Interventions for Childhood Obesity in the First 1,000 Days A Systematic Review.

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Blake-Lamb, Tiffany L; Locks, Lindsey M; Perkins, Meghan E; Woo Baidal, Jennifer A; Cheng, Erika R; Taveras, Elsie M

2016-06-01

The "first 1,000 days"-conception through age 24 months-are critical for the development and prevention of childhood obesity. This study systematically reviews existing and ongoing interventions during this period, identifies gaps in current research, and discusses conceptual frameworks and opportunities for future interventions. PubMed, Embase, Web of Science, and ClinicalTrials.gov were searched to identify completed and ongoing interventions implemented during pregnancy through age 24 months that aimed to prevent overweight/obesity between ages 6 months and 18 years. English-language, controlled interventions published between January 1, 1980 and December 12, 2014, were analyzed between December 13, 2014 and March 15, 2015. Of 34 completed studies from 26 unique identified interventions, nine were effective. Effective interventions focused on individual- or family-level behavior changes through home visits, individual counseling or group sessions in clinical settings, a combination of home and group visits in a community setting, and using hydrolyzed protein formula. Protein-enriched formula increased childhood obesity risk. Forty-seven ongoing interventions were identified. Across completed and ongoing interventions, the majority target individual- or family-level changes, many are conducted in clinical settings, and few target early-life systems and policies that may impact childhood obesity. Obesity interventions may have the greatest preventive effect if begun early in life. Yet, few effective interventions in the first 1,000 days exist, and many target individual-level behaviors of parents and infants. Interventions that operate at systems levels and are grounded in salient conceptual frameworks hold promise for improving future models of early-life obesity prevention. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The effect of regular walking and alternate day fasting on health-related factors in overweight and obese females

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Roya Seighali

2017-03-01

Full Text Available Introduction: Obesity is a complex health problem. The aim of this study was to determine the effects of regular walking with alternate day fasting (ADF on health-related factors of overweight and obese females.‎  Methods: 30 healthy inactive, overweight and obese women were divided randomly into three equal groups.  The groups were: control group (BMI: 30.72±4.40 kg/m2; the experimental group I: ADF along with regular walking with 50% to 65% maximal heart rate (BMI: 28.69 ±2.81 kg/m2 and the experimental group II: ADF (BMI: 30.56 ±3.66 kg/m2. Participants were under the diet for six weeks. The diet ADF means that, they had days of fasting and free day (with regular walking, alternately. Two days before and two days after the end of the study, the participants’ fasting blood sugar were measured after 12 hours. Resting heart rate, blood pressure and body composition were assessed in the same day. The collected data were analyzed using paired t-test and ANOVA test. Results: Body mass index in both experimental groups had significant decrease‎ (P

OBESITY : A MODERN DAY PLAGUE

OpenAIRE

YADAV, YATENDRA KUMAR

2002-01-01

Obesity is the presence of excess body fat. Unfortunately obesity is taken as a mere cosmetic problem and not a medical one. Today obesity is being ‘dealt’ with more by the self-proclaimed fitness experts running the rapidly mushrooming fitness centres rather than by medical professionals. But rather than merely a cosmetic problem, obesity should be viewed as a disease because there are multiple biologic hazards at surprisingly low levels of excess fat With the rapid pace of industrialisation...

Canadian children's and youth's pedometer-determined steps/day, parent-reported TV watching time, and overweight/obesity: The CANPLAY Surveillance Study

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Craig Cora L

2011-06-01

Full Text Available Abstract Background This study examines associations between pedometer-determined steps/day and parent-reported child's Body Mass Index (BMI and time typically spent watching television between school and dinner. Methods Young people (aged 5-19 years were recruited through their parents by random digit dialling and mailed a data collection package. Information on height and weight and time spent watching television between school and dinner on a typical school day was collected from parents. In total, 5949 boys and 5709 girls reported daily steps. BMI was categorized as overweight or obese using Cole's cut points. Participants wore pedometers for 7 days and logged daily steps. The odds of being overweight and obese by steps/day and parent-reported time spent television watching were estimated using logistic regression for complex samples. Results Girls had a lower median steps/day (10682 versus 11059 for boys and also a narrower variation in steps/day (interquartile range, 4410 versus 5309 for boys. 11% of children aged 5-19 years were classified as obese; 17% of boys and girls were overweight. Both boys and girls watched, on average, Discussion Television viewing is the more prominent factor in terms of predicting overweight, and it contributes to obesity, but steps/day attenuates the association between television viewing and obesity, and therefore can be considered protective against obesity. In addition to replacing opportunities for active alternative behaviours, exposure to television might also impact body weight by promoting excess energy intake. Conclusions In this large nationally representative sample, pedometer-determined steps/day was associated with reduced odds of being obese (but not overweight whereas each parent-reported hour spent watching television between school and dinner increased the odds of both overweight and obesity.

Day-3 embryo metabolomics in the spent culture media is altered in obese women undergoing in vitro fertilization.

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Bellver, José; De Los Santos, María J; Alamá, Pilar; Castelló, Damià; Privitera, Laura; Galliano, Daniela; Labarta, Elena; Vidal, Carmen; Pellicer, Antonio; Domínguez, Francisco

2015-06-01

To determine whether the global metabolomic profile of the spent culture media (SCM) of day-3 embryos is different in obese and normoweight women undergoing in vitro fertilization (IVF). Prospective cohort analysis. IVF clinic. Twenty-eight young, nonsmoking women with normoweight, nonsmoking male partners with mild/normal sperm factors undergoing a first IVF attempt for idiopathic infertility, tubal factor infertility, or failed ovulation induction: obese ovulatory women (n = 12); obese women with polycystic ovary syndrome (PCOS; n = 4); normoweight ovulatory women (n = 12). Fifty μl of SCM collected from two day-3 embryos of each cohort. Metabolomic profiling via ultrahigh performance liquid chromatography coupled to mass spectrometry of SCM from a total of 56 embryos. The untargeted metabolomic profile was different in obese and normoweight women. Partial least squares discriminant analysis resulted in a clear separation of samples when a total of 551 differential metabolites were considered. A prediction model was generated using the most consistent metabolites. Most of the metabolites identified were saturated fatty acids, which were detected in lower concentrations in the SCM of embryos from obese women. The metabolomic profile was similar in obese women with or without PCOS. The metabolomic profile in the SCM of day-3 embryos is different in normoweight and obese women. Saturated fatty acids seem to be reduced when embryos from obese patients are present. NCT01448863. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Prevalence of overweight and obesity among Seventh-day Adventist African American and Caucasian college students.

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Pawlak, Roman; Sovyanhadi, Marta

2009-01-01

All age, sex, and racial groups are affected by the obesity epidemic in the United States, although disparities exist among these groups. The Seventh-day Adventists are a religious group of people who are believed to live longer and healthier lives than do their non-Adventist counterparts because they do not smoke or drink alcohol and they eat a healthier diet. This study assessed the prevalence of overweight and obesity among Seventh-day Adventist college students attending 2 private universities in the southern United States. Most students' body mass index (65.8%) was within the normal weight category, 3.7% were underweight, 20.6% were overweight, and 9.9% were obese. Body mass index > or = 25 kg/m2 was more prevalent among men and African Americans. In all ethnic subgroups, the prevalence of overweight and obesity was lower than that among non-Adventist students reported in other studies.

Contemporary pharmacological obesity treatments

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Kaszubska Katarzyna

2016-06-01

Full Text Available In the last few years, obesity has become a global epidemic. Consequently, worldwide costs associated with managing obesity and obesity-related comorbidities are huge. Numerous studies have focused on discerning the appropriate proper treatment of weight related problems such as overweight and obesity. Moreover, many clinical trials have been conducted for many years in order to introduce effective anti-obesity drugs. The aim of the present review is to provide an overview of current and future pharmacotherapy for obesity, and to provide the reader with a determination of the concentration and composition of long and short term anti-obesity drugs, doing so by placing emphasis on pharmacotherapy and up-to-day solutions. It should be noted that, currently, the worldwide pharmacotherapy is represented by phendimetrazine, benzphetamine and diethylpropion, as well as by orlistat, lorcaserin, phentermine/topiramate, naltrexone/bupropion and liraglutide. In our paper, individual cases of patients’ needs are thoroughly illustrated by way of examples. Medical prescriptions and contraindications are also described.

Occurrence of child obesity in preschool children in a São Paulo day-care center

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Marcia Carla Morete Pinto

2009-03-01

Full Text Available Objective: To identify the occurrence of overweight and obesity in preschool children (two to five years in a day-care center in the city of São Paulo, using the weight/height ratio. Methods: This is a descriptive study, with exploratory quantitative approach, conducted in a day-care center in São Paulo. The sample consisted of 29 children, aged from two to five years and the data were collected through questionnaires. Rresults: As for the nutritional assessment of children according to the Waterlow criteria, 12 (41% were normal, 7 (24% obese, 5 (17% overweight, 3 (10% had grade 1 malnutrition, 1 (4%, morbid obesity and 1 (4%, grade 3 malnutrition. Cconclusions: It is concluded that a significant proportion of the children assessed is above the appropriate weight range, requiring the implementation of preventive actions aimed to guide habits of good nutrition, encouraging physical activity, thereby decreasing the rates of child obesity and impacting their health at adulthood.

[Project to improve abdominal obesity in day care ward psychiatric patients].

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Liu, Yu-Chieh; Wang, Hui-Yu; Huang, Hui-Ling; Chen, Min-Li

2011-06-01

Over half (57.14%) of patients in our ward suffer from abdominal obesity. This rate is on a continuing upward trend. Reasons for such obesity include lack of physical activity classes, inadequate physical activity, high calorie diets and unhealthy eating habits, chronic diseases and drug side effects, poor motivation to reduce weight, and lack of crisis awareness of abdominal obesity. This project was designed to lessen the problem of abdominal obesity among psychiatric day care inpatients. Resolution measures implemented included: (1) arranging aerobic exercise classes; (2) scheduling classes to teach patients healthy diet habits and knowledge regarding diseases and drugs; (3) holding a waistline reduction competition; (4) displaying health education bulletin boards; (5) holding a quiz contest with prizes for correct answers. The eight abdominally obese patients in the ward achieved an average waist circumference reduction of 2.9 cm and the overall abdominal obesity rate in the ward fell to 35.7%. BMI, eating habits, and awareness of weight loss importance and motivation all improved. The outcome achieved targeted project objectives. We recommend the integration of obesity prevention into routine ward activities and quality control indicators. Nurses should provide patients with weight loss concepts, regularly monitor risk factors, and encourage patient family cooperation to maintain medical care quality.

Early-Life Obesity Prevention: Critique of Intervention Trials During the First One Thousand Days.

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Reilly, John J; Martin, Anne; Hughes, Adrienne R

2017-06-01

To critique the evidence from recent and ongoing obesity prevention interventions in the first 1000 days in order to identify evidence gaps and weaknesses, and to make suggestions for more informative future intervention trials. Completed and ongoing intervention trials have had fairly modest effects, have been limited largely to high-income countries, and have used relatively short-term interventions and outcomes. Comparison of the evidence from completed prevention trials with the evidence from systematic reviews of behavioral risk factors shows that some life-course stages have been neglected (pre-conception and toddlerhood), and that interventions have neglected to target some important behavioral risk factors (maternal smoking during pregnancy, infant and child sleep). Finally, while obesity prevention interventions aim to modify body composition, few intervention trials have used body composition measures as outcomes, and this has limited their sensitivity to detect intervention effects. The new WHO Healthy Lifestyles Trajectory (HeLTI) initiative should address some of these weaknesses. Future early obesity prevention trials should be much more ambitious. They should, ideally: extend their interventions over the first 1000 days; have longer-term (childhood) outcomes, and improved outcome measures (body composition measures in addition to proxies for body composition such as the BMI for age); have greater emphasis on maternal smoking and child sleep; be global.

Individual differences and day-to-day fluctuations in goal planning and type 1 diabetes management.

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Wiebe, Deborah J; Baker, Ashley C; Suchy, Yana; Stump, Tammy K; Berg, Cynthia A

2018-04-26

To examine whether individual differences and day-to-day fluctuations in diabetes goal planning are associated with Type 1 diabetes (T1D) management during late adolescence, and whether lapses in daily diabetes goal planning are more disruptive to diabetes management among those with poorer executive functioning (EF). Late adolescents with T1D (N = 236, Mage = 17.77 years) completed survey measures assessing individual differences in levels of diabetes goal planning and adherence, as well as survey and performance-based measures of EF; glycemic control was assessed through glycated hemoglobin (HbA1c) assays. Participants then completed a 2-week daily diary, rating items measuring daily diabetes goal planning, goal effort, and adherence, and recording blood-glucose tests from their glucometer at the end of each day. Analyses of survey measures indicated that higher individual differences in diabetes goal planning were associated with better adherence and glycemic control. Analyses of daily data using hierarchical linear modeling indicated that adolescents displayed higher daily adherence and lower blood-glucose levels on days when they had higher-than-their-average levels of daily goal planning and daily goal effort. EF moderated the association between daily goal planning and daily adherence, indicating that lapses in daily goal planning were more disruptive for adolescents with poorer EF. Both individual differences and day-to-day fluctuations in diabetes goal planning are associated with diabetes management, highlighting the challenges of managing T1D in daily life. Youth in late adolescence with poorer EF may especially benefit from planning to attain diabetes goals on a daily basis. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Prevalence of malnutrition, obesity and nutritional risk of Australian paediatric inpatients: a national one-day snapshot.

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White, Melinda; Dennis, Nicole; Ramsey, Rebecca; Barwick, Katie; Graham, Christie; Kane, Sarah; Kepreotes, Helen; Queit, Leah; Sweeney, Annabel; Winderlich, Jacinta; Wong See, Denise; Littlewood, Robyn

2015-03-01

Low prevalence rates of malnutrition at 2.5% to 4% have previously been reported in two tertiary paediatric Australian hospitals. The current study is the first to measure the prevalence of malnutrition, obesity and nutritional risk of paediatric inpatients in multiple hospitals throughout Australia. Malnutrition, obesity and nutritional risk prevalence were investigated in 832 and 570 paediatric inpatients, respectively, in eight tertiary paediatric hospitals and eight regional hospitals across Australia on a single day. Malnutrition and obesity prevalence was determined using z-scores and body mass index (BMI) percentiles. High nutritional risk was determined as a Paediatric Yorkhill Malnutrition Score of 2 or more. The prevalence rates of malnourished, wasted, stunted, overweight and obese paediatric patients were 15%, 13.8%, 11.9%, 8.8% and 9.9%, respectively. Patients who identified as Aboriginal and Torres Strait Islander were more likely to have lower height-for-age z-scores (P malnutrition and nutritional risk of Australian paediatric inpatients on a given day was much higher when compared with the healthy population. In contrast, the proportion of overweight and obese patients was less. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Validation of Fully Automated VMAT Plan Generation for Library-Based Plan-of-the-Day Cervical Cancer Radiotherapy

OpenAIRE

Sharfo, Abdul Wahab M.; Breedveld, Sebastiaan; Voet, Peter W. J.; Heijkoop, Sabrina T.; Mens, Jan-Willem M.; Hoogeman, Mischa S.; Heijmen, Ben J. M.

2016-01-01

textabstractPurpose: To develop and validate fully automated generation of VMAT plan-libraries for plan-of-the-day adaptive radiotherapy in locally-advanced cervical cancer. Material and Methods: Our framework for fully automated treatment plan generation (Erasmus-iCycle) was adapted to create dual-arc VMAT treatment plan libraries for cervical cancer patients. For each of 34 patients, automatically generated VMAT plans (autoVMAT) were compared to manually generated, clinically delivered 9-be...

Obesity Is Associated With More Complications and Longer Hospital Stays After Orthopaedic Trauma.

