near FAIM2/BCDIN3, TMEM18, INSIG2, GNPDA2 and SEC16B/RASAL2 were significantly associated with BMI and/or WC in the combined analysis of Mexican-mestizo children and adults, and FTO locus was significantly associated with increased BMI in Indigenous Mexican populations. Conclusions Our findings replicate the association of 8 obesity-related SNPs with obesity risk in Mexican adults, and confirm the role of some of these SNPs in BMI in Mexican adults and children. PMID:23950976

Secretory granule neuroendocrine protein 1 (SGNE1 genetic variation and glucose intolerance in severe childhood and adult obesity

Directory of Open Access Journals (Sweden)

Charpentier Guillaume

2007-07-01

Full Text Available Abstract Background 7B2 is a regulator/activator of the prohormone convertase 2 which is involved in the processing of numerous neuropeptides, including insulin, glucagon and pro-opiomelanocortin. We have previously described a suggestive genetic linkage peak with childhood obesity on chr15q12-q14, where the 7B2 encoding gene, SGNE1 is located. The aim of this study is to analyze associations of SGNE1 genetic variation with obesity and metabolism related quantitative traits. Methods We screened SGNE1 for genetic variants in obese children and genotyped 12 frequent single nucleotide polymorphisms (SNPs. Case control analyses were performed in 1,229 obese (534 children and 695 adults, 1,535 individuals with type 2 diabetes and 1,363 controls, all French Caucasians. We also studied 4,922 participants from the D.E.S.I.R prospective population-based cohort. Results We did not find any association between SGNE1 SNPs and childhood or adult obesity. However, the 5' region SNP -1,701A>G associated with higher area under glucose curve after oral glucose tolerance test (p = 0.0005, higher HOMA-IR (p = 0.005 and lower insulinogenic index (p = 0.0003 in obese children. Similar trends were found in obese adults. SNP -1,701A>G did not associate with risk of T2D but tends to associate with incidence of type 2 diabetes (HR = 0.75 95%CI [0.55–1.01]; p = 0.06 in the prospective cohort. Conclusion SGNE1 genetic variation does not contribute to obesity and common forms of T2D but may worsen glucose intolerance and insulin resistance, especially in the background of severe and early onset obesity. Further molecular studies are required to understand the molecular bases involved in this process.

Lifestyle habits and obesity progression in overweight and obese American young adults: Lessons for promoting cardiometabolic health.

Science.gov (United States)

Cha, EunSeok; Akazawa, Margeaux K; Kim, Kevin H; Dawkins, Colleen R; Lerner, Hannah M; Umpierrez, Guillermo; Dunbar, Sandra B

2015-12-01

Obesity among young adults is a growing problem in the United States and is related to unhealthy lifestyle habits, such as high caloric intake and inadequate exercise. Accurate assessment of lifestyle habits across obesity stages is important for informing age-specific intervention strategies to prevent and reduce obesity progression. Using a modified version of the Edmonton Obesity Staging System (mEOSS), a new scale for defining obesity risk and predicting obesity morbidity and mortality, this cross-sectional study assessed the prevalence of overweight/obese conditions in 105 young adults and compared their lifestyle habits across the mEOSS stages. Descriptive statistics, chi-square tests, and one-way analyses of variance were performed. Eighty percent of participants (n = 83) fell into the mEOSS-2 group and had obesity-related chronic disorders, such as diabetes, hypertension, and/or dyslipidemia. There were significant differences in dietary quality and patterns across the mEOSS stages. Findings highlighted the significance of prevention and early treatment for overweight and obese young adults to prevent and cease obesity progression. © 2015 Wiley Publishing Asia Pty Ltd.

Hormonal therapy (hCG and rhFSH) for infertile men with adult-onset idiopathic hypogonadotropic hypogonadism.

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Kobori, Yoshitomo; Suzuki, Keisuke; Iwahata, Toshiyuki; Shin, Takeshi; Sato, Ryo; Nishio, Kojiro; Yagi, Hiroshi; Arai, Gaku; Soh, Shigehiro; Okada, Hiroshi

2015-04-01

Adult-onset idiopathic male hypogonadotropic hypogonadism (IMHH) is a very rare but treatable disease. This study was conducted to examine the efficacy and safety of a combination of human chorionic gonadotropin (hCG) and recombinant human follicle-stimulating hormone (rhFSH) for inducing spermatogenesis in men with adult-onset IMHH. Seven men (34-45 years of age) with azoospermia and/or sexual dysfunction, with a low serum testosterone concentration, and apulsatile secretion of luteinizing hormone, were referred to our hospital for infertility. All had normal secondary sexual characteristics. Thorough endocrinologic examination and magnetic resonance imaging revealed no identifiable cause of hypogonadotropic hypogonadism. Adult-onset IMHH was diagnosed in all cases and treatment was started with 150 IU rhFSH and 5,000 IU hCG, both administered two times per week. Spermatogenesis was restored in five of the seven patients. During treatment one patient achieved spontaneous pregnancy with his wife, and spermatozoa recovered from the other four patients were frozen for future use in intracytoplasmic sperm injection.

Does Family History of Obesity, Cardiovascular, and Metabolic Diseases Influence Onset and Severity of Childhood Obesity?

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Domenico Corica

2018-05-01

Full Text Available ObjectivesThe objectives were to evaluate (1 the metabolic profile and cardiometabolic risk in overweight/obese children at first assessment, stratifying patients according to severity of overweight and age; and (2 to investigate the relationship between family history (FH for obesity and cardiometabolic diseases and severity of childhood obesity.MethodsIn this cross-sectional, retrospective, observational study, 260 children (139 female, aged between 2.4 and 17.2 years, with overweight and obesity were recruited. Data regarding FH for obesity and cardiometabolic diseases were collected. Each patient underwent clinical and auxological examination and fasting blood sampling for metabolic profile. Homeostasis model assessment of insulin resistance (HOMA-IR, triglyceride-to-high-density lipoprotein cholesterol ratio, and atherogenic index of plasma were calculated. To evaluate the severity of obesity, children were divided into two groups for BMI standard deviation (SD ≤2.5 and BMI SD >2.5. Moreover, study population was analyzed, dividing it into three groups based on the chronological age of patient (<8, 8–11, >11 years.ResultsBMI SD was negatively correlated with chronological age (p < 0.005 and significantly higher in the group of children <8 years. BMI SD was positively associated with FH for obesity. Patients with more severe obesity (BMI SD >2.5 were younger (p < 0.005, mostly prepubertal, presented a significantly higher HOMA-IR (p = 0.04, and had a significantly higher prevalence of FH for arterial hypertension, type 2 diabetes mellitus, and coronary heart disease than the other group.Conclusion(1 Family history of obesity and cardiometabolic diseases are important risk factors for precocious obesity onset in childhood and are related to the severity of obesity. (2 Metabolic profile, especially HOMA-IR, is altered even among the youngest obese children at first evaluation. (3 Stratification of obesity severity

RELATIONSHIP OF ADIPOKINES AND PROINFLAMMATORY CYTOKINES AMONG ASIAN INDIANS WITH OBESITY AND YOUTH ONSET TYPE 2 DIABETES.

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Gokulakrishnan, Kuppan; Amutha, Anandakumar; Ranjani, Harish; Bibin, Subramanian Y; Balakumar, Mahalingam; Pandey, Gautam Kumar; Anjana, Ranjit Mohan; Ali, Mohammed K; Narayan, K M Venkat; Mohan, Viswanathan

2015-10-01

It is well known that inflammation is associated with diabetes, but it is unclear whether obesity mediates this association in individuals with youth-onset type 2 diabetes mellitus (T2DM-Y). We recruited individuals with T2DM-Y (age at onset obesity and categorized as: nonobese NGT (n = 100), Obese NGT (n = 50), nonobese T2DM-Y (n = 50), and obese T2DM-Y (n = 50). We compared adipokines (adiponectin and leptin) and proinflammatory cytokines (tumor necrosis factor alpha [TNF-α] and monocyte chemotactic protein-1 [MCP-1]) across groups. Compared to nonobese NGT, the other 3 groups (obese NGT, nonobese T2DM-Y, and obese T2DM-Y) were found to have lower adiponectin (7.7 vs. 5.7, 4.2, 3.8 μg/mL, Pobese T2DM-Y (141 pg/mL, Pobese T2DM, respectively. However, adjusted for same factors, leptin, TNF-α, and MCP-1 were associated with markedly higher odds (5- to 14-fold) of nonobese and obese T2DM. In young Asian Indians, leptin and proinflammatory cytokines are positively, and adiponectin negatively, associated with both nonobese and obese T2DM-Y compared to nonobese NGT individuals.

Association between objectively measured sleep quality and obesity in community-dwelling adults aged 80 years or older: a cross-sectional study.

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Kim, Miji

2015-02-01

The purpose of this study was to examine the association between objective measures of sleep quality and obesity in older community-dwelling people. This cross-sectional study included 189 community-dwelling adults aged ≥ 80 yr (83.4 ± 2.5 yr [age range, 80-95 yr]). Participants wore an accelerometer (ActiGraph GT3X+) on their non-dominant wrist 24 hr per day for 7 consecutive nights. Sleep parameters measured included total sleep time, sleep efficiency, and wake after sleep onset (WASO) during the night. Associations between sleep parameters and obesity were investigated by using multivariate logistic regression analysis. In multivariate models, those with sleep efficiency lower than 85% had a 2.85-fold increased odds of obesity, compared with those with sleep efficiency of 85% or higher. Similarly, those with WASO of ≥ 60 min (compared with obesity. However, there were no significant associations between total sleep time or self-reported napping duration and obesity. We found that poor sleep quality was an independent risk factor for obesity in community-dwelling Japanese adults aged ≥ 80 yr, even after controlling for potential confounding factors, including daily physical activity.

Differences in disease features between childhood-onset and adult-onset systemic lupus erythematosus patients presenting with acute abdominal pain.

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Tu, Yu-Ling; Yeh, Kuo-Wei; Chen, Li-Chen; Yao, Tsung-Chieh; Ou, Liang-Shiou; Lee, Wen-I; Huang, Jing-Long

2011-04-01

Abdominal pain in systemic lupus erythematosus (SLE) patients has rarely been analyzed in pediatric populations. We planned to investigate the potential differences between childhood-onset and adult-onset SLE patients who were hospitalized because of acute abdominal pain. A retrospective study including 23 childhood-onset SLE patients with 38 admissions and 88 adult-onset SLE patients with 108 admissions from 1999 to 2008 were conducted in our hospital. All of them had the chief complaint of diffuse abdominal pain. The etiologies of acute abdominal pain in adult-onset SLE patients were more diverse than childhood-onset SLE patients. The most common cause of acute abdominal pain in SLE patients was lupus mesenteric vasculitis (LMV) (18.5%), followed by acute gastroenteritis (14.4%), pancreatitis (10.3%), appendicitis (7.5%), and cholecystitis (6.2%). Compared with adults, children were admitted more often due to LMV (31.6% versus 13.9%; P = 0.016), had more frequently recurrent episodes (39.1% versus 14.8%; P = 0.009), and were more often treated with immunosuppressive agents (31.6% versus 7.4%; P abdominal pain should be considered in SLE patients. LMV is the most common cause of acute abdomen in childhood-onset SLE patients with low mortality and morbidity provided by prompt diagnosis and timely administration of high-dose intravenous corticosteroids after excluding real surgical abdomen. Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.

Early Onset Childhood Obesity and Risk of Metabolic Syndrome

Centers for Disease Control (CDC) Podcasts

2017-10-09

This podcast features Lorena Pacheco, a doctoral student at the University of California San Diego and one of the winners of PCD’s 2017 Student Research Paper Contest. Lorena answers questions about her winning research, which focuses on the relationship between early onset obesity as a risk factor for increased metabolic syndrome in Chilean children.  Created: 10/9/2017 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 10/9/2017.

Understanding Adult Overweight and Obesity

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... Step in the Right Direction Understanding Adult Overweight & Obesity View or Print All Sections Definition & Facts The terms “overweight” and “obesity” refer to body weight that is greater than ...

Clinical and MRI features of supratentorial gliomas with adult-onset epilepsy

International Nuclear Information System (INIS)

Hashimoto, Takahiro; Yamaura, Akira; Watanabe, Osamu.

1992-01-01

Although some patients with supratentorial gliomas develop epilepsy in their clinical course, the details of adult-onset epilepsy with gliomas have not been fully evaluated. This paper reports on 15 cases of supratentorial glioma with the sole symptom of adult-onset epilepsy and characterizes their clinical and MRI features. The patients, 5 males and 10 females, developed the first epilepsy at the mean age of 37 years. Generalized seizure was encountered in all cases and focal seizure alone was never seen. Seizure was satisfactorily controlled with anticonvulsants in all except 2 cases. The tumor was located in the frontal lobe (9 cases) or temporal lobe (6 cases). Histologically, there were 12 astrocytomas, 2 glioblastomas, and 1 oligoastrocytoma. Of these, 12 were benign gliomas. Surprisingly, CT scan and MRI revealed tumors larger than predicted. The abnormal intensity region was delineated most prominently on T 2 -weighted SE image and was broader on T 2 -weighted spin echo image than on T 1 -weighted spin echo and inversion recovery image. The authors conclude that gliomas presenting with epilepsy tend to be histologically benign, are predominantly seen in middle-aged women, and are located in the frontal and temporal lobes. Although a tumor may be large enough to be detected on CT scan or MRI, as in the present study, histological examination is needed to establish the diagnosis. Additionally, gliomas with equivocal abnormalities on CT and MRI do evolve despite further neurological deficits, so meticulous evaluation including stereotactic biopsy is the method of choice. Finally, T 2 -weighted SE image in the coronal plane is advocated for patients with adult-onset epilepsy to achieve accurate diagnosis and to initiate early treatment. (author)

Obesity and suicide risk in adults--a systematic review.

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Klinitzke, G; Steinig, J; Blüher, M; Kersting, A; Wagner, B

2013-03-05

There is evidence from prospective studies that obesity is positively associated with depression. In contradiction to this, however, a number of studies have revealed that the number of completed suicides decreases with increasing BMI. The objective of this systematic review is to elucidate this ambiguous research field, providing an overview of literature examining the relationship between obesity and risk of suicide in adults (>18 years). Literature searches of the databases PubMed/Medline, PsychInfo, and Web of Sciences were conducted. Fifteen studies concerning completed suicide, suicide attempts and suicidal ideation met the inclusion criteria (seven prospective and eight cross-sectional studies). Eight studies evaluating completed suicide reported an inverse relationship between BMI and suicide, meaning that obese people are less likely to commit suicide than people of low or normal weight, whereas one study showed no association and one showed a positive association. Studies about suicide attempts and ideation, on the other hand, found results that differed depending on gender. While obese woman reported more suicide attempts and suicidal ideation, obese men reported less attempts and thoughts. The role of confounding variables such as age or psychiatric illness on suicide risk are discussed and remaining research questions are outlined, especially regarding the role of different underlying biological pathways and consideration of different classes of obesity. Copyright © 2012 Elsevier B.V. All rights reserved.

The utility of childhood and adolescent obesity assessment in relation to adult health.

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Goldhaber-Fiebert, Jeremy D; Rubinfeld, Rachel E; Bhattacharya, Jay; Robinson, Thomas N; Wise, Paul H

2013-02-01

High childhood obesity prevalence has raised concerns about future adult health, generating calls for obesity screening of young children. To estimate how well childhood obesity predicts adult obesity and to forecast obesity-related health of future US adults. Longitudinal statistical analyses; microsimulations combining multiple data sets. National Longitudinal Survey of Youth, Population Study of Income Dynamics, and National Health and Nutrition Evaluation Surveys. The authors estimated test characteristics and predictive values of childhood body mass index to identify 2-, 5-, 10-, and 15 year-olds who will become obese adults. The authors constructed models relating childhood body mass index to obesity-related diseases through middle age stratified by sex and race. Twelve percent of 18-year-olds were obese. While screening at age 5 would miss 50% of those who become obese adults, screening at age 15 would miss 9%. The predictive value of obesity screening below age 10 was low even when maternal obesity was included as a predictor. Obesity at age 5 was a substantially worse predictor of health in middle age than was obesity at age 15. For example, the relative risk of developing diabetes as adults for obese white male 15-year-olds was 4.5 versus otherwise similar nonobese 15-year-olds. For obese 5-year-olds, the relative risk was 1.6. Main results do not include Hispanics due to sample size. Past relationships between childhood and adult obesity and health may change in the future. Early childhood obesity assessment adds limited information to later childhood assessment. Targeted later childhood approaches or universal strategies to prevent unhealthy weight gain should be considered.

Lifetime Increased Risk of Adult Onset Atopic Dermatitis in Adolescent and Adult Patients with Food Allergy

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Hsu-Sheng Yu

2016-12-01

Full Text Available Food allergy can result in life-threatening anaphylaxis. Atopic dermatitis (AD causes intense itching and impaired quality of life. Previous studies have shown that patients with classical early-onset AD tend to develop food allergy and that 10% of adults with food allergies have concomitant AD. However, it is not known whether late-onset food allergy leads to adult-onset AD, a recently recognized disease entity. Using an initial cohort of one-million subjects, this study retrospectively followed-up 2851 patients with food allergy (age > 12 years for 14 years and compared them with 11,404 matched controls. While 2.8% (81 of the 2851 food allergy patients developed AD, only 2.0% (227 of the 11,404 controls developed AD. Multivariate regression analysis showed that food allergy patients were more likely to develop AD (adjusted hazard ratio = 2.49, p < 0.0001. Controls had a 1.99% risk of developing AD, while food allergy patients had a significantly higher risk (7.18% and 3.46% for patients with ≥3 and <3 food allergy claims, respectively of developing adult-onset AD. This is the first study to describe the chronological and dose-dependent associations between food allergy in adolescence and the development of adult-onset AD.

A comparison between nailfold capillaroscopy patterns in adulthood in juvenile and adult-onset systemic sclerosis

DEFF Research Database (Denmark)

Ingegnoli, Francesca; Boracchi, Patrizia; Gualtierotti, Roberta

2015-01-01

OBJECTIVE: Qualitative capillaroscopy patterns in juvenile- and adult-onset systemic sclerosis (SSc) were studied in adulthood using data from the EULAR Scleroderma Trials and Research (EUSTAR) database. METHODS: Data collected between June 2004 and April 2013 were examined with focus on capillar......OBJECTIVE: Qualitative capillaroscopy patterns in juvenile- and adult-onset systemic sclerosis (SSc) were studied in adulthood using data from the EULAR Scleroderma Trials and Research (EUSTAR) database. METHODS: Data collected between June 2004 and April 2013 were examined with focus...... on capillaroscopy. In this retrospective exploratory study, series of patients with juvenile-onset SSc were matched with series of adult-onset SSc having the same gender and autoantibody profile. RESULTS: 30 of 123 patients with juvenile-onset and 2108 of 7133 with adult-onset SSc had data on capillaroscopy...... in 61% of juvenile- and 55.5% of adult-onset SSc. The OR was 1.06 and 95% CI 0.34-3.56. CONCLUSION: This is the first exploratory study on the comparison of capillaroscopy between juvenile- and adult-onset SSc in adulthood. Juvenile-onset SSc had an increase prevalence of scleroderma pattern...

Food insecurity is associated with obesity among US adults in 12 states.

Science.gov (United States)

Pan, Liping; Sherry, Bettylou; Njai, Rashid; Blanck, Heidi M

2012-09-01

A redesigned food insecurity question that measured food stress was included in the 2009 Behavioral Risk Factor Surveillance System in the Social Context optional module. The objective of our study was to examine the association between food stress and obesity using this question as a surrogate for food insecurity. Our analytic sample included 66,553 adults from 12 states. Food insecurity was determined by response (always/usually/sometimes) to the question, "How often in the past 12 months would you say you were worried or stressed about having enough money to buy nutritious meals?" T tests were used to compare prevalence differences between groups, and logistic regression was used to examine the association between food insecurity and obesity. Among the 12 states, the prevalence of obesity was 27.1% overall, 25.2% among food secure adults, and 35.1% among food insecure adults. Food insecure adults had 32% increased odds of being obese compared to food secure adults. Compared with food secure adults, food insecure adults had significantly higher prevalence of obesity in the following population subgroups: adults ages ≥30 years, women, non-Hispanic whites, non-Hispanic blacks, adults with some college education or a college degree, a household income of food insecure adults were obese. Food insecurity was associated with obesity in the overall population and most population subgroups. These findings are consistent with previous research and highlight the importance of increasing access to affordable healthy foods for all adults. Published by Elsevier Inc.

A Cross-Sectional Study of the Phenotypes of Obesity and Insulin Resistance in Adults with Down Syndrome

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Diego Real de Asua

2014-12-01

Full Text Available BackgroundDespite the confluence of multiple cardiovascular risk factors, subclinical atherosclerotic damage and cardiovascular events remain extremely rare in adults with Down syndrome (DS. We aim to determine the prevalence of obesity and metabolic disorders in an adult cohort with DS and to compare our findings with adults without DS.MethodsCross-sectional study of 51 consecutively selected adults with DS living in the community and 51 healthy controls in an outpatient clinic of a tertiary care hospital in Madrid, Spain. Epidemiological data (age and gender, anthropometric data (body mass index and waist-to-height ratio, coexisting clinical conditions, and laboratory data (fasting glucose, insulin, glycated hemoglobin, creatinine, thyroid hormones, vitamins, and lipid profile were measured and compared between the groups.ResultsAdults with DS were significantly younger and more often men with a higher prevalence of overweight and obesity than controls. Their waist-to-height ratio was higher, and they more frequently had abdominal obesity. The results of an analysis adjusted for age and gender revealed no differences in fasting insulin levels, homeostatic model assessment indexes, or lipid profile between adults with DS and controls.ConclusionAdults with DS presented a high prevalence of overweight and obesity. However, we found no differences in lipid profile, prevalence of insulin resistance, or metabolic syndrome between adults with DS and controls.

Growing into obesity: patterns of height growth in those who become normal weight, overweight, or obese as young adults.

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Stovitz, Steven D; Demerath, Ellen W; Hannan, Peter J; Lytle, Leslie A; Himes, John H

2011-01-01

To study whether patterns of height growth differ by adult obesity status, and determine the contribution of subcutaneous fatness as an explanatory variable for any differences. A multicenter, prospective longitudinal cohort assessed in 3rd grade (8.8 years), 5th grade (11.1 years), 8th grade (14.1 years), and 12th grade (18.3 years). Exposures were young adult obesity status classified by CDC adult BMI categories at 12th grade. Skinfolds were measured in third, fifth, and eighth grades. Outcome was mean height (cm) at the four measurements using repeated-measures ANCOVA for young adult obesity status, and height increments between grades by adult obesity status in sequential models including initial height and, secondarily, initial skinfolds. Adjusted for age, and race/ethnicity, young adult obesity status explained a small, but statistically significant amount of height growth among both females and males within each of the three intervals. Compared with normal weight young adults, overweight or obese young adults stood taller in childhood, but had relatively less growth in height throughout the teenage years. There was no association between adult height and weight status. Skinfolds explained only a small amount of the height patterns in the three weight groups. Childhood and adolescent height growth patterns differ between those who become young adults who are normal weight and those who become overweight or obese. Since differences in fatness explain only a small amount of these height growth patterns, research is needed to identify other determinants. Copyright © 2011 Wiley-Liss, Inc.

Anorexigenic postprandial responses of PYY and GLP1 to slow ice cream consumption: preservation in obese adolescents, but not in obese adults.

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Rigamonti, A E; Agosti, F; Compri, E; Giunta, M; Marazzi, N; Muller, E E; Cella, S G; Sartorio, A

2013-03-01

Eating slowly increases the postprandial responses of some anorexigenic gut hormones in healthy lean subjects. As the rate of food intake is positively associated with obesity, the aim of the study was to determine whether eating the same meal at different rates evokes different postprandial anorexigenic responses in obese adolescent and adult subjects. Eighteen obese adolescents and adults were enrolled. A test meal was consumed on two different sessions by each subject, meal duration taking either 5  min (fast feeding) or 30  min (slow feeding). Circulating levels of glucagon-like peptide 1 (GLP1), peptide YY (PYY), glucose, insulin, and triglycerides were measured over 210  min. Visual analog scales were used to evaluate the subjective feelings of hunger and satiety. fast feeding did not stimulate GLP1 release in obese adolescent and adults, whereas slow feeding increased circulating levels of GLP1 only in obese adolescents. Plasma PYY concentrations increased both in obese adolescents and in adults, irrespective of the eating rate, but slow feeding was more effective in stimulating PYY release in obese adolescents than in adults. simultaneously, slow feeding evoked a higher satiety only in obese adolescents compared with fast feeding but not in obese adults. in obese adolescents, slow feeding decreased hunger (only at 210 min). irrespective of the eating rate, postprandial responses of insulin and triglycerides were higher in obese adults than in obese adolescents. Slow feeding leads to higher concentrations of anorexigenic gut peptides and favors satiety in obese adolescents, but this physiological control of food intake is lost in obese adults.

Differential Secretion of Satiety Hormones With Progression of Obesity in JCR: LA-corpulent Rats

Science.gov (United States)

Parnell, Jill A.; Reimer, Raylene A.

2013-01-01

Objective To characterize the gastrointestinal tract at the onset and in well-established obesity. Methods and Procedures Lean (+/?) and obese (cp/cp) male JCR:LA-cp rats lacking a functional leptin receptor were killed at 3.5 weeks and 9 months of age and plasma concentrations of satiety hormones determined. The small intestine, colon, and stomach were measured, weighed, and mRNA levels of satiety genes quantified. Results At the onset of obesity, obese rats had greater intestine, colon, and liver mass when adjusted for body weight compared to lean rats. Conversely, adult rats with established obesity had lower intestine and colon mass and length after adjustment for body weight. Early changes in gene expression included decreased ghrelin mRNA levels in stomach and increased peptide YY (PYY) mRNA levels in duodenum of young obese rats. After massive accumulation of adipose tissue had occurred, adult obese rats had increased proglucagon and ghrelin mRNA expression in the proximal intestine. In the distal small intestine, obese rats had lower proglucagon, ghrelin, and PYY mRNA levels. Finally, at the onset and in well-established obesity, obese rats had higher plasma insulin, amylin, glucagon like peptide-1 (GLP-1), and PYY, a finding, with the exception of insulin, unique to this model. Plasma total ghrelin levels were significantly lower at the onset of obesity and established obesity compared to the lean rats. Discussion Several defects are manifested in the obese gut early on in the disease before the accumulation of large excesses of body fat and represent potential targets for early intervention in obesity. PMID:18239578

Hepatic tuberculosis presenting with extreme hyperferritinemia masquerading as adult-onset Still’s disease: a case report

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Manoj Edirisooriya

2012-07-01

Full Text Available Abstract Introduction Isolated hepatic tuberculosis is an uncommon manifestation of one of the most common infections worldwide, caused by Mycobacterium tuberculosis. Extremely high serum ferritin, which is regarded as a marker of adult onset Still’s disease, has not been observed in patients with tuberculosis of the liver. We report a case of hepatic tuberculosis who presented with clinical criteria of adult-onset Still’s disease and extreme hyperferritinemia, which posed a diagnostic confusion. Case presentation Our patient was a 48-year-old Sri Lankan man who presented with fever, polyarthralgia and a generalized skin rash of three months duration. He had marked constitutional symptoms, oral ulcers, hair loss, anemia and hepatomegaly. Laboratory investigations disclosed an inflammatory syndrome, evidence of hepatic dysfunction, bone marrow suppression and a raised serum ferritin level of 34,674 ng/ml. A rapidly deteriorating course of illness prompted treatment based on a presumptive diagnosis of adult-onset Still’s disease until liver histology was available. The patient died of sepsis followed by multi-organ dysfunction. Later, the liver histology revealed tuberculosis. Conclusion Extrapulmonary tuberculosis, although well known to present with peculiar manifestations, has not been reported to be associated with extremely high levels of serum ferritin in immunocompetent individuals. Isolated hepatic tuberculosis presenting with clinical criteria of adult-onset Still’s disease is remarkable. Since tuberculosis remains a potentially curable disease, an awareness of its’ protean manifestations is essential.

Pediatric-Onset and Adult-Onset Separation Anxiety Disorder Across Countries in the World Mental Health Survey

NARCIS (Netherlands)

Silove, Derrick; Alonso, Jordi; Bromet, Evelyn; Gruber, Mike; Sampson, Nancy; Scott, Kate; Andrade, Laura; Benjet, Corina; Caldas de Almeida, Jose Miguel; De Girolamo, Giovanni; de Jonge, Peter; Demyttenaere, Koen; Fiestas, Fabian; Florescu, Silvia; Gureje, Oye; He, Yanling; Karam, Elie; Lepine, Jean-Pierre; Murphy, Sam; Villa-Posada, Jose; Zarkov, Zahari; Kessler, Ronald C.

Objective: The age-at-onset criterion for separation anxiety disorder was removed in DSM-5, making it timely to examine the epidemiology of separation anxiety disorder as a disorder with onsets spanning the life course, using cross-country data. Method: The sample included 38,993 adults in 18

Adipokine Profiling in Adult Women With Central Obesity and Hypertension

Directory of Open Access Journals (Sweden)

Rashmi Supriya

2018-03-01

Full Text Available Central obesity and hypertension are common risk factors for the metabolic syndrome, cardiovascular and renal diseases. Studies have shown that it is more difficult to control blood pressure and prevent end-organ damage in obese individuals with hypertension compared to their non-obese counterparts, especially among women. Obese females have a 6 times higher risk of developing hypertension than non-obese females while obese males are at a 1.5 times higher risk of developing hypertension, compared to their non-obese counterparts. Indeed, the inter-relationship between obesity and hypertension is unclear. Adipokines have been proposed to play a mediating role in the relationship between obesity and hypertension and are involved in the pathogenesis of metabolic diseases. Therefore, this study sought to determine the role of adipokines (adiponectin, plasminogen activator inhibitor-1, leptin, and tumor necrosis factor-α in hypertensive Hong Kong Chinese women with central obesity. A total of 387 women aged 58 ± 11 years who were examined with a 2 × 2 factorial design for central obesity (waist circumference ≥ 80 cm and hypertension (blood pressure ≥ 140/90 mmHg, were recruited from a pool of 1,492 Hong Kong Chinese adults who were previously screened for metabolic syndrome. Subjects with hyperglycemia, hypertriglyceridemia, and dyslipidemia were excluded to eliminate confounding effects. Our findings revealed that hypertensive women with central obesity had a lower anti-inflammatory status (adiponectin and a higher pro-inflammatory status (TNF-α than obese alone or hypertensive alone women. Also, women with central obesity had higher circulatory PAI-1 and leptin concentrations than their non-obese counterparts. We conclude that obesity may shift toward a more pro-inflammatory state and may become more severe in the presence of hypertension or vice versa.

Early-Onset Physical Frailty in Adults with Diabesity and Peripheral Neuropathy.

Science.gov (United States)

Tuttle, Lori J; Bittel, Daniel C; Bittel, Adam J; Sinacore, David R

2017-12-07

Diabesity (obesity and diabetes mellitus) has been identified as a potential contributor to early-onset frailty. Impairments contributing to early onset of physical frailty in this population are not well understood, and there is little evidence of the impact of peripheral neuropathy on frailty. The purpose of this study was to determine impairments that contribute to early-onset physical frailty in individuals with diabesity and peripheral neuropathy. We studied 105 participants, 82 with diabesity and peripheral neuropathy (57 years of age, body mass index [BMI] 31 kg/m 2 ); 13 with diabesity only (53 years of age, BMI 34 kg/m 2 ) and 10 obese controls (67 years of age, BMI 32 kg/m 2 ). Peripheral neuropathy was determined using Semmes Weinstein monofilaments; physical frailty was classified using the 9-item, modified Physical Performance Test; and knee extension and ankle plantarflexion peak torques were measured using isokinetic dynamometry. Participants with diabesity and peripheral neuropathy were 7.4 times more likely to be classified as physically frail. Impairments in lower-extremity function were associated with classification of frailty. Individuals with diabesity and peripheral neuropathy are particularly likely to be classified as frail. Earlier identification and interventions aimed at improving lower-extremity function may be important to mitigate the early-onset functional decline. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

Cardiometabolic Risks and Severity of Obesity in Children and Young Adults.

Science.gov (United States)

Skinner, Asheley C; Perrin, Eliana M; Moss, Leslie A; Skelton, Joseph A

2015-10-01

The prevalence of severe obesity among children and young adults has increased over the past decade. Although the prevalence of cardiometabolic risk factors is relatively low among children and young adults who are overweight or obese, those with more severe forms of obesity may be at greater risk. We performed a cross-sectional analysis of data from overweight or obese children and young adults 3 to 19 years of age who were included in the National Health and Nutrition Examination Survey from 1999 through 2012 to assess the prevalence of multiple cardiometabolic risk factors according to the severity of obesity. Weight status was classified on the basis of measured height and weight. We used standard definitions of abnormal values for total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol, triglycerides, blood pressure, glycated hemoglobin, and fasting glucose and report the prevalence of abnormal values in children and young adults according to weight status. Among 8579 children and young adults with a body-mass index at the 85th percentile or higher (according to the Centers for Disease Control and Prevention growth charts), 46.9% were overweight, 36.4% had class I obesity, 11.9% had class II obesity, and 4.8% had class III obesity. Mean values for some, but not all, cardiometabolic variables were higher with greater severity of obesity in both male and female participants, and the values were higher in male participants than in female participants; for HDL cholesterol, the mean values were lower with greater severity of obesity. Multivariable models that controlled for age, race or ethnic group, and sex showed that the greater the severity of obesity, the higher the risks of a low HDL cholesterol level, high systolic and diastolic blood pressures, and high triglyceride and glycated hemoglobin levels. Severe obesity in children and young adults was associated with an increased prevalence of cardiometabolic risk factors

Prevalence and change of central obesity among US Asian adults: NHANES 2011-2014.

Science.gov (United States)

Liu, Xuefeng; Chen, Yang; Boucher, Nicole L; Rothberg, Amy E

2017-08-25

Central obesity is a major risk factor for cardiometabolic diseases. The prevalence of central obesity has not been reported fully among Asian adults in the United States (US). Cross-sectional data of 1288 Asian adults aged 20 years or over was selected from the US National Health and Nutrition Examination Survey with a stratified multi-stage sampling design. The prevalence of central obesity was calculated with 95% confidence intervals (CIs) and Chi-square tests were conducted to test the significance of the prevalence differences across characteristic groups. The overall prevalence of central obesity among US Asian adults was 58.1% in 2011-2014. The prevalence of central obesity was higher in older adults (73.5%) than in young adults (45.4%) (p young adults (39.2% vs 51.5%), men (45.4% vs 56.6%), adults with college education or above (54.2% vs 61.7%) and non-poor adults (55.4% vs 62.4%). Compared with men, women had higher prevalence in each subgroup of age, education, poverty, and length of time (except for the subgroup of "born in the US") (all p obesity is prevalent in Asian adults, particularly in older adults and women. More efforts are needed to prevent and treat obesity in Asian adults as Asians are incurring the greatest increase in type 2 diabetes in parallel with the rising rate of central adiposity.

Factors mediating the depression in the adult obese outpatients

Directory of Open Access Journals (Sweden)

Gudelj-Rakić Jelena

2007-01-01

Full Text Available Introduction: The prevalence of obesity is rising to epidemic proportions at the alarming rate in both developed and underdeveloped countries around the world. Current prevalence data from individual national studies suggest that the obesity prevalence in the European countries ranges from 10% to 20% for men, and 10% to 25% for women. Health consequences of obesity imply both a number of fatal and non-fatal health problems (out of which the most common are cardiovascular problems, non-insulin dependent diabetes mellitus, cancers, and also a wide spectrum of psychological consequences from diminished self-esteem to clinical depression. Causal relationship between obesity and many chronic diseases is evidence- based. At the same time, there are marked differences in research data regarding causal obesity-depression relationship. Several studies have found no direct association between obesity and depression, while in others the prevalence of depression in obese patients was up to 50%. Gender, obesity grade, socioeconomic status and asking for professional help are named as moderators and mediators of this relationship. Among recommended screening methods, BDI-II is the most frequently used in the adult outpatient departments. Objective The aim of the study was to determine possible risk factors of depression in adult obese patients treated for obesity. Gender, obesity and education level as well as marital status were analyzed as possible moderators of depression-obesity relationship. Method The research included 267 patients, 38.0±14.6 years of age, who referred to the Outpatient Nutrition Department for dietetic consultation or nutritional medical therapy. Nutritional status was assessed by BMI (kg/mІ, calculated from measured values of body weight and height according to WHO recommendations. An estimate of the existence and/or depression level was investigated by Beck Depression Inventory - self administered questionnaire recommended for use

Relation between local food environments and obesity among adults

Directory of Open Access Journals (Sweden)

Raine Kim D

2009-06-01

Full Text Available Abstract Background Outside of the United States, evidence for associations between exposure to fast-food establishments and risk for obesity among adults is limited and equivocal. The purposes of this study were to investigate whether the relative availability of different types of food retailers around people's homes was associated with obesity among adults in Edmonton, Canada, and if this association varied as a function of distance between food locations and people's homes. Methods Data from a population health survey of 2900 adults (18 years or older conducted in 2002 was linked with geographic measures of access to food retailers. Based upon a ratio of the number of fast-food restaurants and convenience stores to supermarkets and specialty food stores, a Retail Food Environment Index (RFEI was calculated for 800 m and 1600 m buffers around people's homes. In a series of logistic regressions, associations between the RFEI and the level of obesity among adults were examined. Results The median RFEI for adults in Edmonton was 4.00 within an 800 m buffer around their residence and 6.46 within a 1600 m buffer around their residence. Approximately 14% of the respondents were classified as being obese. The odds of a resident being obese were significantly lower (OR = 0.75, 95%CI 0.59 – 0.95 if they lived in an area with the lowest RFEI (below 3.0 in comparison to the highest RFEI (5.0 and above. These associations existed regardless of the covariates included in the model. No significant associations were observed between RFEI within a 1600 m buffer of the home and obesity. Conclusion The lower the ratio of fast-food restaurants and convenience stores to grocery stores and produce vendors near people's homes, the lower the odds of being obese. Thus the proximity of the obesogenic environment to individuals appears to be an important factor in their risk for obesity.

Clinical and MRI features of supratentorial gliomas with adult-onset epilepsy

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Hashimoto, Takahiro; Yamaura, Akira (Chiba Univ. (Japan). School of Medicine); Watanabe, Osamu

1992-02-01

Although some patients with supratentorial gliomas develop epilepsy in their clinical course, the details of adult-onset epilepsy with gliomas have not been fully evaluated. This paper reports on 15 cases of supratentorial glioma with the sole symptom of adult-onset epilepsy and characterizes their clinical and MRI features. The patients, 5 males and 10 females, developed the first epilepsy at the mean age of 37 years. Generalized seizure was encountered in all cases and focal seizure alone was never seen. Seizure was satisfactorily controlled with anticonvulsants in all except 2 cases. The tumor was located in the frontal lobe (9 cases) or temporal lobe (6 cases). Histologically, there were 12 astrocytomas, 2 glioblastomas, and 1 oligoastrocytoma. Of these, 12 were benign gliomas. Surprisingly, CT scan and MRI revealed tumors larger than predicted. The abnormal intensity region was delineated most prominently on T[sub 2]-weighted SE image and was broader on T[sub 2]-weighted spin echo image than on T[sub 1]-weighted spin echo and inversion recovery image. The authors conclude that gliomas presenting with epilepsy tend to be histologically benign, are predominantly seen in middle-aged women, and are located in the frontal and temporal lobes. Although a tumor may be large enough to be detected on CT scan or MRI, as in the present study, histological examination is needed to establish the diagnosis. Additionally, gliomas with equivocal abnormalities on CT and MRI do evolve despite further neurological deficits, so meticulous evaluation including stereotactic biopsy is the method of choice. Finally, T[sub 2]-weighted SE image in the coronal plane is advocated for patients with adult-onset epilepsy to achieve accurate diagnosis and to initiate early treatment. (author).

[Yogurt consumption and reduced risk of overweight and obesity in adults].

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Martinchik, A N; Baturin, A K; Peskova, E V; Keshabyants, E E; Mikhaylov, N A

2016-01-01

Fermented dairy products comprise a large food group in Russia and are an important source of dietary nutrients like protein, calcium, fat. Obesity is a rising public health issue in Russia. Observing the role of fermented dairy in the maintenance of healthy weights is important. Current study objective was to explore the association between obesity/overweight prevalence and yogurt consumption in Russian adults. Data from RLMS-HSE 1994-2012 was used. Primary materials are available on http://www.cpc.unc.edu/projects/rlms-hse, http://www. hse.ru/org/hse/rlms. Data collected included dietary intake by single 24h recalls and anthropometric measures for 72.400 adults (≥ 19 y.o.). Logistic regression models were used to explore the relationships between yogurt consumption and obesity prevalence (BMI > 30.0 compared with. 18.5-25.0), controlling for age and gender. Daily average intake (g/day) of yogurt significantly increased from 1994 to 2012. Yogurt consumption decreased over 40 y.o. in both gender. Women yogurt consumption is inversely correlated with the magnitude of the BMI: the consumption of yogurt in women with normal BMI values (> 18.5-25.0) was significantly higher than in women who are overweight and/or obese (BMI > 25.0; or > 30.0). The mean values of BMI in women who ate yogurt, were significantly lower than in women not consuming yogurt. In men, the relationship between consumption of yogurt and BMI is not revealed. Thus, among women, a significant inverse association was observed between yogurt consumption and obesity (OR 0.582, CI 95% 0.497, 0.680; p yogurt intake and prevalence of obesity is dependent on gender: yogurt is associated with lower obesity prevalence only in women.

DYNAPENIA AND METABOLIC HEALTH IN OBESE AND NON-OBESE OLDER ADULTS AGED 70 YEARS AND OLDER: THE LIFE STUDY

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Anton, S; Beavers, DP; Manini, TM; Fielding, R; Newman, A; Church, T; Kritchevsky, SB; Conroy, D; McDermott, MM; Botoseneanu, A; Hauser, ME; Pahor, M

2016-01-01

Objective The purpose of this study was to examine the relationship between dynapenia and metabolic risk factors in obese and non-obese older adults. Methods A total of 1453 men and women (age ≥ 70 years) from the Lifestyle Interventions and Independence for Elders (LIFE) Study were categorized as (1) non-dynapenic/non-obese (NDYN-NO), (2) dynapenic/non-obese (DYN-NO), (3) non-dynapenic/obese (NDYN-O), or (4) dynapenic/obese (DYN-O), based on muscle strength (FNIH criteria) and body mass index. Dependent variables were blood lipids, fasting glucose, blood pressure, presence of at least three metabolic syndrome (MetS) criteria and other chronic conditions. Results A significantly higher likelihood of having abdominal obesity criteria in NDYN-NO compared to DYN-NO groups (55.6 vs 45.1%, p ≤ 0.01) was observed. Waist circumference was also significantly higher in obese groups (DYN-O=114.0±12.9 and NDYN-O=111.2±13.1) than in non-obese (NDYN-NO=93.1±10.7 and DYN-NO=92.2±11.2, p ≤ 0.01); and higher in NDYN-O compared to DYN-O (p = 0.008). Additionally, NDYN-O demonstrated higher diastolic blood pressure compared to DYN-O (70.9±10.1 vs 67.7±9.7, p ≤ 0.001). No significant differences were found across dynapenia and obesity status for all other metabolic components (p>0.05). The odds of having metabolic syndrome or its individual components were similar in obese and non-obese, combined or not with dynapenia (non-significant OR [95%CI]). Conclusion Non-obese dynapenic older adults had fewer metabolic disease risk factors than non-obese and non-dynapenic older adults. Moreover, among obese older adults, dynapenia was associated with lower risk of meeting metabolic syndrome criteria for waist circumference and diastolic blood pressure. Additionally, the presence of dynapenia did not increase cardiometabolic disease risk in either obese or non-obese older adults. PMID:27914851

Prevalence of overweight and obesity in young adults in Uganda ...

African Journals Online (AJOL)

Conclusion: We observed significant gender differences in the prevalence of obesity among young adults in Uganda. Contrary to expectation, we did not observe significant rural-urban differences in the prevalence of overweight. Keywords: Obesity; overweight; prevalence; Uganda; young adults. African Health Sciences ...