Science.gov (United States)

Childs, Benjamin R; Nahm, Nickolas J; Dolenc, Andrea J; Vallier, Heather A

2015-11-01

The objective of this study was to characterize relationships between obesity and initial hospital stay, including complications, in patients with multiple system trauma and surgically treated fractures. Prospective, observational. Level 1 trauma center. Three hundred seventy-six patients with an Injury Severity Score greater than 16 and mechanically unstable high-energy fractures of the femur, pelvic ring, acetabulum, or spine requiring stabilization. Data for obese (body mass index ≥ 30) versus nonobese patients included presence of pneumonia, deep vein thrombosis, pulmonary embolism, infection, organ failure, and mortality. Days in ICU and hospital, days on ventilator, transfusions, and surgical details were documented. Complications occurred more often in obese patients (38.0% vs. 28.4%, P = 0.03), with more acute renal failure (5.70% vs. 1.38%, P = 0.02) and infection (11.4% vs. 5.50%, P = 0.04). Days in ICU and mechanical ventilation times were longer for obese patients (7.06 vs. 5.25 days, P = 0.05 and 4.92 vs. 2.90 days, P = 0.007, respectively). Mean total hospital stay was also longer for obese patients (12.3 vs. 9.79 days, P = 0.009). No significant differences in rates of mortality, multiple organ failure, or pulmonary complications were noted. Medically stable obese patients were almost twice as likely to experience delayed fracture fixation due to preference of the surgeon and were more likely to experience delay overall (26.0% vs. 16.1%; P = 0.02). Mean time from injury to fixation was 34.9 hours in obese patients versus 23.7 hours in nonobese patients (P = 0.03). Obesity was noted among 42% of our trauma patients. In obese patients, complications occurred more often and hospital and ICU stays were significantly longer. These increases are likely to be associated with greater hospital costs. Surgeon decision to delay procedures in medically stable obese patients may have contributed to these findings; definitive fixation was more likely to be

Complete and Voluntary Starvation of 50 Days

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Bradley Elliott

2016-09-01

Full Text Available A 34-year-old obese male (96.8 kg; BMI, 30.2 kg m −1 volitionally undertook a 50-day fast with the stated goal of losing body mass. During this time, only tea, coffee, water, and a daily multivitamin were consumed. Severe and linear loss of body mass is recorded during these 50 days (final 75.4 kg; BMI, 23.5 kg mT 1 . A surprising resilience to effects of fasting on activity levels and physical function is noted. Plasma samples are suggestive of early impairment of liver function, and perturbations to cardiovascular dynamics are also noted. One month following resumption of feeding behavior, body weight was maintained (75.0 kg; BMI, 23.4 kg m −1 . Evidence-based decision-making with the fasting or hunger striking patient is limited by a lack of evidence. This case report suggests that total body mass, not mass lost, may be a key observation in clinical decision-making during fasting and starvation.

A patient-specific planning target volume used in 'plan of the day' adaptation for interfractional motion mitigation

International Nuclear Information System (INIS)

Chen, Wenjing; Gemmel, Alexander; Rietzel, Eike

2013-01-01

We propose a patient-specific planning target volume (PTV) to deal with interfractional variations, and test its feasibility in a retrospective treatment-planning study. Instead of using one planning image only, multiple scans are taken on different days. The target and organs at risk (OARs) are delineated on each images. The proposed PTV is generated from a union of those target contours on the planning images, excluding voxels of the OARs, and is denoted the PTV 'GP-OAR' (global prostate-organs at risk). The study is performed using 'plan of the day' adaptive workflow, which selects a daily plan from a library of plans based on a similarity comparison between the daily scan and planning images. The daily plans optimized for GP-OAR volumes are compared with those optimized for PTVs generated from a single prostate contour (PTV SP). Four CT serials of prostate cancer patient datasets are included in the test, and in total 28 fractions are simulated. The results show that the daily chosen GP-OAR plans provide excellent target coverage, with V95 values of the prostate mostly >95%. In addition, dose delivered to the OARs as calculated from applying daily chosen GP-OAR plans is slightly increased but comparable to that calculated from applying daily SP plans. In general, the PTV GP-OARs are able to cover possible target variations while keeping dose delivered to the OARs at a similar level to that of the PTV SPs. (author)

The impact of obesity on 30-day complications in pediatric surgery.

Science.gov (United States)

Train, A T; Cairo, S B; Meyers, H A; Harmon, C M; Rothstein, D H

2017-11-01

To examine the effects of obesity on specialty-specific surgical outcomes in children. Retrospective cohort study using the National Surgical Quality Improvement Program, Pediatric, 2012-2014. Patients included those aged 2-17 years who underwent a surgical procedure in one of six specialties. Obesity was the primary patient variable of interest. Outcomes of interest were postoperative complications and operative times. Odds ratios for development of postoperative complications were calculated using stepwise multivariate regression analysis. Obesity was associated with a significantly greater risk of wound complications (OR 1.24, 95% CI 1.13-1.36), but decreased risk of non-wound complications (OR 0.68, 95% CI 0.63-0.73) and morbidity (OR 0.79, 95% CI 0.75-0.84). Obesity was not a significant factor in predicting postoperative complications in patients undergoing otolaryngology or plastic surgery procedures. Anesthesia times and operative times were significantly longer for obese patients undergoing most types of pediatric surgical procedures. Obesity confers an increased risk of wound complications in some pediatric surgical specialties and is associated with overall decreased non-wound complications and morbidity. These findings suggest that the relationship between obesity and postoperative complications is complex and may be more dependent on underlying procedure- or specialty-related factors than previously suspected.

Moderators of the Mediated Effect of Intentions, Planning, and Saturated-Fat Intake in Obese Individuals

NARCIS (Netherlands)

Soureti, A.; Hurling, R.; van Mechelen, W.; Cobain, M.; Chin A Paw, M.J.M.

2012-01-01

Objective: The present study aimed to advance our understanding of health-related theory, that is, the alleged intention-behavior gap in an obese population. It examined the mediating effects of planning on the intention-behavior relationship and the moderated mediation effects of age, self-efficacy

Obese mice on a high-fat alternate-day fasting regimen lose weight and improve glucose tolerance.

Science.gov (United States)

Joslin, P M N; Bell, R K; Swoap, S J

2017-10-01

Alternate-day fasting (ADF) causes body weight (BW) loss in humans and rodents. However, it is not clear that ADF while maintaining a high-fat (HF) diet results in weight loss and the accompanying improvement in control of circulating glucose. We tested the hypotheses that a high-fat ADF protocol in obese mice would result in (i) BW loss, (ii) improved glucose control, (iii) fluctuating phenotypes on 'fasted' days when compared to 'fed' days and (iv) induction of torpor on 'fasted days'. We evaluated the physiological effects of ADF in diet-induced obese mice for BW, heart rate (HR), body temperature (T b ), glucose tolerance, insulin responsiveness, blood parameters (leptin, insulin, free fatty acids) and hepatic gene expression. Diet-induced obese male C57BL/6J mice lost one-third of their pre-diet BW while on an ADF diet for 10 weeks consisting of HF food. The ADF protocol improved glucose tolerance and insulin sensitivity, although mice on a fast day were less glucose tolerant than the same mice on a fed day. ADF mice on a fast day had low circulating insulin, but had an enhanced response to an insulin-assisted glucose tolerance test, suggesting the impaired glucose tolerance may be a result of insufficient insulin production. On fed days, ADF mice were the warmest, had a high HR and displayed hepatic gene expression and circulating leptin that closely mimicked that of mice fed an ad lib HF diet. ADF mice never entered torpor as assessed by HR and T b . However, on fast days, they were the coolest, had the slowest HR, and displayed hepatic gene expression and circulating leptin that closely mimicked that of Chow-Fed mice. Collectively, the ADF regimen with a HF diet in obese mice results in weight loss, improved blood glucose control, and daily fluctuations in selected physiological and biochemical parameters in the mouse. Journal of Animal Physiology and Animal Nutrition © 2016 Blackwell Verlag GmbH.

Overweight/obesity and gastric fluid characteristics in pediatric day surgery: implications for fasting guidelines and pulmonary aspiration risk.

Science.gov (United States)

Cook-Sather, Scott D; Gallagher, Paul R; Kruge, Lydia E; Beus, Jonathan M; Ciampa, Brian P; Welch, Kevin Conor; Shah-Hosseini, Sina; Choi, Jieun S; Pachikara, Reshma; Minger, Kim; Litman, Ronald S; Schreiner, Mark S

2009-09-01

The safety of 2-h preoperative clear liquid fasts has not been established for overweight/obese pediatric day surgical patients. Healthy children and obese adults who fasted 2 h have small residual gastric fluid volumes (GFVs), which are thought to reflect low pulmonary aspiration risk. We sought to measure the prevalence of overweight/obesity in our day surgery population. We hypothesized that neither body mass index (BMI) percentile nor fasting duration would significantly affect GFV or gastric fluid pH. In children who were allowed clear liquids up until 2 h before surgery, we hypothesized that overweight/obese subjects would not have increased GFV over lean/normal subjects and that emesis/pulmonary aspiration events would be rare. Demographics, medical history, height, and weight were recorded for 1000 consecutive day surgery patients aged 2-12 yr. In addition, 1000 day surgery patients (age 2-12 yr) undergoing general endotracheal anesthesia were enrolled. After tracheal intubation, a 14-18F orogastric tube was inserted and gastric contents evacuated. Medications, fasting interval, GFV, pH, and emetic episodes were documented. Age- and gender-specific Center for Disease Control and Prevention growth charts (2000) were used to determine ideal body weight (IBW = 50th percentile) and to classify patients as lean/normal (BMI 25th-75th percentile), overweight (BMI > or = 85th to obese (BMI > or = 95th percentile). Of all day surgery patients, 14.0% were overweight and 13.3% were obese. Obese children had lower GFV per total body weight (P fasting duration or age. Decreased gastric fluid acidity was associated with younger age (P = 0.005), increased BMI percentile (P = 0.036), and African American race (P = 0.033). Emesis on induction occurred in eight patients (50% of whom were obese, P = 0.052, and 75% of whom had obstructive sleep apnea, P = 0.061). Emesis was associated with increased ASA physical status (P = 0.006) but not with fasting duration. There were no

Effects of overweight and obese body mass on motor planning and motor skills during obstacle crossing in children.

Science.gov (United States)

Gill, Simone V; Hung, Ya-Ching

2014-01-01

Little is known about how obesity relates to motor planning and skills during functional tasks. We collected 3-D kinematics and kinetics as normal weight (n=10) and overweight/obese (n=12) children walked on flat ground and as they crossed low, medium, and high obstacles. We investigated if motor planning and motor skill impairments were evident during obstacle crossing. Baseline conditions showed no group differences (all ps>.05). Increased toe clearance was found on low obstacles (p=.01) for the overweight/obese group and on high obstacles (p=.01) for the normal weight group. With the crossing leg, the overweight/obese group had larger hip abduction angles (p=.01) and medial ground reaction forces (p=.006) on high obstacles and high anterior ground reaction forces on low obstacles (p=.001). With the trailing leg, overweight/obese children had higher vertical ground reaction forces on high obstacles (p=.005) and higher knee angles (p=.01) and anterior acceleration in the center of mass (p=.01) on low obstacles. These findings suggest that differences in motor planning and skills in overweight/obese children may be more apparent during functional activities. Copyright © 2013 Elsevier Ltd. All rights reserved.

Comparison of the longissimus muscle proteome between obese and lean pigs at 180 days.

Science.gov (United States)

Li, Anning; Mo, Delin; Zhao, Xiao; Jiang, Wei; Cong, Peiqing; He, Zuyong; Xiao, Shuqi; Liu, Xiaohong; Chen, Yaosheng

2013-02-01

Production of high-quality meat is important to satisfy the consumer and make the pig industry competitive. Obese and lean breeds of pig show clear differences in adipogenic capacity and meat quality, but the underlying molecular mechanism remains unclear. We have compared protein expression of the longissimus muscle between Lantang (LT, obese) and Landrace (LR, lean) pigs at the age of 180 days using two-dimensional fluorescence difference gel electrophoresis. Of the 1,400 protein spots detected per gel, 18 were differentially expressed between the two breeds. Using peptide mass fingerprint and tandem mass spectrometry, 17 protein spots were identified, corresponding to ten different proteins that could be divided into four groups: metabolism-related, structure-related, stress-related, and other (unclassified). Among the metabolism-related proteins, COX5A and ATP5B, which participate in oxidative phosphorylation, were highly expressed in LT, whereas ENO3, which is involved in glycolysis, was highly expressed in LR. These results may contribute valuable information to our understanding of the molecular mechanism responsible for differences between obese and lean pigs, such as growth rate and meat quality.

Calorie restriction-like effects of 30 days of resveratrol supplementation on energy metabolism and metabolic profile in obese humans

NARCIS (Netherlands)

Timmers, Silvie; Konings, Ellen; Bilet, Lena; Houtkooper, Riekelt H.; Weijer, van de Tineke; Hoeks, Joris; Krieken, van der Sophie; Ryu, Dongryeol; Kersten, Sander; Moonen-Kornips, Esther; Goossens, Gijs H.; Hesselink, Matthijs K.; Kunz, Iris; Schrauwen-Hinderling, Vera B.; Blaak, Ellen E.; Auwerx, Johan; Schrauwen, Patrick

2011-01-01

Resveratrol is a naturally occurring compound that profoundly affects energy metabolism and mitochondrial function and serves as a calorie restriction mimetic, at least in animal models of obesity. Here we treated 10 healthy, obese men with placebo and 150 mg/day resveratrol in a randomized

Physicians and Physician Trainees Rarely Identify or Address Overweight/Obesity in Hospitalized Children.

Science.gov (United States)

King, Marta A; Nkoy, Flory L; Maloney, Christopher G; Mihalopoulos, Nicole L

2015-10-01

To determine how frequently physicians identify and address overweight/obesity in hospitalized children and to compare physician documentation across training level (medical student, intern, resident, attending). We conducted a retrospective chart review. Using an administrative database, Centers for Disease Control and Prevention body mass index calculator, and random sampling technique, we identified a study population of 300 children aged 2-18 years with overweight/obesity hospitalized on the general medical service of a tertiary care pediatric hospital. We reviewed admission, progress, and discharge notes to determine how frequently physicians and physician trainees identified (documented in history, physical exam, or assessment) and addressed (documented in hospital or discharge plan) overweight/obesity. Physicians and physician trainees identified overweight/obesity in 8.3% (n = 25) and addressed it in 4% (n = 12) of 300 hospitalized children with overweight/obesity. Interns were most likely to document overweight/obesity in history (8.3% of the 266 patients they followed). Attendings were most likely to document overweight/obesity in physical examination (8.3%), assessment (4%), and plan (4%) of the 300 patients they followed. Medical students were least likely to document overweight/obesity including it in the assessment (0.4%) and plan (0.4%) of the 244 hospitalized children with overweight/obesity they followed. Physicians and physician trainees rarely identify or address overweight/obesity in hospitalized children. This represents a missed opportunity for both patient care and physician trainee education. Copyright © 2015 Elsevier Inc. All rights reserved.

Calorie Restriction-like Effects of 30 Days of Resveratrol Supplementation on Energy Metabolism and Metabolic Profile in Obese Humans

NARCIS (Netherlands)

Timmers, S.; Konings, E.; Bilet, L.; Houtkooper, R.H.; Weijer, van de T.; Goossens, G.H.; Hoeks, J.; Krieken, van der S.; Ryu, D.; Kersten, A.H.; Moonen-Kornips, E.; Hesselink, M.K.C.; Kunz, I.; Schrauwen-Hinderling, V.B.; Blaak, E.E.; Auwerx, J.; Schrauwen, P.

2011-01-01

Resveratrol is a natural compound that affects energy metabolism and mitochondrial function and serves as a calorie restriction mimetic, at least in animal models of obesity. Here, we treated 11 healthy, obese men with placebo and 150 mg/day resveratrol (resVida) in a randomized double-blind

Calorie restriction-like effects of 30 days of resveratrol supplementation on energy metabolism and metabolic profile in obese humans

NARCIS (Netherlands)

Timmers, Silvie; Konings, Ellen; Bilet, Lena; Houtkooper, Riekelt H.; van de Weijer, Tineke; Goossens, Gijs H.; Hoeks, Joris; van der Krieken, Sophie; Ryu, Dongryeol; Kersten, Sander; Moonen-Kornips, Esther; Hesselink, Matthijs K. C.; Kunz, Iris; Schrauwen-Hinderling, Vera B.; Blaak, Ellen E.; Auwerx, Johan; Schrauwen, Patrick

2011-01-01

Resveratrol is a natural compound that affects energy metabolism and mitochondrial function and serves as a calorie restriction mimetic, at least in animal models of obesity. Here, we treated 11 healthy, obese men with placebo and 150 mg/day resveratrol (resVida) in a randomized double-blind

Association of circulating adipokines with metabolic dyslipidemia in obese versus non-obese individuals.

Science.gov (United States)

Rahimlou, Mehran; Mirzaei, Khadijeh; Keshavarz, Seyed Ali; Hossein-Nezhad, Arash

2016-01-01

Previous studies have shown that circulating adipokines may play an important role in the pathogenesis of some obesity related chronic disease such as dyslipidemia and type2 diabetes mellitus. The aim of the present study was to investigate the association between vaspin, omentin-1 and retinol binding protein-4 levels with metabolic dyslipidemia (MD) criteria in obese and non-obese individuals. The study was conducted on 170 obese and 81 non-obese individuals. After collecting the blood samples, serum levels metabolic parameters as well as three circulating adipokines and body composition were measured. No significant difference was noted regarding the mean serum levels of omentin-1 and vaspin between the obese and non-obese groups, while, serum level of RBP4 was significantly higher in the non-obese group. We found the 0.22 increased risk of MD in obese individuals with higher RBP4 concentration. After the adjustment for confounding factors, this association was still significant. No significant association was noted between MD and its components relative risks with omentin-1 and vaspin levels. Our study demonstrated that circulating RBP4 was significantly higher in the obese individuals which may increase the risk of MD in them. Further researches are needed to address this association. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

The effect of educational intervention on weight loss in adolescents with overweight and obesity: Application of the theory of planned behavior

Directory of Open Access Journals (Sweden)

Seyed Saeed Mazloomy-Mahmoodabad

2017-07-01

Full Text Available BACKGROUND: The increased prevalence of overweight and obesity in children and adolescents is associated with type 2 diabetes, hypertension, dyslipidemia, and cardiovascular diseases. The theory of planned behavior (TPB efficiently explains the ability of perceived behavioral control and possibly attitude to enhance the motivations of the obese people to lose weight. Our aim was to investigate the effect of TPB-based education on weight loss in obese and overweight adolescents. METHODS: In an interventional study, simple random sampling was used to select 86 overweight and obese adolescents aged 13-18 years in the pediatric clinic at the Isfahan Cardiovascular Research Institute. Anthropometric measures and TPB constructs were collected using a researcher-made questionnaire. The questionnaires were filled out before and six weeks after the intervention. Participants received 5 sessions of training based on the constructs of the TPB. RESULTS: A significant increase was observed in the mean score for knowledge and TPB constructs (attitudes, subjective norms, perceived behavioral control, intention, and behavior six weeks after the educational intervention (P < 0.001. Moreover, significant decrease in body mass index (P < 0.001, weight (P = 0.001, and waist circumference (P < 0.001 of adolescents were found after the educational intervention. CONCLUSION: The TPB-based interventions seem to be effective in losing weight in obese and overweight adolescents. This theory serves as a helpful theoretical framework for health-related behaviors and can be an appropriate pattern to plan for educational interventions.   

77 FR 23747 - Notice of Availability of the Proposed John Day Basin Resource Management Plan and Final...

Science.gov (United States)

2012-04-20

... Management Plan (RMP)/Final Environmental Impact Statement (EIS) for the John Day Basin planning area and by... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLORP0000.16100000.DQ0000 LXSS053H0000 HAG10-0234] Notice of Availability of the Proposed John Day Basin Resource Management Plan and Final...

Dealer Group or Financial Planning Group? A Brief Technical Note

Directory of Open Access Journals (Sweden)

Lujer Santacruz

2011-06-01

Full Text Available This technical note examines whether the industry practice of using the term dealer group when referring to afinancial planning group contributes to the general perception that financial advisers are not objective whenmaking financial product recommendations. An experimental design carried out through an online survey isused. This is supplemented by a direct comparison survey on the two terminologies. The results provide acase for the industry to adopt a new terminology.

Chrono-nutrition: a review of current evidence from observational studies on global trends in time-of-day of energy intake and its association with obesity.

Science.gov (United States)

Almoosawi, S; Vingeliene, S; Karagounis, L G; Pot, G K

2016-11-01

The importance of the circadian rhythm in regulating human food intake behaviour and metabolism has long been recognised. However, little is known as to how energy intake is distributed over the day in existing populations, and its potential association with obesity. The present review describes global trends in time-of-day of energy intake in the general population based on data from cross-sectional surveys and longitudinal cohorts. Evidence of the association between time-of-day of energy intake and obesity is also summarised. Overall, there were a limited number of cross-sectional surveys and longitudinal cohorts that provided data on time-of-day of energy intake. In the identified studies, a wide variation in time-of-day of energy intake was observed, with patterns of energy distribution varying greatly by country and geographical area. In relation to obesity, eight cross-sectional surveys and two longitudinal cohorts were identified. The association between time-of-day of energy intake and obesity varied widely, with several studies reporting a positive link between evening energy intake and obesity. In conclusion, the current review summarises global trends in time-of-day of energy intake. The large variations across countries and global regions could have important implications to health, emphasising the need to understand the socio-environmental factors guiding such differences in eating patterns. Evidence of the association between time-of-day of energy intake and BMI also varied. Further larger scale collaborations between various countries and regions are needed to sum data from existing surveys and cohorts, and guide our understanding of the role of chrono-nutrition in health.

Seaweed Fucoxanthin Supplementation Improves Obesity Parameters in Mild Obese Japanese Subjects

Directory of Open Access Journals (Sweden)

Shoketsu Hitoe

2017-04-01

Full Text Available Background: Fucoxanthin is a seaweed xanthophyll that has demonstrated an anti-obesity effect in rodents. However,clinical investigations of its influence on mildly obese subjects has not been performed. We conducted a clinical trial of fucoxanthin supplementation in Japanese obese subjects.Methods: We examined the effect of fucoxanthin (1 or 3 mg daily in a double-blind placebo-controlled study. Capsules containing fucoxanthin or placebo capsules were administered for 4 weeks to male and female Japanese adults with a body mass index (BMI of more than 25 kg/m2. Before and after treatment, the body weight, body composition, abdominal fat area, and the circumferences of the neck, arm,and thigh were evaluated.Results: There was significant reduction of the relative (ratio versus before treatment body weight,BMI, and visceral fat area in the 3 mg/day fucoxanthin group compared to the placebo group. Relative values of total fat mass, subcutaneous fat area, waist circumference, and right thigh circumference were also significantly lower in the 1 mg/day fucoxanthin group than the placebo group. A significant decrease of the absoluteright thigh circumference was noted in the 1 mg/day fucoxanthin group compared to the placebo group. In the subjects ingesting fucoxanthin, there were no abnormalities of the blood pressure, pulse rate, blood parameters, and urinalysis parameters, which thereby suggests adverse effects.Conclusions: Fucoxanthin reduced body weight, BMI, and abdominal fat by acting on both visceraland subcutaneous fat. Consequently, Fucoxanthin may be able to improve a moderate overweight state in both men and women.

Increased in vivo glucose utilization in 30-day-old obese Zucker rat: Role of white adipose tissue

International Nuclear Information System (INIS)

Krief, S.; Bazin, R.; Dupuy, F.; Lavau, M.

1988-01-01

In vivo whole-body glucose utilization and uptake in multiple individual tissues were investigated in conscious 30-day-old Zucker rats, which when obese are hyperphagic, hyperinsulinemic, and normoglycemic. Whole-body glucose metabolism (assessed by [3- 3 H]glucose) was 40% higher in obese (fa/fa) than in lean (Fa/fa) rats, suggesting that obese rats were quite responsive to their hyperinsulinemia. In obese compared with lean rats, tissue glucose uptake was increased by 15, 12, and 6 times in dorsal, inguinal, perigonadal white depots, respectively; multiplied by 2.5 in brown adipose tissue; increased by 50% in skin from inguinal region but not in that from cranial, thoracic, or dorsal area; and increased twofold in diaphragm but similar in heart in proximal intestine, and in total muscular mass of limbs. The data establish that in young obese rats the hypertrophied white adipose tissue was a major glucose-utilizing tissue whose capacity for glucose disposal compared with that of half the muscular mass. Adipose tissue could therefore play an important role in the homeostasis of glucose in obese rats in the face of their increased carbohydrate intake

190-C Facility <90 Day Storage Pad training plan

International Nuclear Information System (INIS)

Little, N.C.

1996-12-01

This is the Environmental Restoration Contractor (ERC) team training plan for the 190-C Facility <90 Day Storage Pad of Hazardous Waste. It is intended to meet the requirements of Washington Administrative Code (WAC) 173-303-330 and the Hanford Dangerous Waste Permit. Training unrelated to compliance with WAC 173-303-330 is not addressed in this training plan. WAC 173-303-330(1)(d)(ii, v, vi) requires that personnel be familiarized, where applicable, with waste feed cut-off systems, response to ground-water contamination incidents, and shutdown of operations. These are not applicable to 190-C Facility <90 Day Storage Pad, and are therefore not covered in this training plan

OBESITY - STRATEGIES FOR THE PREVENTION

Directory of Open Access Journals (Sweden)

Alina-Costina LUCA

2014-12-01

Full Text Available The last decades there has been characterizes by a worrying rise in obesity among both adults and in children's services. Obesity is considered disease XXI century. Obesity includes a medical field which accumulates a major issue and objective public health in developed countries, a vital prognosis health problem in medical practice and, not least, an aesthetic problem, psychosocial implications. The word comes from the Latin obese, "obesus" = fat, corpulent. Since ancient times, 2,500 years ago, Hippocrates noticed danger overweight "corpulence is not only a disease itself, but is a risk factor." Subsequently, the Indian surgeon Sushruta (VI century BC noted connection between obesity and heart disease. In Europe in medieval and Renaissance, obesity was considered a sign of wealth and prosperity among senior officials.

The Prevalence of Obesity in First Year Primary School Students in Nine Districts of Ižzmir Province

Directory of Open Access Journals (Sweden)

Ebru Turhan

2014-03-01

Full Text Available Aim: Obesity and overweight are defined by the World Health Organization (WHO as %u2018%u2018abnormal or excessive fat accumulation that may impair health%u2019%u2019. The prevalence of childhood obesity and overweight has been increased worldwide in recent decades. To determine the prevalence of obesity in first year primary school students in nine districts of Ižzmir province. Material and Method: This study was planned as cross-sectional research, and performed on nine districts selected by simple random method in Izmir province (Aliaga, Beydag, Dikili, Foca, Guzelbahce, Kinik, Odemis, Seferihisar, Selcuk. The height and the weight figures of each child were noted and Z values were calculated with reference to WHO 2007 standards. Children whose Z scores of %u201Cheight for age%u201D ,%u201DBKIž for age%u201D and %u201Cweight for age%u201D are higher than 2 standard deviation were assessed as tall and obese. In analyzing data Chi-square test and t test were used. Statistical significance value was accepted as p

VA OpenNotes: exploring the experiences of early patient adopters with access to clinical notes.

Science.gov (United States)

Nazi, Kim M; Turvey, Carolyn L; Klein, Dawn M; Hogan, Timothy P; Woods, Susan S

2015-03-01

To explore the experience of early patient adopters who accessed their clinical notes online using the Blue Button feature of the My HealtheVet portal. A web-based survey of VA patient portal users from June 22 to September 15, 2013. 33.5% of respondents knew that clinical notes could be viewed, and nearly one in four (23.5%) said that they had viewed their notes at least once. The majority of VA Notes users agreed that accessing their notes will help them to do a better job of taking medications as prescribed (80.1%) and be better prepared for clinic visits (88.6%). Nine out of 10 users agreed that use of visit notes will help them understand their conditions better (91.8%), and better remember the plan for their care (91.9%). In contrast, 87% disagreed that VA Notes will make them worry more, and 88.4% disagreed that access to VA Notes will be more confusing than helpful. Users who had either contacted their provider or healthcare team (11.9%) or planned to (13.5%) primarily wanted to learn more about a health issue, medication, or test results (53.7%). Initial assessment of the patient experience within the first 9 months of availability provides evidence that patients both value and benefit from online access to clinical notes. These findings are congruent with OpenNotes study findings on a broader scale. Additional outreach and education is needed to enhance patient awareness. Healthcare professionals should author notes keeping in mind the opportunity patient access presents for enhanced communication. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Dietary supplementation of obese children with 1000 mg alpha-linolenic acid per day: a placebo-controlled double blind study].

Science.gov (United States)

Lohner, Szimonetta; Marosvölgyi, Tamás; Burus, István; Schmidt, János; Molnár, Dénes; Decsi, Tamás

2007-08-12

Enhanced dietary intake of omega-3 fatty acids may benefit persons with increased cardiovascular risk, among them obese subjects. Incorporation of omega-3 fatty acids into the plasma lipids is a prerequisite to achieve the favorable effects; however, only very few data are available on the dose of omega-3 fatty acid supplementation in children. The aim of our study was to examine the effects of the consumption of a diet supplemented with 1000 mg alpha-linolenic acid daily on plasma lipids in obese children. In this two times six-week-long, placebo-controlled, crossover study, 9 obese children (age: 13.1 [2.5] years, body mass index: 31.2 [6.2] kg/m 2 ), median [IQR]) incorporated into their diet one egg and one meatball (50 g) per day from hens fed diets containing flaxseed oil, i.e. supplementary dietary intake of 1000 mg alpha-linolenic acid per day was provided. The fatty acid composition of plasma lipids was determined by high-resolution gas-liquid chromatography. Tendencies of increase were observed in the alpha-linolenic acid content of plasma lipids in the phospholipid, triacyl-glycerine and sterol-ester fractions after the supplementation with alpha-linolenic acid. In the non-esterified fatty acid fraction, the values of alpha-linolenic acid were significantly higher after the supplementation (0.11 [0.08] versus 0.14 [0.20], % weight/weight, p < 0.05), indicating the beginning of the accumulation of alpha-linolenic acid in plasma lipids. In obese children a six-week-long supplementation of the diet with 1000 mg alpha-linolenic acid per day increased significantly the contribution of omega-3 fatty acids only to the non-esterified fatty acids of plasma lipids, but had no significant effect on the esterified fractions. Increase of the dose of supplementation may be needed to influence omega-3 fatty acid status in obese children.

Optimal day-ahead operational planning of microgrids

International Nuclear Information System (INIS)

Hosseinnezhad, Vahid; Rafiee, Mansour; Ahmadian, Mohammad; Siano, Pierluigi

2016-01-01

Highlights: • A new multi-objective model for optimal day-ahead operational planning of microgrids is proposed. • A new concept called seamlessness is introduced to control the sustainability of microgrid. • A new method is developed to manage the load and renewable energy resources estimation errors. • A new solution based on a combination of numerical and evolutionary approaches is proposed. - Abstract: Providing a cost-efficient, eco-friendly and sustainable energy is one of the main issues in modern societies. In response to this demand, new features of microgrid technology have provided huge potentials while distributing electricity more effectively, economically and securely. Accordingly, this paper presents a new multi-objective generation management model for optimal day-ahead operational planning of medium voltage microgrids. The proposed model optimizes both pollutant emission and operating cost of a microgrid by using multi-objective optimization. Besides, a seamlessness-selective algorithm is integrated into the model, which can be adopted to achieve the desired self-sufficiency level for microgrids along a specified planning horizon. Furthermore, the model is characterized by a reserve-assessment strategy developed to handle the load and renewable energy resources estimation errors. The introduced model is solved using a combination of numerical and evolutionary methods of species-based quantum particle swarm optimization to find the optimal scheduling scheme and minos-based optimal power flow to optimize the operating cost and emission. In addition, the suggested solution approach also incorporates an efficient mechanism for considering energy storage systems and coding the candidate solutions in the evolutionary algorithm. The proposed model is implemented on a test microgrid and is investigated through simulations to study the different aspects of the problem. The results show significant improvements and benefits which are obtained by

Obesity, stigma and public health planning.