Obesity, abdominal obesity, physical activity, and caloric intake in US adults: 1988 to 2010.

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Ladabaum, Uri; Mannalithara, Ajitha; Myer, Parvathi A; Singh, Gurkirpal

2014-08-01

Obesity and abdominal obesity are associated independently with morbidity and mortality. Physical activity attenuates these risks. We examined trends in obesity, abdominal obesity, physical activity, and caloric intake in US adults from 1988 to 2010. Univariate and multivariate analyses were performed using National Health and Nutrition Examination Survey data. Average body mass index (BMI) increased by 0.37% (95% confidence interval [CI], 0.30-0.44) per year in both women and men. Average waist circumference increased by 0.37% (95% CI, 0.30-0.43) and 0.27% (95% CI, 0.22-0.32) per year in women and men, respectively. The prevalence of obesity and abdominal obesity increased substantially, as did the prevalence of abdominal obesity among overweight adults. Younger women experienced the greatest increases. The proportion of adults who reported no leisure-time physical activity increased from 19.1% (95% CI, 17.3-21.0) to 51.7% (95% CI, 48.9-54.5) in women, and from 11.4% (95% CI, 10.0-12.8) to 43.5% (95% CI, 40.7-46.3) in men. Average daily caloric intake did not change significantly. BMI and waist circumference trends were associated with physical activity level but not caloric intake. The associated changes in adjusted BMIs were 8.3% (95% CI, 6.9-9.6) higher among women and 1.7% (95% CI, 0.68-2.8) higher among men with no leisure-time physical activity compared with those with an ideal level of leisure-time physical activity. Our analyses highlight important dimensions of the public health problem of obesity, including trends in younger women and in abdominal obesity, and lend support to the emphasis placed on physical activity by the Institute of Medicine. Copyright © 2014 Elsevier Inc. All rights reserved.

Obesity, Abdominal Obesity, Physical Activity, and Caloric Intake in U.S. Adults: 1988-2010

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Ladabaum, Uri; Mannalithara, Ajitha; Myer, Parvathi A.; Singh, Gurkirpal

2014-01-01

Background Obesity and abdominal obesity are independently associated with morbidity and mortality. Physical activity attenuates these risks. We examined trends in obesity, abdominal obesity, physical activity, and caloric intake in U.S. adults from 1988 to 2010. Methods Univariate and multivariate analyses were performed using National Health and Nutrition Examination Survey (NHANES) data. Results Average body-mass index (BMI) increased by 0.37% (95% CI, 0.30-0.44%) per year in both women and men. Average waist circumference increased by 0.37% (95% CI, 0.30-0.43%) and 0.27% (95% CI, 0.22-0.32%) per year in women and men, respectively. The prevalence of obesity and abdominal obesity increased substantially, as did the prevalence of abdominal obesity among overweight adults. Younger women experienced the greatest increases. The proportion of adults who reported no leisure-time physical activity increased from 19.1% (95% CI, 17.3-21.0%) to 51.7% (95% CI, 48.9-54.5%) in women, and from 11.4% (95% CI, 10.0-12.8%) to 43.5% (95% CI, 40.7-46.3%) in men. Average daily caloric intake did not change significantly. BMI and waist circumference trends were associated with physical activity level, but not caloric intake. The associated changes in adjusted BMIs were 8.3% (95% CI, 6.9-9.6%) higher among women and 1.7% (95% CI, 0.68-2.8%) higher among men with no leisure-time physical activity compared to those with an ideal level of leisure-time physical activity. Conclusions Our analyses highlight important dimensions of the public health problem of obesity, including trends in younger women and in abdominal obesity, and lend support to the emphasis placed on physical activity by the Institute of Medicine. PMID:24631411

Childhood exposure to infection and risk of adult onset wheeze and atopy

OpenAIRE

Bodner, C; Anderson, W; Reid, T; Godden, D

2000-01-01

BACKGROUND—The prevalence of asthma and allergic diseases in children and young adults is inversely associated with family size. It has been suggested that more frequent exposure to infections in a large family group, particularly those spread by the faecal-oral route, may protect against atopic diseases, although not all published data support this hypothesis. Whether similar considerations apply to adult onset wheeze is unknown. The relationship between adult onset whee...

Lifestyle Factors and Incident Mobility Limitation in Obese and Non-obese Older Adults.

NARCIS (Netherlands)

Koster, A.; Penninx, B.W.J.H.; Newman, A.B.; Visser, M.; van Gool, C.H.; Harris, T.B.; van Eijk, J.T.; Kempen, G.I.; Brach, J.S.; Simonsick, E.M.; Houston, D.K.; Tylavsky, F.A.; Rubin, S.M.; Kritchevsky, S.B.

2007-01-01

Objective: This study examines the association between incident mobility limitation and 4 lifestyle factors: smoking, alcohol intake, physical activity, and diet in well-functioning obese (n = 667) and non-obese (n = 2027) older adults. Research Methods and Procedures: Data were from men and women,

Morbidity, including fatal morbidity, throughout life in men entering adult life as obese

DEFF Research Database (Denmark)

Zimmermann, Esther; Holst, Claus; Sørensen, Thorkild I A

2011-01-01

The association between obesity in adults and excess morbidity and mortality is well established, but the health impact throughout adult life of being obese in early adulthood needs elucidation. We investigated somatic morbidity, including fatal morbidity, throughout adulthood in men starting adult...... life as obese....

The prevalence of adult obesity in Ogbomoso, southwest Nigeria ...

African Journals Online (AJOL)

Background: In many developing countries obesity and obesity-related morbidities are now becoming a major health challenges. Objectives: To determine the prevalence of obesity among adults using the measure of body mass index (BMI) and waist circumference (WC). Methods: A hospital based cross-sectional ...

Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD) syndrome may have a hypothalamus-periaqueductal gray localization.

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Chow, Cristelle; Fortier, Marielle Valerie; Das, Lena; Menon, Anuradha P; Vasanwala, Rashida; Lam, Joyce C M; Ng, Zhi Min; Ling, Simon Robert; Chan, Derrick W S; Choong, Chew Thye; Liew, Wendy K M; Thomas, Terrence

2015-05-01

Anatomical localization of the rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD) syndrome has proved elusive. Most patients had neuroimaging after cardiorespiratory collapse, revealing a range of ischemic lesions. A 15-year-old obese boy with an acute febrile encephalopathy had hypoventilation, autonomic dysfunction, visual hallucinations, hyperekplexia, and disordered body temperature, and saltwater regulation. These features describe the ROHHAD syndrome. Cerebrospinal fluid analysis showed pleocytosis, elevated neopterins, and oligoclonal bands, and serology for systemic and antineuronal antibodies was negative. He improved after receiving intravenous steroids, immunoglobulins, and long-term mycophenolate. Screening for neural crest tumors was negative. Magnetic resonance imaging of the brain early in his illness showed focal inflammation in the periaqueductal gray matter and hypothalamus. This unique localization explains almost all symptoms of this rare autoimmune encephalitis. Copyright © 2015 Elsevier Inc. All rights reserved.

Obesity and Associated Health Disparities Among Understudied Multiracial, Pacific Islander, and American Indian Adults.

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Subica, Andrew M; Agarwal, Neha; Sullivan, J Greer; Link, Bruce G

2017-12-01

This study examined the state of obesity, diabetes, and associated health disparities among understudied multiracial, Native Hawaiian and Other Pacific Islander (NHOPI), and American Indian and Alaskan Native (AIAN) adults. Aggregated data for 184,617 adults from the California Health Interview Survey (2005 to 2011) were analyzed to determine obesity, diabetes, poor/fair health, and physical disability prevalence by racial group. Logistic regressions controlling for age, gender, and key social determinants (education, marital status, poverty, health insurance) generated multiracial, NHOPI, and AIAN adults' odds ratios (ORs) for our targeted health conditions versus non-Hispanic white adults. Obesity, diabetes, and other targeted health conditions were highly prevalent among multiracial, NHOPI, and AIAN adults, who displayed significantly greater adjusted odds than non-Hispanic white adults for obesity (ORs = 1.2-1.9), diabetes (ORs = 1.6-2.4), poor/fair health (ORs = 1.4-1.7), and, with the exception of NHOPI adults, physical disability (ORs = 1.5-1.6). Multiracial and AIAN adults with obesity also had significantly higher adjusted odds of diabetes (OR = 1.5-2.6) than non-Hispanic white adults with obesity. Multiracial, NHOPI, and AIAN adults experience striking obesity-related disparities versus non-Hispanic white adults, urging further disparities research with these vulnerable minority populations. © 2017 The Obesity Society.

Prevalence of overweight and obesity in young adults in Uganda.

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Baalwa, J; Byarugaba, B B; Kabagambe, E K; Kabagambe, K E; Otim, A M

2010-12-01

Obesity in young adults is rising and predicts diabetes and cardiovascular diseases later in life. Data on prevalence and determinants of obesity in developing countries are needed for primary prevention. To determine the prevalence of overweight and obesity in young adults in urban (Kampala city) and rural areas (Kamuli District) of Uganda. Cross-sectional survey of 683 randomly selected young adults aged 18-30 years. Obesity was defined as body mass index (BMI) > 30 kg/m(2) and overweight as BMI > 25 kg/m(2). Distribution of BMI by socio-demographic characteristics was determined. Of the 683 participants, 50.5% were female and 53.2% were from Kampala. The overall prevalence of obesity and overweight was 2.3% and 10.4%, respectively. The prevalence of obesity was 4.4% in Kampala and 0% in Kamuli while the prevalence of overweight was 10.2% and 10.6% in Kampala and Kamuli, respectively. Compared to males, females were more likely to be obese (2.9% vs. 1.8%) or overweight (17.4% vs. 3.3%). Residing in the city, alcohol consumption, smoking, non-engagement in sports activities, commuting to school by taxi or private vehicle and being from a rich family were the main factors significantly associated (Pobesity. Being female (p = 0.0001) and not engaging in any sports activities (P = 0.002) were two factors significantly associated with being overweight. We observed significant gender differences in the prevalence of obesity among young adults in Uganda. Contrary to expectation, we did not observe significant rural-urban differences in the prevalence of overweight.

Obesity Among Young Adults in Developing Countries: A Systematic Overview.

Science.gov (United States)

Poobalan, Amudha; Aucott, Lorna

2016-03-01

This article discusses the overweight/obesity situation among young adults in developing countries. For this target population, obesity prevalence ranges from 2.3 to 12 %, and overweight is 28.8 %, mostly affecting females. Weight is now increasing during this life stage of transition at a higher rate, 1 kg/year, than in developed countries. Maternal factors and early childhood socioeconomic status are associated with BMI in young adults along with changing environmental and behavioural factors in some low and middle income countries, brought about by demographic and socioeconomic transitions. Young adults with 'normal weight' obesity need identification using other convenient low cost measures (skin folds or waist circumference) along with BMI. Obesity prevention or management interventions were not identified, but clearly needed to help stem the obesity pandemic. Young people generally give little priority to their future health, so such interventions need to be conducted at some optimal age, be innovative, country specific and culturally acceptable.

Indicated prevention of adult obesity: reference data for weight normalization in overweight children

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Background: Pediatric obesity is a major risk factor for adult obesity. Indicated prevention--that is, helping overweight or obese youth attain non-overweight status--has been suggested to prevent adult obesity. This study aimed to support the notion of indicated prevention by demonstrating that rel...

Epidemiology of adult-onset hydrocephalus: institutional experience with 2001 patients.

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Bir, Shyamal C; Patra, Devi Prasad; Maiti, Tanmoy K; Sun, Hai; Guthikonda, Bharat; Notarianni, Christina; Nanda, Anil

2016-09-01

OBJECTIVE Adult-onset hydrocephalus is not commonly discussed in the literature, especially regarding its demographic distribution. In contrast to pediatric hydrocephalus, which is related to a primary CSF pathway defect, its development in adults is often secondary to other pathologies. In this study, the authors investigated the epidemiology of adult-onset hydrocephalus as it pertains to different etiologies and in reference to age, sex, and race distributions. METHODS The authors retrospectively reviewed the clinical notes of 2001 patients with adult-onset hydrocephalus who presented to Louisiana State University Health Sciences Center within a 25-year span. Significant differences between the groups were analyzed by a chi-square test; p hydrocephalus in this population was 77 ± 30 per year, with a significant increase in incidence in the past decade (55 ± 3 [1990-2003] vs 102 ± 6 [2004-2015]; p Hydrocephalus in a majority of the patients had a vascular etiology (45.5%) or was a result of a tumor (30.2%). The incidence of hydrocephalus in different age groups varied according to various pathologies. The incidence was significantly higher in males with normal-pressure hydrocephalus (p = 0.03) or head injury (p = 0.01) and higher in females with pseudotumor cerebri (p hydrocephalus was significantly higher in Caucasian patients (p = 0.0002) than in those of any other race. CONCLUSIONS Knowledge of the demographic variations in adult-onset hydrocephalus is helpful in achieving better risk stratification and better managing the disease in patients. For general applicability, these results should be validated in a large-scale meta-analysis based on a national population database.

Fast-food consumption and obesity among Michigan adults.

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Anderson, Beth; Rafferty, Ann P; Lyon-Callo, Sarah; Fussman, Christopher; Imes, Gwendoline

2011-07-01

Consumption of meals eaten away from home, especially from fast-food restaurants, has increased in the United States since the 1970s. The main objective of this study was to examine the frequency and characteristics of fast-food consumption among adults in Michigan and obesity prevalence. We analyzed data from 12 questions about fast-food consumption that were included on the 2005 Michigan Behavioral Risk Factor Survey, a population-based telephone survey of Michigan adults, using univariate and bivariate analyses and multivariate logistic regression, and compared these data with data on Michigan obesity prevalence. Approximately 80% of Michigan adults went to fast-food restaurants at least once per month and 28% went regularly (≥2 times/wk). Regular fast-food consumption was higher among younger adults (mostly men) but was not significantly associated with household income, education, race, or urbanicity (in a multivariate framework). The prevalence of obesity increased consistently with frequenting fast-food restaurants, from 24% of those going less than once a week to 33% of those going 3 or more times per week. The predominant reason for choosing fast food was convenience. Although hypothetically 68% of adults who go to fast-food restaurants would choose healthier fast-food items when available, only 16% said they ever use nutritional information when ordering. The prevalence of fast-food consumption is high in Michigan across education, income, and racial groups and is strongly associated with obesity. Making nutritional information at fast-food restaurants more readily available and easier to use may help consumers to order more healthful or lower-calorie items.

Adult-Onset Type 1 Diabetes and Pregnancy: Three Case Reports

Directory of Open Access Journals (Sweden)

Barbara Bonsembiante

2013-01-01

Full Text Available From 5% to 10% of diabetic patients have type 1 diabetes. Here we describe three cases of adult-onset type 1 diabetes in pregnancy treated at our clinic between 2009 and 2012. Two patients came for specialist examination during pregnancy, the third after pregnancy. These women had no prior overt diabetes and shared certain characteristics, that is, no family diabetes history, age over 35, normal prepregnancy BMI, need for insulin therapy as of the early weeks of pregnancy, and high-titer anti-GAD antibody positivity. The patients had persistent diabetes after delivery, suggesting that they developed adult-onset type 1 diabetes during pregnancy. About 10% of GDM patients become pancreatic autoantibody positive and the risk of developing overt diabetes is higher when two or more autoantibodies are present (particularly GAD and ICA. GAD-Ab shows the highest sensitivity for type 1 diabetes prediction. We need to bear in mind that older patients might conceivably develop an adult-onset type 1 diabetes during or after pregnancy. So we suggest that women with GDM showing the described clinical features shall be preferably tested for autoimmunity. Pregnant patients at risk of type 1 diabetes should be identified to avoid the maternal and fetal complications and the acute onset of diabetes afterwards.

Cognition and event-related potentials in adult-onset non-demented myotonic dystrophy type 1.

Science.gov (United States)

Tanaka, H; Arai, M; Harada, M; Hozumi, A; Hirata, K

2012-02-01

To clarify the cognitive and event-related potentials (ERPs) profiles of adult-onset genetically-proven non-demented myotonic dystrophy type 1 (DM1). Fourteen DM1 patients and matched 14 normal controls were enrolled. DM1 patients were compared with normal controls, using a variety of neuropsychological tests; an auditory "oddball" counting paradigm for the ERPs, and low-resolution brain electromagnetic tomography (LORETA). For patients, ERPs and neuropsychological parameters were correlated with CTG repeat size, duration of illness, grip strength, and arterial blood gas analysis. Frontal lobe dysfunction, prolonged N1 latency, and attenuated N2/P3 amplitudes were observed in DM1. Longer CTG repeat size was associated with fewer categories achieved on Wisconsin Card Sorting Test. Greater grip strength was associated with better scores on color-word "interference" of Stroop test. P3 latency was negatively correlated with PaO(2). LORETA revealed significant hypoactivities at the orbitofrontal and medial temporal lobe, cingulate, and insula. There was no correlation between ERPs and CTG expansion. Adult-onset non-demented DM1 presented frontal lobe dysfunction. Absence of correlations between CTG repeat size and objective ERP parameters suggested CTG expansion in lymphocytes does not directly contribute to cognitive dysfunction. CTG expansion in lymphocytes does not directly contribute to cognitive dysfunction of adult-onset non-demented DM1. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Microvascular Blood Flow Improvement in Hyperglycemic Obese Adult Patients by Hypocaloric Diet.

Science.gov (United States)

Mastantuono, T; Di Maro, M; Chiurazzi, M; Battiloro, L; Starita, N; Nasti, G; Lapi, D; Iuppariello, L; Cesarelli, M; D'Addio, G; Colantuoni, A

2016-11-01

The present study was aimed to assess the changes in skin microvascular blood flow (SBF) in newly diagnosed hyperglycemic obese subjects, administered with hypocaloric diet. Adult patients were recruited and divided in three groups: NW group (n=54), NG (n=54) and HG (n=54) groups were constituted by normal weight, normoglycemic and hyperglycemic obese subjects, respectively. SBF was measured by laser Doppler perfusion monitoring technique and oscillations in blood flow were analyzed by spectral methods under baseline conditions, at 3 and 6 months of dietary treatment. Under resting conditions, SBF was lower in HG group than in NG and NW ones. Moreover, all subjects showed blood flow oscillations with several frequency components. In particular, hyperglycemic obese patients revealed lower spectral density in myogenic-related component than normoglycemic obese and normal weight ones. Moreover, post-occlusive reactive hyperemia (PORH) was impaired in hyperglycemic obese compared to normoglycemic and normal weigh subjects. After hypocaloric diet, in hyperglycemic obese patients there was an improvement in SBF accompanied by recovery in myogenic-related oscillations and arteriolar responses during PORH. In conclusion, hyperglycemia markedly affected peripheral microvascular function; hypocaloric diet ameliorated tissue blood flow.

Age at asthma onset and asthma self-management education among adults in the United States.

Science.gov (United States)

Mirabelli, Maria C; Beavers, Suzanne F; Shepler, Samantha H; Chatterjee, Arjun B

2015-01-01

Asthma self-management education improves asthma-related outcomes. We conducted this analysis to evaluate variation in the percentages of adults with active asthma reporting components of asthma self-management education by age at asthma onset. Data from 2011 to 2012 Asthma Call-back Surveys were used to estimate percentages of adults with active asthma reporting six components of asthma self-management education. Components of asthma self-management education include having been taught to what to do during an asthma attack and receiving an asthma action plan. Differences in the percentages of adults reporting each component and the average number of components reported across categories of age at asthma onset were estimated using linear regression, adjusted for age, education, race/ethnicity, sex, smoking status, and years since asthma onset. Overall, an estimated 76.4% of adults with active asthma were taught what to do during an asthma attack and 28.7% reported receiving an asthma action plan. Percentages reporting each asthma self-management education component declined with increasing age at asthma onset. Compared with the referent group of adults whose asthma onset occurred at 5-14 years of age, the percentage of adults reporting being taught what to do during an asthma attack was 10% lower among those whose asthma onset occurred at 65-93 years of age (95% CI: -18.0, -2.5) and the average number of components reported decreased monotonically across categories of age at asthma onset of 35 years and older. Among adults with active asthma, reports of asthma self-management education decline with increasing age at asthma onset.

The experience of living with adult-onset epilepsy.

Science.gov (United States)

Kılınç, Stephanie; van Wersch, Anna; Campbell, Carol; Guy, Alison

2017-08-01

The incidence and prevalence of adults diagnosed with epilepsy is higher compared to those diagnosed in childhood, yet the experience of living with adult-onset epilepsy has rarely been examined. Hence, the current study took a phenomenological approach to examining the experience of living with epilepsy following diagnosis in adulthood. Semi-structured interviews were conducted with 39 people from across the UK, diagnosed with epilepsy between the ages of eighteen and sixty, at two points in time, six months apart. Phenomenological analysis identified three central themes: the unpredictability of seizure occurrence; the ripple effect; and re-evaluating the future. Despite the accepted consensus in the epilepsy literature that living and coping with epilepsy becomes more difficult the older a person is diagnosed, the current findings indicated that this is inadequate. Rather, it is more suitable to consider that those living with adult-onset epilepsy have a specific experience of the condition and particular support needs, given that they once lived their lives as people without epilepsy. Copyright © 2017 Elsevier Inc. All rights reserved.

Coexistence of Obesity and Anemia in Older Mexican Adults.

Science.gov (United States)

Samper-Ternent, Rafael; Michaels-Obregon, Alejandra; Wong, Rebeca

2011-12-08

INTRODUCTION: Developing countries in Latin America (LA) are experiencing rapid aging as a result of advances in medical interventions. This rapid aging has not occurred with comparable improvements in standards of living. Chronic conditions are becoming highly prevalent while exposure to infectious communicable diseases is very common. This unique situation where communicable and non-communicable diseases coexist in the presence of low socioeconomic status place countries in LA in a unique epidemiological situation. Mexico presents a very good example where the impact of this situation on health warrants further analysis. METHODS: We use data from the Mexican National Health and Nutrition Survey (ENSANut 2006), a cross-sectional study representative of all urban and rural areas of Mexico. A total of 5,605 adults older than 60 years of age with valid values for Body Mass Index and Hemoglobin were analyzed. We first included a descriptive analysis of the coexistence of anemia and obesity by age, gender and characteristics of the living environment. We reported the weighted percentages for each covariate by each of four nutritional condition categories (obese and anemic, only-obese, only-anemic, not obese and not anemic). We used multinomial logit regressions to determine the association of socioeconomic characteristics, health status and the living environment with the presence of the three nutritional condition categories. RESULTS: In the ENSANut cohort 10.3% of older adults are anemic, 25.0% are obese and 2.6% are both anemic and obese. Approximately 62% has neither anemia nor obesity. Within the 38% that fall in the three nutritional condition categories, the co-existence of obesity & anemia appears to be associated with metropolitan area residence, living alone, being male, having relatively high wealth, and reporting two or more chronic health conditions. Analyzing the effect of the covariates to distinguish between outcome categories, living environment, age

Age Variation in the Association Between Obesity and Mortality in Adults.

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Wang, Zhiqiang; Peng, Yang; Liu, Meina

2017-12-01

The aim of this study was to evaluate the previously reported finding that the association between obesity and mortality strengthens with increasing age. The data were derived from the National Health Interview Survey. Age-specific hazard ratios of mortality for grade 2/3 obesity (BMI ≥ 35 kg/m 2 ), relative to a BMI of 18.5 kg/m 2 to obesity and age at the survey, hazard ratios appeared to increase with age if those interaction terms were ignored by fixing age at the survey as a single value. However, when recalculated for adults with various ages at the survey, according to model specifications, hazard ratios were higher for younger adults than for older adults with the same follow-up duration. Based on matched data, hazard ratios were also higher for younger adults (2.14 [95% CI: 1.90-2.40] for those 40-49 years of age) than for older adults (1.22 [95%: 0.91-1.63] for those 90+ years of age). For any given follow-up duration, the association between obesity and mortality weakens with age. The previously reported strengthening of the obesity-mortality association with increasing age was caused by the failure to take all the model specifications into consideration when calculating adjusted hazard ratios. © 2017 The Obesity Society.

The p. N103K mutation of leptin (LEP gene and severe early onset obesity in Pakistan

Directory of Open Access Journals (Sweden)

Shabana

Full Text Available BACKGROUND: Obesity is a complex disorder and has been increasing globally at alarming rates including Pakistan. However, there is scarce research on understanding obesity genetics in Pakistan. Leptin is a hormone secreted by adipocytes in response to satiety and correlates with body weight. Any mutations in the LEP gene have an adverse effect on energy regulation pathway and lead to severe, early onset obesity. To date, only eight mutations have been described in the LEP gene of which p. N103K is one. METHODS: We aimed to analyze the prevalence of this mutation in Pakistani subjects. A total of 475 subjects were genotyped by PCR-RFLP analysis and their serum profiling was done. RESULTS: Results showed that this mutation was present only in one male child with early onset obesity (10 year. He had very low serum leptin levels suggestive of functional impact of the mutation. The prevalence of such mutations is, however, low due to the drastic effects on the energy regulation. CONCLUSION: In conclusion, LEP gene mutations contribute significantly to the monogenic forms of obesity and are important due to the availability of treatment options. Such mutations may exert their effect by directly affecting energy regulation pathway and are more prominent in the early stages of life only.

How Much Do We Know about Adult-onset Primary Tics? Prevalence, Epidemiology, and Clinical Features.

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Robakis, Daphne

2017-01-01

Tic disorders are generally considered to be of pediatric onset; however, reports of adult-onset tics exist in the literature. Tics can be categorized as either primary or secondary, with the latter being the larger group in adults. Primary or idiopathic tics that arise in adulthood make up a subset of tic disorders whose epidemiologic and clinical features have not been well delineated. Articles to be included in this review were identified by searching PubMed, SCOPUS, and Web of Science using the terms adult- and late-onset tics, which resulted in 120 unique articles. Duplicates were removed. Citing references were identified using Google Scholar; all references were reviewed for relevance. The epidemiologic characteristics, clinical phenomenology, and optimal treatment of adult-onset tics have not been ascertained. Twenty-six patients with adult-onset, primary tics were identified from prior case reports. The frequency of psychiatric comorbidities may be lower in adults than in children, and obsessive compulsive disorder was the most common comorbidity. Adult-onset primary tics tend to wax and wane, occur predominantly in males, are often both motor and phonic in the same individual, and are characterized by a poor response to treatment. We know little about adult-onset tic disorders, particularly ones without a secondary association or cause. They are not common, and from the limited data available, appear to share some but not all features with childhood tics. Further research will be important in gaining a better understanding of the epidemiology and clinical manifestations of this disorder.

Adult-onset epilepsy in focal cortical dysplasia of Taylor type

NARCIS (Netherlands)

Siegel, A. M.; Cascino, G. D.; Elger, C. E.; Devinsky, O.; Laff, R.; Najjar, S.; Sperling, M. R.; LoRusso, G.; Cossu, M.; Urbach, H.; Aronica, E.; Meyer, F. B.; Scheithauer, B. W.; Dubeau, F.; Andermann, F.

2005-01-01

Focal cortical dysplasia of Taylor type (FCDT) usually presents with seizures at an early age, whereas adult onset of epilepsy is uncommon. We reviewed the medical records of 213 patients with FCDT. In 21 patients (10%), age at seizure onset ranged from 18 to 55 years (mean 25.3). The outcome of

De Novo Advanced Adult-Onset Offending: New Evidence from a Population of Federal Correctional Clients.

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DeLisi, Matt; Tahja, Katherine N; Drury, Alan J; Elbert, Michael J; Caropreso, Daniel E; Heinrichs, Timothy

2018-01-01

Adult antisocial behavior is almost always predated by delinquency during childhood or adolescence; however, there is also evidence of adult-onset criminal offending. This study examined this controversial subgroup of offenders using self-reported and official data from a total population of federal correctional clients selected from the Midwestern United States. Difference of means t-tests, chi-square tests, and logistic regression models found that 11.7% of clients had an adult onset of offending and 2.7% of clients (n = 23) had an onset occurring at age 60 years or older. This group-introduced as de novo advanced adult-onset offenders-had high socioeconomic status, mixed evidence of adverse childhood experiences, and virtually no usage of drugs with the exception of alcohol. These offenders were primarily convicted of social security and white-collar crimes and evinced remarkably low psychopathology and criminal risk. More research is needed to replicate the phenomenon of de novo advanced adult-onset offending. © 2017 American Academy of Forensic Sciences.

Sporadic adult onset primary torsion dystonia is a genetic disorder by the temporal discrimination test.

LENUS (Irish Health Repository)

Kimmich, Okka

2012-02-01

Adult-onset primary torsion dystonia is an autosomal dominant disorder with markedly reduced penetrance; patients with sporadic adult-onset primary torsion dystonia are much more prevalent than familial. The temporal discrimination threshold is the shortest time interval at which two stimuli are detected to be asynchronous and has been shown to be abnormal in adult-onset primary torsion dystonia. The aim was to determine the frequency of abnormal temporal discrimination thresholds in patients with sporadic adult-onset primary torsion dystonia and their first-degree relatives. We hypothesized that abnormal temporal discrimination thresholds in first relatives would be compatible with an autosomal dominant endophenotype. Temporal discrimination thresholds were examined in 61 control subjects (39 subjects <50 years of age; 22 subjects >50 years of age), 32 patients with sporadic adult-onset primary torsion dystonia (cervical dystonia n = 30, spasmodic dysphonia n = 1 and Meige\\'s syndrome n = 1) and 73 unaffected first-degree relatives (36 siblings, 36 offspring and one parent) using visual and tactile stimuli. Z-scores were calculated for all subjects; a Z > 2.5 was considered abnormal. Abnormal temporal discrimination thresholds were found in 1\\/61 (2%) control subjects, 27\\/32 (84%) patients with adult-onset primary torsion dystonia and 32\\/73 (44%) unaffected relatives [siblings (20\\/36; 56%), offspring (11\\/36; 31%) and one parent]. When two or more relatives were tested in any one family, 22 of 24 families had at least one first-degree relative with an abnormal temporal discrimination threshold. The frequency of abnormal temporal discrimination thresholds in first-degree relatives of patients with sporadic adult-onset primary torsion dystonia is compatible with an autosomal dominant disorder and supports the hypothesis that apparently sporadic adult-onset primary torsion dystonia is genetic in origin.

Sporadic adult onset primary torsion dystonia is a genetic disorder by the temporal discrimination test.

Science.gov (United States)

Kimmich, Okka; Bradley, David; Whelan, Robert; Mulrooney, Nicola; Reilly, Richard B; Hutchinson, Siobhan; O'Riordan, Sean; Hutchinson, Michael

2011-09-01

Adult-onset primary torsion dystonia is an autosomal dominant disorder with markedly reduced penetrance; patients with sporadic adult-onset primary torsion dystonia are much more prevalent than familial. The temporal discrimination threshold is the shortest time interval at which two stimuli are detected to be asynchronous and has been shown to be abnormal in adult-onset primary torsion dystonia. The aim was to determine the frequency of abnormal temporal discrimination thresholds in patients with sporadic adult-onset primary torsion dystonia and their first-degree relatives. We hypothesized that abnormal temporal discrimination thresholds in first relatives would be compatible with an autosomal dominant endophenotype. Temporal discrimination thresholds were examined in 61 control subjects (39 subjects 50 years of age), 32 patients with sporadic adult-onset primary torsion dystonia (cervical dystonia n = 30, spasmodic dysphonia n = 1 and Meige's syndrome n = 1) and 73 unaffected first-degree relatives (36 siblings, 36 offspring and one parent) using visual and tactile stimuli. Z-scores were calculated for all subjects; a Z > 2.5 was considered abnormal. Abnormal temporal discrimination thresholds were found in 1/61 (2%) control subjects, 27/32 (84%) patients with adult-onset primary torsion dystonia and 32/73 (44%) unaffected relatives [siblings (20/36; 56%), offspring (11/36; 31%) and one parent]. When two or more relatives were tested in any one family, 22 of 24 families had at least one first-degree relative with an abnormal temporal discrimination threshold. The frequency of abnormal temporal discrimination thresholds in first-degree relatives of patients with sporadic adult-onset primary torsion dystonia is compatible with an autosomal dominant disorder and supports the hypothesis that apparently sporadic adult-onset primary torsion dystonia is genetic in origin.

Fluid Distribution Pattern in Adult-Onset Congenital, Idiopathic, and Secondary Normal-Pressure Hydrocephalus: Implications for Clinical Care.

Science.gov (United States)

Yamada, Shigeki; Ishikawa, Masatsune; Yamamoto, Kazuo

2017-01-01

In spite of growing evidence of idiopathic normal-pressure hydrocephalus (NPH), a viewpoint about clinical care for idiopathic NPH is still controversial. A continuous divergence of viewpoints might be due to confusing classifications of idiopathic and adult-onset congenital NPH. To elucidate the classification of NPH, we propose that adult-onset congenital NPH should be explicitly distinguished from idiopathic and secondary NPH. On the basis of conventional CT scan or MRI, idiopathic NPH was defined as narrow sulci at the high convexity in concurrent with enlargement of the ventricles, basal cistern and Sylvian fissure, whereas adult-onset congenital NPH was defined as huge ventricles without high-convexity tightness. We compared clinical characteristics and cerebrospinal fluid distribution among 85 patients diagnosed with idiopathic NPH, 17 patients with secondary NPH, and 7 patients with adult-onset congenital NPH. All patients underwent 3-T MRI examinations and tap-tests. The volumes of ventricles and subarachnoid spaces were measured using a 3D workstation based on T2-weighted 3D sequences. The mean intracranial volume for the patients with adult-onset congenital NPH was almost 100 mL larger than the volumes for patients with idiopathic and secondary NPH. Compared with the patients with idiopathic or secondary NPH, patients with adult-onset congenital NPH exhibited larger ventricles but normal sized subarachnoid spaces. The mean volume ratio of the high-convexity subarachnoid space was significantly less in idiopathic NPH than in adult-onset congenital NPH, whereas the mean volume ratio of the basal cistern and Sylvian fissure in idiopathic NPH was >2 times larger than that in adult-onset congenital NPH. The symptoms of gait disturbance, cognitive impairment, and urinary incontinence in patients with adult-onset congenital NPH tended to progress more slowly compared to their progress in patients with idiopathic NPH. Cerebrospinal fluid distributions and

The relationship between adenovirus-36 seropositivity, obesity and metabolic profile in Turkish children and adults.

Science.gov (United States)

Karamese, M; Altoparlak, U; Turgut, A; Aydogdu, S; Karamese, S Aksak

2015-12-01

Obesity potentially arising from viral infection is known as 'infectobesity'. The latest reports suggest that adenovirus-36 (Adv36) is related to obesity in adults and children. Our aim was not only to determine the Adv36 seropositivity in both obese and non-obese children and adults, but also to investigate correlations between antibody positivity and serum lipid profiles. Both Adv36 positivity and tumour-necrosis-factor-alpha, leptin and interleukin-6 levels were detected in blood samples collected from 146 children and 130 adults by ELISA. Fasting plasma triglycerides, total cholesterol and low-density lipoprotein levels were also measured. Adv36 positivity was determined to be 27·1% and 6% in obese and non-obese children and 17·5% and 4% in obese and non-obese adults, respectively. There was no difference with regard to total cholesterol, low-density lipoprotein, triglyceride, tumour-necrosis-factor-alpha and interleukin-6 levels (P > 0·05). However, there was a significant difference between groups in terms of leptin levels (P obese children and adults. Our results showed that Adv36 may be an obesity agent for both adults and children, parallel with current literature data. However, the available data on a possible relationship between Adv36 infection and obesity both in children and adults do not completely solve the problem.

Resting and exercise energy metabolism in weight-reduced adults with severe obesity.

Science.gov (United States)

Hames, Kazanna C; Coen, Paul M; King, Wendy C; Anthony, Steven J; Stefanovic-Racic, Maja; Toledo, Frederico G S; Lowery, Jolene B; Helbling, Nicole L; Dubé, John J; DeLany, James P; Jakicic, John M; Goodpaster, Bret H

2016-06-01

To determine effects of physical activity (PA) with diet-induced weight loss on energy metabolism in adults with severe obesity. Adults with severe obesity (n = 11) were studied across 6 months of intervention, then compared with controls with less severe obesity (n = 7) or normal weight (n = 9). Indirect calorimetry measured energy metabolism during exercise and rest. Markers of muscle oxidation were determined by immunohistochemistry. Data were presented as medians. The intervention induced 7% weight loss (P = 0.001) and increased vigorous PA by 24 min/wk (P = 0.02). During exercise, energy expenditure decreased, efficiency increased (P ≤ 0.03), and fatty acid oxidation (FAO) did not change. Succinate dehydrogenase increased (P = 0.001), but fiber type remained the same. Post-intervention subjects' resting metabolism remained similar to controls. Efficiency was lower in post-intervention subjects compared with normal-weight controls exercising at 25 W (P ≤ 0.002) and compared with all controls exercising at 60% VO2peak (P ≤ 0.019). Resting and exercise FAO of post-intervention subjects remained similar to adults with less severe obesity. Succinate dehydrogenase and fiber type were similar across all body weight statuses. While metabolic adaptations to PA during weight loss occur in adults with severe obesity, FAO does not change. Resulting FAO during rest and exercise remains similar to adults with less severe obesity. © 2016 The Obesity Society.

Effect of exercise intensity on lipid profile in sedentary obese adults.

Science.gov (United States)

Kannan, Umamaheswari; Vasudevan, Kavita; Balasubramaniam, Kavita; Yerrabelli, Dhanalakshmi; Shanmugavel, Karthik; John, Nitin Ashok

2014-07-01

Exercise is a lifestyle change that has been recommended for lowering atherogenic index in adults. The intensity and duration of exercise to bring about a change in the lipid parameters are yet to be determined. Previous studies examining the effects of exercise intensity on lipid and lipoprotein levels have reported conflicting findings. Thus we aimed at determining the changes in lipid profile in sedentary obese adults influenced by different intensity of exercise. Study included 51 obese adults with sedentary lifestyle. Participants performed exercise of moderate intensity (n=22) and high intermittent intensity (n=29) for a duration of 40min/day for 5 days/week and 20 min/day for 3 days/week respectively on bicycle ergometer for a period of 15 weeks. Pretesting and post testing included measurement of height, weight, blood pressure and lipid profile. RESULTS were analysed using the Paired and Unpaired samples t-test. Postexercise revealed significant reduction in the LDL-C and diastolic blood pressure (plife. High intermittent intensity can be considered for individuals who have time constraints and lead a sedentary life style and moderate intensity exercise advised for individuals who are willing to create time for their health benefits. A programmed protocol of exercise will help in reduction of lipid parameters.

Lifestyle habits and obesity progression in overweight and obese American young adults: Lessons for promoting cardiometabolic health

OpenAIRE

Cha, EunSeok; Akazawa, Margeaux K.; Kim, Kevin H.; Dawkins, Colleen R.; Lerner, Hannah M.; Umpierrez, Guillermo; Dunbar, Sandra B.

2015-01-01

Obesity among young adults is a growing problem in the United States and is related to unhealthy lifestyle habits such as high caloric intake and inadequate exercise. Accurate assessment of lifestyle habits across obesity stages is important for informing age-specific intervention strategies to prevent and reduce obesity progression. Using a modified version of the Edmonton Obesity Staging System (mEOSS), a new scale for defining obesity risk and predicting obesity morbidity and mortality, th...

Adult-Onset Metachromatic Leukodystrophy: Two Cases

Directory of Open Access Journals (Sweden)

Gaye Eryaşar

2011-12-01

Full Text Available Metachromatic Leukodystrophy(MLD is a lisosomal storage disorder which is characterized with arylsulphatase A deficiency. Enzyme deficiency results with demiyelination and storage of sulphatides in central nervous system.According to onset age;the disease has three major clinical forms as late infantile,juvenile and adult form. It is a rare disorder. For the patients who did not develop neurological findings bone marrow or hematopoietic stem cell transplantation may be effective as treatment.

Asthma and obesity

DEFF Research Database (Denmark)

Ulrik, Charlotte S

2016-01-01

PURPOSE OF REVIEW: Obesity has significant negative impact on asthma control and risk of exacerbations. The purpose of this review is to discuss recent studies evaluating the effects of weight reduction on asthma control in obese adults. RECENT FINDINGS: Clinical studies have shown that weight...... reduction in obese patients is associated with improvements in symptoms, use of controller medication, and asthma-related quality of life together with a reduction in the risk for severe exacerbations. Furthermore, several studies have also revealed improvements in lung function and airway responsiveness...... reduction in obese adults with asthma leads to an overall improvement in asthma control, including airway hyperresponsiveness and inflammation. Weight reduction should be a cornerstone in the management of obese patients with asthma....

[Food insecurity is associated with obesity in adult women of Mexico].

Science.gov (United States)

Morales-Ruán, Ma Del Carmen; Méndez-Gómez Humarán, Ignacio; Shamah-Levy, Teresa; Valderrama-Álvarez, Zaira; Melgar-Quiñónez, Hugo

2014-01-01

To describe the association of food insecurity (FI) and obesity in adults in Mexico. Cross-sectional design. We included adults' data from the health and nutrition national survey 2012 (Ensanut 2012). Measures of weight and height were obtained and BMI was calculated. The level of household food insecurity was measured through the Latin American Scale of Food Security (ELCSA). Linear and logistic regression models were adjusted. 70.6% of the population had some level of food insecurity, 42.6% mild insecurity, 17.7% moderate insecurity and 10.3% severe insecurity. Adults with mild FI had higher probability of obesity (OR: 1.66; 95%CI 1.11-2.50). Women were slightly more likely to be obese (OR: 1.78; 95%CI 1.01-3.12). Mild FI is associated with obesity, particularly among women.

Genetics of Childhood Obesity

Directory of Open Access Journals (Sweden)

Jianhua Zhao

2011-01-01

Full Text Available Obesity is a major health problem and an immense economic burden on the health care systems both in the United States and the rest of the world. The prevalence of obesity in children and adults in the United States has increased dramatically over the past decade. Besides environmental factors, genetic factors are known to play an important role in the pathogenesis of obesity. Genome-wide association studies (GWAS have revealed strongly associated genomic variants associated with most common disorders; indeed there is general consensus on these findings from generally positive replication outcomes by independent groups. To date, there have been only a few GWAS-related reports for childhood obesity specifically, with studies primarily uncovering loci in the adult setting instead. It is clear that a number of loci previously reported from GWAS analyses of adult BMI and/or obesity also play a role in childhood obesity.

Unmasked adult-onset urea cycle disorders in the critical care setting.

Science.gov (United States)

Summar, Marshall L; Barr, Frederick; Dawling, Sheila; Smith, Wendy; Lee, Brendan; Singh, Rani H; Rhead, William J; Sniderman King, Lisa; Christman, Brian W

2005-10-01

Most often, urea cycle disorders have been described as acute onset hyperammonemia in the newborn period; however, there is a growing awareness that urea cycle disorders can present at almost any age, frequently in the critical care setting. This article presents three cases of adult-onset hyperammonemia caused by inherited defects in nitrogen processing in the urea cycle, and reviews the diagnosis, management, and pathophysiology of adult-onset urea cycle disorders. Individuals who have milder molecular urea cycle defects can lead a relatively normal life until a severe environmental stress triggers a hyperammonemic crisis. Comorbid conditions such as physical trauma often delay the diagnosis of the urea cycle defect. Prompt recognition and treatment are essential in determining the outcome of these patients.

The effect of a high-carbohydrate meal on postprandial thermogenesis and sympathetic nervous system activity in boys with a recent onset of obesity.

Science.gov (United States)

Nagai, Narumi; Sakane, Naoki; Hamada, Taku; Kimura, Tetsuya; Moritani, Toshio

2005-04-01

The purpose of the present study was to investigate the thermic effect of food (TEF) and sympathetic nervous system (SNS) activity in obese boys. Ten obese (9.2+/-0.4 years) and 13 lean boys (8.8+/-0.4 years) were examined for energy expenditure and fat oxidation measured via indirect calorimetry for 3 hours after a high-carbohydrate (HC; 70% carbohydrate, 20% fat, and 10% protein) or a high-fat (HF; 20% carbohydrate, 70% fat, and 10% protein) meal served on 2 different days at random. The activity of the SNS was assessed by means of a power spectral analysis of the heart rate variability. The TEF, expressed as a percentage of the consumed energy, was significantly lower in obese boys than in lean boys after the HC meal; however, such a difference was not observed after the HF meal. Multiple regression analysis revealed that obesity was a significant variable contributing to the variances in the TEF induced by the HC meal. Moreover, after the HC meal, the boys with a recent onset of obesity (duration, frequency component of the heart rate variability, an index of thermoregulatory SNS functions, compared with the remaining obese and lean boys. In conclusion, obese boys possessed normal metabolic and sympathetic responses to the HF meal but showed a diminished thermogenic response to the HC meal, especially during the early phase of obesity.