Science.gov (United States)

MacLean, Lynne; Edwards, Nancy; Garrard, Michael; Sims-Jones, Nicki; Clinton, Kathryn; Ashley, Lisa

2009-03-01

Given the rise in obesity rates in North America, concerns about obesity-related costs to the health care system are being stressed in both the popular media and the scientific literature. With such constant calls to action, care must be taken not to increase stigmatization of obese people, particularly of children. While there is much written about stigma and how it is exacerbated, there are few guidelines for public health managers and practitioners who are attempting to design and implement obesity prevention programs that minimize stigma. We examine stigmatization of obese people and the consequences of this social process, and discuss how stigma is manifest in health service provision. We give suggestions for designing non-stigmatizing obesity prevention public health programs. Implications for practice and policy are discussed.

Effects of 2-day calorie restriction on cardiovascular autonomic response, mood, and cognitive and motor functions in obese young adult women.

Science.gov (United States)

Solianik, Rima; Sujeta, Artūras; Čekanauskaitė, Agnė

2018-06-02

Although long-term energy restriction has been widely investigated and has consistently induced improvements in health and cognitive and motor functions, the responses to short-duration calorie restriction are not completely understood. The purpose of this study was to investigate the effects of a 2-day very low-calorie diet on evoked stress, mood, and cognitive and motor functions in obese women. Nine obese women (body fatness > 32%) aged 22-31 years were tested under two randomly allocated conditions: 2-day very low-calorie diet (511 kcal) and 2-day usual diet. The perceived stressfulness of the diet, cardiovascular autonomic response, and cognitive and motor performances were evaluated before and after each diet. The subjective stress rating of the calorie-restricted diet was 41.5 ± 23.3. Calorie restriction had no detectable effects on the heart rate variability indices, mood, grip strength, or psychomotor functions. By contrast, calorie restriction increased (p restriction evoked moderate stress in obese women, cardiovascular autonomic function was not affected. Calorie restriction had complex effects on cognition: it declined cognitive flexibility, and improved spatial processing and visuospatial working memory, but did not affect mood or motor behavior.

Day-Ahead Energy Planning with 100% Electric Vehicle Penetration in the Nordic Region by 2050

Directory of Open Access Journals (Sweden)

Zhaoxi Liu

2014-03-01

Full Text Available This paper presents the day-ahead energy planning of passenger cars with 100% electric vehicle (EV penetration in the Nordic region by 2050. EVs will play an important role in the future energy systems which can both reduce the greenhouse gas (GHG emissions from the transport sector and provide the demand side flexibility required by smart grids. On the other hand, the EVs will increase the electricity consumption. In order to quantify the electricity consumption increase due to the 100% EV penetration in the Nordic region to facilitate the power system planning studies, the day-ahead energy planning of EVs has been investigated with different EV charging scenarios. Five EV charging scenarios have been considered in the energy planning analysis which are: uncontrolled charging all day, uncontrolled charging at home, timed charging, spot price based charging all day and spot price based charging at home. The demand profiles of the five charging analysis show that timed charging is the least favorable charging option and the spot priced based EV charging might induce high peak demands. The EV charging demand will have a considerable share of the energy consumption in the future Nordic power system.

New insights into the field of children and adolescents' obesity

DEFF Research Database (Denmark)

Flodmark, C-E; Lissau, I; Moreno, L A

2004-01-01

information about healthy nutrition and to avoid the marketing of unhealthy foods including sweet drinks, for example, in TV. Many different approaches of treatments of obesity have been investigated, including diet, exercise, behavioral therapy, surgery, and medication. None have been found to be effective......EDITOR'S NOTE: The problem of childhood obesity is accelerating throughout the world. The following is a position paper from The European Childhood Obesity Group (ECOG) that outlines the nature of the problem of childhood obesity along with treatment and prevention methods available today....... The paucity of literature on prevention and treatment of obesity in children as documented in this paper points out the need for much additional research on obesity in children. OBJECTIVES: The awareness of childhood obesity as a major health problem and an uncontrolled worldwide epidemic has to be increased...

Risk for obesity in adolescence starts in early childhood.

Science.gov (United States)

Shankaran, S; Bann, C; Das, A; Lester, B; Bada, H; Bauer, C R; La Gasse, L; Higgins, R D

2011-11-01

The objective of this study was to assess the predictive value of body mass index (BMI) at earlier ages on risk of overweight/obesity at age of 11 years. This is a longitudinal study of 907 children from birth to age of 11 years. Predictors include BMI at earlier ages and outcome is overweight/obesity status at age of 11 years. Analyses were adjusted for covariates known to affect BMI. At 11 years, 17% were overweight and 25% were obese. Children whose BMI was measured as ≥85th percentile once at preschool age had a twofold risk for overweight/obesity at 11 years of age. Risk increased by 11-fold if a child's BMI measured was noted more than once during this age. During early elementary years, if a child's BMI was>85th percentile once, risk for overweight/obesity at 11 years was fivefold and increased by 72-fold if noted more than two times. During late elementary years, if a child's BMI was>85th percentile once, risk for overweight/obesity was 26-fold and increased by 351-fold if noted more than two times. Risk of overweight/obesity at 11 years was noted with higher maternal prepregnancy weight, higher birth weight, female gender and increased television viewing. Children in higher BMI categories at young ages have a higher risk of overweight/obesity at 11 years of age. Effect size was greater for measurements taken closer to 11 years of age. Pediatricians need to identify children at-risk for adolescent obesity and initiate counseling and intervention at earlier ages.

Efficacy of low-calorie, partial meal replacement diet plans on weight and abdominal fat in obese subjects with metabolic syndrome: a double-blind, randomised controlled trial of two diet plans - one high in protein and one nutritionally balanced.

Science.gov (United States)

Lee, K; Lee, J; Bae, W K; Choi, J K; Kim, H J; Cho, B

2009-02-01

Little is known about the relative efficacy of high-protein vs. conventional diet plans that include partial meal replacements on body fat loss in obese subjects with metabolic syndrome. We aimed to evaluate the efficacy of two low-calorie diets with partial meal replacement plans-a high-protein plan (HP) and a nutritionally balanced conventional (C) plan-on reducing obesity in obese subjects with metabolic syndrome. In a 12-week, double-blind study, we randomised 75 participants to either the HP- or the C-plan group. We recorded key metrics at 0 and 12 weeks. The overall mean weight loss was 5 kg in the HP-plan group and 4.9 kg in the C-plan group (p = 0.72). Truncal fat mass decreased 1.6 kg in the HP-plan group (p or = 70% dietary compliance, however, truncal and whole body fat mass decreased more in the HP-plan group (Delta 2.2 kg and Delta 3.5 kg respectively) than in the C-plan group (Delta 1.3 kg and Delta 2.3 [corrected] kg respectively) (p < 0.05). The HP- and C-plans had a similar effect on weight and abdominal fat reduction, but the HP-plan was more effective in reducing body fat among compliant subjects.

A Community Based Systems Diagram of Obesity Causes.

Directory of Open Access Journals (Sweden)

Steven Allender

Full Text Available Application of system thinking to the development, implementation and evaluation of childhood obesity prevention efforts represents the cutting edge of community-based prevention. We report on an approach to developing a system oriented community perspective on the causes of obesity.Group model building sessions were conducted in a rural Australian community to address increasing childhood obesity. Stakeholders (n = 12 built a community model that progressed from connection circles to causal loop diagrams using scripts from the system dynamics literature. Participants began this work in identifying change over time in causes and effects of childhood obesity within their community. The initial causal loop diagram was then reviewed and elaborated by 50 community leaders over a full day session.The process created a causal loop diagram representing community perceptions of determinants and causes of obesity. The causal loop diagram can be broken down into four separate domains; social influences; fast food and junk food; participation in sport; and general physical activity.This causal loop diagram can provide the basis for community led planning of a prevention response that engages with multiple levels of existing settings and systems.

The Epigenomic Analysis of Human Obesity.

Science.gov (United States)

Bell, Christopher G

2017-09-01

Analysis of the epigenome-the chemical modifications and packaging of the genome that can influence or indicate its activity-enables molecular insight into cell type-specific machinery. It can, therefore, reveal the pathophysiological mechanisms at work in disease. Detected changes can also represent physiological responses to adverse environmental exposures, thus enabling the epigenetic mark of DNA methylation to act as an epidemiological biomarker, even in surrogate tissue. This makes epigenomic analysis an attractive prospect to further understand the pathobiology and epidemiological aspects of obesity. Furthermore, integrating epigenomic data with known obesity-associated common genetic variation can aid in deciphering their molecular mechanisms. This review primarily examines epidemiological or population-based studies of epigenetic modifications in relation to adiposity traits, as opposed to animal or cell models. It discusses recent work exploring the epigenome with respect to human obesity, which to date has predominately consisted of array-based studies of DNA methylation in peripheral blood. It is of note that highly replicated BMI DNA methylation associations are not causal, but strongly driven by coassociations for more precisely measured intertwined outcomes and factors, such as hyperlipidemia, hyperglycemia, and inflammation. Finally, the potential for the future exploration of the epigenome in obesity and related disorders is considered. © 2017 The Obesity Society.

Endoscopic Devices for Obesity.

Science.gov (United States)

Sampath, Kartik; Dinani, Amreen M; Rothstein, Richard I

2016-06-01

The obesity epidemic, recognized by the World Health Organization in 1997, refers to the rising incidence of obesity worldwide. Lifestyle modification and pharmacotherapy are often ineffective long-term solutions; bariatric surgery remains the gold standard for long-term obesity weight loss. Despite the reported benefits, it has been estimated that only 1% of obese patients will undergo surgery. Endoscopic treatment for obesity represents a potential cost-effective, accessible, minimally invasive procedure that can function as a bridge or alternative intervention to bariatric surgery. We review the current endoscopic bariatric devices including space occupying devices, endoscopic gastroplasty, aspiration technology, post-bariatric surgery endoscopic revision, and obesity-related NOTES procedures. Given the diverse devices already FDA approved and in development, we discuss the future directions of endoscopic therapies for obesity.

<90 day storage training plan for the 103-B, 1701-BA, AND 1714-C buildings

International Nuclear Information System (INIS)

Snider, P.M.

1996-10-01

The 103-B, 1701-BA, and 1714C < 90 Day Storage Area stores characteristic wastes generated in the demolition of the 103-B, 1701-BA, and 1714-C Complex. Wastes (lead-based painted components) are packaged and stored in vendor shipment containers. This is the Environmental Restoration Contractor team training plan for the 103-B, 1701-BA, and 1714-C subgrade demolition < 90 Day Storage of Hazardous Waste. This document is intended to meet the requirements of Washington Administrative Code 173-303-330 and the Hanford Dangerous Waste Permit. Training unrelated to compliance with WAC 173-303-330 is not addressed in this training plan. WAC 173-303-330(1)(d)(2, 5, 6) requires that personnel be familiarized, where applicable, with waste feed cut-off systems, response to ground-water contamination incidents, and shutdown of operations. These are not applicable to 103-B, 1701-BA, and 1714-C Subgrade Demolition < 90 Day Storage, and therefore are not covered in this training plan

A pilot study on the evaluation of medical student documentation: assessment of SOAP notes

Directory of Open Access Journals (Sweden)

Ji-Hyun Seo

2016-06-01

Full Text Available Purpose: The purpose of this study was evaluation of the current status of medical students' documentation of patient medical records. Methods: We checked the completeness, appropriateness, and accuracy of 95 Subjective-Objective-Assessment-Plan (SOAP notes documented by third-year medical students who participated in clinical skill tests on December 1, 2014. Students were required to complete the SOAP note within 15 minutes of an standard patient (SP-encounter with a SP complaining rhinorrhea and warring about meningitis. Results: Of the 95 SOAP notes reviewed, 36.8% were not signed. Only 27.4% documented the patient’s symptoms under the Objective component, although all students completed the Subjective notes appropriately. A possible diagnosis was assessed by 94.7% students. Plans were described in 94.7% of the SOAP notes. Over half the students planned workups (56.7% for diagnosis and treatment (52.6%. Accurate documentation of the symptoms, physical findings, diagnoses, and plans were provided in 78.9%, 9.5%, 62.1%, and 38.0% notes, respectively. Conclusion: Our results showed that third-year medical students’ SOAP notes were not complete, appropriate, or accurate. The most significant problems with completeness were the omission of students’ signatures, and inappropriate documentation of the physical examinations conducted. An education and assessment program for complete and accurate medical recording has to be developed.

On the occasion of world kidney day 2017; obesity and its relationship with chronic kidney disease.

Science.gov (United States)

Mahmoodnia, Leila; Tamadon, Mohammad Reza

2017-07-01

Numerous studies have reported the impact of obesity in the incidence of chronic kidney disease (CKD). Some studies have suggested the direct role of obesity in the incidence of CKD, while some other studies suggest an indirect effect caused by the effects of obesity on blood pressure and diabetes. PubMed, EBSCO, Web of Science, directory of open access journals (DOAJ), EMBASE, and Google Scholar have been searched. Recent studies have presented more strong evidences on the role of obesity on the incidence of CKD. The double role of obesity in the incidence of CKD has also been mentioned in some studies. Such an additional effect arises from the impact of obesity on the incidence of some conditions and diseases such as cardiovascular disease, hypertension, and diabetes, which in turn are involved in the incidence of CKD and are considered as its risk factors.

Unprompted generation of obesity stereotypes.

Science.gov (United States)

Horsburgh-McLeod, G; Latner, J D; O'Brien, K S

2009-01-01

Prejudice towards obese people is widespread and has negative consequences for individuals with obesity. The present study covertly examined whether participants spontaneously generate different written transcript content (i.e., more negative stereotypes) when presented with a picture of an obese person or a normal-weight person. Two pictures of young women were computer generated to appear identical in all features except for body shape, which was either obese or normal-weight. Forty-nine women blind to the nature of the study were randomized to receive either the obese or normal-weight picture and asked to write a free-response description of a typical "day in the life" of the woman depicted. Independent coding of the transcripts revealed more frequent negative stereotypes and more negative valence generated by participants asked to describe a typical day of the obese target. These differences are consistent with the prevalent negative stereotypes of obese individuals.

Superstorm Sandy's forgotten patient: a lesson in emergency preparedness in severe obesity.

Science.gov (United States)

Ramme, Austin J; Vira, Shaleen; McLaurin, Toni M

2015-02-01

Superstorm Sandy gained national attention in late 2012 after its impact on the Northeastern US. In New York City, thousands of residents lost power, and multiple hospitals were forced to evacuate. Bellevue Hospital Center (BHC), the nation's oldest public hospital, was forced to close for the first time in over 275 years. Two patients remained in BHC three days after the primary evacuation without water service and minimal power. Herein, we describe the challenges associated with evacuating a severely obese patient. Obesity management is challenging and at an institutional level must be addressed in emergency preparedness plans. © 2014 The Obesity Society.

Impact of education on obesity and blood pressure in developing countries: A study on the Ibos of Nigeria.

Science.gov (United States)

Anyanwu, Godson Emeka; Ekezie, Jervase; Danborno, Barnabas; Ugochukwu, Anthony Ikemefuna

2010-07-01

Increase in the prevalence of hypertension, obesity and obesity related diseases has become significant cause of disability and premature death in both developing and newly developed countries, with over bearing demand on national health budgets. To evaluate the impact of various levels of education on obesity and blood pressure. 325 male and 254 female Nigerians of ages 20-80 years of the Ibo ethnicity through random sampling, were selected for this study. The participants were broken into three major groups based on their educational levels; primary, secondary and tertiary levels. systolic and diastolic blood pressure (SBP & DBP) levels, body mass index (BMI), waist hip ratio (WHR), waist height ratio (WHtR), waist circumference (WC),various skin fold thicknesses, and other anthropometric parameters were measured. For all the indicators of subcutaneous fat, general obesity, and central obesity, largest mean deposition was noted to be highest in the lowest education group and least in the highest education group. Mean blood pressure parameters were also highest in the least education group. While fat deposition was noted to be highest in all the females of all the groups, the males showed larger mean BP values. Education was noted to have a significant inverse relationship with most of the fat indicators and blood pressure parameters and cardiovascular disease risk highest in the least education groups. Education showed a significant impact on obesity and blood pressure and could be one of the major tools to reduce the high prevalence of obesity, hypertension and other obesity associated diseases.