Association between Obesity and Serum 25(OH)D Concentrations in Older Mexican Adults.

Science.gov (United States)

Rontoyanni, Victoria G; Avila, Jaqueline C; Kaul, Sapna; Wong, Rebeca; Veeranki, Sreenivas P

2017-01-31

Vitamin D is essential for maintaining bone mineralization and calcium homeostasis, and prevents falls and fractures in older adults. Mexico is undergoing an epidemiologic and demographic transition with increasing obesity rates. The study's aim was to determine the association of obesity with serum 25-hydroxyvitamin D [25(OH)D] concentrations in older Mexican adults. Data from 1772 Mexicans, aged ≥50 years, enrolled in a sub-sample of the 3rd wave of the Mexican Health and Aging Study, were included. Serum 25(OH)D concentrations were used to define vitamin D status, and were categorized into tertiles. Body mass index measures were used to categorize older adults into under/normal weight, overweight, and obese groups. Multinomial logistic regression models were used to assess the relationship, adjusting for potential confounders. Approximately 40% and 37% of older Mexican adults were either overweight or obese, respectively. Compared to under/normal weight older Mexicans, obese adults were 1.78 times (95% Confidence Interval (CI) 1.27-2.48) and 1.94 times (95% CI 1.40-2.68) more associated with the first and second tertile concentrations of serum 25(OH)D, respectively. Overweight adults were 1.52 times (95% CI 1.12-2.06) more associated with the second tertile of serum 25(OH)D concentration than under/normal weight adults. Overweight/Obesity was found to be significantly associated with low concentrations of serum 25(OH) in older Mexican adults.

Prevalence Of Overweight And Obesity Among Urban Nigeria Adults ...

African Journals Online (AJOL)

Prevalence Of Overweight And Obesity Among Urban Nigeria Adults In Jos. ... to be associated with non-communicable disease (NCDS) like type 2 Diabetes, ... and obesity was 21.4% (19.4%) in males and 23.5% in females (M:F= 1:1.3, ...

Trends of obesity prevalence among Spanish adults with diabetes, 1987-2012.

Science.gov (United States)

Basterra-Gortari, Francisco Javier; Bes-Rastrollo, Maira; Ruiz-Canela, Miguel; Gea, Alfredo; Sayón-Orea, Carmen; Martínez-González, Miguel Ángel

2018-04-24

Our aim was to examine the secular trends in obesity prevalence among Spanish adults with diabetes. Data were collected from 8 waves (from 1987 to 2012) of the National Health Surveys (NHS). NHS are cross-sectional studies conducted in representative samples of the Spanish adult population. Data of 7378 adults (≥16 years) who reported having been diagnosed of diabetes were analyzed. Previously validated self-reported weight and height were used to estimate body mass index (BMI). Obesity was defined as a BMI of 30kg/m 2 or greater. Age-adjusted obesity prevalence for each wave was calculated by the direct standardization method. From 1987 to 2012 age-adjusted prevalence of obesity among persons with diabetes increased from 18.2% (95% confidence interval [CI]: 14.2-22.2%) to 39.8% (95% CI: 36.8-42.8%). Age-adjusted prevalence of obesity in males with diabetes increased from 13.2% (95% CI: 7.3-19.1%) to 38.0% (95% CI: 33.8-42.1%) and in females from 23.0% (95% CI: 17.6-28.4%) to 42.3% (95% CI: 38.0-46.6%). Between 1987 and 2012 the prevalence of obesity markedly increased in Spain among adults with diabetes. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

A community-based exercise intervention transitions metabolically abnormal obese adults to a metabolically healthy obese phenotype

Science.gov (United States)

Dalleck, Lance C; Van Guilder, Gary P; Richardson, Tara B; Bredle, Donald L; Janot, Jeffrey M

2014-01-01

Background Lower habitual physical activity and poor cardiorespiratory fitness are common features of the metabolically abnormal obese (MAO) phenotype that contribute to increased cardiovascular disease risk. The aims of the present study were to determine 1) whether community-based exercise training transitions MAO adults to metabolically healthy, and 2) whether the odds of transition to metabolically healthy were larger for obese individuals who performed higher volumes of exercise and/or experienced greater increases in fitness. Methods and results Metabolic syndrome components were measured in 332 adults (190 women, 142 men) before and after a supervised 14-week community-based exercise program designed to reduce cardiometabolic risk factors. Obese (body mass index ≥30 kg · m2) adults with two to four metabolic syndrome components were classified as MAO, whereas those with no or one component were classified as metabolically healthy but obese (MHO). After community exercise, 27/68 (40%) MAO individuals (Pmetabolically healthy, increasing the total number of MHO persons by 73% (from 37 to 64). Compared with the lowest quartiles of relative energy expenditure and change in fitness, participants in the highest quartiles were 11.6 (95% confidence interval: 2.1–65.4; Pexercise transitions MAO adults to metabolically healthy. MAO adults who engaged in higher volumes of exercise and experienced the greatest increase in fitness were significantly more likely to become metabolically healthy. Community exercise may be an effective model for primary prevention of cardiovascular disease. PMID:25120373

Obese adults have visual attention bias for food cue images: evidence for altered reward system function.

Science.gov (United States)

Castellanos, E H; Charboneau, E; Dietrich, M S; Park, S; Bradley, B P; Mogg, K; Cowan, R L

2009-09-01

The major aim of this study was to investigate whether the motivational salience of food cues (as reflected by their attention-grabbing properties) differs between obese and normal-weight subjects in a manner consistent with altered reward system function in obesity. A total of 18 obese and 18 normal-weight, otherwise healthy, adult women between the ages of 18 and 35 participated in an eye-tracking paradigm in combination with a visual probe task. Eye movements and reaction time to food and non-food images were recorded during both fasted and fed conditions in a counterbalanced design. Eating behavior and hunger level were assessed by self-report measures. Obese individuals had higher scores than normal-weight individuals on self-report measures of responsiveness to external food cues and vulnerability to disruptions in control of eating behavior. Both obese and normal-weight individuals demonstrated increased gaze duration for food compared to non-food images in the fasted condition. In the fed condition, however, despite reduced hunger in both groups, obese individuals maintained the increased attention to food images, whereas normal-weight individuals had similar gaze duration for food and non-food images. Additionally, obese individuals had preferential orienting toward food images at the onset of each image. Obese and normal-weight individuals did not differ in reaction time measures in the fasted or fed condition. Food cue incentive salience is elevated equally in normal-weight and obese individuals during fasting. Obese individuals retain incentive salience for food cues despite feeding and decreased self-report of hunger. Sensitization to food cues in the environment and their dysregulation in obese individuals may play a role in the development and/or maintenance of obesity.

Changes in serum aldosterone are associated with changes in obesity-related factors in normotensive overweight and obese young adults.

Science.gov (United States)

Cooper, Jennifer N; Fried, Linda; Tepper, Ping; Barinas-Mitchell, Emma; Conroy, Molly B; Evans, Rhobert W; Mori Brooks, Maria; Woodard, Genevieve A; Sutton-Tyrrell, Kim

2013-10-01

Recent data suggest excess circulating aldosterone promotes cardiometabolic decline. Weight loss may lower aldosterone levels, but little longitudinal data is available in normotensive adults. We aimed to determine whether, independent of changes in sodium excretion, reductions in serum aldosterone are associated with favorable changes in obesity-related factors in normotensive overweight/obese young adults. We studied 285 overweight/obese young adult participants (body mass index ≥ 25 andobesity-related factors were measured at baseline, 6, 12 and 24 months. Weight loss was significant at 6 (7%), 12 (6%) and 24 months (4%; all Pobesity-related factors are associated with reductions in aldosterone in young adults with no risk factors besides excess weight, an important finding, given aldosterone's emergence as an important cardiometabolic risk factor.

Effect of Obesity on Arch Index in Young Adults

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Sneha Sameer Ganu

2013-01-01

Full Text Available Background: Excessive increases in weight bearing forces caused by obesity may negatively affect the lower limbs and feet but minimal research has examined the long-term loading effects of obesity on the musculoskeletal system, particularly in reference to the feet. Objectives: The purpose of the study was to investigate the effect of obesity on medial longitudinal arch of foot in young adults. Method: 60 subjects, 30 obese & 30 non obese were assessed for height & weight using standard technique. Radiographic images under static condition were used for calculating the arch index. Result: The arch index of obese subjects was significantly lower than the non obese subjects & there is a negative correlation between the BMI & the arch index. Conclusion: These results suggests that obesity lowers the medial longitudinal arch of foot.

Effects of obesity on health-related quality of life in juvenile-onset systemic lupus erythematosus.

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Mina, R; Klein-Gitelman, M S; Nelson, S; Eberhard, B A; Higgins, G; Singer, N G; Onel, K; Tucker, L; O'Neil, K M; Punaro, M; Levy, D M; Haines, K; Ying, J; Brunner, H I

2015-02-01

This study evaluated the effects of obesity on health-related quality of life (HRQOL) measures in juvenile-onset systemic lupus erythematosus (jSLE). Obesity was defined as a body mass index (BMI) ≥ 95 th percentile according to the Sex-specific Center for Disease Control BMI-For-Age Charts and determined in a multicenter cohort of jSLE patients. In this secondary analysis, the domain and summary scores of the Pediatric Quality of Life (PedsQL) Inventory and the Child Health Questionnaire (CHQ) of obese jSLE patients were compared to those of non-obese jSLE patients as well as historical obese and non-obese healthy controls. Mixed-effects modeling was performed to evaluate the relationship between obesity and HRQOL measures. Among the 202 jSLE patients, 25% (n = 51) were obese. Obesity had a significant negative impact on HRQOL in jSLE, even after adjusting for differences in current corticosteroid use, disease activity, disease damage, gender and race between groups. Obese jSLE patients had lower physical functioning compared to non-obese jSLE patients, and to non-obese and obese healthy controls. Compared to their non-obese counterparts, obese jSLE patients also had worse school functioning, more pain, worse social functioning and emotional functioning. Parents of obese jSLE patients worry more. The CHQ scores for obese jSLE patients were also worse compared to non-obese jSLE patients in several other domains. Our study demonstrates the detrimental effects of obesity on patient-reported outcomes in jSLE. This supports the importance of weight management for the therapeutic plan of jSLE. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Cyclic Vomiting Syndrome (CVS: is there a difference based on onset of symptoms - pediatric versus adult?

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Kumar Nilay

2012-05-01

Full Text Available Abstract Background Cyclic Vomiting Syndrome (CVS is a well-recognized functional gastrointestinal disorder in children but its presentation is poorly understood in adults. Genetic differences in pediatric-onset (presentation before age 18 and adult-onset CVS have been reported recently but their clinical features and possible differences in response to therapy have not been well studied. Methods This was a retrospective review of 101 CVS patients seen at the Medical College of Wisconsin between 2006 and 2008. Rome III criteria were utilized to make the diagnosis of CVS. Results Our study population comprised of 29(29% pediatric-onset and 72 (71% adult-onset CVS patients. Pediatric-onset CVS patients were more likely to be female (86% vs. 57%, p = 0.005 and had a higher prevalence of CVS plus (CVS + neurocognitive disorders as compared to adult-onset CVS patients (14% vs. 3%, p = 0.05. There was a longer delay in diagnosis (10 ± 7 years in the pediatric-onset group when compared to (5 ± 7 years adult-onset CVS group (p = 0.001. Chronic opiate use was less frequent in the pediatric-onset group compared to adult-onset patients (0% vs. 23%, p = 0.004. Aside from these differences, the two groups were similar with regards to their clinical features and the time of onset of symptoms did not predict response to standard treatment. The majority of patients (86% responded to treatment with tricyclic antidepressants, anticonvulsants (topiramate, coenzyme Q-10, and L-carnitine. Non-response to therapy was associated with coalescence of symptoms, chronic opiate use and more severe disease as characterized by longer episodes, greater number of emergency department visits in the year prior to presentation, presence of disability and non-compliance on univariate analysis. On multivariate analysis, only compliance to therapy was associated with a response. (88% vs. 38%, Odds Ratio, OR 9.6; 95% Confidence Interval [CI], 1.18-77.05. Conclusion Despite reported

Cyclic Vomiting Syndrome (CVS): is there a difference based on onset of symptoms--pediatric versus adult?

Science.gov (United States)

Kumar, Nilay; Bashar, Qumseya; Reddy, Naveen; Sengupta, Jyotirmoy; Ananthakrishnan, Ashwin; Schroeder, Abigail; Hogan, Walter J; Venkatesan, Thangam

2012-05-28

Cyclic Vomiting Syndrome (CVS) is a well-recognized functional gastrointestinal disorder in children but its presentation is poorly understood in adults. Genetic differences in pediatric-onset (presentation before age 18) and adult-onset CVS have been reported recently but their clinical features and possible differences in response to therapy have not been well studied. This was a retrospective review of 101 CVS patients seen at the Medical College of Wisconsin between 2006 and 2008. Rome III criteria were utilized to make the diagnosis of CVS. Our study population comprised of 29(29%) pediatric-onset and 72 (71%) adult-onset CVS patients. Pediatric-onset CVS patients were more likely to be female (86% vs. 57%, p = 0.005) and had a higher prevalence of CVS plus (CVS + neurocognitive disorders) as compared to adult-onset CVS patients (14% vs. 3%, p = 0.05). There was a longer delay in diagnosis (10 ± 7 years) in the pediatric-onset group when compared to (5 ± 7 years) adult-onset CVS group (p = 0.001). Chronic opiate use was less frequent in the pediatric-onset group compared to adult-onset patients (0% vs. 23%, p = 0.004). Aside from these differences, the two groups were similar with regards to their clinical features and the time of onset of symptoms did not predict response to standard treatment. The majority of patients (86%) responded to treatment with tricyclic antidepressants, anticonvulsants (topiramate), coenzyme Q-10, and L-carnitine. Non-response to therapy was associated with coalescence of symptoms, chronic opiate use and more severe disease as characterized by longer episodes, greater number of emergency department visits in the year prior to presentation, presence of disability and non-compliance on univariate analysis. On multivariate analysis, only compliance to therapy was associated with a response. (88% vs. 38%, Odds Ratio, OR 9.6; 95% Confidence Interval [CI], 1.18-77.05). Despite reported genetic differences, the clinical features and

Prevalence and change of central obesity among US Asian adults: NHANES 2011–2014

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Xuefeng Liu

2017-08-01

Full Text Available Abstract Background Central obesity is a major risk factor for cardiometabolic diseases. The prevalence of central obesity has not been reported fully among Asian adults in the United States (US. Methods Cross-sectional data of 1288 Asian adults aged 20 years or over was selected from the US National Health and Nutrition Examination Survey with a stratified multi-stage sampling design. The prevalence of central obesity was calculated with 95% confidence intervals (CIs and Chi-square tests were conducted to test the significance of the prevalence differences across characteristic groups. Results The overall prevalence of central obesity among US Asian adults was 58.1% in 2011–2014. The prevalence of central obesity was higher in older adults (73.5% than in young adults (45.4% (p < 0.0001. Women had 13.4% higher prevalence than men (64.4% vs 51.0%, p < 0.0001. The prevalence increased over time (2011–2012 vs 2013–2014 in young adults (39.2% vs 51.5%, men (45.4% vs 56.6%, adults with college education or above (54.2% vs 61.7% and non-poor adults (55.4% vs 62.4%. Compared with men, women had higher prevalence in each subgroup of age, education, poverty, and length of time (except for the subgroup of “born in the US” (all p < 0.05 and in the subgroup of “married or living with partner” for marital status (p < 0.0001. Conclusion Central obesity is prevalent in Asian adults, particularly in older adults and women. More efforts are needed to prevent and treat obesity in Asian adults as Asians are incurring the greatest increase in type 2 diabetes in parallel with the rising rate of central adiposity.

Influence of Central Obesity Assessed by Conicity Index on Lung Age in Young Adults.

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Shenoy, Usha; Jagadamba

2017-04-01

Central obesity is an emerging public health problem in young adults which compromises lung mechanics. Conicity Index (CI) is a simple anthropometric measure to assess central adiposity. The concept of lung age relates to a person's current lung function at which his/her lung function would be considered abnormal in relation to the present actual age. To determine the effect of central obesity by CI on lung age in young adults. A total of 319 young adults in the age group 18-25 years were recruited for this cross-sectional observational study. Written informed consent and Institutional Ethical Clearance (IEC) approval were obtained. Anthropometric parameters were measured and CI was calculated using the following formula: CI = Waist Circumference (WC) (m)/ [0.109 X√ {Bodyweight (kg)/ Height (m)}] where 0.109 is a constant. Spirometry was performed and all the lung volumes and capacities were obtained. There was a significant increase in mean values of CI in obese young adults compared to non obese (1.36±0.15 and 1.16±0.08, pobesity on lung age in young adults was compared using an independent t-test. Mean of lung age was significantly higher in centrally obese young adults compared to non obese 23.87±3.03 and 21.30±2.6, pobese young adults compared to non obese. Hence, lung age can be used as a potential psychological tool to show an individual with central obesity that there is premature aging of their lungs.

A comparison between nailfold capillaroscopy patterns in adulthood in juvenile and adult-onset systemic sclerosis: A EUSTAR exploratory study.

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Ingegnoli, Francesca; Boracchi, Patrizia; Gualtierotti, Roberta; Smith, Vanessa; Cutolo, Maurizio; Foeldvari, Ivan

2015-11-01

Qualitative capillaroscopy patterns in juvenile- and adult-onset systemic sclerosis (SSc) were studied in adulthood using data from the EULAR Scleroderma Trials and Research (EUSTAR) database. Data collected between June 2004 and April 2013 were examined with focus on capillaroscopy. In this retrospective exploratory study, series of patients with juvenile-onset SSc were matched with series of adult-onset SSc having the same gender and autoantibody profile. 30 of 123 patients with juvenile-onset and 2108 of 7133 with adult-onset SSc had data on capillaroscopy. Juvenile-onset SSc showed scleroderma pattern more frequently than adult-onset SSc (93.3% and 88%). The OR was 2.44 and 95% CI 0.57-10.41. An active scleroderma pattern was present in 58% of juvenile- and 61% of adult-onset SSc. The OR was 0.91 and 95% CI 0.28-2.93. The late scleroderma pattern was present in 61% of juvenile- and 55.5% of adult-onset SSc. The OR was 1.06 and 95% CI 0.34-3.56. This is the first exploratory study on the comparison of capillaroscopy between juvenile- and adult-onset SSc in adulthood. Juvenile-onset SSc had an increase prevalence of scleroderma pattern, but a similar distribution of the three patterns was suggested. Further studies are needed to define this issue. Copyright © 2015 Elsevier Inc. All rights reserved.

Genetics of pediatric obesity.

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Manco, Melania; Dallapiccola, Bruno

2012-07-01

Onset of obesity has been anticipated at earlier ages, and prevalence has dramatically increased worldwide over the past decades. Epidemic obesity is mainly attributable to modern lifestyle, but family studies prove the significant role of genes in the individual's predisposition to obesity. Advances in genotyping technologies have raised great hope and expectations that genetic testing will pave the way to personalized medicine and that complex traits such as obesity will be prevented even before birth. In the presence of the pressing offer of direct-to-consumer genetic testing services from private companies to estimate the individual's risk for complex phenotypes including obesity, the present review offers pediatricians an update of the state of the art on genomics obesity in childhood. Discrepancies with respect to genomics of adult obesity are discussed. After an appraisal of findings from genome-wide association studies in pediatric populations, the rare variant-common disease hypothesis, the theoretical soil for next-generation sequencing techniques, is discussed as opposite to the common disease-common variant hypothesis. Next-generation sequencing techniques are expected to fill the gap of "missing heritability" of obesity, identifying rare variants associated with the trait and clarifying the role of epigenetics in its heritability. Pediatric obesity emerges as a complex phenotype, modulated by unique gene-environment interactions that occur in periods of life and are "permissive" for the programming of adult obesity. With the advent of next-generation sequencing techniques and advances in the field of exposomics, sensitive and specific tools to predict the obesity risk as early as possible are the challenge for the next decade.

Underweight, overweight and obesity in adults Nigerians living in ...

African Journals Online (AJOL)

2011-06-15

Jun 15, 2011 ... Obesity in Developing Countries: People are Overweight But Still Not Well Nourished. Available. Sola, et al.: Underweight, overweight and obesity in adults. [Downloaded from http://www.annalsafrmed.org on Wednesday, June 15, 2011, IP: 41.185.171.19] || Click here to download free Android application ...

A Community-Based Intervention to Prevent Obesity Beginning at Birth among American Indian Children: Study Design and Rationale for the PTOTS Study

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Karanja, Njeri; Aickin, Mikel; Lutz, Tam; Mist, Scott; Jobe, Jared B.; Maupome, Gerardo; Ritenbaugh, Cheryl

2012-01-01

Eating and physical activity behaviors associated with adult obesity have early antecedents, yet few studies have focused on obesity prevention interventions targeting very young children. Efforts to prevent obesity beginning at birth seem particularly important in populations at risk for early-onset obesity. National estimates indicate that…

Obese older adults suffer foot pain and foot-related functional limitation.

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Mickle, Karen J; Steele, Julie R

2015-10-01

There is evidence to suggest being overweight or obese places adults at greater risk of developing foot complications such as osteoarthritis, tendonitis and plantar fasciitis. However, no research has comprehensively examined the effects of overweight or obesity on the feet of individuals older than 60 years of age. Therefore we investigated whether foot pain, foot structure, and/or foot function is affected by obesity in older adults. Three hundred and twelve Australian men and women, aged over 60 years, completed validated questionnaires to establish the presence of foot pain and health related quality of life. Foot structure (anthropometrics and soft tissue thickness) and foot function (ankle dorsiflexion strength and flexibility, toe flexor strength, plantar pressures and spatiotemporal gait parameters) were also measured. Obese participants (BMI >30) were compared to those who were overweight (BMI=25-30) and not overweight (BMI foot pain and scored significantly lower on the SF-36. Obesity was also associated with foot-related functional limitation whereby ankle dorsiflexion strength, hallux and lesser toe strength, stride/step length and walking speed were significantly reduced in obese participants compared to their leaner counterparts. Therefore, disabling foot pain and altered foot structure and foot function are consequences of obesity for older adults, and impact upon their quality of life. Interventions designed to reduce excess fat mass may relieve loading of the foot structures and, in turn, improve foot pain and quality of life for older obese individuals. Copyright © 2015 Elsevier B.V. All rights reserved.

Nutrition Transition and Obesity Among Teenagers and Young Adults in South Asia.

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Jayawardena, Ranil; Ranasinghe, Priyanga; Wijayabandara, Maheshi; Hills, Andrew P; Misra, Anoop

2017-01-01

Obesity among teenagers/adolescents and young adults is associated with significant adverse short and longer-term effects on health. To date, no narrative reviews have evaluated nutrition transition and its contribution to the obesity epidemic among adolescents and young adults in the South Asian (SA) region. Data were retrieved by a four-stage systematic search process. A search of the online Pub- Med/Medline, SciVerse Scopus and Web of Science databases was performed. The age groups were defined as follows; teenage:13-19 years, adolescence:10-18 years and young adult:19-24 years. Among teenagers/adolescents, the prevalence of overweight ranged from 11.0% (Sri Lanka) to 19.0% (India), while obesity ranged from 2.4% (Sri Lanka) to 11.0% (Pakistan). In young adults, prevalence of overweight ranged between 7.9% (Nepal) to 15.0% (Pakistan), while obesity showed a much wider variation (0.005%[Nepal] - 22.8%[India]). Nutritional risk factors associated with overweight/ obesity among SAs of this age group included reduced fruit and vegetable consumption, a total vegetarian diet, consumption of fast food and soft drinks, and skipping breakfast. Other contributing factors identified were: adding extra salt to meals, eating meals outside of the home, frequently visiting restaurants and eating while watching television. Daily milk/yoghurt consumption and a family supper have shown a protective effect against overweight/obesity. Overweight and obesity are common amongst teenagers/adolescents and young adults of the SA region. Several food types and habits were identified as being associated with overweight/ obesity in this population. Identifying common protective and contributory factors is very important for the development of a shared regional preventive strategy. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Prevalence of General Obesity and Abdominal Obesity in the Spanish Adult Population (Aged 25-64 Years) 2014-2015: The ENPE Study.

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Aranceta-Bartrina, Javier; Pérez-Rodrigo, Carmen; Alberdi-Aresti, Goiuri; Ramos-Carrera, Natalia; Lázaro-Masedo, Sonia

2016-06-01

According to the 2013 analysis of the Institute of Health Metrics, high body mass index values are the most important risk factor for disease in Spain. Consequently, we describe the prevalence of total obesity and abdominal obesity in the Spanish adult population (25-64 years) for 2014-2015. The sample was taken from the ENPE study, a cross-sectional study with a representative sample of the noninstitutionalized population (n = 6800) carried out between May 2014 and May 2015. This analysis refers to the population between age 25 and 64 years (n = 3966). The anthropometric measurements were performed by trained observers at participants' homes according to standard international protocols. Body mass index ≥ 25 was defined as overweight and ≥ 30 as obesity. Abdominal obesity was classified as waist > 102 cm in men and > 88 cm in women. The estimated prevalence of overweight in the Spanish adult population (25-64 years) was 39.3% 95% confidence interval [95%CI], 35.7%-42.9%). The prevalence of general obesity was 21.6% (95%CI, 19.0%-24.2%) and, more specifically, was 22.8% (95%CI, 20.6%-25.0%) among men and 20.5% (95%CI, 18.5%-22.5%) among women, and rose with age. The prevalence of abdominal obesity was estimated at 33.4% (95%CI, 31.1%-35.7%) and was higher among women (43.3%; 95%CI, 41.1%-45.8%) than among men (23.3%; 95%CI, 20.9%-25.5%), and also rose with age. The prevalence of general obesity and abdominal obesity in Spain is high, although the distribution differs according to autonomous community. A comparison with earlier data reveals a considerable increase in overweight, indicating the need for routine monitoring and comprehensive initiatives. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Delayed effects of obese and overweight population conditions on all-cause adult mortality rate in the USA

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Albert A Okunade

2016-09-01

Full Text Available Currently, there are few studies separating the linkage of pathological obese and overweight body mass indices (BMI to the all-cause mortality rate in adults. Consequently, this paper, using annual Behavioral Risk Factor Surveillance System (BRFSS data of the 50 US states and the District of Columbia (DC estimates empirical regression models linking the US adult population overweight and obesity rates separately to the all-cause mortality rate. The biochemistry of multi-period cumulative adiposity (saturated fatty acid from unexpended caloric intakes (net energy storage provides the natural theoretical foundation for tracing unhealthy BMI to all-cause mortality. Cross-sectional and panel data regression models are separately estimated for the delayed effects of obese and overweight BMIs on the all-cause mortality rate. Controlling for the independent effects of economic, socio-demographic and other factors on the all-cause mortality rate, our findings confirm that the estimated panel data models are more appropriate. The panel data regression results reveal that the obesity-mortality link strengthens significantly after multiple years in the condition. The faster mortality response to obesity detected here is conjectured to arise from the significantly more obese. Compared with past studies postulating a static (rather than delayed effects, the statistically significant lagged effects of adult population BMI pathology in this study are novel and insightful. And, as expected, these lagged effects are more severe in the obese than overweight population segment. Public health policy implications of this social science study findings agree with those of the clinical sciences literature advocating timely lifestyle modification interventions (e.g., smoking cessation to slow premature mortality linked to unhealthy BMIs.

Obesity and rhinitis in a nationwide study of children and adults in the United States.

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Han, Yueh-Ying; Forno, Erick; Gogna, Mudita; Celedón, Juan C

2016-05-01

Obesity has been associated with higher risk of asthma and asthma severity both in children and adults. However, studies evaluating the relation between obesity and rhinitis have yielded conflicting results. We performed a cross-sectional study of obesity indicators and rhinitis using data from 8165 participants in the 2005-2006 National Health and Nutrition Examination Survey. Allergic rhinitis was defined as physician-diagnosed hay fever or allergy, the presence of symptoms in the past 12 months, and at least 1 positive allergen-specific IgE level. Nonallergic rhinitis was defined as a physician's diagnosis and symptoms but no positive allergen-specific IgE levels. Multivariate regression was used to assess the relationship between obesity and rhinitis in children and adults. In adults, overweight or obesity was associated with increased odds of nonallergic rhinitis (adjusted odds ratio, 1.43; 95% CI, 1.06-1.93; P = .02). Similarly, central obesity was associated with increased odds of nonallergic rhinitis in adults (adjusted odds ratio, 1.61; 95% CI, 1.20-2.16; P obesity, or central obesity were not associated with allergic rhinitis in adults. In children, central obesity was associated with reduced odds of allergic rhinitis (adjusted odds ratio, 0.35; 95% CI, 0.19-0.64; P children. In adults, obesity is associated with increased odds of nonallergic rhinitis, particularly in male subjects. In children, central obesity is associated with reduced odds of allergic rhinitis, regardless of sex. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Neighborhood disadvantage and obesity across childhood and adolescence: Evidence from the NLSY children and young adults cohort (1986-2010).

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Alvarado, Steven Elías

2016-05-01

Previous research suggests that youth who grow up in socioeconomically disadvantaged neighborhoods face higher odds of becoming obese. Neighborhood effects scholars, meanwhile, have suggested that contextual influences may increase in strength as children age. This is the first study to examine whether developmental epochs moderate the effect of neighborhood disadvantage on obesity over time. I use thirteen waves of new restricted and geo-coded data on children ages 2-18 from the National Longitudinal Survey of Youth, Children and Young Adults. Bivariate and pooled logistic regression results suggest that neighborhood disadvantage has a stronger impact on adolescents' likelihood of becoming obese. Fixed effects models reveal that after adjusting for observed and unobserved confounders, adolescents continue to face higher odds of becoming obese due to the conditions associated with living in disadvantaged neighborhoods. Moreover, as research on adults suggests, girls experience larger impacts of neighborhood disadvantage than boys. Copyright © 2016 Elsevier Inc. All rights reserved.

Preserved microvascular endothelial function in young, obese adults with functional loss of nitric oxide signaling

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John eHarrell

2015-12-01

Full Text Available Data indicate endothelium-dependent dilation (EDD may be preserved in the skeletal muscle microcirculation of young, obese adults. Preserved EDD might be mediated by compensatory mechanisms, impeding insight into preclinical vascular dysfunction. We aimed to determine the functional roles of nitric oxide synthase (NOS and cyclooxygenase (COX toward EDD in younger obese adults. We first hypothesized EDD would be preserved in young, obese adults. Further, we hypothesized a reduced contribution of NOS in young, obese adults would be replaced by increased COX signaling. Microvascular EDD was assessed with Doppler ultrasound and brachial artery infusion of acetylcholine (ACh in younger (27±1 yr obese (n=29 and lean (n=46 humans. Individual and combined contributions of NOS and COX were examined with intra-arterial infusions of L-NMMA and ketorolac, respectively. Vasodilation was quantified as an increase in forearm vascular conductance (ΔFVC. Arterial endothelial cell biopsies were analyzed for protein expression of endothelial nitric oxide synthase (eNOS. ΔFVC to ACh was similar between groups. After L-NMMA, ΔFVC to ACh was greater in obese adults (p<0.05. There were no group differences in ΔFVC to ACh with ketorolac. With combined NOS-COX inhibition, ΔFVC was greater in obese adults at the intermediate dose of ACh. Surprisingly, arterial endothelial cell eNOS and phosphorylated eNOS were similar between groups. Younger obese adults exhibit preserved EDD and eNOS expression despite functional dissociation of NOS-mediated vasodilation and similar COX signaling. Compensatory NOS- and COX-independent vasodilatory mechanisms conceal reduced NOS contributions in otherwise healthy obese adults early in life, which may contribute to vascular dysfunction.

Metabolic syndrome and Framingham risk score in obese young adults

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Felix F. Widjaja

2013-05-01

Full Text Available Background: The increase number of the metabolic syndrome (MetS among young adults was mostly caused by obesity. MetS increases the risk of coronary heart disease (CHD which can be estimated by Framingham risk score (FRS. The study was aimed to know the prevalence of MetS and FRS in obese young adults and to associate them with the components of MetS. Methods: A total of 70 male and female students aged 18 to 25 years with BMI ≥ 25 kg/m2 in Faculty of Medicine Universitas Indonesia were selected consecutively. The blood samples used to test fasting blood glucose, total cholesterol, high-density lipoprotein, and triglyceride were examined in Department of Clinical Pathology, Cipto Mangunkusumo Hospital after fasting for 14 to 16 hours. International Diabetes Federation (IDF definition was used to diagnose MetS. Univariate and bivariate analysis were done. Results: The prevalence of MetS based on IDF definition was 18.6% among obese young adults. The most associated MetS components was hypertriglyceridemia (OR 12.13; 95% CI 2.92-50.46; p = 0.001, followed with high blood pressure (OR 9.33; 95% CI 2.26-38.56; p = 0.001, low-HDL (OR 8.33; 95% CI 2.17-32.05; p = 0.003, and impaired fasting glucose (p = 0.03. Four subjects had FRS ≥ 1% and 66 subjects had risk < 1%. Increased FRS was not associated with MetS (p = 0.154. There was no component of MetS associated with increased FRS. Conclusion: Prevalence of MetS in obese young adults was similar with obese children and adolescents. Although no association of MetS and FRS was found, they are significant predictors for CHD which should not be used separately. (Med J Indones. 2013;22:100-6Keywords: Abdominal obesity, Framingham risk score, metabolic syndrome, young adults

Macular Xanthophylls Are Related to Intellectual Ability among Adults with Overweight and Obesity.

Science.gov (United States)

Khan, Naiman A; Walk, Anne M; Edwards, Caitlyn G; Jones, Alicia R; Cannavale, Corinne N; Thompson, Sharon V; Reeser, Ginger E; Holscher, Hannah D

2018-03-23

Excess adiposity or obesity has been inversely related to cognitive function and macular xanthophyll status. However, whether the neuroprotective effects of macular xanthophylls on cognitive function are independent of excess adiposity is unclear. We investigated the relationship between macular xanthophylls and intellectual ability among adults ( N = 114) between 25 and 45 years with overweight and obesity (≥25 kg/m²). Dual energy X-ray absorptiometry and heterochromatic flicker photometry were used to assess whole body adiposity (%Fat) and macular pigment optical density (MPOD), respectively. Dietary xanthophylls (lutein and zeaxanthin) were assessed using 7-day diet records. The Kaufman Brief Intelligence Test-2 (KBIT-2) was used to assess general intelligence (IQ) as well as fluid and crystallized intelligence. Bivariate correlations revealed that MPOD was inversely related to %Fat and positively associated with IQ and fluid intelligence. Although %Fat was inversely correlated to IQ and fluid intelligence, this relationship did not persist following adjustment for sex and MPOD. Further, MPOD was an independent predictor of IQ and fluid intelligence. However, no significant relationships were observed between MPOD and crystalized intelligence. These results suggest that macular xanthophylls are selectively related to fluid intelligence, regardless of degree of adiposity among adults with overweight and obesity.

Perceived stress and risk of adult-onset asthma and other atopic disorders

DEFF Research Database (Denmark)

Rod, N H; Kristensen, T S; Lange, Peter

2012-01-01

BACKGROUND: Psychological stress can affect airway inflammatory response to irritants and allergens, but the importance of stress in the etiology of adult-onset respiratory and dermatologic allergic disorders remains unclear. We aim to address the relationship between perceived stress and the risk...... of adult-onset asthma, allergic rhinitis, atopic dermatitis, and asthma/bronchitis medication. METHODS: Participants (n = 9785) from the Copenhagen City Heart Study, Denmark, free of atopic disorders at baseline in 1981-1983 were asked questions on stress intensity and frequency. They were followed...

Comparison of Self-Concept of Nonobese and Obese University Junior Female Nursing Students.

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Stein, Rita F.

1987-01-01

Compared self-concept of obese (N=28) and nonobese (N=58) female students in a junior nursing class. Found that obese students and students who considered themselves to be obese had lower self-esteem than did nonobese students. Revealed no relationships with regard to age of onset of obesity, and no significant relationships between social class…

The utility of childhood and adolescent obesity assessment in relation to adult health

Science.gov (United States)

Goldhaber-Fiebert, Jeremy D.; Rubinfeld, Rachel E.; Bhattacharya, Jay; Robinson, Thomas N.; Wise, Paul H.

2014-01-01

The high prevalence of childhood obesity has raised concerns regarding long-term patterns of adult health and has generated calls for obesity screening of young children. This study examined patterns of obesity and the predictive utility of obesity screening for children of different ages in terms of adult health outcomes. Using the National Longitudinal Survey of Youth, the Population Study of Income Dynamics, and National Health and Nutrition Evaluation Surveys, we estimated the sensitivity, specificity and predictive value of childhood BMI to identify 2, 5, 10, or 15 year-olds who will become obese adults. We constructed models assessing the relationship of childhood BMI to obesity-related diseases through middle age stratified by sex and race/ethnicity. 12% of 18 year-olds were obese. While 50% of these adolescents would not have been identified by screening at age 5, 9% would have been missed at age 15. Approximately 70% of obese children at age 5 became non-obese at age 18. The predictive utility of obesity screening below the age of 10 was low, even when maternal obesity was also included. The elevated risk of diabetes, obesity, and hypertension in middle age predicted by obesity at age 15 was significantly higher than at age 5 (e.g., the RR of diabetes for obese white male 15 year-olds was 4.5; for 5 year-olds, it was 1.6). Early childhood obesity assessment adds limited predictive utility to strategies that also include later childhood assessment. Targeted approaches in later childhood or universal strategies to prevent unhealthy weight gain should be considered. PMID:22647830

Limbic encephalitis associated with anti-voltage-gated potassium channel complex antibodies as a cause of adult-onset mesial temporal lobe epilepsy.

Science.gov (United States)

Toyota, Tomoko; Akamatsu, Naoki; Tsuji, Sadatoshi; Nishizawa, Shigeru

2014-06-01

Recently, some reports have indicated that limbic encephalitis associated with anti-voltage-gated potassium channel complex antibodies (VGKC-Ab) is a cause of adult-onset mesial temporal lobe epilepsy (MTLE). We report a 53-year-old woman who had her first epileptic seizure at the age of 50 years old. Examination by 3-Tesla brain MRI revealed left hippocampal high signal intensity and swelling on fluid-attenuated inversion recovery (FLAIR) and T2-weighted imaging at 2 months after her first seizure. The patient received intravenous methylprednisolone and carbamazepine 300 mg/day. One month later, MRI revealed improvement of her left hippocampal abnormalities. Thereafter, she had no seizures, however, three years after her first seizure, EEG revealed a seizure pattern in the left temporal region. Brain MRI revealed left hippocampal high signal intensity and brain fluorodeoxyglucose positron emission tomography revealed hypermetabolism. Her serum VGKC-Ab levels were 118 pM(normal VGKC-Ab levels decreased to 4.4 pM. Remission of the epileptic seizures was also observed. This MTLE in the middle age was considered as limbic encephalitis associated with anti- VGKC-Ab. In cases of unexplained adult-onset MTLE, limbic encephalitis associated with anti-VGKC-Ab, which responds well to immunotherapy, should be considered in the differential diagnosis.

Psychiatric adult-onset of urea cycle disorders: A case-series

Directory of Open Access Journals (Sweden)

Adrien Bigot

2017-09-01

Full Text Available Adult onset urea cycle disorders (UCD may present with psychiatric symptoms, occasionally as the initial presentation. We aimed to describe the characteristics of patients presenting with a psychiatric adult-onset of UCDs, to discuss which signs could suggest this diagnosis in such a situation, and to determine which tests should be conducted. A survey of psychiatric symptoms occurring in teenagers or adults with UCD was conducted in 2010 among clinicians involved in the French society for the study of inborn errors of metabolism (SFEIM. Fourteen patients from 14 to 57 years old were reported. Agitation was reported in 10 cases, perseveration in 5, delirium in 4, and disinhibition in 3 cases. Three patients had pre-existing psychiatric symptoms. All patients had neurological symptoms associated with psychiatric symptoms, such as ataxia or dysmetria, psychomotor slowing, seizures, or hallucinations. Fluctuations of consciousness and coma were reported in 9 cases. Digestive symptoms were reported in 7 cases. 9 patients had a personal history suggestive of UCD. The differential diagnoses most frequently considered were exogenous intoxication, non-convulsive status epilepticus, and meningoencephalitis. Hyperammonemia (180–600 μmol/L was found in all patients. The outcome was severe: mechanical ventilation was required in 10 patients, 5 patients died, and only 4 patients survived without sequelae. Adult onset UCDs can present with predominant psychiatric symptoms, associated with neurological involvement. These patients, as well as patients presenting with a suspicion of intoxication, must have UCD considered and ammonia measured without delay.

The performance of obesity screening tools among young Thai adults.

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Limpawattana, Panita; Kengkijkosol, Thepkhachi; Assantachai, Prasert; Krairit, Orapitchaya; Pimporm, Jiraporn

2014-12-01

Obesity is a worldwide medical condition that leads to physical and psychological impairment. Specific ethnicity, gender and age group are related to different performances of anthropometric indices to predict obesity. The objectives of this study were to estimate the performance of the anthropometric indices for detecting obesity based on percentage of body fat (PBF), to study the correlation among those indices, and to determine the optimal cut-off point of the indices among young Thai adults. This is a cross-sectional study of healthy urban subjects in Khon Kaen, Thailand who were aged 20-39 years. Baseline characteristics and anthropometric measures were collected. PBF was determined using bioelectrical impedance analysis. Demographic data and anthropometric variables were analyzed using descriptive statistics. Receiver-operating characteristic (ROC) curves were used to compare the performance of anthropometric measures as predictors of obesity. One-hundred men and 100 women were recruited for this study. Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-stature ratio (WSR) were significantly correlated to PBF. BMI demonstrated the best performance according to the area under the ROC curves in both sexes at cut-off points of 22.5 in women or 25 kg/m(2) in men. WC and WSR showed better performance than WHR to detect obesity. In conclusion, anthropometric indices in young Thai adults were correlated well with PBF to predict obesity as shown in prior reports. Different cut-off points of these indices to define obesity in young Thai adults are recommended. The global cut-off points of WSR in women regardless of ethnicity are supported.

The Need for Improved Detection and Management of Adult-Onset Hearing Loss in Australia

Directory of Open Access Journals (Sweden)

Catherine M. McMahon

2013-01-01

Full Text Available Adult-onset hearing loss is insidious and typically diagnosed and managed several years after onset. Often, this is after the loss having led to multiple negative consequences including effects on employment, depressive symptoms, and increased risk of mortality. In contrast, the use of hearing aids is associated with reduced depression, longer life expectancy, and retention in the workplace. Despite this, several studies indicate high levels of unmet need for hearing health services in older adults and poor use of prescribed hearing aids, often leading to their abandonment. In Australia, the largest component of financial cost of hearing loss (excluding the loss of well-being is due to lost workplace productivity. Nonetheless, the Australian public health system does not have an effective and sustainable hearing screening strategy to tackle the problem of poor detection of adult-onset hearing loss. Given the increasing prevalence and disease burden of hearing impairment in adults, two key areas are not adequately met in the Australian healthcare system: (1 early identification of persons with chronic hearing impairment; (2 appropriate and targeted referral of these patients to hearing health service providers. This paper reviews the current literature, including population-based data from the Blue Mountains Hearing Study, and suggests different models for early detection of adult-onset hearing loss.

Can mHealth Revolutionize the Way We Manage Adult Obesity?

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Bhardwaj, Niharika N; Wodajo, Bezawit; Gochipathala, Keerthi; Paul, David P; Coustasse, Alberto

2017-01-01

Obesity is the largest driver of chronic preventable diseases, accounting for an estimated $147 billion or 10 percent of total US healthcare costs in 2008. It has been forecasted that 42 percent of Americans will be obese by 2030. Mobile health (mHealth) technologies target and may modify the behavioral factors that lead to obesity to promote a healthy lifestyle. These technologies could potentially reduce the cost and the morbidity and mortality burden of obesity because of their inexpensive and portable nature. This study aimed to analyze the efficacy and cost-effectiveness of mHealth interventions for adult obesity in the United States. The methodology used in this study was a literature review of 54 articles. Weight, body mass index (BMI), waist circumference reductions, and favorable lifestyle behavior changes were noted across most studies. Existing data and research on efficacy and linked costs indicated that mHealth technologies were more effective than other methods and could be inexpensively delivered remotely to manage adult obesity, offering significant benefits over conventional care. Further studies on the costs and benefits of adapting such mHealth interventions in clinical settings are needed.

Adult obesity, disease and longevity in Mexico

OpenAIRE

Palloni, Alberto; Beltrán-Sánchez, Hiram; Novak, Beatriz; Pinto, Guido; Wong, Rebeca

2015-01-01

Objective: To obtain estimates of the effects of overweight and obesity on the incidence of type 2 diabetes (T2D) and adult mortality. Materials and methods: We use three waves (2000, 2002, 2012) of the Mexican Health and Aging Survey (MHAS). We employ parametric hazard models to estimate mortality and conventional logistic models to estimate incidence of T2D. Results: Obesity and overweight have a strong effect on the incidence of T2D; this, combined with the large impact of diabetes on adul...

Increased prospective health service use for depression among adults with childhood onset bipolar disorder.

Science.gov (United States)

Sala, Regina; Goldstein, Benjamin I; Wang, Shuai; Flórez-Salamanca, Ludwing; Iza, Miren; Blanco, Carlos

2013-11-01

To examine the prospective relationship between age of onset of bipolar disorder and the demographic and clinical characteristics, treatment, new onset of psychiatric comorbidity, and psychosocial functioning among adults with bipolar disorder. As part of the National Epidemiologic Survey on Alcohol and Related Conditions, 1600 adults who met lifetime Statistical Manual of Mental Disorders, 4th edition criteria for bipolar disorder-I (n = 1172) and bipolar disorder-II (n = 428) were included. Individuals were evaluated using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV version for Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and data were analyzed from Waves 1 and 2, approximately 3 years apart. Individuals with bipolar disorder were divided into three age at onset groups: childhood (adolescence (13-18 years old, n = 396), and adulthood (>19 year old, n = 1017). After adjusting for confounding factors, adults with childhood-onset bipolar disorder were more likely to see a counselor, have been hospitalized, and have received emergency room treatment for depression compared with those with adulthood-onset bipolar disorder. By contrast, there were no differences in the severity of mania or hypomania, new onset of comorbidity, and psychosocial functioning by age of bipolar disorder onset. Childhood-onset bipolar disorder is prospectively associated with seeking treatment for depression, an important proxy for depressive severity. Longitudinal studies are needed in order to determine whether prompt identification, accurate diagnosis, and early intervention can serve to mitigate the burden of childhood onset on the long-term depressive burden of bipolar disorder. Copyright © 2013 Mosby, Inc. All rights reserved.

Metabolic syndrome among overweight and obese adults in Palestinian refugee camps.

Science.gov (United States)

Damiri, Basma; Abualsoud, Mohammed S; Samara, Amjad M; Salameh, Sakhaa K

2018-01-01

Metabolic syndrome (MetS) is one of the main reasons for elevated cardiovascular morbidity and mortality worldwide. Obese and overweight individuals are at high risk of developing these chronic diseases. The aim of this study was to characterize and establish sex-adjusted prevalence of metabolic syndrome and its components. A cross-sectional study was conducted in 2015, 689 (329 men and 360 women) aged 18-65 years from three refugee camps in the West Bank. International Diabetes Federation and modified National Cholesterol Education Program-Third Adult Treatment Panel definitions were used to identify MetS. The overall prevalence of obesity and overweight was high, 63.1%; Obesity (42 and 29.2% in women men; respectively and overweight 25.8 and 28.9% in women and men; respectively. The prevalence of MetS among obese and overweight was significantly higher (69.4%) according to IDF than NCEP definition (52%) ( p  family history of hypertension or diabetes mellitus. In this study, irrespective of the definition used, metabolic syndrome is highly prevalent in obese and overweight Palestinian adults with no gender-based differences. The contribution of the metabolic components to the metabolic syndrome is different in men and women. With the increase of age and obesity, the clustering of metabolic syndrome components increased remarkably. More attention through health care providers should, therefore, be given to the adult population at risk to reduce adulthood obesity and subsequent cardiovascular diseases.

Attention deficit hyperactivity disorder increases the risk of having abnormal eating behaviours in obese adults.

Science.gov (United States)

Docet, M F; Larrañaga, A; Pérez Méndez, L F; García-Mayor, R V

2012-06-01

To determine the rate of abnormal eating behaviours in obese adult patients with attention deficit hyperactivity disorder (ADHD) in comparison with obese adult patients without ADHD. This case-control study includes: obese adult patients defined by a body mass index (BMI) ≥30 kg/m², screening positive in the adult ADHD self-report scale-V1.1. (ASRS-V1.1), attending the Nutrition Section, as cases; and obese adult patients screening negative, as controls. Weight, height and BMI were determined in all the participants. The rate of abnormal eating behaviours was determined using an eating pattern questionnaire. Forty-five out of 51 (88.2%) cases vs 127 out of 179 (70.9%) controls had abnormal eating behaviours (p=0.01). Eating between-meal snacks was found in 39 (76.5%) cases vs 107 (59.8%) controls (p=0.03), going on binge eating episodes in 28 (54.9%) vs 42 (23.5%) (p=0.00), waking up at night to eat in 11 (21.6%) vs 16 (8.9%) (p=0.01), eating large amounts of food in 13 (25.5%) vs 38 (21.2%) (p=0.52), and eating in secret in 11 (21.6%) vs 16 (8.9%) (p=0.01), respectively. This is the first study that determines the rate of these abnormal eating behaviours in obese adult patients with ADHD in comparison with obese adult patients without ADHD. A high rate of abnormal eating behaviours was observed in obese patients with ADHD. Our results suggest that ADHD is a risk factor for the development of these abnormal eating behaviours, which may be contributing factors of obesity and the unsuccessful treatment of obese patients.

Trends in the prevalence of underweight, obesity, abdominal obesity and their related lifestyle factors in Korean young adults, 1998-2012.

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Lim, Jisun; Park, Hye Soon

2017-05-05

This study aimed to assess trends of underweight, obesity, and abdominal obesity and related lifestyle factors in young Korean adults. The analysis focused on adults aged 19-39 years using data from the Korea National Health and Nutrition Examination Survey (KNHANES) I-V (1998-2012). Underweight was defined as body mass index (BMI) obesity as BMI≥30kg/m 2 ; and abdominal obesity as waist circumference ≥90cm in men and ≥85cm in women. We evaluated trends by analyzing the prevalence and odds ratios (ORs) of underweight, obesity, abdominal obesity, and the proportions and ORs of lifestyles. As compared with KNHANES I, the ORs for obesity were higher in III, IV, and V and the ORs for abdominal obesity were higher in IV and V in men, which showed an increasing trend (P for trendobesity showed a significant increasing tendency (P for trendobesity in young men and women, and abdominal obesity in young men is needed. Meanwhile, management of underweight in young women is simultaneously required. Copyright © 2017. Published by Elsevier Ltd.

Long working hours and overweight and obesity in working adults.

Science.gov (United States)

Kim, Byung-Mi; Lee, Bo-Eun; Park, Hye-Sook; Kim, Young-Ju; Suh, Young-Ju; Kim, Jeong-Youn; Shin, Ji-Young; Ha, Eun-Hee

2016-01-01

Previous studies have identified a link between gender and the various risk factors associated with obesity. We examined obesity risk factors in working adults to identify the effects of differences in body mass index (BMI) and percentage body fat (PBF) between women and men. A total of 1,120 adults agreed to participate in the study. Data from 711 participants, including 411 women and 300 men, were analyzed. Multiple logistic regression analysis was used to estimate the effects of risk factors on obesity and being overweight. In addition, the least-squares (LS) means of both BMI and PBF were estimated by analysis of covariance (ANCOVA) in a generalized linear model. Increases in BMI and PBF were significantly related to an age > 50 years and long working hours in women after compensating for confounding factors. Using the PBF criterion, the odds ratio (OR) of being overweight or obese in women > 50 years of age who worked for > 9 h a day was 3.9 (95% confidence interval [CI], 1.05-11.00). For BMI, women who were > 50 years of age and worked for > 9 h a day were 3.82 times (95% CI, 1.31-11.14) more likely to be overweight or obese than those who were worked for working adults was associated with > 50 years of age and long working hours in women. Further studies are needed to investigate the underlying mechanisms of this relationship and its potential implications for the prevention and management of excess weight and obesity.

Disability prevalence among healthy weight, overweight, and obese adults.

Science.gov (United States)

Armour, Brian S; Courtney-Long, Elizabeth A; Campbell, Vincent A; Wethington, Holly R

2013-04-01

Obesity is associated with adverse health outcomes in people with and without disabilities. However, little is known about disability prevalence among people who are obese. The purpose of this study is to determine the prevalence and type of disability among adults who are obese. Pooled data from the 2003-2009 National Health Interview Survey (NHIS) were analyzed to obtain national prevalence estimates of disability, disability type and obesity. The disability prevalence was stratified by body mass index (BMI): healthy weight (BMI 18.5-reported a disability. In contrast, 26.7% of those with a healthy weight and 28.5% of those who were overweight reported a disability. The most common disabilities among respondents with obesity were movement difficulty (32.5%) and work limitation (16.6%). This research contributes to the literature on obesity by including disability as a demographic in assessing the burden of obesity. Because of the high prevalence of disability among those who are obese, public health programs should consider the needs of those with disabilities when designing obesity prevention and treatment programs. Copyright © 2013 The Obesity Society.

Sex differences in biopsychosocial correlates of binge eating disorder: a study of treatment-seeking obese adults in primary care setting.

Science.gov (United States)

Udo, Tomoko; McKee, Sherry A; White, Marney A; Masheb, Robin M; Barnes, Rachel D; Grilo, Carlos M

2013-01-01

Although community-based studies suggest equivalent levels of physical and psychological impairment by binge eating disorder (BED) in men and women, men with BED are still underrepresented in clinical studies. This study aimed to provide a comprehensive analysis of sex differences in biopsychosocial correlates of treatment-seeking obese patients with BED in primary care. One hundred-ninety obese adults (26% men) were recruited in primary care settings for a treatment study for obesity and BED. Very few significant sex differences were found in the developmental history and in current levels of eating disorder features, as well as psychosocial factors. Women reported significantly earlier age at onset of overweight and dieting and greater frequency of dieting. Men reported more frequent strenuous exercise. Men were more likely than women to meet criteria for metabolic syndrome; men were more likely to show clinically elevated levels of triglycerides, blood pressure, and fasting glucose levels. Despite few sex differences in behavioral and psychosocial factors, metabolic problems associated with obesity were more common among treatment-seeking obese men with BED than women. The findings highlight the importance of including men in clinical studies of BED and active screening of BED in obese men at primary care settings. © 2013.

Prevalence of Overweight and Obesity among Rural Adults in North ...

African Journals Online (AJOL)

Background: Obesity has been associated with cardiovascular diseases, type 2 diabetes mellitus, several cancers and numerous other Non-Communicable Diseases (NCDs).The objective of this study was to determine the prevalence of overweight and obesity among rural adults in North Central Nigeria. Methods: A ...

Tackling inequalities in obesity: a protocol for a systematic review of the effectiveness of public health interventions at reducing socioeconomic inequalities in obesity among adults.

Science.gov (United States)

Bambra, Clare L; Hillier, Frances C; Moore, Helen J; Cairns-Nagi, Joanne-Marie; Summerbell, Carolyn D

2013-05-10

will provide evidence, and reveal any gaps in the evidence base, of public health strategies which reduce and prevent inequalities in the prevalence of obesity in adults and provide information on the organization, implementation and delivery of such interventions. PROSPERO registration number: CRD42013003612.

The Evidence-Based Approach to Adult-Onset Idiopathic Nephrotic Syndrome.

Science.gov (United States)

Canetta, Pietro A A; Radhakrishnan, Jai

2015-01-01

Adult-onset nephrotic syndrome (NS) differs from its pediatric counterpart in several important ways. Most importantly, NS in adults is more etiologically heterogeneous compared to children, and thus treatment approaches rely heavily on the histological diagnosis provided by renal biopsy. The evidence-based approach to treatment of adult NS has been critically examined by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines in glomerulonephritis, published in 2012. Here, we examine the strengths and limits of those guidelines and review recent work that expands the evidence-based approach.

Severe Obesity in Adolescents and Young Adults Is Associated With Subclinical Cardiac and Vascular Changes.

Science.gov (United States)

Shah, Amy S; Dolan, Lawrence M; Khoury, Philip R; Gao, Zhiqan; Kimball, Thomas R; Urbina, Elaine M

2015-07-01

Severe obesity is the fastest growing subgroup of obesity in youth. We sought to explore the association between severe obesity and subclinical measures of cardiac and vascular structure and function in adolescents and young adults. This was a cross-sectional comparison of 265 adolescents and young adults with severe obesity (defined as body mass index [BMI] ≥120% of the 95th percentile) to 182 adolescents and young adults with obesity (defined as BMI ≥100-119th of the 95th percentile) at tertiary medical center. Noninvasive measures of cardiac and vascular structure and function were assessed. Participants were a mean age of 17.9 years, 62% were non-Caucasian, and 68% were female. Systolic blood pressure, fasting insulin, C-reactive protein, IL-6, and frequency of type 2 diabetes were higher in participants with severe obesity (all P obesity as measured by higher left ventricular mass index, worse diastolic function, higher carotid intima media thickness, and pulse wave velocity and lower brachial distensibility (all P obesity (compared with obesity) was independently associated with each of the above outcomes after adjustment for age, race, sex, blood pressure, lipids, and inflammatory markers (P young adults with severe obesity have a more adverse cardiovascular risk profile and worse cardiac and vascular structure and function. More importantly, severe obesity is independently associated with these subclinical cardiac and vascular changes.

Adult-onset Still's disease: current challenges and future prospects

Directory of Open Access Journals (Sweden)

Siddiqui M

2016-03-01

Full Text Available Mariam Siddiqui,1 Michael S Putman,2 Anisha B Dua,11Department of Rheumatology, 2Department of Internal Medicine, The University of Chicago Medical Center, Chicago, IL, USA Abstract: Adult-onset Still's disease (AOSD – a multi-systemic inflammatory condition characterized by high fevers, polyarthritis, an evanescent rash, and pharyngitis – has been a challenging condition to diagnose expediently and treat effectively. Questions remain regarding the underlying pathophysiology and etiology of AOSD. Pathognomonic diagnostic tests and reliable biomarkers remain undiscovered. Over the past decade, important progress has been made. Diagnostic criteria employing glycosylated ferritin have improved specificity. More important, novel biologic therapies have offered important clues to AOSD's underlying pathophysiology. Cytokine-specific biologic therapies have been instrumental in providing more effective treatment for disease refractory to conventional treatment. While IL-1 therapy has demonstrated efficacy in refractory disease, novel therapies targeting IL-6 and IL-18 show great promise and are currently under investigation. Keywords: adult-onset Still's disease, biomarkers, therapeutics

Comparison of Neuropsychological Functioning Between Adults With Early- and Late-Onset DSM-5 ADHD.

Science.gov (United States)

Lin, Yu-Ju; Gau, Susan Shur-Fen

2017-09-01

We aimed to compare the visually dependent neuropsychological functioning among adults with Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) ADHD who recalled symptom onset by and after age 7 and non-ADHD controls. We divided the participants, aged 17 to 40 years, into three groups-(a) ADHD, onset DSM-5 criteria for diagnosing adult ADHD are not too lax regarding neuropsychological functioning.

Obesity indices predict hypertension among indigenous adults in Krau Wildlife Reserve, Peninsular Malaysia.

Science.gov (United States)

Chua, Ee Yin; Zalilah, Mohd Shariff; Haemamalar, Karppaya; Norhasmah, Sulaiman; Geeta, Appannah

2017-05-25

The disease burden of indigenous peoples has been augmented by the rising prevalence of obesity and hypertension in this population. This study assessed the ability of obesity indices to predict hypertension among indigenous adults of Peninsular Malaysia. In this cross-sectional study, 482 adults (223 men, 259 women) aged ≥18 years old were measured for body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), waist-hip ratio (WHR), and blood pressure. Receiver operating characteristic (ROC) analysis was used to determine the predictive ability of obesity indices for hypertension in men and women. Gender-specific logistic regression analyses were done to examine the association between obesity, defined by BMI, WC, WHtR and WHR, and hypertension. Prevalence of hypertension was 25.5%. Overall, WHtR was the best predictor of the presence of hypertension, in both men and women. The optimal WHtR cut-off values for hypertension were 0.45 and 0.52 in men and women, respectively. Obese adults with WHtR ≥0.5 had about two times increased odds of having hypertension compared to non-obese adults. WHtR may serve as a simple and inexpensive screening tool to identify individuals with hypertension in this relatively difficult to reach population.

Regular aerobic exercise reduces endothelin-1-mediated vasoconstrictor tone in overweight and obese adults.

Science.gov (United States)

Dow, Caitlin A; Stauffer, Brian L; Brunjes, Danielle L; Greiner, Jared J; DeSouza, Christopher A

2017-09-01

What is the central question of this study? Does aerobic exercise training reduce endothelin-1 (ET-1)-mediated vasoconstrictor tone in overweight/obese adults? And, if so, does lower ET-1 vasoconstriction underlie the exercise-related enhancement in endothelium-dependent vasodilatation in overweight/obese adults? What is the main finding and its importance? Regular aerobic exercise reduces ET-1-mediated vasoconstrictor tone in previously sedentary overweight/obese adults, independent of weight loss. Decreased ET-1 vasoconstriction is an important mechanism underlying the aerobic exercise-induced improvement in endothelium-dependent vasodilator function in overweight/obese adults. Endothelin-1 (ET-1)-mediated vasoconstrictor tone is elevated in overweight and obese adults, contributing to vasomotor dysfunction and increased cardiovascular disease risk. Although the effects of habitual aerobic exercise on endothelium-dependent vasodilatation in overweight/obese adults have been studied, little is known regarding ET-1-mediated vasoconstriction. Accordingly, the aims of the present study were to determine the following: (i) whether regular aerobic exercise training reduces ET-1-mediated vasoconstrictor tone in overweight and obese adults; and, if so, (ii) whether the reduction in ET-1-mediated vasoconstriction contributes to exercise-induced improvement in endothelium-dependent vasodilatation in this population. Forearm blood flow (FBF) in response to intra-arterial infusion of selective ET A receptor blockade (BQ-123, 100 nmol min -1 for 60 min), acetylcholine [4.0, 8.0 and 16.0 μg (100 ml tissue) -1  min -1 ] in the absence and presence of ET A receptor blockade and sodium nitroprusside [1.0, 2.0 and 4.0 μg (100 ml tissue) -1  min -1 ] were determined before and after a 3 month aerobic exercise training intervention in 25 (16 men and nine women) overweight/obese (body mass index 30.1 ± 0.5 kg m -2 ) adults. The vasodilator response to BQ-123 was

Obesity prevalence in adult residents of ile-ife, nigeria | Adedoyin ...

African Journals Online (AJOL)

The overall crude prevalence of overweight (25.0-29.9 Kg/m2) and obesity (>30 Kg/m2) were 20.3% and 12.5% respectively. The rates of overweight (17.9 vs. 22.1 Kg/m2) and obesity (9.7 vs. 14.5 Kg/m2) were both higher in women than men. Obesity increased across age gradient from young to old adults; peaking in the ...

Temporal discrimination threshold: VBM evidence for an endophenotype in adult onset primary torsion dystonia.

LENUS (Irish Health Repository)

Bradley, D

2012-02-01

Familial adult-onset primary torsion dystonia is an autosomal dominant disorder with markedly reduced penetrance. Most adult-onset primary torsion dystonia patients are sporadic cases. Disordered sensory processing is found in adult-onset primary torsion dystonia patients; if also present in their unaffected relatives this abnormality may indicate non-manifesting gene carriage. Temporal discrimination thresholds (TDTs) are abnormal in adult-onset primary torsion dystonia, but their utility as a possible endophenotype has not been examined. We examined 35 adult-onset primary torsion dystonia patients (17 familial, 18 sporadic), 42 unaffected first-degree relatives of both familial and sporadic adult-onset primary torsion dystonia patients, 32 unaffected second-degree relatives of familial adult-onset primary torsion dystonia (AOPTD) patients and 43 control subjects. TDT was measured using visual and tactile stimuli. In 33 unaffected relatives, voxel-based morphometry was used to compare putaminal volumes between relatives with abnormal and normal TDTs. The mean TDT in 26 control subjects under 50 years of age was 22.85 ms (SD 8.00; 95% CI: 19.62-26.09 ms). The mean TDT in 17 control subjects over 50 years was 30.87 ms (SD 5.48; 95% CI: 28.05-33.69 ms). The upper limit of normal, defined as control mean + 2.5 SD, was 42.86 ms in the under 50 years group and 44.58 ms in the over 50 years group. Thirty out of thirty-five (86%) AOPTD patients had abnormal TDTs with similar frequencies of abnormalities in sporadic and familial patients. Twenty-two out of forty-two (52%) unaffected first-degree relatives had abnormal TDTs with similar frequencies in relatives of sporadic and familial AOPTD patients. Abnormal TDTs were found in 16\\/32 (50%) of second-degree relatives. Voxel-based morphometry analysis comparing 13 unaffected relatives with abnormal TDTs and 20 with normal TDTs demonstrated a bilateral increase in putaminal grey matter in unaffected relatives with abnormal

Trends in overweight and obese adults in Malaysia (1996-2009): a systematic review.

Science.gov (United States)

Khambalia, A Z; Seen, L S

2010-06-01

Like other nations experiencing rapid industrialization, urbanization and a nutrition transition, there is concern in Malaysia of a possible escalation in the prevalence of overweight and obesity. In 1996, the National Health and Morbidity Survey reported a 16.6% and 4.4% prevalence of overweight and obesity, respectively. In the following decade, there have been several national and community surveys on overweight and obesity in Malaysia. The objective of this systematic review is to describe the trend from 1996 to 2009 in the prevalence of overweight and obesity in adults in Malaysia nationally and by gender, age and race. Results indicate that there has been a small rise in overweight adults in the years 1996, 2003 and 2006 (20.7%, 26.7% and 29.1%) and a much more dramatic increase in obesity in 1996, 2003, 2004 and 2006 (5.5%, 12.2%, 12.3% and 14.0%). Evidence showed a greater risk for overweight and obesity among women compared with men. Based on the highest-quality studies, overweight and obesity levels were highest among adults 40-59 years old. Overweight levels were highest among Indians, followed by Malays, Chinese and Aboriginals, with less consistency across studies on the order of risk or obesity by ethnicity.

Adult-Onset Type 1 Diabetes: A Qualitative Study of Decision-Making Needs.

Science.gov (United States)

Jull, Janet; Witteman, Holly O; Ferne, Judi; Yoganathan, Manosila; Stacey, Dawn

2016-04-01

Type 1 diabetes is an autoimmune disease resulting from insulin deficiency and must be carefully managed to prevent serious health complications. Diabetes education and management strategies usually focus on meeting the decision-making needs of children and their families, but little is known about the decisional needs of people with adult-onset type 1 diabetes. The aim of this study was to explore the diabetes-related decision-making needs of people diagnosed with adult-onset type 1 diabetes. An interpretive descriptive qualitative study was conducted. Participants who self-identified as having adult-onset type 1 diabetes were interviewed using a semistructured interview guide. Transcripts were coded to identify needs, supports and barriers using thematic analysis. Participating in the study were 8 adults (2 men, 6 women), ages 33 to 57, with type 1 diabetes for durations of 1 to 20 or more years. Their decision-making needs are summarized in 6 broad themes: 1) people diagnosed with type 1 diabetes are launched into a process of decision-making; 2) being diagnosed with type 1 diabetes means you will always have to make decisions; 3) knowledge is crucial; 4) personal preferences matter; 5) support is critical for decisions about self-care in type 1 diabetes; 6) living with type 1 diabetes means making very individualized decisions about daily life. The findings describe the sudden and ubiquitous nature of type 1 diabetes decision-making and the need to tailor approaches for making care decisions in type 1 diabetes. People diagnosed with adult-onset type 1 diabetes require access to reliable information, support and opportunities for participation in decision-making. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

The food environment and adult obesity in US metropolitan areas.

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Michimi, Akihiko; Wimberly, Michael C

2015-11-26

This research examines the larger-scale associations between obesity and food environments in metropolitan areas in the United States (US). The US Census County Business Patterns dataset for 2011 was used to construct various indices of food environments for selected metropolitan areas. The numbers of employees engaged in supermarkets, convenience stores, full service restaurants, fast food restaurants, and snack/coffee shops were standardised using the location quotients, and factor analysis was used to produce two uncorrelated factors measuring food environments. Data on obesity were obtained from the 2011 Behavioral Risk Factor Surveillance System. Individual level obesity measures were linked to the metropolitan area level food environment factors. Models were fitted using generalised estimating equations to control for metropolitan area level intra-correlation and individual level sociodemographic characteristics. It was found that adults residing in cities with a large share of supermarket and full-service restaurant workers were less likely to be obese, while adults residing in cities with a large share of convenience store and fast food restaurant workers were more likely to be obese. Supermarkets and full-service restaurant workers are concentrated in the Northeast and West of the US, where obesity prevalence is relatively lower, while convenience stores and fast-food restaurant workers are concentrated in the South and Midwest, where obesity prevalence is relatively higher. The food environment landscapes measured at the metropolitan area level explain the continental-scale patterns of obesity prevalence. The types of food that are readily available and widely served may translate into obesity disparities across metropolitan areas.

Long work hours and obesity in Korean adult workers.

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Jang, Tae-Won; Kim, Hyoung-Ryoul; Lee, Hye-Eun; Myong, Jun-Pyo; Koo, Jung-Wan

2014-01-01

The present study was designed to identify the association between work hours and obesity in Korean adult manual and nonmanual workers, and to determine whether there is a gender difference in this association. The study was conducted using Korean National Health and Nutrition Examination Survey data collected between 2007 and 2010. Individuals aged below 25 or over 64 years, pregnant women, part-time workers, soldiers, housewives and students were excluded. The total number of individuals included in the analysis was 8,889 (5,241 male and 3,648 female subjects). The outcome variable was obesity, defined as body mass index ≥25 kg/m(2). Variables considered in the model were age, education, income, marital status, alcohol drinking, smoking, daily energy intake, physical activity, sleep hours per day, the type of job, work hours, and work schedule. Work hours were categorized as 60 hours per week. In the multiple SURVEYLOGISTIC regression analyses, the adjusted odds ratio of obesity for long work hours (>60 hours per week) in male manual workers was 1.647 (95% confidence interval 1.262-2.151). Long work hours did not significantly increase the odds ratio for obesity in male nonmanual workers and female manual and nonmanual workers. More than 60 work hours per week increased the risk of obesity in Korean male manual workers. This result might be helpful in preventing obesity in Korean adult workers, especially male manual workers.

Prevalence of obesity and associated risk factors among adults in Kinondoni municipal district, Dar es Salaam Tanzania

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Mugusi Ferdinand M

2011-05-01

Full Text Available Abstract Background Obesity is on the rise worldwide, not sparing developing countries. Both demographic and socio-economic factors play parts in obesity causation. Few surveys have been conducted in Tanzania to determine the magnitude of obesity and its association with these risk factors. This study aimed at determining the prevalence of obesity and its associated risk factors among adults aged 18 - 65 years in Kinondoni municipality, Dar es Salaam, Tanzania from April 2007 to April 2008. Methods Random sampling of households was performed. Interviews and anthropometric measurement were carried out to eligible and consenting members of the selected households. Obesity was defined using Body Mass Index (BMI. Results Out of 1249 subjects recruited, 814 (65.2% were females. The overall prevalence of obesity was 19.2% (240/1249. However, obesity was significantly more prevalent in women (24.7% than men (9%, p Conclusion This study revealed a higher prevalence of obesity among Kinondoni residents than previously reported in other parts of the country. Independent predictors of obesity in the population studied were increasing age, marriage and cohabitation, high SES, female sex and less vigorous physical activities.

The evidence-based approach to adult-onset idiopathic nephrotic syndrome

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Pietro A. Canetta

2015-09-01

Full Text Available Adult-onset nephrotic syndrome differs from its pediatric counterpart in several important ways. Most importantly, nephrotic syndrome in adults is more etiologically heterogeneous compared to children, and thus treatment approaches rely heavily on the histologic diagnosis provided by renal biopsy. The evidence-based approach to treatment of adult nephrotic syndrome has been critically examined by the Kidney Disease Improving Global Outcomes (KDIGO guidelines in glomerulonephritis, published in 2012. Here, we examine the strengths and limits of those guidelines and review recent work that expands the evidence-based approach.

Anesthetic considerations for rapid-onset obesity, hypoventilation, hypothalamic dysfunction, and autonomic dysfunction (ROHHAD) syndrome in children.

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Chandrakantan, Arvind; Poulton, Thomas J

2013-01-01

Rapid-onset obesity, hypoventilation, hypothalamic dysfunction, and autonomic dysfunction is an increasingly common diagnosis in patients who are being seen at tertiary care children's hospitals. We present two cases of anesthetics from the authors' own experience in addition to a comprehensive review of the disorder and anesthetic implications. © 2012 Blackwell Publishing Ltd.

Coexistence of adult-onset actinic prurigo and shampoo dermatitis: A case report

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Tsung-Ju Lee

2018-06-01

Full Text Available Actinic prurigo is a rare and acquired idiopathic photodermatosis. It usually shows childhood onset and female predominance. Here, we present an unusual case of a male patient with coexistence of adult-onset actinic prurigo and shampoo-induced allergic contact dermatitis. He was initially diagnosed with actinic prurigo. However, after detailed examination of the distribution of the rash, careful collection of his history, and interpretation of the results of histopathologic analysis, photo test, patch test, and photopatch test, coexistence of adult-onset actinic prurigo and shampoo-induced allergic contact dermatitis associated with cocamidopropyl betaine was diagnosed. The rash improved after appropriate use of sunscreen and avoidance of shampoo containing this allergen. Dermatologists should be aware of the possibility of concurrent photodermatitis and contact dermatitis. Keywords: Actinic prurigo, Cocamidopropyl betaine, Contact dermatitis, Photosensitivity, Shampoo dermatitis

Neighborhood walking among overweight and obese adults: age variations in barriers and motivators.

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Lee, Chanam; Ory, Marcia G; Yoon, Jeongjae; Forjuoh, Samuel N

2013-02-01

Walking is a popular form of physical activity that can bring many public health benefits. It can be even more beneficial to those who are currently obese or overweight. However, many barriers discourage people from walking, ranging from lack of motivation to unsafe neighborhood environments, and such barriers vary with age. This study addresses barriers and motivators to walking among overweight and obese adults, and examines their age variations. Particular emphasis was given to modifiable environmental factors as the priority intervention targets. A survey of 161 overweight and obese adults recruited from a large integrated healthcare system in central Texas provided data on walking, demographics, motivators and barriers. Descriptive statistics and correlation analysis were conducted. The respondents had a mean age of 48.4 (20-86), and were predominantly female (80.8%), non-Hispanic White (86.0%), and obese (mean BMI = 32.5). Popular environmental barriers to walking were: bad weather, inadequate lighting, no shade, unattended dogs, disconnected sidewalks, poor walking surfaces, no interesting places to walk nearby, and no benches (74.5-38.5%). Even and smooth walking surfaces and benches were more frequently reported by older adults as motivators. Proximity to recreational facilities was a stronger motivator for younger adults. Two safety related barriers, fear of injury (older adults) and traffic safety concerns (younger adults), also showed significant age differences. Overweight and obese adults experience substantial environmental barriers to walking, but many of them are modifiable. Observed age variations suggest that future interventions may be more effective if tailored to address age-specific barriers.

Post-operative Adult Onset Tic Disorder: A Rare Presentation.

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Upadhyaya, Suneet Kumar; Raval, Chintan M; Sharma, Devendra Kumar; Vijayvergiya, Devendra Kumar

2014-10-01

Tics are rapid and repetitive muscle contractions resulting in stereotype movements and vocalizations that are experienced as involuntary. Onset before 18-year is a diagnostic criterion for tic disorders. Children and adolescents may exhibit tic behaviors after a stimulus or in response to an internal urge. Tic behaviors increase during physical or an emotional stress. Adult onset tic disorders are reported by infections, drugs, cocaine, toxins, chromosomal disorders, head injury, stroke, neurocutaneous syndromes, neurodegenerative disorders and peripheral injuries. Only few cases have yet been reported having onset after surgery though surgery brings both physical and emotional stress to the patient. We report a case of a 55-year-old lady who developed tic disorder as post-operative event of cataract surgery. Our patient had a dramatic response to haloperidol which is in contrast to all earlier reports.

Association between genetic variants and obesity in the Lithuanian adult population

OpenAIRE

Smalinskienė, Alina; Petkevičienė, Janina; Klumbienė, Jūratė; Lesauskaitė, Vaiva

2018-01-01

Introduction: Eating habits play a big role in the onset of obesity and there are some genes, associated with regulation of the food intake. The melanocortin-4 receptor (MC4R) and neuropeptide Y (NPY) are peptides that play part in the hypothalamic appetite regulation mechanism. Fat mass and obesity associated (FTO) gene variant is associated with human adiposity and metabolic disorders. The aim of this study was to evaluate the effect of MC4R, NPY and FTO genes polymorphisms on body mass ind...

Obstructive Sleep Apnea and Multiple Anthropometric Indices of General Obesity and Abdominal Obesity among Young Adults

OpenAIRE

Xiaoli Chen; Wipawan C. Pensuksan; Vitool Lohsoonthorn; Somrat Lertmaharit; Bizu Gelaye; Michelle A.Williams

2014-01-01

Objective;To examine the associations between obstructive sleep apnea (OSA) and obesity among young adults. Design and Methods;A total of 2911 college students in Thailand participated in the study. Anthropometric measurements and blood pressure were taken by trained research staff. Results; Overall, 6.3% of college students had OSA determined by the Berlin Questionnaire, 9.6% were overweight (BMI: 25-29 kg/m2), 4.5% were obese (BMI¡Ý30 kg/m2); 12.4% had abdominal obesity (men: waist circumfe...

The lactase -13910C>T polymorphism (rs4988235) is associated with overweight/obesity and obesity-related variables in a population sample of Portuguese young adults.

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Manco, L; Dias, H; Muc, M; Padez, C

2017-01-01

Several studies reported associations of the lactase gene (LCT) polymorphism -13910C>T (rs4988235) with obesity-related variables and obesity in adults. This study aimed to replicate previously reported associations in a population sample of Portuguese young adults. We genotyped 447 subjects from central and northern regions of Portugal (mean age 20.81±4.24 years) for the lactase variant -13910C>T (rs4988235), using TaqMan probes. Anthropometric variables (weight, height and body fat) were measured using standardized procedures and body mass index (BMI) (kg/m 2 ) was calculated. Frequency of genotypes was 35.8% CC (lactase nonpersistent, LNP), 48.1% CT and 16.1% TT, consistent with Hardy-Weinberg equilibrium (P=1). The frequency for the minor -13910 T allele was 0.402. Assuming a dominance model for the lactase persistence (LP) minor T-allele, linear regression models showed statistically significant associations between the LP genotype CT/TT and BMI, fat mass and weight (β=1.114, P=0.003; β=1.309, P=0.007 and β=2.67, P=0.021, respectively) after adjustment for age and sex. In concordance, logistic regression showed significant association between LP genotype CT/TT and overweight/obesity (OR=1.77; CI 1.08-2.92; P=0.023), as well as with high fat percentage ranges (OR=1.58; CI 1.01-2.46; P=0.041), when adjusting for age and sex. No significant interaction was obtained between the LCT polymorphism and physical activity for BMI (P int =0.454) or FAT % (P int =0.421). In the Portuguese sample of young adults, the lactase -13910C>T polymorphism revealed significant associations with the obesity-related anthropometric variables BMI, fat mass and weight, and previously observed associations with the obesity risk were also confirmed.

Radiographic abnormalities of the wrist in adult-onset still disease: Comparison with juvenile chronic arthritis and rheumatoid arthritis

International Nuclear Information System (INIS)

Bjorkengren, A.G.; Pathria, M.N.; Terkeltaub, R.; Esdaile, J.; Weisman, M.; Sartoris, D.J.; Resnick, D.

1987-01-01

Pericapitate involvement of the wrist has been described as characteristic of adult-onset Still disease, a relatively rare disorder that is often diagnosed by exclusion after extensive and frequently invasive tests. To evaluate the diagnostic value of carpal radiography in cases of adult-onset Still disease, a retrospective blinded analysis of 48 patients, 16 each with adult-onset Still disease, juvenile chronic arthritis, and rheumatoid arthritis, was performed. Pericapitate articular alterations without radiocarpal involvement were found to be frequent in the setting of adult-onset Still disease but distinctly unusual among patients with rheumatoid arthritis. In juvenile chronic arthritis, severe pericapitate involvement was frequent, but generally occurred in conjunction with radiocarpal joint abnormalities

Pediatric-Onset and Adult-Onset Separation Anxiety Disorder Across Countries in the World Mental Health Survey

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Silove, Derrick; Alonso, Jordi; Bromet, Evelyn; Gruber, Mike; Sampson, Nancy; Scott, Kate; Andrade, Laura; Benjet, Corina; de Almeida, Jose Miguel Caldas; De Girolamo, Giovanni; de Jonge, Peter; Demyttenaere, Koen; Fiestas, Fabian; Florescu, Silvia; Gureje, Oye; He, Yanling; Karam, Elie; Lepine, Jean-Pierre; Murphy, Sam; Villa-Posada, Jose; Zarkov, Zahari; Kessler, Ronald C.

2016-01-01

Objective The age-at-onset criterion for separation anxiety disorder was removed in DSM-5, making it timely to examine the epidemiology of separation anxiety disorder as a disorder with onsets spanning the life course, using cross-country data. Method The sample included 38,993 adults in 18 countries in the World Health Organization (WHO) World Mental Health Surveys. The WHO Composite International Diagnostic Interview was used to assess a range of DSM-IV disorders that included an expanded definition of separation anxiety disorder allowing onsets in adulthood. Analyses focused on prevalence, age at onset, comorbidity, predictors of onset and persistence, and separation anxiety-related role impairment. Results Lifetime separation anxiety disorder prevalence averaged 4.8% across countries (interquartile range [25th–75th percentiles]=1.4%–6.4%), with 43.1% of lifetime onsets occurring after age 18. Significant time-lagged associations were found between earlier separation anxiety disorder and subsequent onset of internalizing and externalizing DSM-IV disorders and conversely between these disorders and subsequent onset of separation anxiety disorder. Other consistently significant predictors of lifetime separation anxiety disorder included female gender, retrospectively reported childhood adversities, and lifetime traumatic events. These predictors were largely comparable for separation anxiety disorder onsets in childhood, adolescence, and adulthood and across country income groups. Twelve-month separation anxiety disorder prevalence was considerably lower than lifetime prevalence (1.0% of the total sample; interquartile range=0.2%–1.2%). Severe separation anxiety-related 12-month role impairment was significantly more common in the presence (42.4%) than absence (18.3%) of 12-month comorbidity. Conclusions Separation anxiety disorder is a common and highly comorbid disorder that can have onset across the lifespan. Childhood adversity and lifetime trauma are

Crowdsourcing Novel Childhood Predictors of Adult Obesity

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Bevelander, K.E.; Kaipainen, K.; Swain, R.; Dohle, S.; Bongard, J.C.; Hines, P.D.H.; Wansink, B.

2014-01-01

Effective and simple screening tools are needed to detect behaviors that are established early in life and have a significant influence on weight gain later in life. Crowdsourcing could be a novel and potentially useful tool to assess childhood predictors of adult obesity. This exploratory study

Transgenerational epigenetic effects of the endocrine disruptor vinclozolin on pregnancies and female adult onset disease.

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Nilsson, Eric E; Anway, Matthew D; Stanfield, Jacob; Skinner, Michael K

2008-05-01

Endocrine disruptor exposure during gonadal sex determination was previously found to induce male rat adult onset transgenerational disease (F1-F4 generation), and this was associated with an alteration in the epigenetic (i.e., DNA methylation) programming of the male germ line. The current study was designed to characterize the transgenerational disease phenotypes of the female adult offspring. Pregnant rats (F0 generation) were treated transiently with vinclozolin (i.e., fungicide with anti-androgenic activity) on embryonic (E) days E8-E14 of gestation. F1 control and vinclozolin generation offspring from different litters were mated to produce F2 offspring, and similarly F2 generation animals produced F3 generation offspring. Observations demonstrated that 9 out of 105 pregnant rats (8.6%) from the vinclozolin F1-F3 generations exhibited uterine hemorrhage and/or anemia late in pregnancy. None (0 out of 82) of the control F1-F3 generation females had similar pregnancy problems. Complete blood cell counts and serum chemistry profiles demonstrated that selected vinclozolin generation animals, but not controls, exhibited marked regenerative anemia in late pregnancy. Examination of kidney histology revealed moderate or severe glomerular abnormalities in 67% of the vinclozolin F2 and F3 generation adult females compared with 18% of the controls. Adult female vinclozolin generation animals also developed various types of tumors in 6.5% of the animals (11 out of 170), while 2% of control-line animals (3 out of 151) developed mammary tumors. Observations demonstrate that vinclozolin exposure during gonadal sex determination promotes a transgenerational increase in pregnancy abnormalities and female adult onset disease states.

Neck circumference as a screening measure of overweight/obesity among Indian adults

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Mondal Nitish

2016-09-01

Full Text Available Neck circumference (NC is an anthropometric measurement of differentiating body fat distributions and a marker of upper subcutaneous adiposity. The present study highlights the association and importance of NC as a suitable proxy screening measure of overweight/obesity as compared to the conventional anthropometric variables used among Indian adults. The present community based cross-sectional study was undertaken among 1169 Karbi adults (males: 625; females: 544 residing in Karbi Anglong district of Assam, Northeast India, who were selected through a multistage stratified random sampling method. Height, weight, waist circumference (WC, hip circumference (HC and NC were recorded using standard procedures. The body mass index (BMI was calculated and prevalence of overweight/obesity was assessed using standard cut-offs. The prevalence of obesity using BMI (≥25.00 kg m-2 was 15.52% and 15.26% among males and females, respectively (p≥0.05.The prevalence of obesity using NC was observed to be significantly higher among males (48.80% than females (19.12% (p<0.01. The binary logistic regression analysis showed that NC predicted obesity over the conventional anthropometric variables with reasonable accuracy (p<0.01. The ROC-AUC analysis showed a relatively greater significant association between BMI, WC and HC and NC for obesity (p<0.01. Thus, NC appears to be a potentially simple, easyto- use screening measure for predicting obesity among adults. Further studies are required to validate its use for screening of obesity among other ethnic populations in India.

Prediabetes and prehypertension in disease free obese adults correlate with an exacerbated systemic proinflammatory milieu

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Johnson William D

2010-07-01

Full Text Available Abstract Background Obesity is a pro-inflammatory state frequently associated with widespread metabolic alterations that include insulin resistance and deregulation of blood pressure (BP. This cascade of events in some measure explains the susceptibility of obese adults for co-morbid conditions like diabetes mellitus and hypertension. Hypothesis We hypothesized that an elevated systemic proinflammatory burden correlates with dysglycemia and deregulated blood pressure. Methods We analyzed the screening anthropometric and laboratory measures from healthy disease free obese adults (n = 35; women (W 27, men (M 8 in a weight loss study. Results Healthy obese normoglycemic (fasting serum glucose: FSG Conclusions In otherwise healthy disease free obese adults, a higher degree of systemic inflammation is associated with prediabetes and prehypertension.