Readmission rates after a planned hospital stay of 2 versus 3 days in fast-track colonic surgery

DEFF Research Database (Denmark)

Andersen, Jens; Hjort-Jakobsen, Dorthe; Christiansen, P. S.

2007-01-01

BACKGROUND: Initial programmes of fast-track open colonic surgery with a planned 2-day postoperative hospital stay have had a high readmission rate (about 20 per cent). The aim of this large, consecutive series was to compare readmission rates after a fast-track open colonic surgery programme....... There was no difference in type and incidence of morbidity between the two periods. CONCLUSION: Readmission after fast-track open colonic resection was reduced by planning discharge 3 instead of 2 days after surgery, with the same discharge criteria. Copyright (c) 2007 British Journal of Surgery Society Ltd. Published...... from August 2004. All patients were examined 8 and 30 days after surgery. RESULTS: Readmission rates fell from 20.1 per cent in 408 patients with a planned 2-day hospital stay (period 1) to 11.3 per cent in 133 patients with a planned 3-day hospital stay (period 2) (P

Comparison of a Restricted and Unrestricted Vegan Diet Plan with a Restricted Omnivorous Diet Plan on Health-Specific Measures.

Science.gov (United States)

Bloomer, Richard J; Gunnels, Trint A; Schriefer, JohnHenry M

2015-07-14

We have previously noted beneficial health outcomes when individuals follow a dietary restriction plan in accordance with the Daniel Fast (DF). This is true whether individuals eliminate all animal products or include small amounts of meat and dairy in their plan. The present study sought to compare anthropometric and biochemical measures of health in individuals following a traditional DF (i.e., restricted vegan) or modified DF (i.e., restricted omnivorous; inclusive of ad libitum meat and skim milk consumption), with those following an unrestricted vegan diet plan. 35 subjects (six men; 29 women; 33 ± 2 years; range: 18-67 years) completed a 21-day diet plan. Subjects reported to the lab for pre- (day 1) and post-intervention testing (day 22) in a 10 h fasted state. Blood samples were collected and assayed for complete blood count, metabolic panel, lipid panel, insulin, HOMA-IR, C-reactive protein, and oxidative stress biomarkers (malondialdehyde, advanced oxidation protein products, and nitrate/nitrite). Heart rate and blood pressure were measured and body composition was determined via dual energy X-ray absorptiometry. Subjects' self-reported compliance, mental and physical health, and satiety in relation to the dietary modification were recorded. No interaction effects were noted for our outcome measures (p > 0.05). However, subjects in the traditional DF group reported an approximate 10% increase in perceived mental and physical health, with a 25% reduction in malondialdehyde and a 33% reduction in blood insulin. Systolic BP was reduced approximately 7 mmHg in subjects assigned to the traditional DF, with an approximate 5 mmHg reduction in subjects assigned to the modified DF and the unrestricted vegan plan. A small (2 mmHg) reduction in diastolic BP was noted for subjects in both DF groups; a slight increase in diastolic BP was noted for subjects assigned to the unrestricted vegan group. An approximate 20% reduction was noted in total and LDL cholesterol

Comparison of a Restricted and Unrestricted Vegan Diet Plan with a Restricted Omnivorous Diet Plan on Health-Specific Measures

Science.gov (United States)

Bloomer, Richard J.; Gunnels, Trint A.; Schriefer, JohnHenry M.

2015-01-01

Background: We have previously noted beneficial health outcomes when individuals follow a dietary restriction plan in accordance with the Daniel Fast (DF). This is true whether individuals eliminate all animal products or include small amounts of meat and dairy in their plan. The present study sought to compare anthropometric and biochemical measures of health in individuals following a traditional DF (i.e., restricted vegan) or modified DF (i.e., restricted omnivorous; inclusive of ad libitum meat and skim milk consumption), with those following an unrestricted vegan diet plan. Methods: 35 subjects (six men; 29 women; 33 ± 2 years; range: 18–67 years) completed a 21-day diet plan. Subjects reported to the lab for pre- (day 1) and post-intervention testing (day 22) in a 10 h fasted state. Blood samples were collected and assayed for complete blood count, metabolic panel, lipid panel, insulin, HOMA-IR, C-reactive protein, and oxidative stress biomarkers (malondialdehyde, advanced oxidation protein products, and nitrate/nitrite). Heart rate and blood pressure were measured and body composition was determined via dual energy X-ray absorptiometry. Subjects’ self-reported compliance, mental and physical health, and satiety in relation to the dietary modification were recorded. Results: No interaction effects were noted for our outcome measures (p > 0.05). However, subjects in the traditional DF group reported an approximate 10% increase in perceived mental and physical health, with a 25% reduction in malondialdehyde and a 33% reduction in blood insulin. Systolic BP was reduced approximately 7 mmHg in subjects assigned to the traditional DF, with an approximate 5 mmHg reduction in subjects assigned to the modified DF and the unrestricted vegan plan. A small (2 mmHg) reduction in diastolic BP was noted for subjects in both DF groups; a slight increase in diastolic BP was noted for subjects assigned to the unrestricted vegan group. An approximate 20% reduction was

Comparison of a Restricted and Unrestricted Vegan Diet Plan with a Restricted Omnivorous Diet Plan on Health-Specific Measures

Directory of Open Access Journals (Sweden)

Richard J. Bloomer

2015-07-01

Full Text Available Background: We have previously noted beneficial health outcomes when individuals follow a dietary restriction plan in accordance with the Daniel Fast (DF. This is true whether individuals eliminate all animal products or include small amounts of meat and dairy in their plan. The present study sought to compare anthropometric and biochemical measures of health in individuals following a traditional DF (i.e., restricted vegan or modified DF (i.e., restricted omnivorous; inclusive of ad libitum meat and skim milk consumption, with those following an unrestricted vegan diet plan. Methods: 35 subjects (six men; 29 women; 33 ± 2 years; range: 18–67 years completed a 21-day diet plan. Subjects reported to the lab for pre- (day 1 and post-intervention testing (day 22 in a 10 h fasted state. Blood samples were collected and assayed for complete blood count, metabolic panel, lipid panel, insulin, HOMA-IR, C-reactive protein, and oxidative stress biomarkers (malondialdehyde, advanced oxidation protein products, and nitrate/nitrite. Heart rate and blood pressure were measured and body composition was determined via dual energy X-ray absorptiometry. Subjects’ self-reported compliance, mental and physical health, and satiety in relation to the dietary modification were recorded. Results: No interaction effects were noted for our outcome measures (p > 0.05. However, subjects in the traditional DF group reported an approximate 10% increase in perceived mental and physical health, with a 25% reduction in malondialdehyde and a 33% reduction in blood insulin. Systolic BP was reduced approximately 7 mmHg in subjects assigned to the traditional DF, with an approximate 5 mmHg reduction in subjects assigned to the modified DF and the unrestricted vegan plan. A small (2 mmHg reduction in diastolic BP was noted for subjects in both DF groups; a slight increase in diastolic BP was noted for subjects assigned to the unrestricted vegan group. An approximate 20

Obesity Disrupts the Rhythmic Profiles of Maternal and Fetal Progesterone in Rat Pregnancy.

Science.gov (United States)

Crew, Rachael C; Mark, Peter J; Clarke, Michael W; Waddell, Brendan J

2016-09-01

Maternal obesity increases the risk of abnormal fetal growth, but the underlying mechanisms remain unclear. Because steroid hormones regulate fetal growth, and both pregnancy and obesity markedly alter circadian biology, we hypothesized that maternal obesity disrupts the normal rhythmic profiles of steroid hormones in rat pregnancy. Obesity was established by cafeteria (CAF) feeding for 8 wk prior to mating and throughout pregnancy. Control (CON) animals had ad libitum access to chow. Daily profiles of plasma corticosterone, 11-dehydrocorticosterone, progesterone, and testosterone were measured at Days 15 and 21 of gestation (term = 23 days) in maternal (both days) and fetal (Day 21) plasma. CAF mothers exhibited increased adiposity relative to CON and showed fetal and placental growth restriction. There was no change, however, in total fetal or placental mass due to slightly larger litter sizes in CAF. Nocturnal declines in progesterone were observed in maternal (39% lower) and fetal (45% lower) plasma in CON animals, but these were absent in CAF animals. CAF mothers were hyperlipidemic at both days of gestation, but this effect was isolated to the dark period at Day 21. CAF maternal testosterone was slightly lower at Day 15 (8%) but increased above CON by Day 21 (16%). Despite elevated maternal testosterone, male fetal testosterone was suppressed by obesity on Day 21. Neither maternal nor fetal glucocorticoid profiles were affected by obesity. In conclusion, obesity disrupts rhythmic profiles of maternal and fetal progesterone, preventing the normal nocturnal decline. Obesity subtly changed testosterone profiles but did not alter maternal and fetal glucocorticoids. © 2016 by the Society for the Study of Reproduction, Inc.

Thirty days of resveratrol supplementation does not affect postprandial incretin hormone responses, but suppresses postprandial glucagon in obese subjects

DEFF Research Database (Denmark)

Knop, F K; Konings, E; Timmers, S

2013-01-01

AIMS: Resveratrol, a natural polyphenolic compound produced by various plants (e.g. red grapes) and found in red wine, has glucose-lowering effects in humans and rodent models of obesity and/or diabetes. The mechanisms behind these effects have been suggested to include resveratrol......-induced secretion of the gut incretin hormone glucagon-like peptide-1. We investigated postprandial incretin hormone and glucagon responses in obese human subjects before and after 30 days of resveratrol supplementation. METHODS: Postprandial plasma responses of the incretin hormones glucagon-like peptide-1...... and glucose-dependent insulinotropic polypeptide and glucagon were evaluated in 10 obese men [subjects characteristics (mean ± standard error of the mean): age 52 ± 2 years; BMI 32 ± 1 kg/m(2) , fasting plasma glucose 5.5 ± 0.1 mmol/l] who had been given a dietary supplement of resveratrol (Resvida(®) 150 mg...

Evaluation overview for the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) project.

Science.gov (United States)

Davison, Kirsten K; Falbe, Jennifer; Taveras, Elsie M; Gortmaker, Steve; Kulldorff, Martin; Perkins, Meghan; Blaine, Rachel E; Franckle, Rebecca L; Ganter, Claudia; Baidal, Jennifer Woo; Kwass, Jo-Ann; Buszkiewicz, James; Smith, Lauren; Land, Thomas

2015-02-01

The Massachusetts Childhood Obesity Research Demonstration (MA-CORD) project is a 2-year, multilevel, multisector community intervention to prevent and control obesity among children 2-12 years of age from two predominantly low-income communities in Massachusetts. MA-CORD includes evidence-based interventions in multiple sectors, including community health centers, early care and education centers, schools, afterschool programs, the Special Supplemental Nutrition Program for Women, Infants and Children, and the broader community. Currently, implementation of MA-CORD is complete and the final year of data collection is in progress. Here, the MA-CORD evaluation plan is described and baseline data are presented. The impact of MA-CORD on children's BMI, lifestyle behaviors, obesity-related care, and quality of life will be assessed using sector-specific, pre/post, time-series, and quasi-experimental designs. Change in the primary outcomes will be compared for intervention and comparison communities. Additionally, change in mean BMI and obesity prevalence in intervention school districts will be compared to similar districts throughout the state. At baseline in 2012, approximately 16% of preschool-aged and 25% of school-aged children were obese. Moreover, 15-40% of children consumed no vegetables on the previous day, 25-75% drank a sugar-sweetened beverage on the previous day, up to 87% had insufficient physical activity, 50-75% had a television in the room where they slept, and 50-80% obtained insufficient sleep. There is ample room for improvement in BMI and health behaviors in children in MA-CORD communities. If successful, MA-CORD may serve as a model for multilevel, multisector approaches to childhood obesity prevention and control.

Orthopedic trauma surgery in the morbidly obese patient.

Science.gov (United States)

Bozzio, Anthony E; Gala, Raj J; Villasenor, Mario A; Hao, Jiandon; Mauffrey, Cyril

2014-05-01

The treatment of morbidly obese patients in orthopedic trauma differs in many ways compared to injured patients with normal body mass indices. This paper highlights key differences and ways to overcome obstacles. We present specific tips, as well as considerations for initial planning, positioning for surgery, intra-operative strategies, and a discussion on both anesthesia and imaging. Several treatment strategies have been shown to have better results in morbidly obese patients. Pre-operative planning is necessary for minimizing risk to the patient. The prevalence of morbid obesity has increased in the USA in the past quarter century. Treatment for orthopedic injuries in morbidly obese patients requires a multidisciplinary approach that addresses not only their orthopedic injuries, but also medical co-morbidities. A team of medicine doctors, anesthesiologists, X-ray technicians, physical and occupational therapists, respiratory therapists, and social workers is needed in addition to the orthopedic surgeon. Modifications in both pre-operative planning and intra-operative strategies may be necessary in order to accommodate the patient. This paper presents numerous technical tips that can aid in providing stable fixation for fractures, as well as addressing peri-operative issues specific to the morbidly obese.

[The current state of obesity in Mexico].

Science.gov (United States)

Barrera-Cruz, Antonio; Rodríguez-González, Arturo; Molina-Ayala, Mario Antonio

2013-01-01

Excess weight (overweight and obesity) is currently recognized as one of the most important challenges of public health in the world, given its size, speed of growth, and the negative effect on the population who suffers it. Overweight and obesity increases significantly the risk of chronic non-communicable diseases, and premature mortality, as well as the social cost of health. Today, Mexico has the second global prevalence of obesity in the adult population (30 %), which is ten times higher than Korea's or Japan's (4 %). Until 2012, 26 million Mexican adults were overweight, and 22 million, obese. This implies a major challenge for the health sector. Mexico needs to plan and implement strategies and cost-effective actions for the prevention and control of obesity in children, adolescents, and adults. Global experience shows that proper care of obesity and overweight demands to formulate and coordinate efficient multi-sectoral strategies for enhancing protective factors to health, particularly to modify individual behavior, family and community.

Day-Ahead Energy Planning with 100% Electric Vehicle Penetration in the Nordic Region by 2050

DEFF Research Database (Denmark)

Liu, Zhaoxi; Wu, Qiuwei; Nielsen, Arne Hejde

2014-01-01

This paper presents the day-ahead energy planning of passenger cars with 100% electric vehicle (EV) penetration in the Nordic region by 2050. EVs will play an important role in the future energy systems which can both reduce the greenhouse gas (GHG) emission from the transport sector and provide...... demand side flexibility required by the smart grids. On the other hand, the EVs will increase the electricity consumption. In order to quantify the electricity consumption increase due to the 100% EV penetration in the Nordic region to facilitate the power system planning studies, the day-ahead energy...

Endovascular Treatment of Autogenous Radiocephalic Fistulas with the 'Eighth Note' Deformity for Hemodialysis

International Nuclear Information System (INIS)

Weng Meijui; Chen, Matt Chiung-Yu; Chi Wenche; Liu Yichun; Chien Kofen; Liang Hueilung; Pan, Huay-Ben

2010-01-01

The purpose of this paper is to describe a unique 'eighth note' deformity of the autogenous radiocephalic fistula for hemodialysis and to retrospectively evaluate the efficacy and safety of its endovascular treatment. Over 3 years, a total of 808 patients and 558 autogenous radiocephalic fistulas were treated for vascular access dysfunction or thrombosis. These included 14 fistulas in 14 patients (9 men, 5 women; mean age, 58.2 ± 2.8 years; range 27-79 years) whose fistulograms before treatment resembled a musical note, the eighth note. Endovascular treatment sought to remodel the deformed vascular access to a classic radiocephalic fistula and increase the number of cannulation sites available for hemodialysis. The technical and clinical success rates were each 92.8% (13/14). Fistula remodeling was successful in 13 patients. The postintervention primary patency was 100% at 90 days, 91.7 ± 0.8% at 120 days, 78.6 ± 13.9% at 180 days, 62.9 ± 17.9% at 360 days, 31.4 ± 24.0% at 540 days, and 0% at 720 days. The postintervention secondary patency was 100% at 90 days, 100% at 120 days, 100% at 180 days, 85.7 ± 13.2% at 360 days, and 85.7 ± 13.2% at 720 days. No major complications were noted. Minor complications were found in 71.4% of patients, all of which resolved spontaneously. In conclusion, endovascular treatment of fistulas with the eighth note deformity can effectively increase the number of available cannulation sites, facilitate fistula maturation, and facilitate thromboaspiration after fistula thrombosis.