Obesity May Not Induce Dynamic Stability Disadvantage during Overground Walking among Young Adults.

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Liu, Zhong-Qi; Yang, Feng

2017-01-01

Obesity has been related to postural instability during static standing. It remains unknown how obesity influences stability during dynamic movements like gait. The primary aim of this study was to investigate the effects of obesity on dynamic gait stability control in young adults during gait. Forty-four young adults (21 normal-weight and 23 obese) participated in this study. Participants walked five times at their self-selected gait speeds on a linear walkway. Their full-body kinematics were gathered by a motion capture system. Compared with normal-weight group, individuals with obesity walked more slowly with a shorter but wider step. People with obesity also spent an elongated double stance phase than those with normal weight. A reduced gait speed decreases the body center of mass's velocity relative to the base of support, leading to a reduction in dynamic stability. On the other hand, a shortened step in accompanying with a less backward-leaning trunk has the potential to bring the center of mass closer to the base of support, resulting in an increase in dynamic stability. As the result of these adaptive changes to the gait pattern, dynamic gait stability among people with obesity did not significantly differ from the one among people with normal weight. Obesity seems to not be inducing dynamic stability disadvantage in young adults during level overground walking. These findings could provide insight into the mechanisms of stability control among people affected by obesity during dynamic locomotion.

Morbidity, including fatal morbidity, throughout life in men entering adult life as obese.

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Esther Zimmermann

Full Text Available BACKGROUND: The association between obesity in adults and excess morbidity and mortality is well established, but the health impact throughout adult life of being obese in early adulthood needs elucidation. We investigated somatic morbidity, including fatal morbidity, throughout adulthood in men starting adult life as obese. METHODS: Among 362,200 Danish young men, examined for military service between 1943 and 1977, all obese (defined as BMI≥31.0 kg/m(2, and, as controls, a random 1% sample of the others was identified. In the age range of 18-25 years, there were 1,862 obese, which encompass the men above the 99.5 percentile, and 3,476 controls. Information on morbidity was obtained via national registers. Cox regression models were used to estimate the relative morbidity assessed as first incidence of disease, occurrence of disease in the year preceding death and prevalent disease at time of death. RESULTS: From age 18 through 80 years the obese had an increased risk of becoming diseased by or die from a broad range of diseases. Generally, the incidence of first event, occurrence in the year prior to death, and prevalence at time of death showed the same pattern. As an example, the relative hazard of type 2 diabetes was constant throughout life at 4.9 (95% confidence intervals [CI]: 4.1-5.9, 5.2 (95% CI: 3.6-7.5, and 6.8 (95% CI: 4.6-10.1, respectively. CONCLUSIONS: Our findings strongly support the continued need to avoid beginning adult life as obese, as obese young men experience an increased morbidity, including fatal morbidity, from many diseases throughout life.

Diabetes risk among overweight and obese metabolically healthy young adults.

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Twig, Gilad; Afek, Arnon; Derazne, Estela; Tzur, Dorit; Cukierman-Yaffe, Tali; Gerstein, Hertzel C; Tirosh, Amir

2014-11-01

To determine diabetes incidence over time among obese young adults without metabolic risk factors. Incident diabetes during a median follow-up of 6.1 years was assessed among 33,939 young men (mean age 30.9 ± 5.2 years) of the Metabolic, Lifestyle and Nutrition Assessment in Young Adults cohort who were stratified for BMI and the number of metabolic abnormalities (based on the Adult Treatment Panel-III). Metabolically healthy (MH) obesity was defined as BMI ≥30 kg/m2 in the presence of normoglycemia, normal blood pressure, and normal levels of fasting triglyceride and HDL-cholesterol levels (n = 631). A total of 734 new cases of diabetes were diagnosed during 210,282 person-years of follow-up. The incidence rate of diabetes among participants with no metabolic risk factors was 1.15, 2.10, and 4.34 cases per 1,000 person-years among lean, overweight, and obese participants, respectively. In a multivariable model adjusted for age, region of origin, family history of diabetes, physical activity, fasting plasma glucose, triglyceride level, HDL-cholesterol, systolic blood pressure, and white blood cell count, a higher diabetes risk was observed among MH-overweight (hazard ratio [HR] 1.89 [95% CI 1.25-2.86]; P young adults from incident diabetes associated with overweight and obesity. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Gut Endotoxin Leading to a Decline IN Gonadal function (GELDING) - a novel theory for the development of late onset hypogonadism in obese men.

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Tremellen, Kelton

2016-01-01

Obesity is an increasing public health problem, with two-thirds of the adult population in many Western countries now being either overweight or obese. Male obesity is associated with late onset hypogonadism, a condition characterised by decreased serum testosterone, sperm quality plus diminished fertility and quality of life. In this paper we propose a novel theory underlying the development of obesity related hypogonadism- the GELDING theory (Gut Endotoxin Leading to a Decline IN Gonadal function). Several observational studies have previously reported an association between obesity related hypogonadism (low testosterone) and systemic inflammation. However, for the first time we postulate that the trans-mucosal passage of bacterial lipopolysaccharide (LPS) from the gut lumen into the circulation is a key inflammatory trigger underlying male hypogonadism. Obesity and a high fat/high calorie diet are both reported to result in changes to gut bacteria and intestinal wall permeability, leading to the passage of bacterial endotoxin (lipopolysaccharide- LPS) from within the gut lumen into the circulation (metabolic endotoxaemia), where it initiates systemic inflammation. Endotoxin is known to reduce testosterone production by the testis, both by direct inhibition of Leydig cell steroidogenic pathways and indirectly by reducing pituitary LH drive, thereby also leading to a decline in sperm production. In this paper we also highlight the novel evolutionary benefits of the GELDING theory. Testosterone is known to be a powerful immune-suppressive, decreasing a man's ability to fight infection. Therefore we postulate that the male reproductive axis has evolved the capacity to lower testosterone production during times of infection and resulting endotoxin exposure, decreasing the immunosuppressive influence of testosterone, in turn enhancing the ability to fight infection. While this response is adaptive in times of sepsis, it becomes maladaptive in the setting of "non

European Guidelines for Obesity Management in Adults

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Volkan Yumuk

2015-12-01

Full Text Available Obesity is a chronic metabolic disease characterised by an increase of body fat stores. It is a gateway to ill health, and it has become one of the leading causes of disability and death, affecting not only adults but also children and adolescents worldwide. In clinical practice, the body fatness is estimated by BMI, and the accumulation of intra-abdominal fat (marker for higher metabolic and cardiovascular disease risk can be assessed by waist circumference. Complex interactions between biological, behavioural, social and environmental factors are involved in regulation of energy balance and fat stores. A comprehensive history, physical examination and laboratory assessment relevant to the patient's obesity should be obtained. Appropriate goals of weight management emphasise realistic weight loss to achieve a reduction in health risks and should include promotion of weight loss, maintenance and prevention of weight regain. Management of co-morbidities and improving quality of life of obese patients are also included in treatment aims. Balanced hypocaloric diets result in clinically meaningful weight loss regardless of which macronutrients they emphasise. Aerobic training is the optimal mode of exercise for reducing fat mass while a programme including resistance training is needed for increasing lean mass in middle-aged and overweight/obese individuals. Cognitive behavioural therapy directly addresses behaviours that require change for successful weight loss and weight loss maintenance. Pharmacotherapy can help patients to maintain compliance and ameliorate obesity-related health risks. Surgery is the most effective treatment for morbid obesity in terms of long-term weight loss. A comprehensive obesity management can only be accomplished by a multidisciplinary obesity management team. We conclude that physicians have a responsibility to recognise obesity as a disease and help obese patients with appropriate prevention and treatment. Treatment

European Guidelines for Obesity Management in Adults

Science.gov (United States)

Yumuk, Volkan; Tsigos, Constantine; Fried, Martin; Schindler, Karin; Busetto, Luca; Micic, Dragan; Toplak, Hermann

2015-01-01

Obesity is a chronic metabolic disease characterised by an increase of body fat stores. It is a gateway to ill health, and it has become one of the leading causes of disability and death, affecting not only adults but also children and adolescents worldwide. In clinical practice, the body fatness is estimated by BMI, and the accumulation of intra-abdominal fat (marker for higher metabolic and cardiovascular disease risk) can be assessed by waist circumference. Complex interactions between biological, behavioural, social and environmental factors are involved in regulation of energy balance and fat stores. A comprehensive history, physical examination and laboratory assessment relevant to the patient's obesity should be obtained. Appropriate goals of weight management emphasise realistic weight loss to achieve a reduction in health risks and should include promotion of weight loss, maintenance and prevention of weight regain. Management of co-morbidities and improving quality of life of obese patients are also included in treatment aims. Balanced hypocaloric diets result in clinically meaningful weight loss regardless of which macronutrients they emphasise. Aerobic training is the optimal mode of exercise for reducing fat mass while a programme including resistance training is needed for increasing lean mass in middle-aged and overweight/obese individuals. Cognitive behavioural therapy directly addresses behaviours that require change for successful weight loss and weight loss maintenance. Pharmacotherapy can help patients to maintain compliance and ameliorate obesity-related health risks. Surgery is the most effective treatment for morbid obesity in terms of long-term weight loss. A comprehensive obesity management can only be accomplished by a multidisciplinary obesity management team. We conclude that physicians have a responsibility to recognise obesity as a disease and help obese patients with appropriate prevention and treatment. Treatment should be based on

Rapid-Onset Obesity with Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation (ROHHAD) Syndrome: A Case Report

OpenAIRE

Bagheri; Pourbakhtyaran; Talebi Kiasari; Taherkhanchi; Salarian; Sadeghi

2016-01-01

Introduction Rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation (ROHHAD) is a rare disease. To date, there have been only few reported cases of ROHHAD syndrome. Case Presentation We report a 5-year-old- Iranian girl who had normal growth and development until her 4th year of life. At that time, the patient developed weight gain, constipation, coldness in the extremities, and hyperhidros...

The impact of obesity on early postoperative outcomes in adults with congenital heart disease.

Science.gov (United States)

Zaidi, Ali N; Bauer, John A; Michalsky, Marc P; Olshove, Vincent; Boettner, Bethany; Phillips, Alistair; Cook, Stephen C

2011-01-01

As the prevalence of obesity continues to increase, it now includes the growing number of patients with congenital heart disease (CHD). This particular obese patient population may pose additional intraoperative as well as postoperative challenges that may contribute to poor outcomes. Our aims were to determine the influence of obesity on morbidity and mortality in adults with CHD undergoing surgical repair at a free standing children's hospital. A retrospective analysis of adult (≥18 years) CHD surgery cases from 2002 to 2008 was performed. Congenital heart lesions were defined as mild, moderate, or complex. Patients were categorized by body mass index (BMI): underweight (BMI obese (BMI ≥ 30 kg/m(2)). Demographics, incidence of mortality, or specific morbidities were statistically compared using Fisher's exact test and analyses of variance (anovas). In this population (n = 165), overweight (29%) and obese (22%) patients were prevalent. Hypertension (HTN) and pre-HTN were more prevalent in obese and overweight patients. Postoperative renal dysfunction was observed in obese patients with complex CHD (P = .04). Mortality was not different among groups. Obesity is becoming increasingly common among adults with CHD. Despite marginal evidence of postoperative renal complications in obese patients with CHD of severe complexity, the overall presence of obesity did not influence mortality or short term postoperative morbidities. © 2011 Copyright the Authors. Congenital Heart Disease © 2011 Wiley Periodicals, Inc.

ADULT-ONSET STILL'S DISEASE: DIAGNOSIS AND TREATMENT

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Rimma Mikhailovna Balabanova

2009-09-01

Full Text Available The paper describes adult-onset Still's disease (AOSD, a rare multisystemic disease of unknown etiology that is referred to as seronegative rheumatoid arthritis. It presents the major manifestations of AOSD: long-term fever, arthritis or persistent arthralgias, maculopapular eruption, seronegativity for rheumatoid factor, neutrophilic leukocytosis, and disease onset after 16 years of age, as well as additional signs: lymphadenopathy, hepatosplenomegaly, polyserositis, nasopharyngeal infection. It is noted that particular difficulties in the diagnosis of AOSD emerge when it is complicated by the hematophagocytic syndrome (HPS. The distinctive features of AOSD are the development of cutaneous and articular symptoms in practically 80% of patients and their absence in HPS. It is stated that of greater value in the diagnosis of HPS is examination of aspirate of the bone marrow than its biopsy. Most patients develop refractoriness to glucocorticoids and essential anti-inflammatory drugs. The positive results of using anakinra, rituximab, and tocilizumab are promising.

ADULT-ONSET STILL'S DISEASE: DIAGNOSIS AND TREATMENT

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Rimma Mikhailovna Balabanova

2009-01-01

Full Text Available The paper describes adult-onset Still's disease (AOSD, a rare multisystemic disease of unknown etiology that is referred to as seronegative rheumatoid arthritis. It presents the major manifestations of AOSD: long-term fever, arthritis or persistent arthralgias, maculopapular eruption, seronegativity for rheumatoid factor, neutrophilic leukocytosis, and disease onset after 16 years of age, as well as additional signs: lymphadenopathy, hepatosplenomegaly, polyserositis, nasopharyngeal infection. It is noted that particular difficulties in the diagnosis of AOSD emerge when it is complicated by the hematophagocytic syndrome (HPS. The distinctive features of AOSD are the development of cutaneous and articular symptoms in practically 80% of patients and their absence in HPS. It is stated that of greater value in the diagnosis of HPS is examination of aspirate of the bone marrow than its biopsy. Most patients develop refractoriness to glucocorticoids and essential anti-inflammatory drugs. The positive results of using anakinra, rituximab, and tocilizumab are promising.

Patterns of dietary habits in relation to obesity in Iranian adults.

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Saneei, Parvane; Esmaillzadeh, Ahmad; Keshteli, Ammar Hassanzadeh; Feizi, Awat; Feinle-Bisset, Christine; Adibi, Peyman

2016-03-01

Findings from few studies that investigated the relation between dietary behaviors and obesity are inconsistent. We aimed to assess the relation between patterns of dietary habits, identified by latent class analysis (LCA), and obesity in a large sample of Iranian adults. In a cross-sectional study on 7958 adults, dietary behaviors were assessed in five domains (meal patterns, eating rate, intra-meal fluid intake, meal-to-sleep interval, and fatty foods intake) using a pretested questionnaire. LCA was applied to identify classes of diet-related practices. Anthropometric measures were assessed through the use of a validated self-reported questionnaire. General and abdominal obesity were defined as a body mass index ≥ 30 kg/m(2), and a waist circumference ≥ 88 cm for women and ≥ 102 cm for men. General and abdominal obesity were prevalent in 9.7 and 27.7 % of the study population, respectively. We identified three distinct classes of eating rates (moderate, moderate to slow, and moderate to fast), two classes of meal patterns (regular and irregular), two classes of intra-meal fluid intake (moderate and more intra-meal drinking), three classes of meal-to-sleep interval (short, moderate, and long meal-to-sleep interval), and three classes of fatty food intake (low to moderate, moderate to high, and low intake of fatty foods). After adjustment for potential confounders, individuals with 'irregular meal pattern' were 21, 24, and 22 % more likely to be overweight/obese, abdominally overweight/obese, and abdominally obese, compared with those who had a 'regular meal pattern.' Individuals with 'more intra-meal drinking' had greater odds of overweight (OR 1.37; 1.19-1.458) and obesity (OR 1.51; 1.16-1.97) than those with 'moderate intra-meal drinking.' Moderate-to-high intake of fatty foods was inversely associated with abdominally overweight/obese (OR 0.85; 0.73-1.00) and abdominally obesity (OR 0.80; 0.68-0.96) compared with 'low-to-moderate intake of fatty foods

Associations among physical activity, television watching, and obesity in adult Pima Indians

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Fitzgerald, S J; Kriska, A M; Pereira, M A

1997-01-01

in adult Pima Indians, a population with a high prevalence of obesity. Hours per day of television watched, past-year physical levels (MET-h/wk; leisure and occupational combined) and BMI (kg.m-2) were measured in 2452 men and women subjects 21-59 yr old. In adults between the ages of 21 and 39 yr, TV...... and physical activity levels were negatively correlated (r = -0.11 for men and -0.10 for women). Weaker associations were found between TV and BMI (r = 0.08 for men and 0.04 for women). There were no significant relationships among these variables in older adults (49-59 yr), possibly because of low reported...... levels of physical activity and TV. Multiple linear regression analysis revealed that physical activity and television watching in men and activity in women were significantly related to BMI. These data suggest that increasing activity levels and decreasing the time spent in sedentary behavior...

Clinical Manifestations and Treatment of Adult-Onset Asthma and Periocular Xanthogranuloma

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Rodrigo Cavallazzi

2009-01-01

Full Text Available BACKGROUND: Adult-onset asthma and periocular xanthogranuloma is an uncommon and recently described disease. Little is known about the condition because only a few case reports and series are available.

Television, Home-Cooked Meals, and Family Meal Frequency: Associations with Adult Obesity.

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Tumin, Rachel; Anderson, Sarah E

2017-06-01

Adults, regardless of whether they are parents, regularly eat meals with family at home, but few studies have analyzed large, population-based samples to examine how mealtime practices or family meal frequency are associated with health. The aim of this study was to evaluate associations between the frequency of family meals eaten at home, watching television or videos during family meals, and consumption of meals that were cooked and eaten at home and the odds of being obese in adults. This was an analysis of the cross-sectional 2012 Ohio Medicaid Assessment Survey (OMAS), a telephone survey of Ohio's population. The study sample was adult Ohio residents responding to the 2012 OMAS who ate at least one family meal in the past week (n=12,842). Obesity (body mass index [BMI] ≥30), calculated from self-reported height and weight, was the outcome. Logistic regression models were used to examine the association between obesity and family meal practices, adjusted for respondents' employment status, marital status, race/ethnicity, educational attainment, and age. Family meal frequency was not associated with odds of obesity: those who ate family meals most (6-7) days were as likely as those who ate family meals few (1-2) days to be obese (adjusted odds ratio [OR adj ]=1.01, 95% CI=0.86, 1.18). Thirty-six percent of adults never watched television or videos while eating family meals, and 62% ate family meals that were all home-cooked. Adults who never watched television or videos during family meals had 37% lower odds of obesity compared with those who always did (95% CI=0.54, 0.73), regardless of family meal frequency. Adults whose family meals were all home-cooked had 26% lower odds of obesity than those who ate some or no home-cooked family meals (95% CI=0.62, 0.88). This association was more pronounced among adults who ate few family meals. Family meal practices may be associated with obesity in adults, even if they eat few family meals per week. Future research

Osteomalacia in a Case of Adult-Onset Bartter Syndrome

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Rashid Naseem Khan

2018-01-01

Full Text Available Bartter syndrome is a rare heterogeneous disease characterised by a deficiency in sodium and chloride absorption. Gain-of-function mutations in the CASR gene have been described in some patients with Bartter syndrome associated with hypocalcaemia and hypercalciuria. We describe a case of adult-onset Bartter syndrome with hypocalcaemia severe enough to cause osteomalacia.

Socioeconomic status in childhood and obesity in adults: a population-based study.

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Wagner, Katia Jakovljevic Pudla; Bastos, João Luiz Dornelles; Navarro, Albert; Gonzalez-Chica, David Alejandro; Boing, Antonio Fernando

2018-01-01

OBJECTIVE To test whether there is an association between socioeconomic status in childhood and measures of body mass index, waist circumference and the presence of overall and abdominal obesity in adult life. METHODS A cross-sectional analysis of a population-based cohort study, including a sample of adults (22-63 years old) living in Florianópolis, Southern Brazil. The socioeconomic status in childhood was analyzed through the education level of the participant's parents. Height, weight and waist circumference were measured by previously trained interviewers. Linear and logistic regressions with adjustment for confounding factors and stratification of data according to gender were used. RESULTS Of the 1,222 adults evaluated, 20.4% (95%CI 18.1-22.8) presented overall obesity and 24.8% (95%CI 22.4-27.4), abdominal obesity. The body mass index and waist circumference averages among women were, respectively, 1.2 kg/m2 (95%CI -2.3- -0.04) and 2.8 cm (95%CI -5.3- -0.2) lower among those with higher socioeconomic status in childhood. Among men, waist circumference was 3.9 cm (95%CI 1.0-6.8) higher in individuals with higher socioeconomic status in childhood. Regarding obesity, women of higher socioeconomic status in childhood had lower odds of abdominal obesity (OR = 0.56, 95%CI 0.34-0.90), and no such association was observed among men. CONCLUSIONS The socioeconomic status in childhood influences body mass index, waist circumference and obesity in adults, with a difference in the direction of association according to gender. The higher socioeconomic status among men and the lower socioeconomic status among women were associated with higher adiposity indicators.

The Association between Sarcopenic Obesity and Depressive Symptoms in Older Japanese Adults.

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Shinya Ishii

Full Text Available The effects of sarcopenic obesity, the co-existence of sarcopenia and obesity, on mood disorders have not been studies extensively. Our objective was to examine the association of depressive symptoms with sarcopenia and obesity status in older Japanese adults. We analyzed data from 1731 functionally-independent, community-dwelling Japanese adults aged 65 years or older (875 men, 856 women randomly selected from the resident register of Kashiwa city, Chiba, Japan in 2012. Sarcopenia was defined based on appendicular skeletal muscle mass, grip strength and usual gait speed. Obesity was defined as the highest sex-specific quintile of the percentage body fat. Depressive symptoms were defined as a Geriatric Depression Scale 15-item score ≥ 6. Multiple logistic regression was employed to examine the association of depressive symptoms with four groups defined by the presence/absence of sarcopenia and obesity. The prevalence of depressive symptoms was 10.1% and the proportions of sarcopenia/obesity, sarcopenia/non-obesity, non-sarcopenia/obesity, non-sarcopenia/non-obesity were 3.7%, 13.6%, 16.9% and 65.8%, respectively. After adjustment for potential confounders, sarcopenia/obesity was positively associated with depressive symptoms compared with non-sarcopenia/non-obesity, whereas either sarcopenia or obesity alone was not associated with depressive symptoms. The association was particularly pronounced in those aged 65 to 74 years in age-stratified analysis. We conclude that our findings suggest a synergistic impact exerted by sarcopenic obesity on the risk of depressive symptoms, particularly in those aged 65 to 74 years.

Factors affecting overweight and obesity among urban adults: a cross-sectional study

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Jaydip Sen

2013-01-01

Full Text Available Background: the prevalence of overweight and obesity are increasing at an alarming rate in the developing countries. The present cross-sectional study assesses the prevalence of overweight and obesity along with their associated variables among urban adult individuals belonging to the Bengalee Hindu Caste Population (BHCP.Methods: the study has been carried out among 600 adult individuals belonging to the BHCP in the age group of 20-60 years and residing in the district of Jalpaiguri, West Bengal, India. Height and weight, along with a number of socio-economic, demographic and lifestyle variables were recorded. International cut off points of the body mass index were used to assess overweight (BMI ≥ 23.00 kg/m2 and obesity (BMI ≥ 25.00 kg/m2. The statistical tests (ANOVA, chi-square and multinomial logistic regression were done using SPSS (version 15.00.Results: the prevalence of overweight and obesity were observed to be high among both the male (23.67% and 9.67% and the female (20.33% and 29.33% individuals. The sex difference was observed to be significant in case of obesity (p<0.01 and combined overweight-obesity (p<0.01. The multinomial logistic regression indicated that age and monthly income had significant effects on overweight (p<0.05. Sex, age, monthly income, marital status, education and alcohol intake were observed to have significant effects on obesity (p<0.05. Sex, age, monthly income and monthly income and marital status also showed significant effects with combined overweight-obesity (BMI ≥ 23.00 kg/m2 (p<0.05.Conclusions: the prevalence of overweight and obesity exhibited an increasing trend among urban adults of the BHCP. Sex, age, marital status and monthly income were observed to have more influence on the prevalence of overweight and obesity among them. There appears to be an urgent need for the development of health strategies and intervention programmes for combating the consequences of overweight and obesity.

Prevalence of obesity and diabetes in Spanish adults 1987-2012.

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Basterra-Gortari, Francisco Javier; Bes-Rastrollo, Maira; Ruiz-Canela, Miguel; Gea, Alfredo; Martinez-Gonzalez, Miguel Ángel

2017-03-22

The prevalence of obesity and diabetes mellitus (DM) has increased worldwide. Our objective was to examine trends in the prevalence of overweight, obesity, morbid obesity and DM in Spain from 1987 to 2012. Data were obtained from 8 waves of the national health surveys which are cross-sectional studies conducted in representative samples of the Spanish adult population. Self-reported data of 156,440 adults (≥16 years) from 1987 to 2012 were used. Body mass index (BMI) was calculated from self-reported weight and height. Overweight was defined as a BMI of 25.0 to 29.9kg/m 2 , obesity as a BMI≥30kg/m 2 and morbid obesity as a BMI≥40kg/m 2 . DM was considered present if the participant reported having been diagnosed. Age-adjusted prevalence was adjusted by the direct standardisation method to the 2003 survey population. From 1987 to 2012 age-adjusted prevalence of overweight increased from 34.0% (95% confidence interval [95% CI] 33.2-34.8) to 35.8% (95% CI 35.0-36.6), prevalence of obesity from 8.0% (95% CI 7.5-8.5) to 16.5% (95% CI 15.7-17.1%) and DM prevalence from 4.2% (95% CI 3.9-4.5) to 7.1% (95% CI 6.7-7.4%). Morbid obesity increased from 0.20% (95% CI 0.13-0.27) in 1993 to 0.88% (95% CI 0.70-1.05) in 2012. The growth rate was greater among males. An increasing trend of the prevalence of overweight, obesity, morbid obesity and DM was found in Spain from 1987 to 2012, particularly in males. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Is obesity a risk factor for impaired cognition in young adults with low birth weight?

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Lundgren, M; Morgården, E; Gustafsson, J

2014-10-01

Overweight and obesity are risk factors for cardiovascular disease. There is also an association between body mass index (BMI) and cognitive ability. Since low birth weight is associated with adult metabolic disease, particularly in obese subjects, the question emerges whether obesity has an additional negative effect on cognitive function in subjects with low birth weight. The aim was to analyse whether overweight or obesity influence intellectual performance in young adults with particular focus on those with a low birth weight. Data were collected from the Swedish Medical Birth Register on 620,834 males born between 1973 and 1988 and matched to results on intellectual performance and BMI at conscription. The risk for low intellectual performance was higher for those with high BMI compared to those with normal. The highest risk was found among subjects with low birth weight and overweight or obesity in young adulthood (odds ratios, 1.98 [1.73-2.22] and 2.59 [2.00-3.34], respectively). However, subjects with further high birth weight and a high BMI at conscription had no further increased risk. Overweight and obesity are associated with an increased risk of subnormal intellectual performance in young adult males. Subjects with low birth weight and adolescent overweight/obesity are at particular risk of subnormal performance. A high birth weight increases the risk for obesity, but a high adult BMI does not further increase the risk for subnormal performance. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

Obesity in Childhood and Adolescence, Genetic Factors.

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Kostovski, Marko; Tasic, Velibor; Laban, Nevena; Polenakovic, Momir; Danilovski, Dragan; Gucev, Zoran

2017-12-01

Obesity and excess weight are a pandemic phenomenon in the modern world. Childhood and adolescent obesity often ends up in obesity in adults. The costs of obesity and its consequences are staggering for any society, crippling for countries in development. Childhood obesity is also widespread in Macedonia. Metabolic syndrome, dyslipidemia and carbohydrate intolerance are found in significant numbers. Parents and grandparents are often obese. Some of the children are either dysmorphic, or slightly retarded. We have already described patients with Prader-Willi syndrome, Bardet-Biedl syndrome or WAGR syndrome. A genetic screening for mutations in monogenic obesity in children with early, rapid-onset or severe obesity, severe hyperphagia, hypogonadism, intestinal dysfunction, hypopigmentation of hair and skin, postprandial hypoglycaemia, diabetes insipidus, abnormal leptin level and coexistence of lean and obese siblings in the family discovers many genetic forms of obesity. There are about 30 monogenic forms of obesity. In addition, obesity is different in ethnic groups, and the types of monogenic obesity differ. In brief, an increasing number of genes and genetic mechanisms in children continue to be discovered. This sheds new light on the molecular mechanisms of obesity and potentially gives a target for new forms of treatment.

Multifactor Assessment of Metabolic Syndrome Risk in Uzbek Children and Adolescents with Obesity

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Gulnara N. Rakhimova

2016-03-01

Full Text Available Metabolic syndrome (MetS contributes to early atherosclerotic changes of blood vessels and type 2 diabetes mellitusnot only among adults, but among children and adolescents, causing onset and progression of severe diseases resulting in early disablement and death. Multifactor analysis of MetS risk in Uzbek children and adolescents with exogenous-constitutional obesity (ECO was the purpose of the study. The study included 100 Uzbek children and adolescents with ECO aged from 6 to 16 (mean age 11.7±0.25 years—54(54.0% boys and 46(46.0% girls. Prognostic matrix was made up by means of a modification of Bayesian probability by E. Shigan (1986. Mathematical analysis confirmed a high degree of risk for MetS onset and progression in obese patients with disorders of lipid profile and hemodynamics. MetS risk is 8.2 times higher with levels of HDL-C 3.0, HbA1c >6.7%, and obesity onset before 5 years of age.

Adult onset Niemann-Pick type C disease: A clinical, neuroimaging and molecular genetic study.

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Battisti, Carla; Tarugi, Patrizla; Dotti, Maria Teresa; De Stefano, Nicola; Vattimo, Angelo; Chierichetti, Francesea; Calandra, Sebastiano; Federico, Antonio

2003-11-01

We report on a patient with adult-onset Niemann-Pick type C (NPC) disease, carrying the mutations P1007 and I1061T in the NPC1 gene, presenting with marked psychiatric changes followed by dystonia and cognitive impairment. Filipin staining, single photon emission computed tomography perfusional, positron emission tomography metabolic, conventional magnetic resonance imaging, and magnetic resonance spectroscopy findings suggested a pathophysiological correlation with phenotype expression. This case expands the clinical and genetic spectrum of the rare adult-onset NPC disease phenotype.

The impact of isolated obesity on right ventricular function in young adults.

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Sokmen, Abdullah; Sokmen, Gulizar; Acar, Gurkan; Akcay, Ahmet; Koroglu, Sedat; Koleoglu, Murat; Yalcintas, Sila; Aydin, M Naci

2013-08-01

Obesity is an independent risk factor for cardiovascular diseases. The effects of obesity on left ventricular structure and function have been reported, but relatively little is known regarding right ventricular (RV) function in obesity. To evaluate subclinical RV alterations in obese, but otherwise healthy, young adults by conventional echocardiography and tissue Doppler imaging (TDI). In this study, we included 35 normal weight healthy subjects with a body mass index (BMI) 35 kg/m² (group III). All subjects underwent transthoracic echocardiography. In addition to standard echocardiographic measurements, tricuspid annular peak systolic (Sm), peak early (Em), and late diastolic (Am) velocities, isovolumetric contraction (ICTm), relaxation (IRTm) time, and ejection time (ETm) were obtained by TDI, and RV myocardial performance index (MPIm) was calculated. In group II, RV Em/Am was significantly decreased and IRTm and MPIm were significantly increased compared to group I (p obesity in young normotensive adults was associated with subclinical abnormalities in RV structure and function.

Effect of food prices on the prevalence of obesity among young adults.

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Han, E; Powell, L M

2011-03-01

To examine the extent to which various food prices were associated with the obesity status of young adults. Retrospective cohort study of 6537 men and 5324 women in the USA using panel data from the Monitoring the Future Surveys (1992-2003), which were merged with two food-at-home and one food-away-from-home price measures from the American Chamber of Commerce Researchers Association. Longitudinal individual random effect and fixed effect models were estimated. This study found that food prices did not have a significant effect on the prevalence of obesity among young female adults. For young adult men, an individual random effect estimator suggested that a 10% increase in the price of fast food was associated with a 13.2% decrease in the probability of obesity, but this effect lost its economic and statistical significance once individual fixed effects were controlled for in the estimation. Overall, the results imply that observed time-varying individual characteristics, such as working status, marital status and school enrolment status, may over-ride the effect of changes in food prices for young adults. More research employing longitudinal data is necessary to determine if food subsidies or taxes, particularly soft drink and fast food taxes or subsidies for fruit and vegetables, could be effective policy measures to curtail the increasing prevalence of obesity among young adults. Copyright © 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Increased Eating Frequency Is Associated with Lower Obesity Risk, But Higher Energy Intake in Adults: A Meta-Analysis

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Yue-Qiao Wang

2016-06-01

Full Text Available Body weight is regulated by energy intake which occurs several times a day in humans. In this meta-analysis, we evaluated whether eating frequency (EF is associated with obesity risk and energy intake in adults without any dietary restriction. Experimental and observational studies published before July 2015 were selected through English-language literature searches in several databases. These studies reported the association between EF and obesity risk (odd ratios, ORs in adults who were not in dietary restriction. R software was used to perform statistical analyses. Ten cross-sectional studies, consisting of 65,742 participants, were included in this analysis. ORs were considered as effect size for the analysis about the effect of EF on obesity risk. Results showed that the increase of EF was associated with 0.83 time lower odds of obesity (i.e., OR = 0.83, 95% confidence intervals (CI 0.70–0.99, p = 0.040. Analysis about the effect of EF on differences in participants’ energy intake revealed that increased EF was associated with higher energy intake (β = 125.36, 95% CI 21.76–228.97, p = 0.017. We conclude that increased EF may lead to lower obesity risk but higher energy intake. Clinical trials are warranted to confirm these results and to assess the clinical practice applicability.

Links between Childhood and Adult Social Circumstances and Obesity and Hypertension in the Mexican Population

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Beltrán-Sánchez, Hiram; Crimmins, Eileen M.; Teruel, Graciela M.; Thomas, Duncan

2011-01-01

Objectives This study examines links between early life circumstances and adult socioeconomic status and obesity and hypertension in the adult Mexican population. Methods We use data from the Mexican Family Life Survey (MxFLS) collected in 2002 for people aged 20 or older (N=14, 280). Results We found that men with low education and women with more education have significantly lower obesity. Women with higher education also have significantly less hypertension. Obesity triples the likelihood of hypertension among both men and women. Better childhood experiences are associated with less hypertension among women, but more hypertension among men in rural areas. Discussion Recent changes in income, nutrition, and infection in Mexico may be responsible for the observed high prevalence of overweight and obesity and the extremely high odds of hypertension among obese young adults. PMID:21948773

Prevalence of obesity and metabolic syndrome components in Mexican adults without type 2 diabetes or hypertension.

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Rojas-Martínez, Rosalba; Aguilar-Salinas, Carlos A; Jiménez-Corona, Aída; Gómez-Pérez, Francisco J; Barquera, Simón; Lazcano-Ponce, Eduardo

2012-01-01

To describe the number of Mexican adults with undiagnosed diabetes and arterial hypertension and their association with obesity. The study included a sub-sample of 6 613 subjects aged 20 years or more who participated in the 2006 National Health and Nutrition Survey (ENSANUT 2006). Subjects with a previous diagnosis of diabetes or hypertension (n=1 861) were excluded. Prevalences and standard errors were estimated, taking into account the complex sample design. 6.4 million adults have obesity and undiagnosed impaired fasting glucose. Almost two million more have fasting glucose levels diagnostic for diabetes. As for arterial blood pressure, 5.4 million adults had prehypertension. Another 5.4 million adults had blood pressure levels suggestive of probable hypertension. A total of 21.4 million Mexican adults with obesity had at least one further component of the metabolic syndrome. A large proportion of adults with obesity-related metabolic comorbidities remains undiagnosed in Mexico.

Clinical value of NPHS2 analysis in early- and adult-onset steroid-resistant nephrotic syndrome.

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Santín, Sheila; Tazón-Vega, Bárbara; Silva, Irene; Cobo, María Ángeles; Giménez, Isabel; Ruíz, Patricia; García-Maset, Rafael; Ballarín, José; Torra, Roser; Ars, Elisabet

2011-02-01

To date, very few cases with adult-onset focal segmental glomerulosclerosis (FSGS) carrying NPHS2 variants have been described, all of them being compound heterozygous for the p.R229Q variant and one pathogenic mutation. Mutation analysis was performed in 148 unrelated Spanish patients, of whom 50 presented with FSGS after 18 years of age. Pathogenicity of amino acid substitutions was evaluated through an in silico scoring system. Haplotype analysis was carried out using NPHS2 single nucleotide polymorphism and microsatellite markers. Compound heterozygous or homozygous NPHS2 pathogenic mutations were identified in seven childhood-onset steroid-resistant nephrotic syndrome (SRNS) cases. Six additional cases with late childhood- and adult-onset SRNS were compound heterozygotes for p.R229Q and one pathogenic mutation, mostly p.A284V. p.R229Q was more frequent among SRNS cases relative to controls (odds ratio=2.65; P=0.02). Significantly higher age at onset of the disease and slower progression to ESRD were found in patients with one pathogenic mutation plus the p.R229Q variant in respect to patients with two NPHS2 pathogenic mutations. NPHS2 analysis has a clinical value in both childhood- and adult-onset SRNS patients. For adult-onset patients, the first step should be screening for p.R229Q and, if positive, for p.A284V. These alleles are present in conserved haplotypes, suggesting a common origin for these substitutions. Patients carrying this specific NPHS2 allele combination did not respond to corticoids or immunosuppressors and showed FSGS, average 8-year progression to ESRD, and low risk for recurrence of FSGS after kidney transplant.

Changes in radiation dose with variations in human anatomy: moderately and severely obese adults.

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Clark, Landon D; Stabin, Michael G; Fernald, Michael J; Brill, Aaron B

2010-06-01

The phantoms used in standardized dose assessment are based on a median (i.e., 50th percentile) individual of a large population, for example, adult males or females or children of a particular age. Here we describe phantoms that model instead the influence of obesity on specific absorbed fractions (SAFs) and dose factors in adults. The literature was reviewed to evaluate how individual organ sizes change with variations in body weight in mildly and severely obese adult men and women. On the basis of the literature evaluation, changes were made to our deformable reference adult male and female total-body models. Monte Carlo simulations of radiation transport were performed. SAFs for photons were generated for mildly and severely obese adults, and comparisons were made to the reference (50th) percentile SAF values. SAFs studied between the obese phantoms and the 50th percentile reference phantoms were not significantly different from the reference 50th percentile individual, with the exception of intestines irradiating some abdominal organs, because of an increase in separation between folds caused by an increase in mesenteric adipose deposits. Some low-energy values for certain organ pairs were different, possibly due only to the statistical variability of the data at these low energies. The effect of obesity on dose calculations for internal emitters is minor and may be neglected in the routine use of standardized dose estimates.

Personality traits, education, physical exercise, and childhood neurological function as independent predictors of adult obesity.

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Cheng, Helen; Furnham, Adrian

2013-01-01

To investigate whether personality traits, education, physical exercise, parental socio-economic conditions, and childhood neurological function are independently associated with obesity in 50 year old adults in a longitudinal birth cohort study. The sample consisted of 5,921 participants born in Great Britain in 1958 and followed up at 7, 11, 33, 42, and 50 years with data on body mass index measured at 42 and 50 years. There was an increase of adult obesity from 14.2% at age 42 to 23.6% at 50 years. Cohort members who were reported by teachers on overall clumsiness as "certainly applied" at age 7 were more likely to become obese at age 50. In addition, educational qualifications, traits Conscientiousness and Extraversion, psychological distress, and physical exercise were all significantly associated with adult obesity. The associations remained to be significant after controlling for birth weight and gestation, maternal and paternal BMI, childhood BMI, childhood intelligence and behavioural adjustment, as well as diet. Neurological function in childhood, education, trait Conscientiousness, and exercise were all significantly and independently associated with adult obesity, each explained unique individual variability.

Psychiatric comorbidities of adults with early- and late-onset attention-deficit/hyperactivity disorder.

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Lin, Yu-Ju; Yang, Li-Kuang; Gau, Susan Shur-Fen

2016-06-01

We evaluated the psychiatric comorbidities in adults who were diagnosed with Diagnostic and Statistical Manual of Mental disorders, 5th edition attention-deficit/hyperactivity disorder as a function of recalled symptom onset before and after the age of 7 years and whether the childhood attention-deficit/hyperactivity disorder symptoms were associated with psychiatric comorbidities. In all, 214 adults who were diagnosed with Diagnostic and Statistical Manual of Mental disorders, 5th edition attention-deficit/hyperactivity disorder and 174 non-attention-deficit/hyperactivity disorder controls (aged 17-40 years) received psychiatric interviews to confirm their previous and current attention-deficit/hyperactivity disorder status and other psychiatric diagnoses. Demographics and risks of lifetime psychiatric disorders were compared among three groups: (1) attention-deficit/hyperactivity disorder, onset attention-deficit/hyperactivity disorder, onset between 7 and 12 years (late-onset) and (3) non-attention-deficit/hyperactivity disorder controls. We also tested the effects of attention-deficit/hyperactivity disorder symptoms on the risk of later psychiatric comorbidities by Cox regression analyses. Regardless of the age of onset, attention-deficit/hyperactivity disorder was significantly associated with a wide range of psychiatric comorbidities. There were similar comorbid patterns between early- and late-onset attention-deficit/hyperactivity disorder. Regardless of attention-deficit/hyperactivity disorder diagnosis, increased severity of attention-deficit/hyperactivity disorder symptoms was associated with higher risks of oppositional defiant disorder, conduct disorder, dysthymia and sleep disorder but not major depression, which was associated with the attention-deficit/hyperactivity disorder diagnosis. Our findings suggest that elevating the threshold of age of onset to 12 years in Diagnostic and Statistical Manual of Mental disorders, 5th edition would not

European Guidelines for Obesity Management in Adults.

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Yumuk, Volkan; Tsigos, Constantine; Fried, Martin; Schindler, Karin; Busetto, Luca; Micic, Dragan; Toplak, Hermann

2015-01-01

Obesity is a chronic metabolic disease characterised by an increase of body fat stores. It is a gateway to ill health, and it has become one of the leading causes of disability and death, affecting not only adults but also children and adolescents worldwide. In clinical practice, the body fatness is estimated by BMI, and the accumulation of intra-abdominal fat (marker for higher metabolic and cardiovascular disease risk) can be assessed by waist circumference. Complex interactions between biological, behavioural, social and environmental factors are involved in regulation of energy balance and fat stores. A comprehensive history, physical examination and laboratory assessment relevant to the patient's obesity should be obtained. Appropriate goals of weight management emphasise realistic weight loss to achieve a reduction in health risks and should include promotion of weight loss, maintenance and prevention of weight regain. Management of co-morbidities and improving quality of life of obese patients are also included in treatment aims. Balanced hypocaloric diets result in clinically meaningful weight loss regardless of which macronutrients they emphasise. Aerobic training is the optimal mode of exercise for reducing fat mass while a programme including resistance training is needed for increasing lean mass in middle-aged and overweight/obese individuals. Cognitive behavioural therapy directly addresses behaviours that require change for successful weight loss and weight loss maintenance. Pharmacotherapy can help patients to maintain compliance and ameliorate obesity-related health risks. Surgery is the most effective treatment for morbid obesity in terms of long-term weight loss. A comprehensive obesity management can only be accomplished by a multidisciplinary obesity management team. We conclude that physicians have a responsibility to recognise obesity as a disease and help obese patients with appropriate prevention and treatment. Treatment should be based on

Obesity and Metabolic Syndrome Among Adult Survivors of Childhood Leukemia.

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Gibson, Todd M; Ehrhardt, Matthew J; Ness, Kirsten K

2016-04-01

Treatment-related obesity and the metabolic syndrome in adult survivors of childhood acute lymphoblastic leukemia (ALL) are risk factors for cardiovascular disease. Both conditions often begin during therapy. Preventive measures, including dietary counseling and tailored exercise, should be initiated early in the course of survivorship, with referral to specialists to optimize success. However, among adults who develop obesity or the metabolic syndrome and who do not respond to lifestyle therapy, medical intervention may be indicated to manage underlying pathology, such as growth hormone deficiency, or to mitigate risk factors of cardiovascular disease. Because no specific clinical trials have been done in this population to treat metabolic syndrome or its components, clinicians who follow adult survivors of childhood ALL should use the existing American Heart Association/National Heart Lung and Blood Institute Scientific Statement to guide their approach.

Socio- demographic correlates of overweight and obesity among adults in rural Meerut

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Shailendra Kumar

2014-12-01

Full Text Available Background:  Obesity is most common nutritional disorder in developed countries and is assuming significant dimensions in developing countries. Objectives:  To find out the prevalence of overweight and obesity in adults aged 18 years and above and socio-demographic factors affecting overweight and obesity in rural population of Meerut. To suggest measures for prevention of overweight and obesity in adults population of rural Meerut. Material and Methods:  In present community based cross sectional study 1382 individuals aged 18 years and above were covered from 400 families spread over 5 villages with the help of systemic random sampling in rural area of Meerut District. The Individuals were interviewed and examined personally using Pre-designed and Pre-tested Questionnaire. Results:  Out of 1382 individuals 244 (17.7% were having BMI ≥ 25. Prevalence of obesity in females (22% was found more than males (13.8%. Prevalence of Overweight and Obesity increased with advancing age, maximum being in age group 50-59 years (22.2%. Maximum numbers of males (19.9% were overweight in their most productive life (30 -39 years whereas maximum females were overweight in their menopausal decade i.e. 40-49 years (32.8%. Overweight was more in persons who were married (18.9%, professional/Technical person (33.3%, Savarna upper caste (23.1%, belonging to high standard of living index (21.0%, person living in joint families (18.2%, and Alcoholics (18.6% while smokers were having lower prevalence of overweight (10.6%. Conclusion: The prevalence of Overweight and Obesity is increasing in adult population of rural area. Various socio-demographic correlates are affecting the prevalence of Overweight and Obesity in Rural population.

Association between Body Mass Index and Migraine: A Survey of Adult Population in China

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Qingqing Huang

2018-01-01

Full Text Available Both migraine and obesity are prevalent disorders in the general population, which are characterized by disability and impaired quality of life. Although so many researches had studied the association between migraine and obesity, there are still no full knowledge of the relationship between body mass index (BMI and migraine, especially chronic migraine (CM. In this study, we analyzed a previous epidemiological survey data of primary headache patients in Chongqing, which surveyed consecutive neurological outpatients through face-to-face interview with physicians using a headache questionnaire. 166 episodic migraine (EM patients and 134 chronic migraine (CM patients were included in the study out of 1327 primary headache patients. And 200 healthy adults from the physical examination center were included as a control group. Finally, we found that the patients with migraine (EM and CM were more likely to be overweight, obese, or morbidly obese compared to those in the healthy group. Significant difference was found between BMI and frequency of migraine attacks but not severity or duration of headache onset. And no significant difference was found in severity and duration of headache onset between episodic and chronic migraine among different BMI classifications. Such may update our knowledge about the clinical features of migraine and BMI, revealing that the frequency of attacks may be associated with being overweight, obese, or morbidly obese in patients with migraine and that the extent of being overweight, obese, or morbidly obese in CM patients was lower than that in EM patients.

Energy intake and expenditure in obese older adults with and without type 2 diabetes

NARCIS (Netherlands)

Memelink, R.G.; Verreijen, A.M.; de Vogel-van den Bosch, J.; Weijs, P.J.; Deutz, N.E.P.; Mays, J.A.; Roeske, S.C.

2017-01-01

Rationale: Obesity is a risk factor for type 2 diabetes (DM2), however not all obese people develop DM2. We explored differences in energy intake and expenditure between obese older adults with and without DM2. Methods: Baseline data from 2 lifestyle interventions with a total of 202 obese older

Chilli consumption and the incidence of overweight and obesity in a Chinese adult population.

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Shi, Z; Riley, M; Taylor, A W; Page, A

2017-07-01

The frequency of spicy food intake has recently been associated with a reduced risk of mortality in the Chinese population. This study aimed to prospectively examine the association between chilli intake and the incidence of overweight/obesity in a Chinese adult population. Adults aged 20-75 years in the China Health and Nutrition Survey were followed between 1991 and 2011. Dietary data were collected during home visits using a 3-day food record in 1991, 1993, 1997, 2000, 2004, 2006, 2009 and 2011. Cox regression was used in the analysis. Overweight/obesity was defined as body mass index ⩾25 kg m - 2 . A total 12 970 adults were followed for a median of 9 years. During 126 884 person-years of follow-up, 3203 subjects developed overweight/obesity. The absolute incidence rate of overweight/obesity was 26.4, 22.3, 24.4 and 20.5 per 1000 person-years among those who consumed no chilli or 1-20, 20.1-50, ⩾50.1 g per day, respectively. Chilli consumption was therefore inversely associated with the incidence of overweight/obesity. After adjusting for age, gender, energy and fat intake, smoking, alcohol drinking and physical activity, those whose cumulative average chilli intake was 0, 1-20, 20.1-50 and ⩾50.1 g per day had a hazard ratio for overweight/obesity of 1.00, 0.81 (95% confidence interval=0.73-0.89), 0.77 (0.69-0.86) and 0.73 (0.63-0.84); P for trend overweight/obesity. Chilli intake is inversely associated with the risk of becoming overweight/obese in Chinese adults.

Abdominal Obesity, Race and Chronic Kidney Disease in Young Adults: Results from NHANES 1999-2010.

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Sarathy, Harini; Henriquez, Gabriela; Abramowitz, Matthew K; Kramer, Holly; Rosas, Sylvia E; Johns, Tanya; Kumar, Juhi; Skversky, Amy; Kaskel, Frederick; Melamed, Michal L

2016-01-01

Kidney dysfunction in obesity may be independent of and may precede the development of hypertension and/or diabetes mellitus. We aimed to examine if abdominal obesity is associated with early markers of CKD in a young healthy population and whether these associations differ by race and/or ethnicity. We analyzed data from the NHANES 1999-2010 for 6918 young adults ages 20-40 years. Abdominal obesity was defined by gender criteria of waist circumference. CKD markers included estimated glomerular filtration rate and albuminuria ≥30 mg/g. Race stratified analyses were done overall and in subgroups with normal blood pressures, normoglycemia and normal insulin sensitivity. Awareness of CKD was assessed in participants with albuminuria. Abdominal obesity was present in over one-third of all young adults and was more prevalent among non-Hispanic blacks (45.4%) versus Mexican-Americans (40.6%) or non-Hispanic whites (37.4%) (P-value = 0.004). Mexican-American young adults with abdominal obesity had a higher odds of albuminuria even among those with normal blood pressure, normal glucose, and normal insulin sensitivity [adjusted odds ratio 4.5; 95% confidence interval (1.6-12.2), p = 0.004]. Less than 5% of young adults with albuminuria of all races and ethnicities had been told they had kidney disease. Abdominal obesity in young adults, especially in Mexican-Americans, is independently associated with albuminuria even with normal blood pressures, normoglycemia and normal insulin levels. Greater awareness of CKD is needed to protect this young population from long-standing exposure to abdominal obesity and early progressive renal disease.

Abdominal Obesity, Race and Chronic Kidney Disease in Young Adults: Results from NHANES 1999-2010.

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Harini Sarathy

Full Text Available Kidney dysfunction in obesity may be independent of and may precede the development of hypertension and/or diabetes mellitus. We aimed to examine if abdominal obesity is associated with early markers of CKD in a young healthy population and whether these associations differ by race and/or ethnicity.We analyzed data from the NHANES 1999-2010 for 6918 young adults ages 20-40 years. Abdominal obesity was defined by gender criteria of waist circumference. CKD markers included estimated glomerular filtration rate and albuminuria ≥30 mg/g. Race stratified analyses were done overall and in subgroups with normal blood pressures, normoglycemia and normal insulin sensitivity. Awareness of CKD was assessed in participants with albuminuria.Abdominal obesity was present in over one-third of all young adults and was more prevalent among non-Hispanic blacks (45.4% versus Mexican-Americans (40.6% or non-Hispanic whites (37.4% (P-value = 0.004. Mexican-American young adults with abdominal obesity had a higher odds of albuminuria even among those with normal blood pressure, normal glucose, and normal insulin sensitivity [adjusted odds ratio 4.5; 95% confidence interval (1.6-12.2, p = 0.004]. Less than 5% of young adults with albuminuria of all races and ethnicities had been told they had kidney disease.Abdominal obesity in young adults, especially in Mexican-Americans, is independently associated with albuminuria even with normal blood pressures, normoglycemia and normal insulin levels. Greater awareness of CKD is needed to protect this young population from long-standing exposure to abdominal obesity and early progressive renal disease.

Diet composition and activity level of at risk and metabolically healthy obese American adults.

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Hankinson, Arlene L; Daviglus, Martha L; Van Horn, Linda; Chan, Queenie; Brown, Ian; Holmes, Elaine; Elliott, Paul; Stamler, Jeremiah

2013-03-01

Obesity often clusters with other major cardiovascular disease risk factors, yet a subset of the obese appears to be protected from these risks. Two obesity phenotypes are described, (i) "metabolically healthy" obese, broadly defined as body mass index (BMI) ≥ 30 kg/m(2) and favorable levels of blood pressure, lipids, and glucose; and (ii) "at risk" obese, BMI ≥ 30 with unfavorable levels of these risk factors. More than 30% of obese American adults are metabolically healthy. Diet and activity determinants of obesity phenotypes are unclear. We hypothesized that metabolically healthy obese have more favorable behavioral factors, including less adverse diet composition and higher activity levels than at risk obese in the multi-ethnic group of 775 obese American adults ages 40-59 years from the International Population Study on Macro/Micronutrients and Blood Pressure (INTERMAP) cohort. In gender-stratified analyses, mean values for diet composition and activity behavior variables, adjusted for age, race, and education, were compared between metabolically healthy and at risk obese. Nearly one in five (149/775 or 19%) of obese American INTERMAP participants were classified as metabolically healthy obese. Diet composition and most activity behaviors were similar between obesity phenotypes, although metabolically healthy obese women reported higher sleep duration than at risk obese women. These results do not support hypotheses that diet composition and/or physical activity account for the absence of cardiometabolic abnormalities in metabolically healthy obese. Copyright © 2012 The Obesity Society.

Dioxin (TCDD induces epigenetic transgenerational inheritance of adult onset disease and sperm epimutations.

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Mohan Manikkam

Full Text Available Environmental compounds can promote epigenetic transgenerational inheritance of adult-onset disease in subsequent generations following ancestral exposure during fetal gonadal sex determination. The current study examined the ability of dioxin (2,3,7,8-tetrachlorodibenzo[p]dioxin, TCDD to promote epigenetic transgenerational inheritance of disease and DNA methylation epimutations in sperm. Gestating F0 generation females were exposed to dioxin during fetal day 8 to 14 and adult-onset disease was evaluated in F1 and F3 generation rats. The incidences of total disease and multiple disease increased in F1 and F3 generations. Prostate disease, ovarian primordial follicle loss and polycystic ovary disease were increased in F1 generation dioxin lineage. Kidney disease in males, pubertal abnormalities in females, ovarian primordial follicle loss and polycystic ovary disease were increased in F3 generation dioxin lineage animals. Analysis of the F3 generation sperm epigenome identified 50 differentially DNA methylated regions (DMR in gene promoters. These DMR provide potential epigenetic biomarkers for transgenerational disease and ancestral environmental exposures. Observations demonstrate dioxin exposure of a gestating female promotes epigenetic transgenerational inheritance of adult onset disease and sperm epimutations.

Serum levels of troponin I in obese adults attending University of ...

African Journals Online (AJOL)

Background: Obesity according to World Health Organization (WHO) is a condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health leading to reduced life expectancy and increased health problem. Aim: To determine the serum concentrations of troponin I in obese adults ...

Prevalence of Prediabetes and Abdominal Obesity Among Healthy-Weight Adults: 18-Year Trend.

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Mainous, Arch G; Tanner, Rebecca J; Jo, Ara; Anton, Stephen D

2016-07-01

Trends in sedentary lifestyle may have influenced adult body composition and metabolic health among individuals at presumably healthy weights. This study examines the nationally representative prevalence of prediabetes and abdominal obesity among healthy-weight adults in 1988 through 2012. We analyzed the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and NHANES for the years 1999 to 2012, focusing on adults aged 20 years and older who have a body mass index (BMI) of 18.5 to 24.99 and do not have diabetes, either diagnosed or undiagnosed. We defined prediabetes using glycated hemoglobin (HbA1c) level ranges from 5.7% to 6.4%, as specified by the American Diabetes Association. Abdominal obesity was measured by waist circumference and waist-to-height ratio. The prevalence of prediabetes among healthy-weight adults, aged 20 years and older and without diagnosed or undiagnosed diabetes, increased from 10.2% in 1988-1994 to 18.5% in 2012. Among individuals aged 45 years and older, the prevalence of prediabetes increased from 22.0% to 33.1%. The percentage of adults aged 20 years and older with an unhealthy waist circumference increased from 5.6% in 1988-1994 to 7.6% in 2012. The percentage of individuals with an unhealthy waist-to-height ratio increased from 27.2% in 1988-1994 to 33.7% in 2012. Adjusted models found that measures of abdominal obesity were not independent predictors of prediabetes among adults with a healthy BMI. Among individuals within a healthy BMI range, the prevalence of prediabetes and abdominal obesity has substantially increased. Abdominal obesity does not appear to be the primary cause of the increase. © 2016 Annals of Family Medicine, Inc.

Season of Birth and Risk for Adult Onset Glioma

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Jimmy T. Efird

2010-04-01

Full Text Available Adult onset glioma is a rare cancer which occurs more frequently in Caucasians than African Americans, and in men than women. The etiology of this disease is largely unknown. Exposure to ionizing radiation is the only well established environmental risk factor, and this factor explains only a small percentage of cases. Several recent studies have reported an association between season of birth and glioma risk. This paper reviews the plausibility of evidence focusing on the seasonal interrelation of farming, allergies, viruses, vitamin D, diet, birth weight, and handedness. To date, a convincing explanation for the occurrence of adult gliomas decades after a seasonal exposure at birth remains elusive.

Impaired decision making among morbidly obese adults.

LENUS (Irish Health Repository)

Brogan, Amy

2011-02-01

The Iowa Gambling Task (IGT) measures affective decision making and has revealed decision making impairments across a wide range of eating disorders. This study aimed to investigate affective decision making in severely obese individuals.

The relationship between child abuse and adult obesity among california women.

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Alvarez, Jennifer; Pavao, Joanne; Baumrind, Nikki; Kimerling, Rachel

2007-07-01

Despite clinical studies suggesting that child abuse is associated with adult obesity, very few studies have been conducted with large community or state-based samples. This study examines the relationship between child abuse and adult obesity, relative to other risk factors such as demographics, food insecurity, inadequate fruit and vegetable consumption, and physical inactivity, in a representative sample of California women. Data are from the California Women's Health Survey, a state-based, random-digit-dial annual probability survey of California women. Participants included 11,115 nonpregnant women aged 18 or older, who provided complete data for all study variables. The telephone interview included assessment of child abuse (abstracted from the Traumatic Stress Schedule), food insecurity, perceived stress, physical activity, fruit and vegetable consumption, height, and weight. Data were collected in 2002, 2003, and 2004, and analyzed in 2006. Obese (body mass index [BMI] of 30 or higher) women were significantly more likely to report exposure to child abuse (odds ratio [OR]=1.32, 95% confidence interval [CI]=1.23-1.42). In a multivariate model adjusted for age, race/ethnicity, education, food insecurity, inadequate fruit and vegetable consumption, physical inactivity, and perceived stress, women exposed to child abuse remained significantly more likely to be obese than unexposed women (adjusted OR=1.27, 95% CI=1.13-1.40). The population-attributable fraction of obesity associated with any type of abuse was 4.5% (95% CI=2.28-6.55). Exposure to child abuse is associated with adult obesity among California women, even accounting for other relevant variables. This supports the notion that child abuse and its sequelae may be important targets for public health intervention, particularly in subpopulations where the prevalence of child abuse is known to be high.

Obesity-specific neural cost of maintaining gait performance under complex conditions in community-dwelling older adults.

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Osofundiya, Olufunmilola; Benden, Mark E; Dowdy, Diane; Mehta, Ranjana K

2016-06-01

Recent evidence of obesity-related changes in the prefrontal cortex during cognitive and seated motor activities has surfaced; however, the impact of obesity on neural activity during ambulation remains unclear. The purpose of this study was to determine obesity-specific neural cost of simple and complex ambulation in older adults. Twenty non-obese and obese individuals, 65years and older, performed three tasks varying in the types of complexity of ambulation (simple walking, walking+cognitive dual-task, and precision walking). Maximum oxygenated hemoglobin, a measure of neural activity, was measured bilaterally using a portable functional near infrared spectroscopy system, and gait speed and performance on the complex tasks were also obtained. Complex ambulatory tasks were associated with ~2-3.5 times greater cerebral oxygenation levels and ~30-40% slower gait speeds when compared to the simple walking task. Additionally, obesity was associated with three times greater oxygenation levels, particularly during the precision gait task, despite obese adults demonstrating similar gait speeds and performances on the complex gait tasks as non-obese adults. Compared to existing studies that focus solely on biomechanical outcomes, the present study is one of the first to examine obesity-related differences in neural activity during ambulation in older adults. In order to maintain gait performance, obesity was associated with higher neural costs, and this was augmented during ambulatory tasks requiring greater precision control. These preliminary findings have clinical implications in identifying individuals who are at greater risk of mobility limitations, particularly when performing complex ambulatory tasks. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effect of aerobic exercise on Pancreas Beta-cells function in adult obese males

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Mojtaba Eizadi

2014-08-01

Conclusion: Aerobic exercise training increases beta cells function and decreases FBS in obese men. These findings support the hypothesis that regular physical activity postpones the occurrence of type 2 diabetes in adult obese subjects.

BMI Trajectories Associated With Resolution of Elevated Youth BMI and Incident Adult Obesity.

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Buscot, Marie-Jeanne; Thomson, Russell J; Juonala, Markus; Sabin, Matthew A; Burgner, David P; Lehtimäki, Terho; Hutri-Kähönen, Nina; Viikari, Jorma S A; Jokinen, Eero; Tossavainen, Paivi; Laitinen, Tomi; Raitakari, Olli T; Magnussen, Costan G

2018-01-01

Youth with high BMI who become nonobese adults have the same cardiovascular risk factor burden as those who were never obese. However, the early-life BMI trajectories for overweight or obese youth who avoid becoming obese adults have not been described. We aimed to determine and compare the young-childhood BMI trajectories of participants according to their BMI status in youth and adulthood. Bayesian hierarchical piecewise regression modeling was used to analyze the BMI trajectories of 2717 young adults who had up to 8 measures of BMI from childhood (ages 3-18 years) to adulthood (ages 34-49 years). Compared with those with persistently high BMI, those who resolved their high youth BMI by adulthood had lower average BMI at age 6 years and slower rates of BMI change from young childhood. In addition, their BMI levels started to plateau at 16 years old for females and 21 years old for males, whereas the BMI of those whose high BMI persisted did not stabilize until 25 years old for male subjects and 27 years for female subjects. Compared with those youth who were not overweight or obese and who remained nonobese in adulthood, those who developed obesity had a higher BMI rate of change from 6 years old, and their BMI continued to increase linearly until age 30 years. Efforts to alter BMI trajectories for adult obesity should ideally commence before age 6 years. The natural resolution of high BMI starts in adolescence for males and early adulthood for females, suggesting a critical window for secondary prevention. Copyright © 2018 by the American Academy of Pediatrics.

A rice-based traditional dietary pattern is associated with obesity in Korean adults.

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Kim, Jihye; Jo, Inho; Joung, Hyojee

2012-02-01

Dietary patterns are critical in the prevention of chronic disease. The relationship between specific dietary patterns and obesity has not been evaluated in a Korean adult population. This study examined whether specific dietary patterns are associated with obesity using survey data of the largest, nationally representative, general Korean population. The cross-sectional study was comprised of 10,089 Korean adults (19 years or older) who participated in the second and third Korean National Health and Nutrition Examination Surveys conducted in 2001 and 2005, respectively. Dietary data were assessed by 24-hour recall method. Obesity was defined as body mass index (calculated as kg/m(2)) ≥25, which is the cutoff point for adults in the Asian and Pacific regions. Four dietary patterns were derived using factor analysis (white rice and kimchi pattern; high-fat, sweets, and coffee pattern; meat and alcohol pattern; and grains, vegetables, and fish pattern). Each dietary pattern explained 8.6%, 6.7%, 5.7%, and 5.7% of the variation in food intake, respectively. The white rice and kimchi pattern (P for trend=0.0039) and the high-fat, sweets, and coffee pattern (P for trend=0.0054) were positively associated with obesity after adjustments for age, sex, energy intake, alcohol intake, smoking status, physical activity, and chronic diseases. No significant association was found among the meat and alcohol pattern; the grains, vegetables, and fish pattern; and obesity. Specific dietary patterns, which include the white rice and kimchi and high-fat, sweets, and coffee patterns, may be independently associated with obesity in Korean adults. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Evolution of disease phenotype in adult and pediatric onset Crohn’s disease in a population-based cohort

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Lovasz, Barbara Dorottya; Lakatos, Laszlo; Horvath, Agnes; Szita, Istvan; Pandur, Tunde; Mandel, Michael; Vegh, Zsuzsanna; Golovics, Petra Anna; Mester, Gabor; Balogh, Mihaly; Molnar, Csaba; Komaromi, Erzsebet; Kiss, Lajos Sandor; Lakatos, Peter Laszlo

2013-01-01

AIM: To investigate the evolution of disease phenotype in adult and pediatric onset Crohn’s disease (CD) populations, diagnosed between 1977 and 2008. METHODS: Data of 506 incident CD patients were analyzed (age at diagnosis: 28.5 years, interquartile range: 22-38 years). Both in- and outpatient records were collected prospectively with a complete clinical follow-up and comprehensively reviewed in the population-based Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008 in adult and pediatric onset CD populations. Disease phenotype according to the Montreal classification and long-term disease course was analysed according to the age at onset in time-dependent univariate and multivariate analysis. RESULTS: Among this population-based cohort, seventy-four (12.8%) pediatric-onset CD patients were identified (diagnosed ≤ 17 years of age). There was no significant difference in the distribution of disease behavior between pediatric (B1: 62%, B2: 15%, B3: 23%) and adult-onset CD patients (B1: 56%, B2: 21%, B3: 23%) at diagnosis, or during follow-up. Overall, the probability of developing complicated disease behaviour was 49.7% and 61.3% in the pediatric and 55.1% and 62.4% in the adult onset patients after 5- and 10-years of follow-up. Similarly, time to change in disease behaviour from non stricturing, non penetrating (B1) to complicated, stricturing or penetrating (B2/B3) disease was not significantly different between pediatric and adult onset CD in a Kaplan-Meier analysis. Calendar year of diagnosis (P = 0.04), ileal location (P < 0.001), perianal disease (P < 0.001), smoking (P = 0.038) and need for steroids (P < 0.001) were associated with presence of, or progression to, complicated disease behavior at diagnosis and during follow-up. A change in disease location was observed in 8.9% of patients and it was associated with smoking status (P = 0.01), but not with age at diagnosis. CONCLUSION: Long

Food insecurity and adult overweight/obesity: Gender and race/ethnic disparities.

Science.gov (United States)

Hernandez, Daphne C; Reesor, Layton M; Murillo, Rosenda

2017-10-01

The majority of the food insecurity-obesity research has indicated a positive association among women, especially minority women. Less research has been conducted on men, and the findings are inconsistent. The aim was to assess whether gender and race/ethnic disparities exists between the food insecurity and overweight/obesity relationship among adults ages 18-59. We used the cross-sectional 2011 and 2012 National Health Interview Survey data (N = 19,990). Three or more affirmative responses on the 10-item USDA Food Security Scale indicated food insecure experiences. Self-reported height and weight were used to calculate body mass index according to the Centers for Disease Control and Prevention. Multivariate logistic regression models were stratified by gender and race/ethnicity to estimate the association between food insecurity and overweight/obesity controlling for several demographic characteristics. Adults on average were 36 years of age (51% female; 56% white, 27% Hispanic, and 17% black), 27% were food insecure, and 65% were overweight/obese. Food insecurity was most prevalent among blacks and Hispanics, regardless of gender. A greater percentage of food insecure women were overweight/obese compared to food secure women among all race/ethnicity groups; while similar proportions of white, black, and Hispanic men were overweight/obese irrespective of their food security status. In covariate-adjusted models, food insecurity was associated with a 41% and 29% higher odds of being overweight/obese among white and Hispanic women, respectively. Food insecurity was not related to overweight/obesity among black women nor among white, black, and Hispanic men. The complex relationship between food insecurity and obesity suggests a need to investigate potential behavioral and physiological mechanisms, and moderators of this relationship. Copyright © 2017 Elsevier Ltd. All rights reserved.

Metabolomics Reveals that Momordica charantia Attenuates Metabolic Changes in Experimental Obesity.

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Gong, Zhi-Gang; Zhang, Jianbing; Xu, Yong-Jiang

2017-02-01

Momordica charantia L., also known as bitter melon, has been shown to ameliorate obesity and insulin resistance. However, metabolic changes regulated by M. charantia in obesity are not clearly understood. In this study, serums obtained from obese and M. charantia-treated mice were analyzed by using gas and liquid chromatography-mass spectrometry, and multivariate statistical analysis was performed by Orthogonal partial least squares discriminant analysis. The results from this study indicated that body weight fat and insulin levels of obese mice are dramatically suppressed by 8 weeks of dietary supplementation of M. charantia. Metabolomic data revealed that overproductions of energy and nutrient metabolism in obese mice were restored by M. charantia treatment. The antiinflammatory and inhibition of insulin resistance effect of M. charantia in obesity was illustrated with the restoration of free fatty acids and eicosanoids. The findings achieved in this study further strengthen the therapeutic value of using M. charantia to treat obesity. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Predictors of urinary incontinence between abdominal obesity and non-obese male adults.

Science.gov (United States)

Li, Dongmei; Xu, Yi; Nie, Qingbin; Li, Yan; Mao, Gengsheng

2017-09-01

To investigate factors that may be associated with urinary incontinence (UI) in abdominal obese and non-obese adult males. Data were analyzed for 2671 men (≥40 years of age) who participated in the National Health and Nutrition Examination Survey (2005-2008). We define abdominal obesity as a waist circumference >102 cm. Men with Incontinence Severity Index ≥3 were defined as having UI. Logistic regression analyses were used to identify factors associated with stress and urge UI. Multivariate analysis found that in abdominal obese men, stress UI was associated with enlarged prostate (odds ratio [OR] = 2.20, 95% confidence interval [CI]: 1.16-4.16), chronic respiratory tract disease (OR = 2.78, 95% CI: 1.55-4.97), and major depression (OR = 4.79, 95% CI: 1.79-12.84). In non-obese men, arthritis was associated with stress UI (odds ratio = 3.37, 95% CI: 1.06-10.73). Urge UI in abdominally obese men was associated with age ≥65 years (OR = 1.67, 95% CI: 1.05-2.67), being non-Hispanic black (OR = 1.63, 95% CI: 1.06-2.52), and with enlarged prostate (OR = 2.30, 95% CI: 1.54-3.40), arthritis (OR = 1.39, 95% CI: 1.03-1.88), and major depression (OR = 2.96, 95% CI: 1.89-4.64). Urge UI in non-obese men was associated with current smoking (OR = 1.79, 95% CI: 1.01-3.17), major depression (OR = 2.60, 95% CI: 1.33-5.09) and vitamin D deficiency (OR = 1.61, 95% CI: 1.01-2.59). Factors associated with urinary incontinence varied with abdominal obesity status and type of UI. The findings identify important contributors to urinary incontinence that clinicians should consider to help manage and effectively treat the condition.

Obesity and central adiposity in Mexican adults: results from the Mexican National Health and Nutrition Survey 2006.

Science.gov (United States)

Barquera, Simón; Campos-Nonato, Ismael; Hernández-Barrera, Lucía; Flores, Mario; Durazo-Arvizu, Ramón; Kanter, Rebecca; Rivera, Juan A

2009-01-01

To estimate the prevalence of overweight, obesity and central adiposity in Mexico, and to explore trends compared to the previous Mexican National Health Survey (ENSA 2000) and to Mexican-Americans. The Mexican National Health and Nutrition Survey 2006 (ENSANUT 2006) was used to describe overweight, obesity and central adiposity. Trends over time were assessed using the ENSA 2000 and by comparing the ENSANUT 2006 results to those of Mexican-Americans using the United States National Health and Nutrition Examination Survey (NHANES) 1999-2000 and 2005-2006. A total of 33023 adults > 20 years old were included; 39.7% were found to be overweight and 29.9% were found to be obese; 75.9% of all adults had abdominal obesity. In Mexico between 2000 and 2006, the combined prevalence of overweight and obesity in adults increased approximately 12%. Mexican-Americans showed a higher prevalence of morbid obesity compared to native Mexicans. Mexico has experienced a rapid increase in the number of adults who have experienced excess weight gain between the years 2000 and 2006.

Large heterogeneity of the obesity epidemic in Danish adults

DEFF Research Database (Denmark)

Heitmann, B.L.; Strøger, U.; Mikkelsen, K.L.

2004-01-01

group, except for an increasing trend among men aged 50 years and above. CONCLUSION: Although the overall Danish trend for obesity prevalence, similar to trends world-wide, showed a marked increase, the trend was very heterogeneous and generally neither uniform nor significantly positive; the changes......OBJECTIVE: To examine to what extent the obesity epidemic is a general phenomenon in adults by assessing the secular change, by birth cohort and age, in the prevalence of obesity and median body mass index (BMI) in Danish men and women measured between 1964 and 1994. DESIGN: Multiple cross......-sectional population surveys. SETTING: The greater Copenhagen area of Denmark. SUBJECTS: The study included 17,065 men (30 336 observations) and 13,417 women (24,065 observations), aged 20-84 years. MAIN OUTCOME MEASURES: Trends in median BMI and prevalence of obesity estimated from measured height and weight in 10...

Economic growth and obesity in South African adults: an ecological analysis between 1994 and 2014.

Science.gov (United States)

Pisa, Pedro T; Pisa, Noleen M

2017-06-01

To assess the trend associations between South Africa's economic growth using various economic growth indicators (EGIs) with adult obesity prevalence over a specified period of time. Data for obesity levels reported were obtained from national surveys conducted in South African adults in 1998, 2003 and 2012. EGIs incorporated in the current analysis were obtained from the World Bank and IHS Global insight databases. Obesity prevalence is presented by gender, urbanisation level and ethnicity. EGIs congruent to the time points where obesity data are available are presented. Unadjusted time trend plots were applied to assess associations between obesity prevalence and EGIs by gender, urbanisation level and ethnicity. Females present higher levels of obesity relative to males for all time points. For both males and females, an overall increase in prevalence was observed in both rural and urban settings over-time, with urban dwellers presenting higher obesity levels. An overall increase in Gross Domestic Product (GDP) per capita and Household Final Consumption Expenditure (HFCE) per capita was observed. The Gini coefficient for all ethnicities except the White population increased between 1998 and 2003 but declined by 2012. Overtime per capita GDP and HFCE increased with increasing obesity prevalence in both genders. The trend association between the Gini coefficient for all ethnicities and obesity prevalence was similar for both genders in that as the Gini coefficient increased obesity prevalence declined, and when the coefficient decreased obesity prevalence increased. Trend associations exist between South Africa's economic growth and adult obesity. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Obesity and associated factors in young adults attending tertiary ...

African Journals Online (AJOL)

Obesity and associated factors in young adults attending tertiary institutions ... and associated factors in a group of university undergraduates in south-east Nigeria. ... being a female (X2 = 47.91), first year student (X2 = 41.82), and having high ...

Obesity indices predict hypertension among indigenous adults in Krau Wildlife Reserve, Peninsular Malaysia

OpenAIRE

Chua, Ee Yin; Zalilah, Mohd Shariff; Haemamalar, Karppaya; Norhasmah, Sulaiman; Geeta, Appannah

2017-01-01

Background The disease burden of indigenous peoples has been augmented by the rising prevalence of obesity and hypertension in this population. This study assessed the ability of obesity indices to predict hypertension among indigenous adults of Peninsular Malaysia. Methods In this cross-sectional study, 482 adults (223 men, 259 women) aged ?18?years old were measured for body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), waist-hip ratio (WHR), and blood pressure. Rec...

Relationship between heavy drinking, binge drinking, and metabolic syndrome in obese and non-obese Korean male adults.

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Oh, Jung Eun

2018-04-01

Obesity and alcohol drinking are associated with metabolic syndrome. However, few studies show the relationship between alcohol drinking and metabolic syndrome according to varying degrees of obesity. This study aimed to determine the association between alcohol drinking and metabolic syndrome in obese and non-obese Korean male adults. This cross-sectional study included 5,867 males aged ≥ 20 years who were examined at the Soonchunhyang University health promotion center during June 2008-December 2010. The subjects were divided into non-obese (body mass index [BMI] 14 drinks/week) groups. The subjects were also categorized into binge drinking and non-binge drinking groups. To obtain odds ratios (ORs) for metabolic syndrome, binary logistic regression analysis was performed. The overall metabolic syndrome prevalence was 27.3% (12.8%, non-obese group; 50.4%, obese group). After adjusting for age, physical activity, and smoking, in the non-obese group, the OR for heavy drinking with binge drinking (reference: nondrinking) was 1.56 (95% confidence interval [CI] = 1.12-2.18), with a significant increase in metabolic syndrome prevalence. In the obese group, the OR for heavy drinking with binge drinking was 1.42 (95% CI = 1.07-1.88), showing a significant increase in metabolic syndrome prevalence ( P metabolic syndrome. Thus, both non-obese and obese males should restrict their alcohol intake and not indulge in binge drinking.

Intimal spindle cell sarcoma masquerading as adult-onset symptomatic pulmonic stenosis: a case report and review of the literature.

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Manmadhan, Arun; Malhotra, Sunil P; Weinberg, Catherine R; Reyentovich, Alex; Latson, Larry A; Bhatla, Puneet; Saric, Muhamed

2017-10-30

Pulmonary artery intimal spindle cell sarcomas are rare and carry with them a poor prognosis and high rate of recurrence. In extremely rare cases, this tumor can infiltrate the pulmonic valve and manifest as adult-onset pulmonic stenosis. We report an unusual case of a patient with symptomatic, adult-onset severe pulmonic stenosis who was referred for possible balloon valvuloplasty but was subsequently found to have pulmonary artery intimal sarcoma infiltrating the pulmonary valve leading to progressive exertional dyspnea. The presence of adult-onset pulmonic stenosis should prompt the clinician to investigate further as most cases of pulmonic stenosis are congenital in nature and present early in life. Careful diagnostic evaluation in concert with multimodal imaging should take place to arrive at the correct and challenging diagnosis of sarcoma-induced adult-onset severe pulmonic stenosis. Given the poor prognosis and rapid progression of disease, early diagnosis is crucial.

Health Care Provider Counseling for Weight Loss Among Adults with Arthritis and Overweight or Obesity - United States, 2002-2014.

Science.gov (United States)

Guglielmo, Dana; Hootman, Jennifer M; Murphy, Louise B; Boring, Michael A; Theis, Kristina A; Belay, Brook; Barbour, Kamil E; Cisternas, Miriam G; Helmick, Charles G

2018-05-04

In the United States, 54.4 million adults report having doctor-diagnosed arthritis (1). Among adults with arthritis, 32.7% and 38.1% also have overweight and obesity, respectively (1), with obesity being more prevalent among persons with arthritis than among those who do not have arthritis (2). Furthermore, severe joint pain among adults with arthritis in 2014 was reported by 23.5% of adults with overweight and 31.7% of adults with obesity (3). The American College of Rheumatology recommends weight loss for adults with hip or knee osteoarthritis and overweight or obesity,* which can improve function and mobility while reducing pain and disability (4,5). The Healthy People 2020 target for health care provider (hereafter provider) counseling for weight loss among persons with arthritis and overweight or obesity is 45.3%. † Adults with overweight or obesity who receive weight-loss counseling from a provider are approximately four times more likely to attempt to lose weight than are those who do not receive counseling (6). To estimate changes in the prevalence of provider counseling for weight loss reported by adults with arthritis and overweight or obesity, CDC analyzed National Health Interview Survey (NHIS) data. § Overall, age-standardized estimates of provider counseling for weight loss increased by 10.4 percentage points from 2002 (35.1%; 95% confidence interval [CI] = 33.0-37.3) to 2014 (45.5%; 95% CI = 42.9-48.1) (phealth benefits for this population.

Clinical profile, morbidity, and outcome of adult-onset generalized pustular psoriasis: analysis of 102 cases seen in a tertiary hospital in Johor, Malaysia.

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Choon, Siew Eng; Lai, Nai Ming; Mohammad, Norshaleyna A; Nanu, Nalini M; Tey, Kwee Eng; Chew, Shang Fern

2014-06-01

Generalized pustular psoriasis (GPP) is a severe but rare variant of psoriasis. Our objective is to review the clinical profile, comorbidities, and outcome of patients with GPP. A retrospective note review of all patients with adult-onset GPP. A total of 102 patients with adult-onset GPP were diagnosed between 1989 and November 2011, with a female to male ratio of 2 : 1. The mean age at onset of GPP was 40.9 years (range: 21-81 years). Acute GPP was the most common variant seen (95 cases), followed by four localized variants of GPP and three with annular pustular psoriasis. Fever and painful skin were present in 89% of patients, arthritis in 34.7%, and leukocytosis in 78.4%. Common triggers were systemic steroids (45 cases), pregnancy (17 cases), and upper respiratory tract infections (16 cases). A positive family history of psoriasis and GPP was present in 29% and 11%, respectively. Comorbidities included obesity (42.9%), hypertension (25.7%), hyperlipidemia (25.7%), and diabetes mellitus (23.7%). The mean duration of admission and pustular flare for acute GPP was 10.3 days (range: 3-44 days) and 16 days (range: 7-60 days), respectively. Fifty-four patients responded to systemic retinoid, 21 to methotrexate, eight to cyclosporine, and one to adalimumab, but recurrences were common. Our study confirms the poor response of GPP to currently available anti-psoriatic agents, with frequent flare-ups. There is a need for a more effective targeted therapy for this condition. © 2013 The International Society of Dermatology.

Obesity and the metabolic syndrome in developing countries.

Science.gov (United States)

Misra, Anoop; Khurana, Lokesh

2008-11-01

Prevalence of obesity and the metabolic syndrome is rapidly increasing in developing countries, leading to increased morbidity and mortality due to type 2 diabetes mellitus (T2DM) and cardiovascular disease. Literature search was carried out using the terms obesity, insulin resistance, the metabolic syndrome, diabetes, dyslipidemia, nutrition, physical activity, and developing countries, from PubMed from 1966 to June 2008 and from web sites and published documents of the World Health Organization and Food and Agricultural Organization. With improvement in economic situation in developing countries, increasing prevalence of obesity and the metabolic syndrome is seen in adults and particularly in children. The main causes are increasing urbanization, nutrition transition, and reduced physical activity. Furthermore, aggressive community nutrition intervention programs for undernourished children may increase obesity. Some evidence suggests that widely prevalent perinatal undernutrition and childhood catch-up obesity may play a role in adult-onset metabolic syndrome and T2DM. The economic cost of obesity and related diseases in developing countries, having meager health budgets is enormous. To prevent increasing morbidity and mortality due to obesity-related T2DM and cardiovascular disease in developing countries, there is an urgent need to initiate large-scale community intervention programs focusing on increased physical activity and healthier food options, particularly for children. International health agencies and respective government should intensively focus on primordial and primary prevention programs for obesity and the metabolic syndrome in developing countries.

Management of adults with paediatric-onset chronic liver disease: strategic issues for transition care.

Science.gov (United States)

Vajro, Pietro; Ferrante, Lorenza; Lenta, Selvaggia; Mandato, Claudia; Persico, Marcello

2014-04-01

Advances in the management of children with chronic liver disease have enabled many to survive into adulthood with or without their native livers, so that the most common of these conditions are becoming increasingly common in adult hepatology practice. Because the aetiologies of chronic liver disease in children may vary significantly from those in adulthood, adults with paediatric-onset chronic liver disease may often present with clinical manifestations unfamiliar to their adulthood physician. Transition of medical care to adult practice requires that the adulthood medical staff (primary physicians and subspecialists) have a comprehensive knowledge of childhood liver disease and their implications, and of the differences in caring for these patients. Pending still unavailable Scientific Society guidelines, this article examines causes, presentation modes, evaluation, management, and complications of the main paediatric-onset chronic liver diseases, and discusses key issues to aid in planning a program of transition from paediatric to adult patients. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

The relationship of waist circumference and body mass index to grey matter volume in community dwelling adults with mild obesity.

Science.gov (United States)

Hayakawa, Y K; Sasaki, H; Takao, H; Yoshikawa, T; Hayashi, N; Mori, H; Kunimatsu, A; Aoki, S; Ohtomo, K

2018-02-01

Previous work has shown that high body mass index (BMI) is associated with low grey matter volume. However, evidence on the relationship between waist circumference (WC) and brain volume is relatively scarce. Moreover, the influence of mild obesity (as indexed by WC and BMI) on brain volume remains unclear. This study explored the relationships between WC and BMI and grey matter volume in a large sample of Japanese adults. The participants were 792 community-dwelling adults (523 men and 269 women). Brain magnetic resonance images were collected, and the correlation between WC or BMI and global grey matter volume were analysed. The relationships between WC or BMI and regional grey matter volume were also investigated using voxel-based morphometry. Global grey matter volume was not correlated with WC or BMI. Voxel-based morphometry analysis revealed significant negative correlations between both WC and BMI and regional grey matter volume. The areas correlated with each index were more widespread in men than in women. In women, the total area of the regions significantly correlated with WC was slightly greater than that of the regions significantly correlated with BMI. Results show that both WC and BMI were inversely related to regional grey matter volume, even in Japanese adults with somewhat mild obesity. Especially in populations with less obesity, such as the female participants in current study, WC may be more sensitive than BMI as a marker of grey matter volume differences associated with obesity.

Obesity stigmatization as the status quo: structural considerations and prevalence among young adults in the U.S.

Science.gov (United States)

Ambwani, Suman; Thomas, Katherine M; Hopwood, Christopher J; Moss, Sara A; Grilo, Carlos M

2014-08-01

Although obesity stigmatization contributes to significant health, economic, and quality-of-life challenges for U.S. adults, the prevalence and nature of stigmatizing attitudes requires an update and clarification. The present study sought to examine the prevalence and major dimensions of negative attitudes toward obesity through assessment of young U.S. adults' responses to the Attitudes Toward Obese Persons Scale. Participants were women (n=578) and men (n=233) who completed self-report questionnaires assessing obesity stigmatization and eating disorder features. Results indicate that at least one stigmatizing attitude was endorsed by 92.5% of respondents, with an average endorsement rate of 32.8% across items. Eating disorder features, body size, and gender were not related to one's likelihood of endorsing negative attitudes toward obesity. Distinct clusters of negative attitudes were identified involving beliefs that "obese people suffer" and "obese people are inferior." Data suggest that large proportions of young U.S. adults harbor negative attitudes toward obese persons and these attitudes are pervasive across individuals with different characteristics. Although such negative attitudes have traditionally been conceptualized as relatively unidimensional, results suggest that future research would benefit from deconstructing negative attitudes into those related to pitying the obese and those related to perceiving the obese with harsh judgment. Copyright © 2014. Published by Elsevier Ltd.