Readmission rates after a planned hospital stay of 2 versus 3 days in fast-track colonic surgery

DEFF Research Database (Denmark)

Andersen, Jens; Hjort-Jakobsen, Dorthe; Christiansen, P. S.

2007-01-01

BACKGROUND: Initial programmes of fast-track open colonic surgery with a planned 2-day postoperative hospital stay have had a high readmission rate (about 20 per cent). The aim of this large, consecutive series was to compare readmission rates after a fast-track open colonic surgery programme...... from August 2004. All patients were examined 8 and 30 days after surgery. RESULTS: Readmission rates fell from 20.1 per cent in 408 patients with a planned 2-day hospital stay (period 1) to 11.3 per cent in 133 patients with a planned 3-day hospital stay (period 2) (P ... hospital stay was 2 and 3 days, median stay after readmission was 5 and 5.5 days, and median (mean) total stay was 3 (5.6) and 3 (5.7) days in periods 1 and 2 respectively. The readmission rate in period 2 was lower because there were fewer readmissions for short-term observation or social reasons...

The cost of obesity for nonbariatric inpatient operative procedures in the United States: national cost estimates obese versus nonobese patients.

Science.gov (United States)

Mason, Rodney J; Moroney, Jolene R; Berne, Thomas V

2013-10-01

To evaluate the economic impact of obesity on hospital costs associated with the commonest nonbariatric, nonobstetrical surgical procedures. Health care costs and obesity are both rising. Nonsurgical costs associated with obesity are well documented but surgical costs are not. National cost estimates were calculated from the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) database, 2005-2009, for the highest volume nonbariatric nonobstetric procedures. Obesity was identified from the HCUP-NIS severity data file comorbidity index. Costs for obese patients were compared with those for nonobese patients. To control for medical complexity, each obese patient was matched one-to-one with a nonobese patient using age, sex, race, and 28 comorbid defined elements. Of 2,309,699 procedures, 439,8129 (19%) were successfully matched into 2 medically equal groups (obese vs nonobese). Adjusted total hospital costs incurred by obese patients were 3.7% higher with a significantly (P cost of $648 (95% confidence interval [CI]: $556-$736) compared with nonobese patients. Of the 2 major components of hospital costs, length of stay was significantly increased in obese patients (mean difference = 0.0253 days, 95% CI: 0.0225-0.0282) and resource utilization determined by costs per day were greater in obese patients due to an increased number of diagnostic and therapeutic procedures needed postoperatively (odds ratio [OR] = 0.94, 95% CI: 0.93-0.96). Postoperative complications were equivalent in both groups (OR = 0.97, 95% CI: 0.93-1.02). Annual national hospital expenditures for the largest volume surgical procedures is an estimated $160 million higher in obese than in a comparative group of nonobese patients.

Obesity Prevention from Conception: A Workshop to Guide the Development of a Pan-Canadian Trial Targeting the Gestational Period

Directory of Open Access Journals (Sweden)

Kristi B. Adamo

2014-01-01

Full Text Available This report summarizes a meeting, Obesity Prevention from Conception , held in Ottawa in 2012. This planning workshop was funded by the Canadian Institutes of Health Research (CIHR to bring together researchers with expertise in the area of maternal obesity (OB and weight gain in pregnancy and pregnancy-related disease to attend a one-day workshop and symposium to discuss the development of a cross-Canada lifestyle intervention trial for targeting pregnant women. This future intervention will aim to reduce downstream OB in children through encouraging appropriate weight gain during the mother's pregnancy. The workshop served to (i inform the development of a lifestyle intervention for women with a high pre-pregnancy body mass index (BMI, (ii identify site investigators across Canada, and (iii guide the development of a grant proposal focusing on the health of mom and baby. A brief summary of the presentations as well as the focus groups is presented for use in planning future research.

Laparoscopic colectomy in the obese, morbidly obese, and super morbidly obese: when does weight matter?

Science.gov (United States)

Champagne, Bradley J; Nishtala, Madhuri; Brady, Justin T; Crawshaw, Benjamin P; Franklin, Morris E; Delaney, Conor P; Steele, Scott R

2017-10-01

Previous studies have demonstrated that obese patients (BMI >30) undergoing laparoscopic colectomy have longer operative times and increased complications when compared to non-obese cohorts. However, there is little data that specifically evaluates the outcomes of obese patients based on the degree of their obesity. The aim of this study was to evaluate the impact of increasing severity of obesity on patients undergoing laparoscopic colectomy. A retrospective review was performed of all patients undergoing laparoscopic colectomy between 1996 and 2013. Patients were classified according to their BMI as obese (BMI 30.0-39.9), morbidly obese (BMI 40.0-49.9), and super obese (BMI >50). Main outcome measures included conversion rate, operative time, estimated blood loss, post-operative complications, and length of stay. There were 923 patients who met inclusion criteria. Overall, 604 (65.4%), 257 (27.9%), and 62 (6.7%) were classified as obese (O), morbidly obese (MO), and super obese (SO), respectively. Clinicopathologic characteristics were similar among the three groups. The SO group had significantly higher conversion rates (17.7 vs. 7 vs. 4.8%; P = 0.031), longer average hospital stays (7.1 days vs. 4.9 vs. 3.4; P = 0.001), higher morbidity (40.3 vs. 16.3 vs. 12.4%; P = 0.001), and longer operative times (206 min vs. 184 vs. 163; P = 0.04) compared to the MO and O groups, respectively. The anastomotic leak rate in the SO (4.8%; P = 0.027) and MO males (4.1%; P = 0.033) was significantly higher than MO females (2.2%) and all obese patients (1.8%). Increasing severity of obesity is associated with worse perioperative outcomes following laparoscopic colectomy.

Does obesity compromise ovarian reserve markers? A clinician's perspective.

Science.gov (United States)

Malhotra, Neena; Bahadur, Anupama; Singh, Neeta; Kalaivani, Mani; Mittal, Suneeta

2013-01-01

The aim of the study was to ascertain if increasing body mass index (BMI) adversely affects ovarian reserve among infertile women of Asian origin undergoing in vitro fertilization (IVF). This prospective study on 183 women was carried out in the infertility clinic of All India Institute of Medical Sciences, New Delhi, India. Blood hormonal assay in all patients including follicle-stimulating hormone (FSH), luteinizing hormone (LH) and inhibin B was performed on day 2/3 of a spontaneous cycle. A transvaginal ultrasonographic examination on day 2-5 of the menstrual cycle was done for antral follicle count (AFC) and ovarian volume. A correlation between BMI and ovarian reserve parameters like FSH, LH, inhibin B, antral follicle count and ovarian volume was noted. Age was comparable in the three BMI groups. The mean duration of infertility was 8.38 years. Compared to the normal weight, the overweight and obese women had a statistically significantly low inhibin B (p women had a significantly low AFC (p right side. Incorporating anti-mullerian hormone, a newer marker for ovarian reserve, may benefit these obese infertile women. Further work is required to elucidate the mechanisms underlying the effect of obesity on inhibin B as a marker of ovarian reserve in infertile women. The best marker to check the ovarian reserve is perhaps the woman's performance during an IVF cycle. However, considering the psychological and financial stress of the procedure, it may seem wise to consider counseling of obese women on their expected performance in the first cycle of IVF through such studies.

Prevalence of adolescent obesity at a high school in the City of Tshwane

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Nomusa A. Ngwenya

2017-05-01

Conclusion: Evidence-based prevalence allowed for conceptualisation of the scope of the obesity epidemic and how children and young people are also affected. To enable proper planning for adolescent obesity interventions, the depth of consequences of obesity for the adolescent cohort should be well defined and clarified.

A Test of the Theory of Planned Behavior to Predict Physical Activity in an Overweight/Obese Population Sample of Adolescents from Alberta, Canada

Science.gov (United States)

Plotnikoff, Ronald C.; Lubans, David R.; Costigan, Sarah A.; McCargar, Linda

2013-01-01

Purpose: To examine the utility of the theory of planned behavior (TPB) for explaining physical activity (PA) intention and behavior among a large population sample of overweight and obese adolescents (Alberta, Canada), using a web-based survey. Secondary objectives were to examine the mediating effects of the TPB constructs and moderating effects…

[Obesity in children. Current concerns].

Science.gov (United States)

Casado de Frías, Enrique

2006-01-01

In the last years there has been a growing interest in chilhood obesity in all developed countries. There is a great concern that is prevalence has raised 2-3 fold during the last 20 years. In the spanish chilhood population the obesity prevalence is estimated around 13%. Of note also, a number of other pathologies develop concomitantly with obesity during chilhood. These include type 2 diabetes, a range of respiratory problems, a metabolic syndrome, liver steatosis and seudotumor cerebri among others. Taking for granted that chilhood obesity in its roots is an exogenous disorder, preventive interventions should focus on modifying those ethiologies, improving the ways and nature of chilhood nutrition and its social and ludic behaviours.

The association of obesity and school absenteeism attributed to illness or injury among adolescents in the United States, 2009.

Science.gov (United States)

Pan, Liping; Sherry, Bettylou; Park, Sohyun; Blanck, Heidi M

2013-01-01

School attendance can impact academic performance. Childhood obesity-related physical and psychosocial consequences are potentially associated with school absenteeism. Thus, we examined the association between school absenteeism attributed to illness or injury and obesity among adolescents aged 12-17 years. We used a weighted sample of 3,470 U.S. adolescents from the 2009 National Health Interview Survey. School absenteeism was measured from the parent-reported number of sick days taken in the preceding 12 months. Body mass index was calculated from parent-reported weight and height. Weight status was classified based on the sex-specific body mass index-for-age percentile defined by the CDC growth charts. Poisson regression was conducted to examine the association between school absenteeism and weight status, controlling for selected sociodemographic characteristics and disease status. The mean number of annual sick days was 3.9 days overall; 3.4 days among normal-weight, 4.4 days among overweight, and 4.5 days among obese adolescents. Obese adolescents had a higher proportion of missing ≥4 days of school per year than adolescents of normal weight. Our multivariate analyses found that compared with adolescents of normal weight, overweight and obese adolescents had greater than one-third more sick days annually (rate ratio = 1.36 for overweight and 1.37 for obese adolescents). Overweight and obese adolescents had 36% and 37% more sick days, respectively, than adolescents of normal weight. The results suggest another potential aspect of obesity prevention and reduction efforts among children and families is to improve children's school attendance. Published by Elsevier Inc.

Improving the quality of orthopaedic elective and trauma operative notes: A completed audit loop study

Directory of Open Access Journals (Sweden)

Parth Arvind Shah

2016-01-01

Discussion: This study showed that the quality of elective operative notes was improved through surgeon education and the circulation of a guideline based electronic operative note. We have further plans to implement procedure specific notes for the most common types of trauma cases to help improve the quality of trauma operative notes.

[Simple obesity in children. A study on the role of nutritional factors].

Science.gov (United States)

Weker, Halina

2006-01-01

carbohydrates and fats, before and after the beginning of dietary treatment. The assessments of the method of nutrition, including eating habits, proportions of food products in the food ration and nutritional value of daily food rations was conducted on the basis of 10-14-day records of the child's diet before the implementation of dietary treatment and on the basis of randomly selected 3-day records of the child's diet from the diet book after the dietary treatment was introduced. The environmental data were collected on the basis of a questionnaire, constructed for this study. The main risk factors for simple obesity in examined children (n=236) aged 3-15 yrs were familial and environmental conditions. A significant correlation was found between the children's obesity expressed by a normalized body mass index BMI z-score, unrelated to age and sex, and mother's level of education and father's obesity (Chi(2) test, pobesity the tendency to central obesity was observed since early childhood. In the examined group of children no distortions of metabolism of carbohydrates were observed (correct fasting levels of glucose), while in children with obesity the irregularities of metabolism of fats were noted. The implemented dietary treatment (low energy diet with elements of low glycemic index) had a significant impact on improvement of lipid metabolism in all children in whom the irregularities of metabolism of fats were noted. Modification of the diet of children aged 3-6 by implementing dietary recommendations, including the increased frequency of meals and the choice of products with low glycemic index, did not have a significant impact on the decrease of the body mass index in 95% of examined children. A considerable number of children aged 3-6 (n=12) continued to eat only three meals a day and their model of nutrition, including the selection of products, was not significantly modified. The introduced low energy diet with elements of low glycemic index in children of school age

The influence of nighttime feeding of carbohydrate or protein combined with exercise training on appetite and cardiometabolic risk in young obese women.

Science.gov (United States)

Ormsbee, Michael J; Kinsey, Amber W; Eddy, Wyatt R; Madzima, Takudzwa A; Arciero, Paul J; Figueroa, Arturo; Panton, Lynn B

2015-01-01

Single macronutrient intake prior to sleep reduces appetite but may negatively impact insulin sensitivity in sedentary obese women. The present study examined the additive impact of nighttime feeding of whey (WH), casein (CAS), or carbohydrate (CHO) combined with exercise training on appetite, cardiometabolic health, and strength in obese women. Thirty-seven sedentary obese women (WH, n = 13, body mass index (BMI) 34.4 ± 1.3 kg/m(2); CAS, n = 14, BMI 36.5 ± 1.8 kg/m(2); CHO, n = 10, BMI 33.1 ± 1.7 kg/m(2)) consumed WH, CAS, or CHO (140-150 kcal/serving), every night of the week, within 30 min of sleep, for 4 weeks. Supervised exercise training (2 days of resistance training and 1 day of high-intensity interval training) was completed 3 days per week. Pre- and post-testing measurements included appetite ratings, mood state, resting metabolic rate, fasting lipids, glucose, and hormonal responses (insulin, leptin, adiponectin, hs-CRP, IGF-1, and cortisol), body composition, and strength. Nighttime intake of CAS significantly (p < 0.05) increased morning satiety (pretraining, 25 ± 5; post-training 41 ± 6) more than WH (pretraining, 34 ± 5; post-training, 35 ± 6) or CHO (pre 40 ± 8, post 43 ± 7). Exercise training increased lean mass and strength, decreased body fat, and improved mood state in all groups. No other differences were noted. Nighttime feeding of CAS combined with exercise training increased morning satiety more than WH or CHO. Nighttime feeding for 4 weeks did not impact insulin sensitivity (assessed via homeostatic model assessment of insulin resistance) when combined with exercise training in obese women. ClinicalTrial.gov: NCT01830946.

The adoption of physical activity and eating behaviors among persons with obesity and in the general population: the role of implicit attitudes within the Theory of Planned Behavior.

Science.gov (United States)

Chevance, Guillaume; Caudroit, Johan; Romain, Ahmed J; Boiché, Julie

2017-03-01

Obesity can be prevented by the combined adoption of a regular physical activity (PA) and healthy eating behaviors (EB). Researchers mainly focused on socio-cognitive models, such as the Theory of Planned Behavior (TPB), to identify the psychological antecedents of these behaviors. However, few studies were interested in testing the potential contribution of automatic processes in the prediction of PA and EB. Thus, the main objective of this study was to explore the specific role of implicit attitudes in the pattern of prediction of self-reported PA and EB in the TPB framework, among persons with obesity and in adults from the general population. One hundred and fifty-three adults participated to this cross-sectional study among which 59 obese persons (74% women, age: 50.6 ± 12.3 years, BMI: 36.8 ± 4.03 kg m - ²) and 94 people from the general population (51% women; age: 34.7 ± 8.9 years). Implicit attitudes toward PA and EB were estimated through two Implicit Association Tests. TPB variables, PA and EB were assessed by questionnaire. Regarding to the prediction of PA, a significant contribution of implicit attitudes emerged in obese people, β = .25; 95%[CI: .01, .50]; P = .044, beyond the TPB variables, contrary to participants from the general population. The present study suggests that implicit attitudes play a specific role among persons with obesity regarding PA. Other studies are needed to examine which kind of psychological processes are specifically associated with PA and EB among obese people.

Policies for promotion of physical activity and prevention of obesity in adolescence.