Very early-onset schizophrenia with secondary onset tic disorder

OpenAIRE

Shilpa A Telgote; Shreyas Shrikant Pendharkar; Amol D Kelkar; Sachin Bhojane

2017-01-01

Very early-onset schizophrenia (defined as an onset of psychosis before 13 years of age) is a rare and severe form of the disorder which is clinically and neurobiologically continuous with the adult-onset disorder. It is rarely reported

Prevalence of attention deficit/hyperactivity disorder among adults in obesity treatment

Directory of Open Access Journals (Sweden)

Altfas Jules R

2002-09-01

Full Text Available Abstract Background Bariatric patients showing poor "focus" during treatment more often failed to lose weight or maintain reduced weight. Evaluation of these patients identified a number having attention deficit/hyperactivity disorder (ADHD, evidently a potent factor limiting successful weight control. After searches found no published reports describing comorbid ADHD and obesity, this report was conceived to begin exploring the prevalence and characteristics of these patients. Method Clinical records of 215 patients receiving obesity treatment during 2000 were reviewed. Data collected and analyzed included age, sex, beginning and ending body mass index (BMI, number of clinic visits, months of treatment, and diagnostic category (ADHD, some ADHD symptoms, non-ADHD. DSM-IV criteria were used, except age of onset was modified to Results Whole sample ADHD prevalence was 27.4% (CI:21.1,32.9, but 42.6% (CI: 36.3% to 48.9% for BMI >= 40. Mean weight loss among obese patients with ADHD (OB+ADHD was 2.6 BMI (kg/m2 vs. 4.0 for non-ADHD (NAD (p = 40, OB+ADHD had BMI loss 2.9 vs. 7.0 (NAD (p Conclusions ADHD was highly prevalent among obese patients and highest in those with extreme obesity. Comorbid obesity and ADHD symptoms rendered treatment less successful compared to NAD counterparts. Reasons for the comorbidity are unknown, but may involve brain dopamine or insulin receptor activity. If replicated in further studies, these findings have important implications for treatment of severe and extreme obesity.

Using open source accelerometer analysis to assess physical activity and sedentary behaviour in overweight and obese adults.

Science.gov (United States)

Innerd, Paul; Harrison, Rory; Coulson, Morc

2018-04-23

Physical activity and sedentary behaviour are difficult to assess in overweight and obese adults. However, the use of open-source, raw accelerometer data analysis could overcome this. This study compared raw accelerometer and questionnaire-assessed moderate-to-vigorous physical activity (MVPA), walking and sedentary behaviour in normal, overweight and obese adults, and determined the effect of using different methods to categorise overweight and obesity, namely body mass index (BMI), bioelectrical impedance analysis (BIA) and waist-to-hip ratio (WHR). One hundred twenty adults, aged 24-60 years, wore a raw, tri-axial accelerometer (Actigraph GT3X+), for 3 days and completed a physical activity questionnaire (IPAQ-S). We used open-source accelerometer analyses to estimate MVPA, walking and sedentary behaviour from a single raw accelerometer signal. Accelerometer and questionnaire-assessed measures were compared in normal, overweight and obese adults categorised using BMI, BIA and WHR. Relationships between accelerometer and questionnaire-assessed MVPA (Rs = 0.30 to 0.48) and walking (Rs = 0.43 to 0.58) were stronger in normal and overweight groups whilst sedentary behaviour were modest (Rs = 0.22 to 0.38) in normal, overweight and obese groups. The use of WHR resulted in stronger agreement between the questionnaire and accelerometer than BMI and BIA. Finally, accelerometer data showed stronger associations with BMI, BIA and WHR (Rs = 0.40 to 0.77) than questionnaire data (Rs = 0.24 to 0.37). Open-source, raw accelerometer data analysis can be used to estimate MVPA, walking and sedentary behaviour from a single acceleration signal in normal, overweight and obese adults. Our data supports the use of WHR to categorise overweight and obese adults. This evidence helps researchers obtain more accurate measures of physical activity and sedentary behaviour in overweight and obese populations.

Very Early-onset Schizophrenia with Secondary Onset Tic Disorder.

Science.gov (United States)

Telgote, Shilpa A; Pendharkar, Shreyas Shrikant; Kelkar, Amol D; Bhojane, Sachin

2017-01-01

Very early-onset schizophrenia (defined as an onset of psychosis before 13 years of age) is a rare and severe form of the disorder which is clinically and neurobiologically continuous with the adult-onset disorder. It is rarely reported tic disorder.

The Link Between Inadequate Sleep and Obesity in Young Adults.

Science.gov (United States)

Vargas, Perla A

2016-03-01

The prevalence of obesity has increased dramatically over the past decade. Although an imbalance between caloric intake and physical activity is considered a key factor responsible for the increase, there is emerging evidence suggesting that other factors may be important contributors to weight gain, including inadequate sleep. Overall research evidence suggests that inadequate sleep is associated with obesity. Importantly, the strength and trajectory of the association seem to be influenced by multiple factors including age. Although limited, the emerging evidence suggests young adults might be at the center of a "perfect health storm," exposing them to the highest risk for obesity and inadequate sleep. Unfortunately, the methods necessary for elucidating the complex relationship between sleep and obesity are lacking. Uncovering the underlying factors and trajectories between inadequate sleep and weight gain in different populations may help to identify the windows of susceptibility and to design targeted interventions to prevent the negative impact of obesity and related diseases.

Association of peripheral total and differential leukocyte counts with obesity-related complications in young adults.

Science.gov (United States)

Yoshimura, Aya; Ohnishi, Shunsuke; Orito, Chieko; Kawahara, Yukako; Takasaki, Hiroyo; Takeda, Hiroshi; Sakamoto, Naoya; Hashino, Satoshi

2015-01-01

Obesity has been demonstrated to be associated with elevated leukocytes in adults and children. This study assessed the associations between peripheral total and differential leukocyte counts and obesity-related complications in young adults. 12 obese (median age 21.5 (range 19-28) years, median BMI 35.7 (range 32.0-44.9) kg/m(2)) and 11 normal (median age 23 (range 18-27) years, median BMI 19.5 (range 18.1-21.7) kg/m(2)) adults were enrolled. Complete blood count and serum levels of liver enzymes, fasting blood glucose, insulin and lipids were measured, and the homeostasis model assessment of insulin resistance was calculated. Fat mass was calculated using a bioimpedance analysis device, and ultrasonography was performed to measure fat thickness and to detect fatty change of the liver. Total leukocyte and monocyte counts were significantly increased in obese young adults. Total leukocyte count was associated with liver enzyme levels, insulin resistance as well as visceral and subcutaneous fat thickness. Neutrophil count was associated with insulin resistance. Lymphocyte count was associated with serum liver enzymes, insulin resistance, and dyslipidemia. Monocyte count was associated with serum liver enzyme, insulin resistance, visceral and subcutaneous fat thickness, body fat mass, and percentage body fat. The results of this study suggest that chronic low-grade systemic inflammation is associated with obesity-related complications such as nonalcoholic fatty liver disease, insulin resistance, and dyslipidemia in young adults. © 2015 S. Karger GmbH, Freiburg.

Prevalence of overweight and obesity and their cardiometabolic comorbidities in Hispanic adults living in Puerto Rico.

Science.gov (United States)

Pérez, Cynthia M; Sánchez, Hesmy; Ortiz, Ana P

2013-12-01

This study characterized the prevalence of overweight and obesity and assessed their cardiometabolic comorbidities in the population aged 21-79 years living in the San Juan metropolitan area of Puerto Rico. We analyzed data from a household survey conducted in Puerto Rico between 2005 and 2007 that used a representative sample of 840 non-institutionalized adults living in the San Juan metropolitan area. Body mass index categories were classified as normal weight, overweight and obese. Poisson regression model with robust variance was used to estimate the prevalence ratio to assess the association of each cardiometabolic comorbidity (hypertension, dyslipidemia, diabetes, prediabetes, systemic inflammation, prothrombotic state, and coronary heart disease) with overweight and obesity. Age-standardized prevalence of overweight and obesity was 35.9 and 41.5%, respectively, figures higher than the combined prevalence for the U.S. adult population (68.8%) but similar to all mainland Hispanics (78.8%). Men were more likely to be overweight than women (40.4 vs. 33.4%), whereas more women than men were obese (43.7 vs. 37.6%). Prevalence of all cardiometabolic comorbidities was significantly (p < 0.05) higher among overweight and obese adults than those of normal weight after adjusting for age, sex, years of education, smoking status, alcohol consumption and physical activity. A considerable proportion of adults in this population are overweight or obese. In view of the wide-ranging effects that overweight and obesity have on health, preventive actions to avert the rise of excess body weight as well as the design of lifestyle interventions are largely needed in this population.

A comparison of adolescent- and adult-onset first-episode, non-affective psychosis: 2-year follow-up

DEFF Research Database (Denmark)

Simonsen, Erik; Langeveld, Johannes; Joa, Inge

2012-01-01

This study aimed to compare 2-year outcome among individuals with early-onset (EO; clinical and treatment characteristics of 43 EO and 189 AO patients 2 years after their inclusion in a clinical epidemiologic...... no longer significant at the 2-year follow-up. This study challenges the findings of a larger and older literature base consisting primarily of non-comparative studies concluding that teenage onset indicates a poor outcome. Our results indicate that adolescent-onset and adult-onset psychosis have similar...... prognostic trajectories, although both may predict a qualitatively different course from childhood-onset psychosis....

[Gender and age characteristics and the trends in prevalence of obesity in the adult population in Russia during the 1994-2012 period].

Science.gov (United States)

Martinchik, A N; Baturin, A K; Keshabyants, E E; Peskova, E V

2015-01-01

The analysis of the prevalence of overweight and obesity in adult age and sex groups of the Russian population in the dynamics of observation from 1994 to 2012 was based on anthropometric measurements of weight and height in Russian Longitudinal Monitoring Survey. The mean values of body mass index (BMI) and the frequency of obesity (BMI > 30.0) of the entire population have been increased during the observation period. The analyzing the data by gender revealed a significant increase in the frequency of obesity mainly among men, especially in the period 2005-2012, whereas among women increased incidence of obesity was negligible. The most rapid increase in the frequency of overweight and obesity in men noted in the age period of 20-30 years, and further increase in frequency of overweight and obesity with age were negligible. The rate of overweight and obesity in women had almost linear increase in the age period of 20-60 years. Comparative analysis of the prevalence of obesity showed that the obtained values for the 2000-2012 period were close to those characteristic of the developed world in recent decades. The growth of obesity rate in the general adult population in 2000-2005 and the 2005-2012 was 0.4% per year. At the same time, men showed a significant acceleration of the growth rate of obesity in the period 2005 to 2012 (0.61% per year) compared with the period 2000-2005 (0.44% per year). Increase in the frequency of obesity was observed in all regions in 2000 to 2012. The data should be considered as a rationale for research into the causes of gender differences in the prevalence of overweight and obesity in the first place to find differences in the peculiarities of dietary intake between men and women at different ages of life, leading to the development of overweight and obesity.

Intimal spindle cell sarcoma masquerading as adult-onset symptomatic pulmonic stenosis: a case report and review of the literature

Directory of Open Access Journals (Sweden)

Arun Manmadhan

2017-10-01

Full Text Available Abstract Background Pulmonary artery intimal spindle cell sarcomas are rare and carry with them a poor prognosis and high rate of recurrence. In extremely rare cases, this tumor can infiltrate the pulmonic valve and manifest as adult-onset pulmonic stenosis. Case presentation We report an unusual case of a patient with symptomatic, adult-onset severe pulmonic stenosis who was referred for possible balloon valvuloplasty but was subsequently found to have pulmonary artery intimal sarcoma infiltrating the pulmonary valve leading to progressive exertional dyspnea. Conclusion The presence of adult-onset pulmonic stenosis should prompt the clinician to investigate further as most cases of pulmonic stenosis are congenital in nature and present early in life. Careful diagnostic evaluation in concert with multimodal imaging should take place to arrive at the correct and challenging diagnosis of sarcoma-induced adult-onset severe pulmonic stenosis. Given the poor prognosis and rapid progression of disease, early diagnosis is crucial.

Thoracic CT findings of adult-onset still's disease: a case report

International Nuclear Information System (INIS)

Choi, Sun Young; Kim, Ki Jun; Lee, Jung Whee; Lee, Sung Yong; Hong, Yeon Sik

2006-01-01

Adult-onset of Still's disease is a rare systemic rheumatic disorder. It involves various organs including the lungs and pleura. We report here the CT findings of a patient with the thoracic manifestations of Still's disease, including axillary and mediastinal lymphadenopathies, pleural and pericardial effusions and infiltrations in both lung bases

Gender Disparities in the Food Insecurity-Overweight and Food Insecurity-Obesity Paradox among Low-Income Older Adults.

Science.gov (United States)

Hernandez, Daphne C; Reesor, Layton; Murillo, Rosenda

2017-07-01

Obesity and obesity-related comorbidities are increasing among older adults. Food insecurity is a nutrition-related factor that coexists with obesity among low-income individuals. The majority of the research on the food insecurity-obesity paradox has been conducted on low-income mothers and children, with research lacking on large diverse samples of older adults. The purpose of this study was to assess gender disparities in the association between food insecurity and overweight and obesity among low-income older adults. Cross-sectional 2011 and 2012 National Health Interview Survey data were used. Food insecurity status was determined by ≥3 affirmative responses on the 10-item US Department of Agriculture Food Security Scale (FSS). Body mass index (BMI) was calculated as outlined by the Centers for Disease Control and Prevention based on self-reported height and weight. Adults included were low-income (≤1.99 federal poverty level [FPL]), older (aged ≥60 years), with a normal BMI (18.5) or greater who had complete data on FSS, BMI, and the following covariates: age, race or ethnicity, marital status, income, nativity status, physical activity, poor health status, health insurance coverage, problems paying medical bills or for medicine, and region of residency (N=5,506). Multivariate logistic regression models were stratified by gender to estimate the association between food insecurity and higher weight status. All models included covariates. In covariate-adjusted models, compared with low-income, food secure men, low-income, food-insecure men had 42% and 41% lower odds of being overweight and overweight or obese, respectively. Despite the high prevalence rate of obesity among low-income, food-insecure women, food insecurity was not significantly related to overweight, obesity, or overweight or obesity for older adult women in adjusted models. Food insecurity-overweight and -obesity paradox appears not to be present in older men. However, food insecurity and

The Impact of Obesity on Postoperative Outcomes in Adults with Congenital Heart Disease Undergoing Pulmonary Valve Replacement.

Science.gov (United States)

Buelow, Matthew W; Earing, Michael G; Hill, Garick D; Cohen, Scott B; Bartz, Peter J; Tweddell, James S; Ginde, Salil

2015-01-01

The impact of obesity on surgical morbidity in adults with congenital heart disease is currently unknown. The aim of our study was to investigate the impact of obesity on postoperative outcomes in adults with congenital heart disease undergoing reoperation for pulmonary valve replacement. A retrospective analysis was performed assessing the influence of obesity on surgical outcomes. Obesity was defined as a body mass index ≥30 kg/m2. The mean body mass index of the cohort was 25.9 ± 6.9 kg/m2 . The cohort included 71 patients with 17 patients (24%) being obese. There was no postoperative mortality. Obese patients had a longer hospital length of stay (6.6 vs. 4.7 days; P obesity was independently associated with hospital length of stay >5 days (odds ratio [OR] = 5.2; 95% confidence interval [CI]: 1.5-18.2, P = .01) and with increased postoperative arrhythmias (OR = 4.2; 95% CI: 1.7-40, P Obesity is associated with increased morbidity in adults with congenital heart disease undergoing pulmonary valve replacement, including longer hospitalization and higher risk for postoperative arrhythmias. © 2015 Wiley Periodicals, Inc.

The History and Timing of Depression Onset as Predictors of Young-Adult Self-Esteem

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Lloyd, Donald A.; Ueno, Koji

2010-01-01

Depression often emerges early in the lifecourse and is consistently shown to be associated with poor self-esteem. The three main objectives of the current study are to (1) evaluate the association between a history major depression and self-esteem in young adulthood; (2) assess the relationship between timing of depression onset and young adult self-esteem; and (3) help rule out the alternative interpretation that the relationship between major depression and self-esteem is due to state dependence bias stemming from recent depressive symptoms and stressful life events. To address these objectives we use data from a two-wave panel study based on a community sample of young adults in Miami-Dade County, Florida (n = 1,197). Results indicated a history of major depression during sensitive periods of social development is associated with negative changes in self-esteem over a two-year period during the transition to young adulthood. Among those with a history of depression, earlier onset was more problematic than later onset for young adult self-esteem, although the difference disappeared once the level of self-esteem two years prior was controlled. The linkages between the history and timing of depression onset with self-esteem were observed net of recent depressive symptoms and stressful life events, and thus robust to an alternative interpretation of state dependence. The findings support the argument that major depression, especially if it develops earlier during child-adolescent development, has negative consequences for one’s self-esteem. PMID:21860585

Weight control behaviors in overweight/obese U.S. adults with diagnosed hypertension and diabetes

Directory of Open Access Journals (Sweden)

Li Chaoyang

2009-03-01

Full Text Available Abstract Background Obesity is a major risk factor for development and progression of hypertension and diabetes, which often coexist in obese patients. Losing weight by means of energy restriction and physical activity has been effective in preventing and managing these diseases. However, weight control behaviors among overweight/obese adults with these conditions are poorly understood. Methods Using self-reported data from 143,386 overweight/obese participants (aged ≥ 18 years in the 2003 Behavioral Risk Factor Surveillance System, we examined the proportion of overweight/obese adults who tried to lose weight and their weight control strategies by hypertension and/or diabetes status. Results Among all participants, 58% of those with hypertension, 60% of those with diabetes, and 72% of those with both diseases tried to lose weight, significantly higher than the 50% of those with neither condition (Bonferroni corrected P Conclusion The proportion of overweight/obese patients with diagnosed hypertension and/or diabetes who attempted to lose weight remains suboptimal and the weight control strategies varied significantly among these patients.

Relationship between heavy drinking, binge drinking, and metabolic syndrome in obese and non-obese Korean male adults

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2018-01-01

BACKGROUND/OBJECTIVES Obesity and alcohol drinking are associated with metabolic syndrome. However, few studies show the relationship between alcohol drinking and metabolic syndrome according to varying degrees of obesity. This study aimed to determine the association between alcohol drinking and metabolic syndrome in obese and non-obese Korean male adults. SUBJECTS/METHODS This cross-sectional study included 5,867 males aged ≥ 20 years who were examined at the Soonchunhyang University health promotion center during June 2008–December 2010. The subjects were divided into non-obese (body mass index [BMI] 14 drinks/week) groups. The subjects were also categorized into binge drinking and non-binge drinking groups. To obtain odds ratios (ORs) for metabolic syndrome, binary logistic regression analysis was performed. RESULTS The overall metabolic syndrome prevalence was 27.3% (12.8%, non-obese group; 50.4%, obese group). After adjusting for age, physical activity, and smoking, in the non-obese group, the OR for heavy drinking with binge drinking (reference: nondrinking) was 1.56 (95% confidence interval [CI] = 1.12–2.18), with a significant increase in metabolic syndrome prevalence. In the obese group, the OR for heavy drinking with binge drinking was 1.42 (95% CI = 1.07–1.88), showing a significant increase in metabolic syndrome prevalence (P metabolic syndrome. Thus, both non-obese and obese males should restrict their alcohol intake and not indulge in binge drinking. PMID:29629034

What is really causing the obesity epidemic? A review of reviews in children and adults.

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Ross, Sharon E; Flynn, Jennifer I; Pate, Russell R

2016-01-01

Obesity prevention is a public health priority and intervention strategies have focused primarily on healthy eating and physical activity in children and adults. To date, no review has systematically compiled and synthesised the scientific evidence from published review articles to determine whether there is clear consensus on the causes of obesity. A systematic review of the literature was conducted searching PubMed/Medline for narrative and systematic review articles published between January 1990 and October 2014 that examined the causes of obesity. In total, 12 of 65 articles met the inclusion criteria; 7 reviews focused on adults (1 systematic, 6 narrative) and 5 reviews on children (2 systematic, 3 narrative). The most popular cause of obesity identified in reviews of adult studies was "combined physical activity and diet" (3 of 7 studies), whereas the most popular cause specified in reviews of child studies was deemed "inconclusive" (2 of 5 studies). While a number of reviews have examined the causes of obesity, the methodology and conclusions varied widely, and few were conducted systematically. Currently, no consensus exists across published literature reviews regarding the primary cause of the obesity epidemic, and more research, particularly prospective studies using state-of-the-art measures, is warranted.

New onset of idiopathic bilateral ear tics in an adult.

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Agrawal, Amit; Shrestha, Rabin

2009-04-01

Tic disorders are commonly considered to be childhood syndromes. Newly presenting tic disorders during adulthood are uncommon and mostly described in relation to an acquired brain lesion or as incidental tics, particularly in context with other neurological or psychiatric diseases. Tic disorder involving the ears is extremely uncommon with only few studies in English literature. In the present case, we describe an adult patient with new-onset idiopathic tics disorder involving both ears, causing social embarrassment. In addition, our patient had recent onset of the tics without any childhood or family history of tic disorders. The single most important component of management is an accurate diagnosis. At the same time, tics should be differentiated from other movement disorders such as chorea, stereotypy, and dystonias.

Adult-onset intradural spinal teratoma: report of 18 consecutive cases and outcomes in a single center.

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Wan, Wei; Yang, Cheng; Yan, Wangjun; Liu, Tielong; Yang, Xinghai; Song, Dianwen; Xiao, Jianru

2017-07-01

Eighteen consecutive patients with adult-onset intradural spinal teratoma underwent surgical treatment in our center from 1998 to 2013. Teratoma is defined as a neoplasm composed of elements derived from three germ cell layers (ectoderm, endoderm and mesoderm). Intraspinal teratoma is extremely rare and accounts for 0.2-0.5% of all spinal cord tumors. Moreover, teratoma occurs primarily in neonates and young children. Adult-onset intradural spinal teratoma is even rare. The aim of this study was to discuss the clinical characteristics, diagnosis and therapeutic strategies of adult-onset intradural spinal teratoma. This retrospective study included 18 consecutive adult patients with intradural teratoma who were surgically treated in our center between 1998 and 2013. The clinical features, pathogenesis, diagnostic strategies and surgical outcomes were discussed. Neurological function outcomes were evaluated by the JOA scoring system. Of the 18 included patients, 4 patients received subtotal resection and the other 14 patients received total resection. All the 18 cases were diagnosed with mature teratoma. The mean follow-up period was 79.7 (median 60.5; range 27-208) months. Local recurrence occurred in two of the four patients who underwent subtotal resection and in no patient who underwent total resection. The neurologic status improved in 16 cases and remained unchanged in the other two patients. Adult-onset intradural spinal teratoma is extremely rare. To the best of our knowledge, this is the largest series of patients with this disease. Despite the slow-growth and indolent nature, radical resection remains the recommended treatment to reduce tumor recurrence.

Criminal Justice Contact, Stressors, and Obesity-Related Health Problems Among Black Adults in the USA.

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Archibald, Paul C; Parker, Lauren; Thorpe, Roland

2018-04-01

Criminal justice contact-defined as lifetime arrest, parole, or incarceration, seems to exacerbate chronic conditions, and those who are most likely to have had contact with the criminal justice system, such as Black adults, often already have pre-existing disproportionately high rates of stress and chronic conditions due to the social determinants of health that affect underrepresented minorities. Findings from this study suggest that there is a mechanism that links the stressors among Black adults manifested by such factors as family, financial, neighborhood, and personal problems with criminal justice contact to obesity-related health status. Using the National Survey of American Life (NSAL), modified Poisson regression analyses were used to determine the association between criminal justice contact, stressors, and obesity-related health problems among a national sample of Black adults (n = 5008). In the full model, the odds of experiencing obesity-related health problems for Black adults who had criminal justice contact was reduced (PR, 1.23 to 1.14) and not statistically significant. Black adults who reported experiencing family stressors (PR, 1.21; 95% CI, 1.08, 1.36), financial stressors (PR, 1.30; 95% CI, 1.16, 1.47), and personal stressors (PR, 1.16; 95% CI, 1.02, 1.31) were statistically significant and higher than those who reported not experiencing any of these stressors; neighborhood stressors was not statistically significant. The evidence suggests a relationship between the stressors associated with criminal justice contact and obesity-related health status. These findings emphasize the need to further explore the family, financial, and personal stressors for Black adults with criminal justice contact in order to further our understanding of their obesity-related health problems.ᅟ.

Prevalence and risk factors with overweight and obesity among Vietnamese adults: Caucasian and Asian cut-offs.

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Trinh, Oanh T H; Nguyen, Nguyen D; Phongsavan, Philayrath; Dibley, Michael J; Bauman, Adrian E

2009-01-01

To determine the prevalence and factors associated with overweight/obesity among adults in Ho Chi Minh City (HCMC) using Caucasian and Asian cut-offs. A cross-sectional survey. In 2005, 1,971 adults aged 25-64 years in HCMC were randomly selected using a proportional to population size sampling method to estimate the prevalence of overweight and obesity, measured by body mass index (BMI) and waist circumference. Multivariable logistic models were used to examine associations between overweight/obesity and socioeconomic status, health-related behaviors, and biochemical indices of chronic disease risk. The prevalence of overweight and obesity using the Caucasian BMI cut-offs were 13.9% and 1.8% respectively, and those with the Asian BMI cut-offs were 27.5% and 5.7%, respectively. The abdominal adiposity rates were higher than the BMI overweight and obesity rates in women, but not in men. Increasing age, low education, high household wealth index, high levels of sitting and reclining time, cholesterol and high blood pressure were significantly associated with overweight and obesity. Current smoking and sedentary leisure time was significantly negatively associated with this status in men. Associations between overweight/obesity and metabolic disorders were evident using both cut-offs. Asian cut-offs identified more risk factors and therefore could be considered for defining at-risk groups. The results highlight the importance of intervention programs to prevent overweight/obesity in young adults.

Rs9939609 Variant of the Fat Mass and Obesity-Associated Gene and Trunk Obesity in Adolescents

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Mangge, Harald; Renner, Wilfried; Almer, Gunter; Weghuber, Daniel; Möller, Reinhard; Horejsi, Renate

2011-01-01

A common T/A polymorphism (rs9939609) in the fat mass and obesity associated (FTO) gene was found associated with early-onset and severe obesity in both adults and children. However, recent observations failed to find associations of FTO with obesity. To investigate the genetic background of early obesity, we analysed the single nucleotide polymorphism (SNP) rs9939609 of FTO in 371 styrian adolescents towards degree of obesity, subcutaneous adipose tissue (SAT)-distribution determined by lipometry, early metabolic and preatherosclerotic symptoms. The percentage of AA homozygotes for the rs9939609 SNP of FTO was significantly increased in the obese adolescents. Compared to the TT wildtype, AA homozygotes showed significantly elevated values of SAT thickness at the trunk-located lipometer measure points neck and frontal chest, body weight, body mass index, waist, and hip circumference. No associations were found with carotis communis intima media thickness, systolic, diastolic blood pressure, ultrasensitive C-reactive protein (US-CRP), homocystein, total cholesterol, triglycerides, HDL cholesterol, oxidized LDL, fasted glucose, insulin, HOMA-index, liver transaminases, uric acid, and adipokines like resistin, leptin, and adiponectin. Taken together, to the best of our knowledge we are the first to report that the rs9939609 FTO SNP is associated with trunk weighted obesity as early as in adolescence. PMID:21318054

Rs9939609 Variant of the Fat Mass and Obesity-Associated Gene and Trunk Obesity in Adolescents

Directory of Open Access Journals (Sweden)

Harald Mangge

2011-01-01

Full Text Available A common T/A polymorphism (rs9939609 in the fat mass and obesity associated (FTO gene was found associated with early-onset and severe obesity in both adults and children. However, recent observations failed to find associations of FTO with obesity. To investigate the genetic background of early obesity, we analysed the single nucleotide polymorphism (SNP rs9939609 of FTO in 371 styrian adolescents towards degree of obesity, subcutaneous adipose tissue (SAT-distribution determined by lipometry, early metabolic and preatherosclerotic symptoms. The percentage of AA homozygotes for the rs9939609 SNP of FTO was significantly increased in the obese adolescents. Compared to the TT wildtype, AA homozygotes showed significantly elevated values of SAT thickness at the trunk-located lipometer measure points neck and frontal chest, body weight, body mass index, waist, and hip circumference. No associations were found with carotis communis intima media thickness, systolic, diastolic blood pressure, ultrasensitive C-reactive protein (US-CRP, homocystein, total cholesterol, triglycerides, HDL cholesterol, oxidized LDL, fasted glucose, insulin, HOMA-index, liver transaminases, uric acid, and adipokines like resistin, leptin, and adiponectin. Taken together, to the best of our knowledge we are the first to report that the rs9939609 FTO SNP is associated with trunk weighted obesity as early as in adolescence.

Audiovisual Integration Delayed by Stimulus Onset Asynchrony Between Auditory and Visual Stimuli in Older Adults.

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Ren, Yanna; Yang, Weiping; Nakahashi, Kohei; Takahashi, Satoshi; Wu, Jinglong

2017-02-01

Although neuronal studies have shown that audiovisual integration is regulated by temporal factors, there is still little knowledge about the impact of temporal factors on audiovisual integration in older adults. To clarify how stimulus onset asynchrony (SOA) between auditory and visual stimuli modulates age-related audiovisual integration, 20 younger adults (21-24 years) and 20 older adults (61-80 years) were instructed to perform an auditory or visual stimuli discrimination experiment. The results showed that in younger adults, audiovisual integration was altered from an enhancement (AV, A ± 50 V) to a depression (A ± 150 V). In older adults, the alterative pattern was similar to that for younger adults with the expansion of SOA; however, older adults showed significantly delayed onset for the time-window-of-integration and peak latency in all conditions, which further demonstrated that audiovisual integration was delayed more severely with the expansion of SOA, especially in the peak latency for V-preceded-A conditions in older adults. Our study suggested that audiovisual facilitative integration occurs only within a certain SOA range (e.g., -50 to 50 ms) in both younger and older adults. Moreover, our results confirm that the response for older adults was slowed and provided empirical evidence that integration ability is much more sensitive to the temporal alignment of audiovisual stimuli in older adults.

The effects of mindfulness training on weight-loss and health-related behaviours in adults with overweight and obesity: A systematic review and meta-analysis.

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Ruffault, Alexis; Czernichow, Sébastien; Hagger, Martin S; Ferrand, Margot; Erichot, Nelly; Carette, Claire; Boujut, Emilie; Flahault, Cécile

The aim of this study was to conduct a comprehensive quantitative synthesis of the effects of mindfulness training interventions on weight-loss and health behaviours in adults with overweight and obesity using meta-analytic techniques. Studies included in the analysis (k=12) were randomised controlled trials investigating the effects of any form of mindfulness training on weight loss, impulsive eating, binge eating, or physical activity participation in adults with overweight and obesity. Random effects meta-analysis revealed that mindfulness training had no significant effect on weight loss, but an overall negative effect on impulsive eating (d=-1.13) and binge eating (d=-.90), and a positive effect on physical activity levels (d=.42). Meta-regression analysis showed that methodological features of included studies accounted for 100% of statistical heterogeneity of the effects of mindfulness training on weight loss (R 2 =1,00). Among methodological features, the only significant predictor of weight loss was follow-up distance from post-intervention (β=1.18; pmindfulness training has short-term benefits on health-related behaviours. Future studies should explore the effectiveness of mindfulness training on long-term post-intervention weight loss in adults with overweight and obesity. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Perceptions of adults with overweight/obesity and chronic musculoskeletal pain: An interpretative phenomenological analysis.

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Cooper, Lesley; Ells, Louisa; Ryan, Cormac; Martin, Denis

2018-03-01

To gain insight into the lived experience of adults with overweight/obesity and chronic musculoskeletal pain. Knowledge gained will inform healthcare professionals about the complexity of the weight-pain relationship and enable more effective engagement with this population. Quantitative studies show links between weight and pain. Adults with overweight/obesity are more likely to experience comorbidity; however, qualitative research describing the complexities of the relationship is limited. A purposive sample of adults with overweight/obesity and chronic musculoskeletal pain participated in face-to-face interviews. Interviews were audio-recorded, transcribed verbatim and analysed using interpretive phenomenological analysis. Eighteen adults (16 female) aged 29-71, body mass index ≥25-46, participated in this study. Three superordinate themes emerged: "pain as a motivator and barrier to weight loss"; "fear of weight causing more damage"; and "activity is positive." Pain motivates some individuals to lose weight while simultaneously inhibiting weight loss efforts. Participants' perception that extra pressure caused by their weight further damaged joints contributed to fear and catastrophising. Fear is often exacerbated by healthcare professionals' descriptions of musculoskeletal damage, or participants' perception of healthcare professionals' attitude towards people with overweight/obesity. Conversely, individuals acknowledged the benefits of increased activity. Adults with overweight/obesity and chronic musculoskeletal pain in this study identified a bidirectional relationship between their weight and pain that challenged their weight loss efforts. Overweight/obesity contributed to fear and catastrophising, which resulted in avoidance of exercise that would have assisted their weight loss. Healthcare professionals need to understand the complex relationship between weight and pain, and their patients' understanding of that relationship. Healthcare professionals

Comparison of CAD risk factors in abdominal obesity versus General obesity with normal WC in adult males

International Nuclear Information System (INIS)

Kamran, S.M.; Iftikhar, R.; Khan, A.

2014-01-01

Objective: To compare the presence of coronary artery disease risk factors in patients with abdominal obesity versus generalised obesity and to determine the probability of developing the disease in both groups. Methods: The cross-sectional study was carried out at the Department of Medicine, Combined Military Hospital, Okara, from January 2012 to April 2013. Using consecutive sampling, 785 outdoor healthy adult males were enrolled. Body mass index >25kg/m/sup 2/ and waist circumference >90cm defined obesity and abdominal obesity respectively. Blood pressure >140/90mmHg defined Hypertension. All the subjects underwent BSF, electrocardiogram, Lipid profile, personality and physical activity assessment. Risk estimation was done using Eric Brittain scoring system. Data was analysed using SPSS 16. Results: In patients with abdominal obesity, 583 (99.2 %) individuals had at least 1 risk factor for coronary artery disease, while in those with generalised obesity this prevalence was 96.5% (n=191). In patients with abdominal obesity, 52.9% had more than 4% risk of developing the disease in the next 6 years compared to 36.9% individuals with generalised obesity. Conclusion: Both increasing body mass index and waist circumference are associated with increased risk of developing coronary artery disease, with significantly higher risk prevalence in the latter group. Moreover, those with abdominal obesity had a higher risk of developing CAD in next 6 years as compared to those with generalised obesity. Thus waist circumference offers additional prognostic information beyond body mass index. (author)

Socioeconomic Position, Rural Residence, and Marginality Influences on Obesity Status in the Adult Mexican Population

OpenAIRE

Sparks, P. Johnelle; Sparks, Corey S.

2012-01-01

This paper assesses individual and social environment determinants of obesity in the adult Mexican population based on socioeconomic position, rural residence, and areal deprivation. Using a nationally representative health and nutrition survey, this analysis considers individual and structural determinants of obesity from a socioeconomic position and health disparities conceptual framework using multilevel logistic regression models. We find that more than thirty percent of Mexican adults we...

Usual interstitial pneumonia in adult-onset still's disease

International Nuclear Information System (INIS)

Rodelo, Joaquin; Gonzalez, Luis Alonso; Velasquez, Monica Patricia; Vasquez, Gloria; Uribe, Oscar; Perez, Maria del Pilar; Ramirez, Luis Alberto

2005-01-01

Adult-onset still's disease (AOSD) is a multi-system inflammatory disorder of unknown origin, characterized by high spiking fevers, evanescent salmon colored rash, arthralgias or arthritis, hepatospleno-megaly, Iymphadenopathy and sore throat. It is not uncommon for AOSD to involve other organs, such as the liver, the kidney; the bone marrow and less often the lungs. Pulmonary involvement ranges from 30 to 40 % (0 to 53 %), the pulmonary manifestations of AOSD include pleurisy, acute pneumonitis and even the acute respiratory distress syndrome. We present a case of a patient with AOSD who developed an interstitial lung disease and reviewed the literature on it

Association between 24-h urinary sodium excretion and obesity in Korean adults: A multicenter study.

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Nam, Ga Eun; Kim, Seon Mee; Choi, Mi-Kyeong; Heo, Young-Ran; Hyun, Tai-Sun; Lyu, Eun-Soon; Oh, Se-Young; Park, Hae-Ryun; Ro, Hee-Kyong; Han, Kyungdo; Lee, Yeon Kyung

2017-09-01

The aim of this study was to explore the association between sodium intake, as assessed by 24-h urinary sodium excretion, and various obesity parameters among South Korean adults. The associations of 24-h urinary sodium excretion and sodium intake calculated from the dietary questionnaire with obesity parameters also were compared. This multicenter, cross-sectional study analyzed data of 640 healthy adults from eight provinces in South Korea. Obesity was assessed by body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Mean 24-h urinary sodium excretion was calculated from repeatedly collected 24-h urine samples. Participants' dietary intake was assessed by 24-h dietary recall interview on the days before 24-h urine collection. In both sexes, the means of all anthropometric measurements tended to increase proportionally with 24-h urinary sodium excretion quartiles, regardless of adjustment. Men in the highest quartile (Q4) of 24-h urinary sodium excretion had increased odds of obesity (as assessed by BMI, WC, WHR, and WHtR) compared with men in the three lower quartiles (Q1-Q3) of 24-h urinary sodium excretion. Women in Q4 of 24-h urinary sodium excretion exhibited a higher chance of general obesity and abdominal obesity. Sodium intake calculated from the dietary questionnaire was not significantly associated with obesity in either sex. In Korean adults, there was a positive association between higher sodium intake as assessed by 24-h urinary sodium excretion and obesity independent of energy intake. Copyright © 2017 Elsevier Inc. All rights reserved.

PCSK1 rs6232 Is Associated with Childhood and Adult Class III Obesity in the Mexican Population

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Villalobos-Comparán, Marisela; Villamil-Ramírez, Hugo; Villarreal-Molina, Teresa; Larrieta-Carrasco, Elena; León-Mimila, Paola; Romero-Hidalgo, Sandra; Jacobo-Albavera, Leonor; Liceaga-Fuentes, Adriana E.; Campos-Pérez, Francisco J.; López-Contreras, Blanca E.; Tusié-Luna, Teresa; del Río-Navarro, Blanca E.; Aguilar-Salinas, Carlos A.; Canizales-Quinteros, Samuel

2012-01-01

Background Common variants rs6232 and rs6235 in the PCSK1 gene have been associated with obesity in European populations. We aimed to evaluate the contribution of these variants to obesity and related traits in Mexican children and adults. Methodology/Principal Findings Rs6232 and rs6235 were genotyped in 2382 individuals, 1206 children and 1176 adults. Minor allele frequencies were 0.78% for rs6232 and 19.99% for rs6235. Rs6232 was significantly associated with childhood obesity and adult class III obesity (OR = 3.01 95%CI 1.64–5.53; P = 4×10−4 in the combined analysis). In addition, this SNP was significantly associated with lower fasting glucose levels (P = 0.01) and with increased insulin levels and HOMA-B (P = 0.05 and 0.01, respectively) only in non-obese children. In contrast, rs6235 showed no significant association with obesity or with glucose homeostasis parameters in any group. Conclusion/Significance Although rs6232 is rare in the Mexican population, it should be considered as an important risk factor for extreme forms of obesity. PMID:22737226

Change in circulating microRNA profile of obese children indicates future risk of adult diabetes.

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Cui, Xianwei; You, Lianghui; Zhu, Lijun; Wang, Xing; Zhou, Yahui; Li, Yun; Wen, Juan; Xia, Yankai; Wang, Xinru; Ji, Chenbo; Guo, Xirong

2018-01-01

Childhood obesity increases susceptibility to type 2 diabetes (T2D) in adults. Circulating microRNAs (miRNAs) in serum have been proposed as potential diagnostic biomarkers, and they may contribute to the progression toward T2D. Here, we investigated the possibility of predicting the future risk of adult T2D in obese children by using circulating miRNAs. We performed miRNA high-throughput sequencing to screen relevant circulating miRNAs in obese children. The expression patterns of targeted miRNAs were further explored in obese children and adults with T2D. To investigate the underlying contributions of these miRNAs to the development of T2D, we detected the impacts of the candidate miRNAs on preadipocyte proliferation, insulin secretion by pancreatic β-cell, and glucose uptake by skeletal muscle cells. Three miRNAs (miR-486, miR-146b and miR-15b), whose expression in the circulation was most dramatically augmented in obese children and adult T2D patients, were selected for further investigation. Of these 3 miRNAs, miR-486 was implicated in accelerating preadipocyte proliferation and myotube glucose intolerance, miR-146b and miR-15b were engaged in the suppression of high concentration glucose-induced pancreatic insulin secretion, and they all contributed to the pathological processes of obesity and T2D. Our results provide a better understanding of the role of circulating miRNAs, particularly miR-486, miR-146b and miR-15b, in predicting the future risk of T2D in obese children. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Obesity and type 2 diabetes mellitus in a birth cohort of First Nation children born to mothers with pediatric-onset type 2 diabetes.

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Mendelson, Michael; Cloutier, Justin; Spence, Louise; Sellers, Elizabeth; Taback, Shayne; Dean, Heather

2011-05-01

Children who are born to mothers with pediatric-onset type 2 diabetes mellitus are exposed to a hyperglycemic intra-uterine environment throughout pregnancy. The growth patterns and risk of type 2 diabetes in these offspring may be influenced by unique gene-environment interactions during intra-uterine and postnatal life. We established a cohort of offspring of First Nation mothers with onset of type 2 diabetes before age 18 years in Manitoba, Canada. We measured height or length and weight at study entry and annually thereafter with fasting blood glucose in offspring aged ≥ 7 years. We collected birth and breastfeeding history and determined the population-specific hepatic nuclear factor-1α (HNF-1α) G319S genotype of offspring at age 7 years. From July 2003 to April 2008, we enrolled 76 offspring of 37 mothers. Sixty-four percent (23/36) of the offspring aged 2-19 years were obese at initial assessment. The rates of obesity remained constant throughout the 5 years. As of April 2008, 7/28 (25%) of the offspring aged 7-19 years have diabetes including 6/14 (43%) aged 10-19 years. Most offspring with diabetes (5/7, 71%) were obese at diagnosis. All of the 7 offspring with diabetes have 1 or 2 copies of the G319S polymorphism. The prevalence of type 2 diabetes in this cohort of offspring of First Nation women with pediatric-onset type 2 diabetes is the highest ever reported. Obesity is an important postnatal risk factor for type 2 diabetes in this population and may result from a unique gene-environment interaction. © 2011 John Wiley & Sons A/S.

FAT-FREE MASS, METABOLICALLY HEALTHY OBESITY, AND TYPE 2 DIABETES IN SEVERELY OBESE ASIAN ADULTS.

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Pramyothin, Pornpoj; Limpattanachart, Vichol; Dawilai, Suwitcha; Sarasak, Rungnapha; Sukaruttanawong, Chariya; Chaiyasoot, Kusuma; Keawtanom, Songsri; Yamwong, Preyanuj

2017-08-01

To determine whether fat free mass (FFM) is independently associated with the metabolically healthy obesity (MHO) phenotype, the metabolic syndrome (MS), and type 2 diabetes (T2D) in obese Asian adults. Obese patients (body mass index [BMI] ≥25 kg/m 2 ) seeking weight management at an academic medical center from 2007 to 2016 were included. FFM was measured by bioelectrical impedance. Of the 552 patients (67.0% female, median age 40.5 years, median BMI 38.3 kg/m 2 ), MHO was present in 19%, MS in 55.4%, and T2D in 32.6%. In multivariate models, higher fat-free mass index (FFMI) was independently associated with the metabolically abnormal obesity (MAO) phenotype, (odds ratio [OR] 1.22, 95% confidence interval [CI] 1.09-1.37), and increased risk of MS (OR 1.12, 95% CI 1.03-1.22) in women but not in men. Older age was independently associated with the MAO phenotype (OR 1.06, 95% CI 1.04-1.09 in women; OR 1.06, 95% CI 1.02-1.09 in men), MS (OR 1.05, 95% CI 1.03-1.06 in women; OR 1.05, 95% CI 1.02-1.07 in men), and T2D (OR 1.07, 95% CI 1.05-1.09 in women; OR 1.06, 95% CI 1.04-1.09 in men). Waist-hip ratio was independently associated with the MAO phenotype in men (OR 1.08, 95% CI 1.01-1.15), while waist circumference was associated with T2D in women (OR 1.03, 95% CI 1.01-1.05). Older age, central fat distribution, and-in contrast to previous findings-an increase in FFMI among women were independent predictors of adverse metabolic health in this cohort of middle-aged obese Asian adults. Further studies are required to elucidate underlying mechanisms and therapeutic implications of these findings. BIA = bioelectrical impedance analysis BMI = body mass index CI = confidence interval DXA = dual-energy X-ray absorptiometry FFM = fat-free mass FFMI = fat-free mass index FM = fat mass HbA1c = glycated hemoglobin A1c MAO = metabolically abnormal obesity MHO = metabolically healthy obesity MS = metabolic syndrome OR = odds ratio T2D = type 2 diabetes WC = waist circumference

Obesity and depression in adolescence and beyond: reciprocal risks.