Science.gov (United States)

Pate, Russell R; Flynn, Jennifer I; Dowda, Marsha

2016-12-01

Obesity rates among children and adolescents in developed countries have increased dramatically since the 1970s. During that same period, numerous secular changes have combined to reduce the demand for physical activity in day-to-day life, and many barriers to physical activity are now evident. As a consequence, most children and adolescents do not meet the accepted public health guidelines for physical activity. Accordingly, public health interventions are needed to increase physical activity in adolescence. Such interventions, if successfully implemented, can be expected to improve fitness and health as well as reduce the prevalence of overweight and obesity in young people. Promotion of physical activity in populations of children and adolescents will require comprehensive strategic planning and adoption of new policies in multiple societal sectors. This paper highlights nine initiatives that can address the problem of physical activity in children. The initiatives are to: establish comprehensive school physical activity programming; demand high quality physical education; require physical activity in early child care and education; require physical activity in afterschool programs; create equity in community resources; activate youth sports programs; re-normalize active transport to school; institutionalize clinic-based physical activity assessment and counseling; and build activity-friendly homes. A case will be made for comprehensive national and international strategic planning aimed at effective and large-scale implementation of these initiatives and tactics.

DOES PRESENTING PATIENT'S BMI INCREASE DOCUMENTATION OF OBESITY?

Directory of Open Access Journals (Sweden)

Norm Clothier, MD, M. Kim Marvel, PhD, Courtney S. Cruickshank, MS

2002-09-01

Full Text Available Purpose: Despite the associated health consequences, obesity is infrequently documented as a problem in medical charts. The purpose of this study is to determine whether a simple intervention (routine listing of the BMI on the medical chart will increase physician documentation of obesity in the medical record. Methods: Participants were resident physicians in a family medicine residency program. Participants were randomly assigned to either an experimental group or a control group. For experimental group physicians, the Body Mass Index was listed alongside other vital signs of patients seen in an ambulatory setting. Physician documentation of patient obesity was assessed by chart review after patient visits. Documentation was defined as inclusion of obesity on the problem list or in the progress note. Results: The intervention did not significantly increase the rate of documentation of obesity in the medical chart. Several reasons for the lack of change are explored, including the difficulty of treating obesity successfully.

Notes on Transition Planning for College. Practice Notes

Science.gov (United States)

Center for Mental Health in Schools at UCLA, 2008

2008-01-01

All students can benefit from well-designed transition planning for college. With specific reference to those students identified for special education, middle and high schools have a responsibility under IDEA to focus on a range of transition interventions. Family stakeholders in a community need to work together to ensure the middle school and…

A randomized pilot study comparing zero-calorie alternate-day fasting to daily caloric restriction in adults with obesity.

Science.gov (United States)

Catenacci, Victoria A; Pan, Zhaoxing; Ostendorf, Danielle; Brannon, Sarah; Gozansky, Wendolyn S; Mattson, Mark P; Martin, Bronwen; MacLean, Paul S; Melanson, Edward L; Troy Donahoo, William

2016-09-01

To evaluate the safety and tolerability of alternate-day fasting (ADF) and to compare changes in weight, body composition, lipids, and insulin sensitivity index (Si) with those produced by a standard weight loss diet, moderate daily caloric restriction (CR). Adults with obesity (BMI ≥30 kg/m(2) , age 18-55) were randomized to either zero-calorie ADF (n = 14) or CR (-400 kcal/day, n = 12) for 8 weeks. Outcomes were measured at the end of the 8-week intervention and after 24 weeks of unsupervised follow-up. No adverse effects were attributed to ADF, and 93% completed the 8-week ADF protocol. At 8 weeks, ADF achieved a 376 kcal/day greater energy deficit; however, there were no significant between-group differences in change in weight (mean ± SE; ADF -8.2 ± 0.9 kg, CR -7.1 ± 1.0 kg), body composition, lipids, or Si. After 24 weeks of unsupervised follow-up, there were no significant differences in weight regain; however, changes from baseline in % fat mass and lean mass were more favorable in ADF. ADF is a safe and tolerable approach to weight loss. ADF produced similar changes in weight, body composition, lipids, and Si at 8 weeks and did not appear to increase risk for weight regain 24 weeks after completing the intervention. © 2016 The Obesity Society.

Does obesity hinder radiotherapy in endometrial cancer patients? The implementation of new techniques in adjuvant radiotherapy – focus on obese patients

Directory of Open Access Journals (Sweden)

Małgorzata Moszyńska-Zielińska

2014-05-01

Full Text Available The increasing incidence of obesity in Poland and its relation to endometrioid endometrial cancer (EEC is resulting in the increasing necessity of treating obese women. Treatment of an overweight patient with EEC may impede not only the surgical procedures but also radiotherapy, especially external beam radiotherapy (EBRT. The problems arise both during treatment planning and when delivering each fraction due to the difficulty of positioning such a patient – it implies the danger of underdosing targets and overdosing organs at risk. Willingness to use dynamic techniques in radiation oncology has increased for patients with EEC, even those who are obese. During EBRT careful daily verification is necessary for both safety and treatment accuracy. The most accurate method of verification is cone beam computed tomography (CBCT with soft tissue assessment, although it is time consuming and often requires a radiation oncologist. In order to improve the quality of such treatment, the authors present the practical aspects of planning and treatment itself by means of dynamic techniques in EBRT. The authors indicate the advantages and disadvantages of different types of on-board imaging (OBI verification images. Considering the scanty amount of literature in this field, it is necessary to conduct further research in order to highlight proper planning and treatment of obese endometrial cancer patients. The review of the literature shows that all centres that wish to use EBRT for gynaecological tumours should develop their own protocols on qualification, planning the treatment and methods of verifying the patients’ positioning.

Obesity and kidney disease: hidden consequences of the epidemic ...

African Journals Online (AJOL)

Obesity has also been shown to be a risk factor for nephrolithiasis, and for a number of malignancies including kidney cancer. This year World Kidney Day promotes education on the harmful consequences of obesity and its association with kidney disease, advocating a healthy lifestyle and health policy measures that ...

Creating community action plans for obesity prevention using the ANGELO (Analysis Grid for Elements Linked to Obesity) Framework

DEFF Research Database (Denmark)

Simmons, A; Mavoa, H M; Bell, A C

2009-01-01

Community-based interventions are an important component of obesity prevention efforts. The literature provides little guidance on priority-setting for obesity prevention in communities, especially for socially and culturally diverse populations. This paper reports on the process of developing pr...

Catecholamines and obesity: effects of exercise and training.

Science.gov (United States)

Zouhal, Hassane; Lemoine-Morel, Sophie; Mathieu, Marie-Eve; Casazza, Gretchen A; Jabbour, Georges

2013-07-01

Excess body fat in obese individuals can affect the catecholamine response to various stimuli. Indeed, several studies report lower plasma catecholamine concentrations in obese subjects compared with nonobese subjects in response to submaximal or maximal exercise. This low catecholamine response reflects decreased sympathetic nervous system (SNS) activity. Although the relationship between the SNS and obesity is not well established, some authors have suggested that low SNS activity may contribute to the development of obesity. A decreased catecholamine response could affect α- and β-adrenoceptor sensitivity in adipose tissue, reducing lipolysis and increasing fat stores. Few studies have examined the effects of obesity on the plasma catecholamine response at rest and during exercise in adolescents. It is interesting to note that the effects of age, sex, and degree of obesity and the impact of very intense exercise on the catecholamine response have not yet been well examined. Moreover, the hormonal concentrations measured in the majority of obesity studies did not take into account plasma volume changes. This methodological factor can also undoubtedly influence plasma catecholamine results.

Development and psychometric testing of the childhood obesity perceptions (COP) survey among African American caregivers: A tool for obesity prevention program planning.

Science.gov (United States)

Alexander, Dayna S; Alfonso, Moya L; Cao, Chunhua

2016-12-01

Currently, public health practitioners are analyzing the role that caregivers play in childhood obesity efforts. Assessing African American caregiver's perceptions of childhood obesity in rural communities is an important prevention effort. This article's objective is to describe the development and psychometric testing of a survey tool to assess childhood obesity perceptions among African American caregivers in a rural setting, which can be used for obesity prevention program development or evaluation. The Childhood Obesity Perceptions (COP) survey was developed to reflect the multidimensional nature of childhood obesity including risk factors, health complications, weight status, built environment, and obesity prevention strategies. A 97-item survey was pretested and piloted with the priority population. After pretesting and piloting, the survey was reduced to 59-items and administered to 135 African American caregivers. An exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was conducted to test how well the survey items represented the number of Social Cognitive Theory constructs. Twenty items were removed from the original 59-item survey and acceptable internal consistency of the six factors (α=0.70-0.85) was documented for all scales in the final COP instrument. CFA resulted in a less than adequate fit; however, a multivariate Lagrange multiplier test identified modifications to improve the model fit. The COP survey represents a promising approach as a potentially comprehensive assessment for implementation or evaluation of childhood obesity programs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Metabolic syndrome and its characteristics among obese patients attending an obesity clinic.

Science.gov (United States)

Termizy, H M; Mafauzy, M

2009-04-01

The increased prevalence of metabolic syndrome worldwide is closely related to the rising obesity epidemic. The objectives of the study were to determine the prevalence and identify the associated and prognostic factors that influence the risk of metabolic syndrome among obese patients attending the Obesity Clinic at Hospital Universiti Sains Malaysia. A study was conducted involving 102 obese persons who attended the Obesity Clinic from January 1 to December 31, 2005. Metabolic syndrome was defined according to the International Diabetes Federation criteria. The overall prevalence of metabolic syndrome among obese patients was 40.2 percent. The prevalence was higher in females (43.7 percent) than in males (32.3 percent). The prevalence of metabolic syndrome was noted to increase with increasing body mass index class, from class 1 to class 2. However, the prevalence was lower in obesity class 3. The prevalence of metabolic comorbidities of raised blood pressure, reduced high density lipoprotein, high triglyceride and raised fasting blood glucose was 42, 40, 36 and 17 percent, respectively. A quarter of obese patients in this study had no other comorbidity. Based on logistic regression multivariable analysis, age was the only significant associated factor that influenced the risk of having metabolic syndrome. The prevalence of metabolic syndrome was high and the highest comorbidity was high blood pressure. Age was the only significant risk factor of having this syndrome.

Anesthesia considerations in the obese gravida.

LENUS (Irish Health Repository)

Tan, Terry

2011-12-01

Obesity is associated with serious morbidity during pregnancy, and obese women also are at a high risk of developing complications during labor, leading to an increased risk for instrumental and Cesarean deliveries. The engagement of the obstetrical anesthetist in the management of this group of high-risk patients should be performed antenatally so that an appropriate management strategy can be planned in advance to prevent an adverse outcome. Good communication between all care providers is essential. The obese patient in labor should be encouraged to have a functioning epidural catheter placed early in labor. Apart from providing analgesia and alleviating physiological derangements during labor, the presence of a functioning epidural catheter can also be used to induce anesthesia quickly in the event of an emergency cesarean section, thus avoiding a general anesthesia, which has exceedingly high risks in the obese parturient. Successful management of the obese patient necessitates a comprehensive strategy that encompasses a multidisciplinary and holistic approach from all care-providers.

Chrono-nutrition: a review of current evidence from observational studies on global trends in time-of-day of energy intake and its association with obesity.

NARCIS (Netherlands)

Almoosawi, S; Vingeliene, S.; Karagounis, L.G.; Pot, G.K.

2016-01-01

The importance of the circadian rhythm in regulating human food intake behaviour and metabolism has long been recognised. However, little is known as to how energy intake is distributed over the day in existing populations, and its potential association with obesity. The present review describes

Screening and treatment of obesity in school health care - the gap between clinical guidelines and reality.

Science.gov (United States)

Häkkänen, Paula; Ketola, Eeva; Laatikainen, Tiina

2018-05-06

School health care offers a natural setting for childhood obesity interventions. Earlier studies reveal inadequate screening and treatment in primary care. However, longitudinal studies in unselected populations are lacking. We aimed to examine how school nurses and physicians identified obesity, diagnosed it and offered interventions over primary school. We compared the results with Finnish recommendations. From our cohort of 2000 primary school sixth graders (aged 12-14), 172 were obese at least once during primary school. We manually collected retrospective electronic health record (EHR) data of these 'ever-obese' children. Of the ever-obese children, 96% attended annual nurse assessments more than twice. School physicians met 53% of the ever-obese children at health checks at first grade and 93% at fifth grade. Of overweight-related extra visits to school nurses, 94% took place without parents. Parents were present in 48% of extra school physician visits. Only 29% of the 157 who became obese during the first five school grades received an obesity diagnosis. However, school physicians mentioned weight problems in EHR for 90% of the children and, similarly, school nurses for 99%. The majority received a treatment plan at least once. For 78%, at least one plan was made with the parents. Still, 28% missed nutrition plans, 31% exercise plans and 90% lacked recorded weight development targets. The gap between clinical guidelines and reality in school health care could be narrowed by improving diagnosing and parent collaboration. Obstacles in parent involvement and work methods in school health care need further study. © 2018 Nordic College of Caring Science.

Early Origins of Child Obesity: Bridging Disciplines and Phases of Development - September 30–October 1, 2010

Science.gov (United States)

Christoffel, Katherine Kaufer; Wang, Xiaobin; Binns, Helen J.

2012-01-01

This report summarizes a conference: “Early Origins of Child Obesity: Bridging Disciplines and Phases of Development”, held in Chicago on September 30–October 1, 2010. The conference was funded in part by the National Institutes of Health and the Williams Heart Foundation, to achieve the conference objective: forging a next-step research agenda related to the early origins of childhood obesity. This research agenda was to include working with an array of factors (from genetic determinants to societal ones) along a continuum from prenatal life to age 7, with an emphasis on how the developing child deals with the challenges presented by his/her environment (prenatal, parental, nutritional, etc.). The conference offered a unique opportunity to facilitate communication and planning of future work among a variety of researchers whose work separately addresses different periods in early life. Over the span of two days, speakers addressed existing, critical research topics within each of the most-studied age ranges. On the final day, workshops fostered the discussion needed to identify the highest priority research topics related to linking varied early factor domains. These are presented for use in planning future research and research funding. PMID:23443002

[Research advances in association between childhood obesity and gut microbiota].

Science.gov (United States)

Gao, Xiao-Lin; Wan, Chao-Min

2017-03-01

In recent years, more and more studies have noted the close association between gut microbiota and the development and progression of obesity. Gut microbiota may act on obesity by increasing energy intake, affecting the secretion of intestinal hormones, inducing chronic systemic inflammation, and producing insulin resistance. This article reviews the association between childhood obesity and gut microbiota, as well as possible mechanisms, in an attempt to provide a reference for the etiology, prevention and treatment of childhood obesity.

The influence of high versus low sodium intake on blood pressure and haemodynamics in patients with morbid obesity

DEFF Research Database (Denmark)

Bonfils, Peter K; Taskiran, Mustafa; Damgaard, Morten

2013-01-01

fluid compartments and haemodynamic responses (at rest and during exercise) after 5 days of a low-sodium diet (90 mmol/day) and 5 days of a high-sodium diet (250 mmol/day) in 12 morbidly obese, hypertensive patients; 12 morbidly obese, normotensive patients and 12 nonobese controls. RESULTS: High sodium......BACKGROUND: Many patients with morbid obesity (BMI > 40 kg/m) have hypertension. The complex pathophysiological abnormalities linking hypertension to obesity have not been fully clarified, but abnormal sodium handling could be an important mechanism. METHOD: Therefore, we examined changes in body...... intake as compared to low sodium intake was associated with an increase in plasma volume (obese, hypertensive patients: 5 ± 4%; obese, normotensive patients: 10 ± 11%; nonobese controls: 7 ± 6%), cardiac output (CO) (obese, hypertensive patients: 17 ± 12%; obese, normotensive patients: 20 ± 16%; nonobese...

Depression and obesity: What is the right choice of medication?