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Marmorstein, N R; Iacono, W G; Legrand, L

2014-07-01

Obesity and major depressive disorder (MDD) are associated, but evidence about how they relate over time is conflicting. The goal of this study was to examine prospective associations between depression and obesity from early adolescence through early adulthood. Participants were drawn from a statewide, community-based, Minnesota sample. MDD and obesity with onsets by early adolescence (by age 14), late adolescence (between 14 and 20) and early adulthood (ages 20-24) were assessed via structured interview (depression) and study-measured height and weight. Cross-sectional results indicated that depression and obesity with onsets by early adolescence were concurrently associated, but the same was not true later in development. Prospective results indicated that depression by early adolescence predicted the onset of obesity (odds ratio (OR)=3.76, confidence interval =1.33-10.59) during late adolescence among female individuals. Obesity that developed during late adolescence predicted the onset of depression (OR=5.89, confidence interval=2.31-15.01) during early adulthood among female individuals. For girls, adolescence is a high-risk period for the development of this comorbidity, with the nature of the risk varying over the course of adolescence. Early adolescent-onset depression is associated with elevated risk of later onset obesity, and obesity, particularly in late adolescence, is associated with increased odds of later depression. Further investigation into the mechanisms of these effects and the reasons for the observed gender and developmental differences is needed. Prevention programs focused on early-onset cases of depression and adolescent-onset cases of obesity, particularly among female individuals, may help in reducing risk for this form of comorbidity.

Growth hormone effects on cortical bone dimensions in young adults with childhood-onset growth hormone deficiency

DEFF Research Database (Denmark)

Hyldstrup, L; Conway, G S; Racz, K

2012-01-01

Growth hormone (GH) treatment in young adults with childhood-onset GH deficiency has beneficial effects on bone mass. The present study shows that cortical bone dimensions also benefit from GH treatment, with endosteal expansion and increased cortical thickness leading to improved bone strength....... INTRODUCTION: In young adults with childhood-onset growth hormone deficiency (CO GHD), GH treatment after final height is reached has been shown to have beneficial effects on spine and hip bone mineral density. The objective of the study was to evaluate the influence of GH on cortical bone dimensions. METHODS...

Perceived and actual obesity in childhood and adolescence and risk of adult depression.

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Sanchez-Villegas, Almudena; Field, Alison E; O'Reilly, Eilis J; Fava, Maurizio; Gortmaker, Steven; Kawachi, Ichiro; Ascherio, Alberto

2013-01-01

Obesity in childhood and adolescence has important health consequences, but its relation to risk of adult depression remains uncertain. To examine the effect of perceived and actual obesity during childhood and adolescence on prevalence and incidence of adult depression risk. Cohort study of 91,798 female registered nurses followed longitudinally for 12 years. As compared with lean women of the same age, women in the two highest categories of body shape at age 10 had both higher prevalence (OR=2.59, 95% CI 1.46 to 4.61) and incidence (OR=2.01, 95% CI 1.08 to 3.71) of depression. Similar results were obtained for body shape at age 20 (OR=3.43 for prevalence and OR=2.03 for incidence) and for body mass index (BMI) at age 18 (OR=2.92 for BMI ≥ 40 kg/m(2)). These associations remained significant after adjustment for multiple confounders. These results indicate that childhood-adolescence obesity is a strong and independent risk factor for adult depression.

Effect of severe obesity in childhood and adolescence on risk of type 2 diabetes in youth and early adulthood in an American Indian population.

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Tanamas, Stephanie K; Reddy, Sanil P; Chambers, Melissa A; Clark, Elena J; Dunnigan, Diana L; Hanson, Robert L; Nelson, Robert G; Knowler, William C; Sinha, Madhumita

2017-12-28

The risk of early-onset type 2 diabetes associated with the severity of obesity in youth is not well understood. This study aims to determine metabolic alterations and type 2 diabetes risk among American Indian children who are obese or severely obese. Incidence rates of diabetes before 20 years (youth-onset) and 45 years were computed in 2728 children who were from 5 to Obesity was defined as age-sex-adjusted body mass index (BMI) ≥95th percentile, and its severity was quantified as the percentage of the 95th percentile (%BMI p95 ). In the younger cohort, 0.9% of those non-obese and 2.9% of those with 100% to obese and 9.8% of those with 100% to youth-onset diabetes was 3.8 and 4.9/1000 person-years in the child and adolescent cohorts, respectively, and before the age of 45 was 12.3 and 16.8/1000 person-years, respectively. Incidence rates of youth-onset diabetes in those with the most severe obesity (≥140%BMI p95 ) were 2.3 to 5.1 times as high as in those with the least severe obesity (100 to obesity in an American Indian population is a major driver of type 2 diabetes developing in adolescents and young adults. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Self-Reported Disability in Adults with Severe Obesity

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I. Kyrou

2011-01-01

Full Text Available Self-reported disability in performing daily life activities was assessed in adults with severe obesity (BMI ≥ 35 kg/m2 using the Health Assessment Questionnaire (HAQ. 262 participants were recruited into three BMI groups: Group I: 35–39.99 kg/m2; Group II: 40–44.99 kg/m2; Group III: ≥45.0 kg/m2. Progressively increasing HAQ scores were documented with higher BMI; Group I HAQ score: 0.125 (median (range: 0–1.75; Group II HAQ score: 0.375 (0–2.5; Group III HAQ score: 0.75 (0–2.65 (Group III versus II P 0. The prevalence of this degree of disability increased with increasing BMI and age. It also correlated to type 2 diabetes, metabolic syndrome, and clinical depression, but not to gender. Our data suggest that severe obesity is associated with self-reported disability in performing common daily life activities, with increasing degree of disability as BMI increases over 35 kg/m2. Functional assessment is crucial in obesity management, and establishing the disability profiles of obese patients is integral to both meet the specific healthcare needs of individuals and develop evidence-based public health programs, interventions, and priorities.

Walking velocity and step length adjustments affect knee joint contact forces in healthy weight and obese adults.

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Milner, Clare E; Meardon, Stacey A; Hawkins, Jillian L; Willson, John D

2018-04-28

Knee osteoarthritis is a major public health problem and adults with obesity are particularly at risk. One approach to alleviating this problem is to reduce the mechanical load at the joint during daily activity. Adjusting temporospatial parameters of walking could mitigate cumulative knee joint mechanical loads. The purpose of this study was to determine how adjustments to velocity and step length affects knee joint loading in healthy weight adults and adults with obesity. We collected three-dimensional gait analysis data on 10 adults with a normal body mass index and 10 adults with obesity during over ground walking in nine different conditions. In addition to preferred velocity and step length, we also conducted combinations of 15% increased and decreased velocity and step length. Peak tibiofemoral joint impulse and knee adduction angular impulse were reduced in the decreased step length conditions in both healthy weight adults (main effect) and those with obesity (interaction effect). Peak knee joint adduction moment was also reduced with decreased step length, and with decreased velocity in both groups. We conclude from these results that adopting shorter step lengths during daily activity and when walking for exercise can reduce mechanical stimuli associated with articular cartilage degenerative processes in adults with and without obesity. Thus, walking with reduced step length may benefit adults at risk for disability due to knee osteoarthritis. Adopting a shorter step length during daily walking activity may reduce knee joint loading and thus benefit those at risk for knee cartilage degeneration. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 9999:XX-XX, 2018. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Is overweight/obesity a risk factor for periodontitis in young adults and adolescents?: a systematic review.

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Khan, S; Barrington, G; Bettiol, S; Barnett, T; Crocombe, L

2018-01-19

Obesity in young adults and adolescents is associated with chronic co-morbidities. This project investigated whether being overweight or obese is a risk factor for periodontitis in adolescents (13-17 years) and young adults (18-34 years). A search of 12 databases was conducted using Medical Subject Headings/Index and Emtree terms. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, articles published between 2003 and 2016 were screened that reported periodontal and anthropometric measures. The Newcastle-Ottawa Scale was used to appraise the quality of studies. Of 25 eligible studies from 12 countries, 17 showed an association between obesity and periodontitis (odds ratios ranged from 1.1 to 4.5). The obesity indicators of body mass index, waist circumference, waist-hip ratio and body fat percentage were significantly associated with measures of periodontitis of bleeding on probing, plaque index, probing depths, clinical attachment loss, calculus, oral hygiene index and community periodontal index. Two prospective cohort studies in the review showed no significant association between obesity and periodontitis, but these studies had limitations of study design and used inappropriate epidemiological diagnostic measures of periodontitis. There was evidence to suggest that obesity is associated with periodontitis in adolescents and young adults. Systematic Review Registration: PROSPERO Registration Number: CRD42016046507. © 2018 World Obesity Federation.

Gender differences in the association between tooth loss and obesity among older adults in Brazil.

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Singh, Ankur; Peres, Marco Aurélio; Peres, Karen Glazer; Bernardo, Carla de Oliveira; Xavier, Andre; D'Orsi, Eleonora

2015-01-01

OBJECTIVE To analyze if differences according to gender exists in the association between tooth loss and obesity among older adults. METHODS We analyzed data on 1,704 older adults (60 years and over) from the baseline of a prospective cohort study conducted in Florianopolis, SC, Southern Brazil. Multivariable logistic regression models were used to assess the association between tooth loss and general and central obesity after adjustment for confounders (age, gender, skin color, educational attainment, income, smoking, physical activity, use of dentures, hypertension, and diabetes). Linear regressions were also assessed with body mass index and waist circumference as continuous outcomes. Interaction between gender and tooth loss was further assessed. RESULTS Overall mean body mass index was 28.0 kg/m2. Mean waist circumference was 96.8 cm for males and 92.6 cm for females. Increasing tooth loss was positively associated with increased body mass index and waist circumference after adjustment for confounders. Edentates had 1.4 (95%CI 1.1;1.9) times higher odds of being centrally obese than individuals with a higher number of teeth; however, the association lost significance after adjustment for confounders. In comparison with edentate males, edentate females presented a twofold higher adjusted prevalence of general and central obesity. In the joint effects model, edentate females had a 3.8 (95%CI 2.2;6.6) times higher odds to be centrally obese in comparison with males with more than 10 teeth present in both the arches. Similarly, females with less than 10 teeth in at least one arch had a 2.7 (95%CI 1.6;4.4) times higher odds ratio of having central obesity in comparison with males with more than 10 teeth present in both the arches. CONCLUSIONS Central obesity was more prevalent than general obesity among the older adults. We did not observe any association between general obesity and tooth loss. The association between central obesity and tooth loss depends on

Understanding How Overweight and Obese Emerging Adults Make Lifestyle Choices.

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Cha, EunSeok; Crowe, James M; Braxter, Betty J; Jennings, Bonnie Mowinski

To better understand health-related decision making among overweight and obese emerging adults. A cross-sectional design was used in the parent study involving overweight and obese emerging adults, ages 18-29 years. The goal of the parent study was to screen participants' diabetes risk and identify characteristics of emerging adults with prediabetes (N=107). A sub-sample of respondents (n=34) from the parent study were invited to participate in focus group interviews depending on whether they had prediabetes (three groups) or they did not have prediabetes (four groups). Each focus group interview lasted 90-120 minutes following a semi-structured interview guide. Conventional content analysis was used in the data analysis. Because of the similarities between participants with and without prediabetes, the findings were synthesized and reported in the aggregate. Moreover, during the analysis, the authors decided that rational choice theory provided a useful organizing structure for presenting the data. Emerging adults' behavioral decisions were rational reactions to their personal competence, perception of health, environment, and availability of resources to handle problems. Calculation of trade-offs and estimations of resource availability were often used when making decisions. Emerging adults choose unhealthy behaviors due to inaccurate information and insufficient competence to practice healthy lifestyles rather than because of laziness or being irrational. Behavioral interventions for emerging adults need to help them develop skills to enhance health literacy and problem solving, thereby enhancing their awareness of available resources and decreasing the perceived cost of making healthy choices. Copyright © 2016 Elsevier Inc. All rights reserved.

The prevalence of obesity and obesity-related health conditions in a large, multiethnic cohort of young adults in California.

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Koebnick, Corinna; Smith, Ning; Huang, Karl; Martinez, Mayra P; Clancy, Heather A; Kushi, Lawrence H

2012-09-01

To identify population groups that are most susceptible to obesity-related health conditions at young age. For this population-based cross-sectional study, measured weight and height, diagnosis, laboratory, and drug prescription information were extracted from electronic medical records of 1,819,205 patients aged 20 to 39 years enrolled in two integrated health plans in California in 2007 through 2009. Overall, 29.9% of young adults were obese. Extreme obesity (body mass index [BMI] ≥ 40 kg/m(2)) was observed in 6.1% of women and 4.5% of men. The adjusted relative risk (RR) for diabetes, hypertension, dyslipidemia, and the metabolic syndrome increased sharply for those individuals with a BMI of 40 or greater, with the sharpest increase in the adjusted RR for hypertension and the metabolic syndrome. The association between weight class and dyslipidemia, hypertension, and the metabolic syndrome but not diabetes was stronger among 20.0- to 29.9-year-olds compared with 30.0- to 39.9-year-olds (P for interaction young adults with a BMI of 40.0 to 49.9, 50.0 to 59.9, and 60 or greater kg/m(2) had a RR for hypertension of 11.73, 19.88, and 30.47 (95% confidence interval [CI], 26.39-35.17) at 20 to 29 years old, and 9.31, 12.41, and 15.43 (95% CI, 14.32-16.63) at 30 to 39 years old. Although older individuals were more likely to be extremely obese, the association between obesity-related health conditions was stronger in younger individuals. Hispanics and Blacks are also more likely to be obese, including extremely obese, putting them at an elevated risk for premature cardiovascular disease and some cancers relative to non-Hispanic Whites. Copyright © 2012 Elsevier Inc. All rights reserved.

Obesity, physical activity and prediabetes in adult children of people with diabetes

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Lidia G. Compeán-Ortiz

2018-01-01

Full Text Available ABSTRACT Objectives: Determine prevalence of obesity / overweight, physical activity (PA and prediabetes in adult children of parents with type 2 diabetes; identify differences according to sociodemographic variables, and describe the relationship of obesity/overweight with fasting glucose (FG and glycosylated hemoglobin (A1C. Methods: Cross-sectional study in 30 Mexican families with 53 participating adult children. Obesity / overweight was determined with Body Mass Index (BMI, Waist Circumference (WC and body fat percentage (BFP; PA with the short International Physical Activity Questionnaire (IPAQ, and prediabetes with FG. Results: 64% of participants presented obesity / overweight, 32% low PA, and 19% prediabetes. Men had higher WC than women (U= 219, p= 0.03. Women showed more BFP than men (U= 142, p <0.01. Blood glucose was related to BFP (rs= 0.336, p < 0.05, the A1C with the BMI (rs= 0.417, p <0.01, WC (rs= 0.394, p<0.01, BFP (rs= 0.494, p<0.01 and intense PA (rs= - 0.285, p<0.05. Conclusions: High prevalence of obesity / overweight and low PA were found. The FG was related only to BFP and A1C, in addition to BMI, WC and inversely with intense BP. It is recommended to modify the educational strategies of nursing at a family level.

Childhood obesity and adult cardiovascular disease risk factors: a systematic review with meta-analysis

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Amna Umer

2017-08-01

Full Text Available Abstract Background Overweight and obesity is a major public health concern that includes associations with the development of cardiovascular disease (CVD risk factors during childhood and adolescence as well as premature mortality in adults. Despite the high prevalence of childhood and adolescent obesity as well as adult CVD, individual studies as well as previous systematic reviews examining the relationship between childhood obesity and adult CVD have yielded conflicting results. The purpose of this study was to use the aggregate data meta-analytic approach to address this gap. Methods Studies were included if they met the following criteria: (1 longitudinal and cohort studies (including case-cohort, (2 childhood exposure and adult outcomes collected on the same individual over time, (3 childhood obesity, as defined by the original study authors, (4 English-language articles, (5 studies published up to June, 2015, (6 one or more of the following CVD risk factors [systolic blood pressure (SBP, diastolic blood pressure (DBP, total cholesterol (TC, high-density lipoprotein cholesterol (HDL, low-density lipoprotein cholesterol (LDL, non-high-density lipoprotein cholesterol (non-HDL, and triglycerides (TG], (7 outcome(s not self-reported, and (8 exposure measurements (child’s adiposity assessed by health professionals, trained investigators, or self-reported. Studies were retrieved by searching three electronic databases as well as citation tracking. Fisher’s r to z score was calculated for each study for each outcome. Pooled effect sizes were calculated using random-effects models while risk of bias was assessed using the STROBE instrument. In order to try and identify sources of heterogeneity, random-effects meta-regression was also performed. Results Of the 4840 citations reviewed, a total of 23 studies were included in the systematic review and 21 in the meta-analysis. The findings suggested that childhood obesity is significantly and

Childhood obesity and adult cardiovascular disease risk factors: a systematic review with meta-analysis.

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Umer, Amna; Kelley, George A; Cottrell, Lesley E; Giacobbi, Peter; Innes, Kim E; Lilly, Christa L

2017-08-29

Overweight and obesity is a major public health concern that includes associations with the development of cardiovascular disease (CVD) risk factors during childhood and adolescence as well as premature mortality in adults. Despite the high prevalence of childhood and adolescent obesity as well as adult CVD, individual studies as well as previous systematic reviews examining the relationship between childhood obesity and adult CVD have yielded conflicting results. The purpose of this study was to use the aggregate data meta-analytic approach to address this gap. Studies were included if they met the following criteria: (1) longitudinal and cohort studies (including case-cohort), (2) childhood exposure and adult outcomes collected on the same individual over time, (3) childhood obesity, as defined by the original study authors, (4) English-language articles, (5) studies published up to June, 2015, (6) one or more of the following CVD risk factors [systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), non-high-density lipoprotein cholesterol (non-HDL), and triglycerides (TG)], (7) outcome(s) not self-reported, and (8) exposure measurements (child's adiposity) assessed by health professionals, trained investigators, or self-reported. Studies were retrieved by searching three electronic databases as well as citation tracking. Fisher's r to z score was calculated for each study for each outcome. Pooled effect sizes were calculated using random-effects models while risk of bias was assessed using the STROBE instrument. In order to try and identify sources of heterogeneity, random-effects meta-regression was also performed. Of the 4840 citations reviewed, a total of 23 studies were included in the systematic review and 21 in the meta-analysis. The findings suggested that childhood obesity is significantly and positively associated with adult SBP (Zr

Diet induced weight loss accelerates onset of negative alliesthesia in obese women

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Frankham Patrick

2005-10-01

Full Text Available Abstract Background The physiological and behavioral responses to hypocaloric diet are to increase energy intake to defend a steady body weight. We utilized the method of "negative alliesthesia" for measuring the hedonic reponse to sweet stimulus before (Initial session and 3 months after entering a weight loss program. The negative alliesthesia test is known by physiologists but few clinical data exist. It is based on the observation that repeated pleasant gustatory stimuli turn into unpleasantness in the process of alliesthesia. At first visit participants repeatedly ingested sweet stimuli until they found them unpleasant and rated quantitatively on a linear analogue scale their hedonic experience. This procedure was repeated every 3 min until participants felt displeasure to end the session. The same protocol was followed after three months of following a weight loss diet. Dieting energy intake was from 1400 – 2000 kcal/d for 8 wk. Energy composition was 50% carb:25% prot: 25% lipid. After 8 wk caloric intake increased by 50 kcal/wk, to reach daily intake of 1800 – 2400 kcal/d. Energy composition was 50% carb:22% prot: 27% lipid. We report results on the effect of slow weight loss on negative alliesthesia in ten obese female participants enrolled in a commercial diet program based on Canada's Food Guide (Mincavi®. Results Results showed that diet lowered the mean BMI (Initial session 36.8 +/- 1.8 vs. 3 mo 34.9 +/- 1.8 kg/m2. At 3 mo the onset of negative alliesthesia, time to abandon experimental session, was shortened (Initial session 33 vs. 3 mo 24 min. The same trend was observed in the time to reach indifference (Initial session 21.9 +/- 3.8 vs. 3 mo 16.2 +/-2.4 min. There was no observed difference in maximum (Initial session +79.5 +/- 11.7; 3 mo +94.5 +/- 9.9 mm and minimum (Initial session -90.0 +/- 14.4; 3 mo -106 +/- 11.1 mm hedonic rating. Conclusion Earlier onset of negative alliesthesia, as seen in our participants, is not

Prevalence of overweight, obesity and metabolic syndrome components in children, adolescents and young adults with type 1 diabetes mellitus.

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Pinhas-Hamiel, Orit; Levek-Motola, Noa; Kaidar, Kfir; Boyko, Valentina; Tisch, Efrat; Mazor-Aronovitch, Kineret; Graf-Barel, Chana; Landau, Zohar; Lerner-Geva, Liat; Frumkin Ben-David, Rachel

2015-01-01

We aimed to determine the prevalence of overweight and obesity among children, adolescents and young adults with type 1 diabetes mellitus (T1DM), and to assess the prevalence of the metabolic syndrome and its components. The study cohort comprised 326 (168 women) consecutive patients aged 5 to 30 years diagnosed with T1DM and followed up in the Juvenile Diabetes Clinic, Maccabi Health Care Services. Anthropometric measurements, blood pressure, presence of additional diseases, other medications, HbA1c , triglycerides and high density lipoprotein cholesterol levels were obtained. The mean age in the study group was 18.5 ± 6.0 years, and the mean diabetes duration was 8.7 ± 5.0 years. Mean HbA1c level was 8.1 ± 1.3%. Nineteen per cent of the study population was overweight (85th > body mass index obese (body mass index ≥ 95th percentile). Female patients aged 15 ≤ 18 and 18 ≤ 25 years were significantly overweight compared with healthy Israeli women in the same age groups, 33.3% versus 12.7% and 26.3% versus 7.8%, respectively, p 1. There were no obese female patients in the 15 ≤ 18 age group. Among the men in all age groups, there was no difference in the prevalence of overweight and obesity compared with healthy men in the general population. There was no difference in the age of onset, disease duration, HbA1c levels, treatment with anti-depressants and associated morbidities between the normal weight, overweight and obese groups. Obese patients had lower levels of HDL and increased prevalence of hypertension and metabolic syndrome. Overweight but not obesity was more prevalent in women with T1DM. Metabolic syndrome and its components were more prevalent among overweight and obese individuals with T1DM than among normal weight individuals. Copyright © 2014 John Wiley & Sons, Ltd.

Obesity in Malaysia.

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Ismail, M N; Chee, S S; Nawawi, H; Yusoff, K; Lim, T O; James, W P T

2002-08-01

This study was undertaken to assess the recent data on Malaysian adult body weights and associations of ethnic differences in overweight and obesity with comorbid risk factors, and to examine measures of energy intake, energy expenditure, basal metabolic rate (BMR) and physical activity changes in urban and rural populations of normal weight. Three studies were included (1) a summary of a national health morbidity survey conducted in 1996 on nearly 29 000 adults > or =20 years of age; (2) a study comparing energy intake, BMR and physical activity levels (PALs) in 409 ethnically diverse, healthy adults drawn from a population of 1165 rural and urban subjects 18-60 years of age; and (3) an examination of the prevalence of obesity and comorbid risk factors that predict coronary heart disease and type 2 diabetes in 609 rural Malaysians aged 30-65 years. Overweight and obesity were calculated using body mass index (BMI) measures and World Health Organization (WHO) criteria. Energy intake was assessed using 3-d food records, BMR and PALs were assessed with Douglas bags and activity diaries, while hypertension, hyperlipidaemia and glucose intolerance were specified using standard criteria. The National Health Morbidity Survey data revealed that in adults, 20.7% were overweight and 5.8% obese (0.3% of whom had BMI values of >40.0 kg m(-2)); the prevalence of obesity was clearly greater in women than in men. In women, obesity rates were higher in Indian and Malay women than in Chinese women, while in men the Chinese recorded the highest obesity prevalences followed by the Malay and Indians. Studies on normal healthy subjects indicated that the energy intake of Indians was significantly lower than that of other ethnic groups. In women, Malays recorded a significantly higher energy intake than the other groups. Urban male subjects consumed significantly more energy than their rural counterparts, but this was not the case in women. In both men and women, fat intakes (%) were

The prevalence and clinical impact of obesity in adults with Marfan syndrome

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Yetman, Anji T; McCrindle, Brian W

2010-01-01

BACKGROUND: Patients with Marfan syndrome characteristically have an asthenic body habitus and are considered to be exempt from the obesity epidemic. OBJECTIVE: To examine the prevalence and clinical impact of obesity in a cohort of adults with Marfan syndrome. METHODS: Fifty outpatients (30 female) with a mean (± SD) age of 38±13 years were studied. Demographic variables including previously identified risk factors for aortic dissection were recorded. Body mass index (BMI) was determined and patients were classified as normal (BMI less than 25 kg/m2), overweight (BMI 25 kg/m2 to 29.9 kg/m2) or obese (BMI 30 kg/m2 or greater). Other cardiovascular risk factors were examined. An adverse clinical outcome was defined as either the attainment of surgical criteria for aortic root replacement or the presence of aortic dissection. RESULTS: A family history of aortic dissection was present in 13 (26%) patients. In 23 (46%) patients, there was no known family history of Marfan syndrome. Mean BMI was 25.4±7.4 kg/m2, with 18 (36%) patients having an elevated BMI. Positive smoking status was present in 15 (30%), hypertension in 13 (26%) and hyperlipidemia in 19 (38%) patients. Adverse clinical outcome was present in 27 (54%) patients. Logistic regression analysis revealed only index case (OR 44; PMarfan syndrome and is associated with an increased risk of aortic complications. PMID:20386774

Household motor vehicle use and weight status among Colombian adults: are we driving our way towards obesity?

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Parra, Diana C; Lobelo, Felipe; Gómez, Luis Fernando; Rutt, Candace; Schmid, Thomas; Brownson, Ross C; Pratt, Michael

2009-01-01

To determine the associations between household motor vehicle ownership and weight status among Colombian adults. Secondary analysis of data from the 2005 Demographic and HealthSurvey of Colombia. Height, weight and waist circumference were objectively measured in 49,079 adults, ages 18 to 64 that resided in urban settings. Abdominal obesity was defined as a waist circumference >80 cm in women and >90 cm in men. Prevalence was 19.9% for motor vehicle ownership in household, 33.1% for BMI between 25 and 29.9 kg/m(2), 14.4% for BMI>30 kg/m(2), and 46% for abdominal obesity. Males reporting any household motor vehicle ownership were more likely to be overweight or obese, and to have abdominal obesity (p for genderexposure variables interaction=motor vehicle ownership is associated with overweight, obesity, and abdominal obesity among Colombian men but not women.

Crowdsourcing novel childhood predictors of adult obesity.

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Bevelander, Kirsten E; Kaipainen, Kirsikka; Swain, Robert; Dohle, Simone; Bongard, Josh C; Hines, Paul D H; Wansink, Brian

2014-01-01

Effective and simple screening tools are needed to detect behaviors that are established early in life and have a significant influence on weight gain later in life. Crowdsourcing could be a novel and potentially useful tool to assess childhood predictors of adult obesity. This exploratory study examined whether crowdsourcing could generate well-documented predictors in obesity research and, moreover, whether new directions for future research could be uncovered. Participants were recruited through social media to a question-generation website, on which they answered questions and were able to pose new questions that they thought could predict obesity. During the two weeks of data collection, 532 participants (62% female; age  =  26.5±6.7; BMI  =  29.0±7.0) registered on the website and suggested a total of 56 unique questions. Nineteen of these questions correlated with body mass index (BMI) and covered several themes identified by prior research, such as parenting styles and healthy lifestyle. More importantly, participants were able to identify potential determinants that were related to a lower BMI, but have not been the subject of extensive research, such as parents packing their children's lunch to school or talking to them about nutrition. The findings indicate that crowdsourcing can reproduce already existing hypotheses and also generate ideas that are less well documented. The crowdsourced predictors discovered in this study emphasize the importance of family interventions to fight obesity. The questions generated by participants also suggest new ways to express known predictors.

Crowdsourcing novel childhood predictors of adult obesity.

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Kirsten E Bevelander

Full Text Available Effective and simple screening tools are needed to detect behaviors that are established early in life and have a significant influence on weight gain later in life. Crowdsourcing could be a novel and potentially useful tool to assess childhood predictors of adult obesity. This exploratory study examined whether crowdsourcing could generate well-documented predictors in obesity research and, moreover, whether new directions for future research could be uncovered. Participants were recruited through social media to a question-generation website, on which they answered questions and were able to pose new questions that they thought could predict obesity. During the two weeks of data collection, 532 participants (62% female; age  =  26.5±6.7; BMI  =  29.0±7.0 registered on the website and suggested a total of 56 unique questions. Nineteen of these questions correlated with body mass index (BMI and covered several themes identified by prior research, such as parenting styles and healthy lifestyle. More importantly, participants were able to identify potential determinants that were related to a lower BMI, but have not been the subject of extensive research, such as parents packing their children's lunch to school or talking to them about nutrition. The findings indicate that crowdsourcing can reproduce already existing hypotheses and also generate ideas that are less well documented. The crowdsourced predictors discovered in this study emphasize the importance of family interventions to fight obesity. The questions generated by participants also suggest new ways to express known predictors.

A Study Of Prevalence Of Obesity In Adult Punjabi Population

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Pooja Goyal

2006-06-01

Full Text Available   Introduction : Obesity has reached epidemic proportions globally with more than 1 billion overweight, Atleast 300 million of them are clinically obese and is a major contributor to the global burden of chronic disease and disability (1. Long considered a buy product of modern life in rich, developed contries, obesity is spreading to developing contries as well. Two critical factors that have influenced this explosion are changes in dietary patterns and levels of physical activity. The latest list of morbidity associated with obesity includes about forty diseases. Though, prevalence of co-morbidities of obesity is quite high among adults in India yet there are relatively less reliable and representative data available. Hence, this study was carried out. Material & Methods : It was a community based, cross sectional study conducted in field practice areas at Rural Health Centre (RHC, Pohir and Urban Health Centre (UHC, Kirti Nagar attached to the department of Community Medicine, DMC & Hospital Ludhiana. Field practice area of RHC is composed of 10 villages serving a total population of 20,450. The Urban health Centre covers ten colonies having a total populaation of 20.645.

Obesity and premature coronary artery disease with myocardial infarction in Puerto Rican young adults.

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Marcial, José M; Altieri, Pablo I

2015-01-01

A cross-sectional study examined adults aged 21 to 35 years who underwent left cardiac catheterization in the Cardiovascular Center for Puerto Rico and the Caribbean during 2008-2012 due to myocardial infarction. Demographic characteristics, clinical risk factors, and the extent of CAD were documented. Chi-square statistic or Fisher's exact test was used to compare the distribution of demographic, clinical, and lifestyle characteristics across CAD extent. Polytomous logistic regression models were fitted to estimate the prevalence odds ratios (POR) with 95% confidence intervals (Cl) for non-obstructive and obstructive coronary disease (OCD) compared with normal coronary anatomy. Statistical analyses were performed using Stata 11.0. Sixty-three (n = 63) adults were evaluated (81% were men). The mean age was 31 ± 4 years. The most frequent clinical risk factors were history of tobacco use, hyper tension, and dyslipidemia. Obesity was present in 45.9% of subjects and OCD was present in 52.38% of subjects. Obesity and family history of CAD were significantly associated with OCD when adjusted by age. Obese patients had 5.94 times the possibility of having OCD than normal weight patients. Obesity was the most important treatable predictor of premature obstructive CAD in our young adult population.

Real-life 10-year retention rate of first-line anti-TNF drugs for inflammatory arthritides in adult- and juvenile-onset populations: similarities and differences.

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Favalli, Ennio Giulio; Pontikaki, Irene; Becciolini, Andrea; Biggioggero, Martina; Ughi, Nicola; Romano, Micol; Crotti, Chiara; Gattinara, Maurizio; Gerloni, Valeria; Marchesoni, Antonio; Meroni, Pier Luigi

2017-08-01

The aim of this study is to retrospectively analyze 10-year drug survival of first-line TNF inhibitor (TNFi) in rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), and juvenile idiopathic arthritis (JIA) patients, comparing withdrawal rates and discontinuation pattern between adult- and juvenile-onset populations. RA, AS, PsA, and JIA patients treated with infliximab, etanercept, or adalimumab as first TNFi between 1999 and 2015 were extracted from a local registry. Drug survival up to 10-year follow-up was evaluated by the Kaplan-Meier method and compared according to age (adult vs juvenile onset), TNFi agent, and discontinuation reason by a stratified log-rank test. Three hundred sixty JIA (205 etanercept, 66 adalimumab, and 89 infliximab) and 951 (607 RA, 188 AS, and 156 PsA) adult patients (464 infliximab, 262 adalimumab, and 225 etanercept) were included. After exclusion of systemic-onset JIA (18.5%), overall 10-year retention rate was 31.8%, with no difference between adult- and juvenile-onset patients (32.1 and 30.2%, respectively; HR 0.938 [95% CI 0.782-1.125]). Etanercept showed the highest drug survival in adult-onset population (p adult population (29.75%) with a significantly higher risk of discontinuation than in juvenile-onset subgroup (HR 1.390 [95% CI 1.060-1.824]). Serious infections and malignancies caused TNFi withdrawal only in adult whereas gastrointestinal, neuropsychiatric, and ocular complications quite only in juvenile patients. Despite a similar 10-year drug survival, adult- and juvenile-onset subpopulations showed a significantly different pattern of TNFi reasons for discontinuation.

Dietary Patterns in Relation to General and Central Obesity among Adults in Southwest China.

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Zhang, Qiang; Chen, Xinguang; Liu, Zhitao; Varma, Deepthi S; Wan, Rong; Wan, Qingqing; Zhao, Shiwen

2016-11-03

Dietary patterns represent a broader picture of food consumption, and are better correlated with a variety of health outcomes. However, few studies have been conducted to explore the associations between dietary patterns and obesity in Southwest China. Data from the 2010-2012 National Nutrition Survey in the province of Yunnan, Southwest China, were analyzed ( n = 1604, aged 18-80 years). Dietary data were collected using the 24 h dietary recall over three consecutive days. Height, weight, and waist circumference were measured following standard methods. Exploratory factor analysis was used to identify dietary patterns. Logistic regression was used to explore the association between dietary patterns and obesity. Three distinct dietary patterns were identified, which were labeled as traditional, modern, and tuber according to their key components. With potential confounders adjusted, adults in the highest quartile of the modern pattern were at higher risk of general and central obesity (odds ratio (OR) 1.95, 95% confidence interval (CI) 1.15-3.48; OR 2.01, 95% CI 1.37-2.93). In contrast, adults in the highest quartile of the tuber pattern were at lower risk of general and central obesity (OR 0.34, 95% CI 0.15-0.61; OR 0.64, 95% CI 0.43-0.95) but at higher risk of underweight (OR 2.57, 95% CI 1.20-6.45). No significant association was found between the traditional pattern and obesity. Moreover, dietary pattern differences occurred due to the differences in socio-demographic characteristics. In conclusion, the modern dietary pattern was positively, and the tuber pattern negatively, associated with general and central obesity among adults in Southwest China.

Assessing the Dim Light Melatonin Onset in Adults with Autism Spectrum Disorder and No Comorbid Intellectual Disability

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Baker, Emma K.; Richdale, Amanda L.; Hazi, Agnes; Prendergast, Luke A.

2017-01-01

This study assessed melatonin levels and the dim light melatonin onset (DLMO) in adults with Autism Spectrum Disorder (ASD) and also investigated the relationships between melatonin and objectively measured sleep parameters. Sixteen adults with ASD (ASD-Only), 12 adults with ASD medicated for comorbid diagnoses of anxiety and/or depression…

Role of the family doctor in the management of adults with obesity: a scoping review

NARCIS (Netherlands)

Sturgiss, E.A.; Elmitt, N.; Haelser, E.; Weel, C. van; Douglas, K.A.

2018-01-01

OBJECTIVES: Obesity management is an important issue for the international primary care community. This scoping review examines the literature describing the role of the family doctor in managing adults with obesity. The methods were prospectively published and followed Joanna Briggs Institute

Management of obesity in children differs from that of adults.

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Hoey, Hilary

2014-11-01

Obesity in childhood is a very common disorder with an increasing prevalence. It is one of the most serious public health challenges. The objectives of the present paper are to increase the awareness of the problem of obesity in childhood, its serious complications and the need for prevention. Overweight and obese children are likely to remain obese into adulthood and more likely to develop serious complications including health problems such as diabetes and CVD, as well as psychological and social challenges. Overweight and obesity are largely preventable. In adults it is difficult to reduce excessive weight gain once it has become established, thus children should be considered the priority population for intervention strategies and prevention. Nutrition, exercise, weight gain in infancy, genetic and environmental factors, all contribute to the aetiology. Prevention and treatment of obesity in childhood requires education and empowerment of families relating to diet and exercise, along with the regulation and control of food marketing and clear nutritional labelling. The eating and physical activity behaviour of a child is strongly influenced by environmental and social factors. Therefore treatment will have only limited success in an environment where adequate physical activity is inhibited and the consumption of high-energy food is stimulated. Government investment in a health promotion programme addressing the issue of obesity in the population as a whole, with particular emphasis on the prevention and management of obesity in childhood is vital. The family doctor and multidisciplinary team play an important role. Regular visits to the family doctor, including growth assessment, will help motivate the family to restrict energy intake and to increase exercise. Therefore the prevention of childhood obesity needs high priority.

Parental Midlife Body Shape and Association with Multiple Adult Offspring Obesity Measures: North West Adelaide Health Study.

Directory of Open Access Journals (Sweden)

Janet F Grant

Full Text Available There is compelling evidence that parental weight is a strong determinant of offspring weight status. The study used cross-sectional self-reported and measured data from a longitudinal cohort of Australian adults (n = 2128 from Stage 3 (2008-10 of the North West Adelaide Health Study (1999-2003, baseline n = 4056 to investigate the association between midlife parental body shape and four indicators of obesity and fat distribution. The analysis used measured body mass index (BMI, waist circumference (WC, waist hip ratio (WHR and waist height ratio (WHtR of adult offspring, together with pictograms for recall of parental body shape. Compared to both parents being a healthy weight, offspring were more likely to be overweight or obese if both parents were an unhealthy weight at age 40 (OR 2.14, 95% CI 1.67-2.76 and further, those participants whose mother was an unhealthy weight were more likely to be overweight or obese themselves (OR 1.50, 95% CI 1.14-1.98. There were similar but lower results for those with an overweight/obese father (OR 1.44, 95% CI 1.08-1.93. The effect of one or both parents being overweight or obese tended to be stronger for daughters than for sons across BMI, WC and WHtR. BMI showed the strongest association with parental body shape (OR 2.14, followed by WC (OR 1.78, WHtR (OR 1.71 and WHR (OR 1.45. WHtR (42-45% and BMI (35-36% provided the highest positive predictive values for overweight/obesity from parental body shape. Parental obesity increases the risk of obesity for adult offspring, both for overall body shape and central adiposity, particularly for daughters. Pictograms could potentially be used as a screening tool in primary care settings to promote healthy weight among young adults.

Post-weaning voluntary exercise exerts long-term moderation of adiposity in males but not in females in an animal model of early-onset obesity.

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Schroeder, Mariana; Shbiro, Liat; Gelber, Vered; Weller, Aron

2010-04-01

Given the alarming increase in childhood, adolescent and adult obesity there is an imperative need for understanding the early factors affecting obesity and for treatments that may help prevent or at least moderate it. Exercise is frequently considered as an effective treatment for obesity however the empirical literature includes many conflicting findings. In the present study, we used the OLETF rat model of early-onset hyperphagia-induced obesity to examine the influence of early exercise on peripheral adiposity-related parameters in both males and females. Rats were provided voluntary access to running wheels from postnatal day (PND) 22 until PND45. We examined fat pad weight (brown, retroperitoneal, inguinal and epididymal); inguinal adipocyte size and number; and leptin, adiponectin, corticosterone and creatinine levels. We also examined body weight, feeding efficiency and spontaneous intake. Early voluntary exercise reduced intake, adiposity and leptin in the OLETF males following a sharp reduction in adipocyte size despite a significant increase in fat cell number. Exercising males from the lean LETO control strain presented stable intake, but reduced body fat, feeding efficiency and increased plasma creatinine, suggesting an increment in muscle mass. OLETF females showed reduced feeding efficiency and liver fat, and a significant increase in brown fat. Exercising LETO control females increased intake, body weight and creatinine, but no changes in body fat. Overall, OLETF rats presented higher adiponectin levels than controls in both basal and post-exercise conditions. The results suggest an effective early time frame, when OLETF males can be successfully "re-programmed" through voluntary exercise; in OLETF females the effect is much more moderate. Findings expose sex-dependent peripheral mechanisms in coping with energy challenges. Copyright 2010 Elsevier Inc. All rights reserved.

Is late-onset OCD a distinct phenotype? Findings from a comparative analysis of "age at onset" groups.

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Sharma, Eesha; Sundar, A Shyam; Thennarasu, Kandavel; Reddy, Y C Janardhan

2015-10-01

Significant differences in clinical profile and comorbidity patterns have been observed between "juvenile-onset" and "adult-onset" obsessive-compulsive disorder (OCD). There is little systematic research on onset of OCD after the fourth decade. The current study aims to compare the demographic, clinical, and comorbidity patterns of patients with "juvenile-onset" (OCD. Eight hundred two consecutive patients who consulted a specialty OCD clinic at a tertiary care hospital in India were evaluated with the Mini International Neuropsychiatric Interview, the Yale-Brown Obsessive-Compulsive Scale, and the Clinical Global Impression scale. 37.4%, 57.4%, and 5.2% of patients had juvenile-, adult-, and late-onset OCD, respectively. Late-onset OCD was associated with female gender (χ2=42, pOCD in first-degree relatives (χ2=20.4, pOCD was significantly associated with female gender, collecting compulsions, and less aggressive obsessions, in comparison with adult-onset OCD. In comparison with juvenile-onset, late-onset OCD was significantly associated with female gender, presence of precipitating factors, and less aggressive obsessions, sexual obsessions, and repeating compulsions. Late-onset OCD is characterized by female gender, lesser familial loading for OCD, and presence of precipitating factors, suggesting that it may have a distinct pathophysiology compared to juvenile- and adult-onset OCD. Systematic research is required to understand the family-genetic, neuropsychological, and neurobiological correlates of late-onset OCD.

Understanding everyday life of morbidly obese adults-habits and body image

Directory of Open Access Journals (Sweden)

Bjørg Christiansen

2012-07-01

Full Text Available Background: Morbid obesity is a progressive, chronic condition associated with failed attempts at change and repeated relapses. Aim: There seems to be little previous research into the understanding of the everyday life of morbidly obese adults. We wanted to gain more knowledge about characteristics of eating habits and body image as well as motivational forces for change. Methods: A qualitative approach was chosen in order to gain insight into how morbidly obese adults experience everyday life. Qualitative interviews are well suited to provide insight into themes from the interviewee's life story from the subjects’ own perspectives. To gain insight into such processes, a narrative approach that allowed the informants to give voice to their ways of doing, thinking and feeling in daily life, was adopted. The informants comprised seven women and four men aged of 26–56 years, recruited from a population of obese individuals who had participated in a weight reduction course. A hermeneutic approach was used where the research question was the basis for a reflective interpretation. Results: The following meaning-units were identified: to be perceived as overweight; and to see oneself as overweight. Ingrained habits: the struggle between knowing and doing; acting without knowing; and eating is soothing. Conclusions: Seeing oneself as an obese person is a gradual process that implied experiencing oneself as different from significant others, such as (slim siblings and friends. To experience a gap between knowing and doing concerning food habits in everyday life indicates that informants value they have a choice. This is an important insight to consider when framing interventions to support this vulnerable group.

Adult-Onset Type 1 Diabetes and Pregnancy: Three Case Reports

OpenAIRE

Bonsembiante, Barbara; Dalfrà, Maria Grazia; Masin, Michela; Gallo, Alessandra; Lapolla, Annunziata

2013-01-01