Directory of Open Access Journals (Sweden)

Latas Milan

2017-01-01

Full Text Available The most common and most significant comorbid psychiatric disorder in patients with obesity is depression. Studies in the general and clinical population indicate that there is a bidirectional correlation between depression and obesity. Chronic depression appears as a precursor or as a factor that generate the onset of obesity. On the other hand, research shows that obesity is one of the main predictors of the onset of depression. In addition, studies have found that women have a greater chance of occurring comorbid depression versus male population. There is no single and one and only mechanism for linking the simultaneous occurrence of depression and obesity in one person, but that a many pathological conditions are involved. Particular attention should be paid to the biological (endocrinological factors as well as the psychological factors that may or may not be related. For the time being, there is certain evidence and experience that certain antidepressants, primarily bupropion and fluoxetine, are associated with weight loss. On the other hand, it has already been noted that some antidepressants (primarily tricyclic antidepressants, paroxetine and mirtazapine are associated with the onset of body mass gain and consequent obesity. It is therefore important to know which of the antidepressants has some effect on the body mass and on the basis of that information psychiatrists could determine what antidepressant to prescribe in each individual case.

The Plan's the Thing.

Science.gov (United States)

Raley, Nancy

1986-01-01

Planning is the process of setting direction, priorities, and guidelines. A CASE survey of public relations professionals is described that notes the use of staff retreats and brainstorming sessions, among other techniques and strategies, that help professionals plan. (MLW)

Dietary transition and obesity in selected Arabicspeaking countries: a review of the current evidence.

Science.gov (United States)

Aboul-Enein, B H; Bernstein, J; Neary, A C

2017-01-23

Escalating obesity rates have become a significant public health problem in the Middle East and North Africa (MENA) region and have been associated with shifts towards a westernized diet. This integrative review aimed to examine the current dietary trends and transitions and their association with obesity in Arabic-speaking countries of the MENA region. Relevant databases were searched for studies in MENA countries between 1998 and 2014 that investigated obesity trends and changes in dietary patterns at the regional level in all age groups. A total of 39 articles fulfilled the inclusion criteria. All the articles noted that obesity was increasingly prevalent and that there was a significant dietary shift away from traditional dietary patterns; 51% reported a shift towards a westernized diet and half found that the western diet was correlated with increased obesity. Culturally relevant dietary health education and health promotion strategies are warranted to address both the dietary shifts towards the westernized diet and the increasing obesity.

The obesity paradox in community-acquired bacterial pneumonia.

Science.gov (United States)

Corrales-Medina, Vicente F; Valayam, Josemon; Serpa, Jose A; Rueda, Adriana M; Musher, Daniel M

2011-01-01

The impact of obesity on the outcome of pneumonia is uncertain. We retrospectively identified 266 hospitalized patients with proven pneumococcal or Haemophilus community-acquired pneumonia who had at least one body mass index (BMI, kg/m²) value documented in the 3 months before admission. Patients were classified as underweight (BMI values and BMI categories with the mortality at 30 days after admission for pneumonia was investigated. Increasing BMI values were associated with reduced 30-day mortality, even after adjustment for significant covariates (odds ratio 0.88, confidence interval 0.81-0.96; p<0.01). There was a significant trend towards lower mortality in the overweight and obese (non-parametric trend, p=0.02). Our data suggest that obesity may exert a protective effect against 30-day mortality from community-acquired bacterial pneumonia. Copyright © 2010 International Society for Infectious Diseases. All rights reserved.

The prevalence of obesity and its relationship with hypertension in ...

African Journals Online (AJOL)

The prevalence of obesity and its relationship with hypertension in an urban community: Data from world kidney day screening programme. ... Background: Obesity is a global health problem that is linked directly with several disease processes, notably hypertension. Aims: The objective of this study was to determine the ...

Adoption of the children's obesity clinic's treatment (TCOCT) protocol into another Danish pediatric obesity treatment clinic

DEFF Research Database (Denmark)

Most, Sebastian W; Højgaard, Birgitte; Teilmann, Grete Katrine

2015-01-01

BACKGROUND: Treating severe childhood obesity has proven difficult with inconsistent treatment results. This study reports the results of the implementation of a childhood obesity chronic care treatment protocol. METHODS: Patients aged 5 to 18 years with a body mass index (BMI) above the 99th......, but independent of baseline BMI SDS, age, co-morbidity, SES, pubertal stage, place of referral, hours of treatment per year, and mean visit interval time. CONCLUSIONS: The systematic use of the TCOCT protocol reduced the degree of childhood obesity with acceptable retention rates with a modest time...... percentile for sex and age were eligible for inclusion. At baseline patients' height, weight, and tanner stages were measured, as well as parents' socioeconomic status (SES) and family structure. Parental weight and height were self-reported. An individualised treatment plan including numerous advices...

Associated factors of obesity in Spanish representative samples.

Science.gov (United States)

Ortega Anta, Rosa M; López-Solaber, Ana M; Pérez-Farinós, Napoleón

2013-09-01

Given the dramatic increase in the prevalence of obesity and the serious health and economic consequences, the scientific community, health professionals and health agencies are looking for the best strategies to prevent/ fight this trend. In order to plan the most appropriate intervention measures the first step is to identify the associated factors of obesity. This paper presents the results of research conducted/coordinated by our research team and promoted by the Spanish Food Safety Agency (AESAN), in the last five years. These studies were focussed on representative samples of the Spanish population, paying attention to the condition of overweight/obesity and their associated factors. The first study, FANPE ("Fuentes alimentarias de nutrientes de la población española") (2009), was centered in 418 adults (18-60 years) from 15 provinces (30 sampling points). Its aim was to analyze the dietary sources of nutrients, paying particular attention to sodium. This research showed that the risk of overweight/obesity increa ses with age, in people who have follow weight control diets, in ex-smokers, married people and those who slept less than 8.5 hours per day, while the risk is lower in women, people who make sport and those with a University degree. It was also found that overweight people had higher sodium intake and urine excretion. Therefore, and having in mind that 88.2% of the subjects took more than 2 g/day of sodium (the maximum recommended), it is advised to lower the sodium intake not only from the health point of view but also as a probably strategy against obesity. The study ALADINO (Estudio de Alimentación, Actividad física, Desarrollo Infantil y Obesidad--Study of the Diet, Physical Activity, Child Development and Obesity) (2010-2011) was focused on 7659 children (6-9 years) from 19 autonomous communities. We founded a higher percentage of overweight/obesity in boys than in girls, and a significant increase in the figures from the age of 7. Being

Effect of Hibiscus sabdariffa on obesity in MSG mice.

Science.gov (United States)

Alarcon-Aguilar, Francisco J; Zamilpa, Alejandro; Perez-Garcia, Ma Dolores; Almanza-Perez, Julio C; Romero-Nuñez, Eunice; Campos-Sepulveda, Efrain A; Vazquez-Carrillo, Laura I; Roman-Ramos, Ruben

2007-10-08

The aim of the present investigation was determine whether a standardized Hibiscus sabdariffa calyces aqueous extract has an effect on body weight in an obese animal model induced by the administration of monosodium glutamate. Hibiscus sabdariffa aqueous extract, containing 33.64 mg of total anthocyanins per each 120 mg of extract, was orally administered (120 mg/kg/day) for 60 days to healthy and obese mice, and body weight gain, food and liquid intake, aspartate aminotransferase (AST), alanine aminotransferase (ALT), cholesterol, and triglycerides levels were measured. Hibiscus sabdariffa administration significantly reduced body weight gain in obese mice and increased liquid intake in healthy and obese mice. ALT levels were significantly increased on the 15th and 45th days in obese mice, but AST levels did not show significant changes. Mortality was not observed in the Hibiscus sabdariffa treated groups. Triglycerides and cholesterol levels showed non-significant reductions in animals treated with Hibiscus sabdariffa. Our data confirm the anti-obesity effect of Hibiscus sabdariffa reported by the Mexican population.

Caloric restriction and aerobic exercise in sarcopenic and non-sarcopenic obese women: an observational and retrospective study.

Science.gov (United States)

Barbat-Artigas, Sébastien; Garnier, Sophie; Joffroy, Sandra; Riesco, Éléonor; Sanguignol, Frédéric; Vellas, Bruno; Rolland, Yves; Andrieu, Sandrine; Aubertin-Leheudre, Mylène; Mauriège, Pascale

2016-06-01

Sarcopenic obese (SO) individuals are a unique subset of subjects that combines obesity and sarcopenia. Traditional weight loss programmes including aerobic exercises may worsen their condition by further reducing their lean mass. The objective of this observational and retrospective study was to verify the effect of a mixed weight loss programme combining caloric restriction and exercise on body composition, and lipid-lipoprotein profile of obese women according to their sarcopenic status. One hundred and forty-six obese women (body mass index ≥ 30 kg/m(2) and fat mass ≥ 40%) participated to the 3 week usual and institutionalized weight-reducing programme combining a dietary plan (1400 ± 200 kcal/day) and aerobic exercise (1 h/day, 6 days/week) of a specialized medical institution. The lean body mass index (LMI; lean mass/height(2)) was calculated, and women in the lowest tertile of LMI were considered SO. At baseline, SO women were older, and their body weight and LMI were lower than non-sarcopenic obese (N-SO) women (p women similarly lost fat mass and improved their lipid-lipoprotein profile (p women lost lean mass (p restriction and aerobic exercise may significantly reduce fat mass and improve lipid-lipoprotein profile in obese women, independently of their sarcopenic status. Such programmes may have deleterious effects on lean mass in N-SO subjects, only.

English obesity policies

DEFF Research Database (Denmark)

Vallgårda, Signild

2015-01-01

Problem definitions constitute a crucial part of the policy process. In 2008 the Labour Government presented a plan to reduce the obesity prevalence in England. Only three years later the Conservative-Liberal Government introduced a plan on the same topic, which it presented as new and innovative...

Nutritional adequacy of energy restricted diets for young obese women.

Science.gov (United States)

O'Connor, Helen; Munas, Zahra; Griffin, Hayley; Rooney, Kieron; Cheng, Hoi Lun; Steinbeck, Katharine

2011-01-01

Energy restricted meal plans may compromise nutrient intake. This study used diet modelling to assess the nutritional adequacy of energy restricted meal plans designed for weight management in young obese women. Diet modelling of 6000 kJ/d animal protein based meal plans was performed using Australian nutrient databases with adequacy compared to the Australian Nutrient Reference Values (NRVs) for women (19-30 years). One diet plan was based on the higher carbohydrate (HC) version of the Australian Guide to Healthy Eating for women 19-60 years. An alternative higher protein (HP) plan was adapted from the CSIRO Total Wellbeing Diet. Vegan and lacto-ovo versions of these plans were also modelled and compared to the appropriate vegetarian NRVs. Both animal protein diets met the estimated average requirement (EAR) or adequate intake (AI) for all nutrients analysed. The recommended dietary intake (RDI) was also satisfied, except for iron. HC met 75±30% and HP 81±31% of the iron RDI when red meat and iron fortified cereal were both included three days a week, and remained below the RDI even when red meat was increased to seven days. Iron for the modified vegan (57±5% HC; 66±4% HP) and lacto-ovo (48±6% HC; 59±7% HP) plans was below the RDI and zinc below the EAR for the vegan (76±8% HC; 84±9% HP) plans. The 6000 kJ/d animal protein meal plans met the RDI for all nutrients except iron. Iron and zinc failed to meet the vegetarian RDI and EAR respectively for the vegan plans.

Behavioral and body size correlates of energy intake underreporting by obese and normal-weight women.

Science.gov (United States)

Kretsch, M J; Fong, A K; Green, M W

1999-03-01

To examine behavioral and body size influences on the underreporting of energy intake by obese and normal-weight women. Seven-day estimated food records were kept by subjects before they participated in a 49-day residential study. Self-reported energy intake was compared with energy intake required to maintain a stable body weight during the residential study (reference standard). Energy intake bias and its relationship to various body size and behavioral measures were examined. Twenty-two, healthy, normal-weight (mean body mass index [BMI] = 21.3) and obese (mean BMI = 34.2) women aged 22 to 42 years were studied. Analysis of variance, paired t test, simple linear regression, and Pearson correlation analyses were conducted. Mean energy intake from self-reported food records was underreported by normal-weight (-9.7%) and obese (-19.4%) women. BMI correlated inversely with the energy intake difference for normal-weight women (r = -.67, P = .02), whereas the Beck Depression Inventory correlated positively with the energy intake difference for obese women (r = .73, P behavioral traits play a role in the ability of women to accurately self-report energy intake. BMI appears to be predictive of underreporting of energy intake by normal-weight women, whereas emotional factors related to depression appear to be more determinant of underreporting for obese women. Understanding causative factors of the underreporting phenomenon will help practicing dietitians to devise appropriate and realistic diet intervention plans that clients can follow to achieve meaningful change.

Obesity: A crisis of growing proportions

OpenAIRE

Berall, Glenn B

2002-01-01

Childhood obesity is a condition characterized by an imbalance between energy consumed and energy expended. A variety of factors that are unique to our modern day western society lead to the increasing prevalence of childhood obesity. The ease and volume of food supply, high calorie density, convenience foods, convenience transportation, sedentary lifestyle, school system issues, and perceptions of unsafe neighbourhoods all contribute to this increase in obesity. Consequences of childhood obe...

[Corticotropic axis and chronic stress in abdominal obesity and metabolic syndrome].

Science.gov (United States)

Boullu-Ciocca, S; Verger, P; Bocquier, A; Oliver, C

2005-12-03

Several indicators of corticotropic axis hyperactivity have been observed in common abdominal obesity, which is clinically similar to the obesity found in Cushing's syndrome. Corticotropic axis hyperactivity may be involved in the development and metabolic and cardiovascular complications of abdominal obesity. Several mechanisms may be responsible for this hormonal dysregulation: genetic, lifestyle, and nutritional factors, and chronic stress. We note the necessity of methodologically-impeccable clinical studies for an objective evaluation of the role of stress in obesity.

[Caloric intake and distribution of the main nutrients in a population of obese children].

Science.gov (United States)

Greco, M; Croci, M; Tufano, A; Sassano, G; Panigoni, G; Costa, M; Morricone, L; Longari, V; Mazzocchi, M; Caviezel, F

1990-01-01

Calorie intake and the main nutrient contents were assessed in a population of 152 obese (OB) children (86 M; 66 F; age 7-11) and 153 normal weight (NW) peers (87 M; 66 F). The following method was used: a) an interview using a food dictionary to assess food intake during the 2 days prior to the study and on one holiday: and b) a weekly questionnaire. The mean food intake of OB did not exceed that of NW, but on the contrary was lower (OB: 1812.9 +/- 39.6 kcal/die; NW: 1928.5 +/- 39.4 kcal/die; p less than 0.05). The population studied consumed approximately 50% of calories as carbohydrates (CHO), 35% as fats (F) and 15% as protein (P), and no difference was noted between OB and NW. The percentage of CHO was lower than that recommended by LARN, whereas the percentages of F and P were higher. A significant increase with age was noted in F and P intake as was a significant reduction of CO. 70% of OB and 80% of NW matched or exceeded the calorie intake recommended by LARN. 30% of OB and 24% of NW consumed 30% less than the daily calorie intake recommended by LARN.

A process evaluation of a social cognitive theory-based childhood obesity prevention intervention: the Comics for Health program.

Science.gov (United States)

Branscum, Paul; Sharma, Manoj; Wang, Lihshing Leigh; Wilson, Bradley; Rojas-Guyler, Liliana

2013-03-01

Process evaluations are an often overlooked yet essential component of health promotion interventions. This study reports the results of a comprehensive process evaluation for the "Comics for Health" program, a childhood obesity prevention intervention implemented at 12 after-school programs. Qualitative and quantitative process data were collected using surveys, field notes, and open-item questionnaires, which assessed program fidelity, dose delivered, dose received, reach, recruitment, and context. Triangulation of methods was also employed to better understand how the program was implemented and received by the facilitator, staff members, and children in the program. Results indicated that program implementation had an almost perfect rate of fidelity with most lessons recording 100% tasks completed. Lessons were implemented in their intended order and lasted approximately 30 minutes as planned. After-school staff members reported that the program was well received by children, and this program should be replicated in the future. Attendance records showed that a majority of the children attended each lesson on the initial day of delivery (70.4%) and informal make-up lessons were implemented to compensate for the other children. Finally, several known sources of contamination were found such as past and concurrent exposure to similar health promotion interventions, which could potentially influence study outcomes. These findings will be used to help explain the results of this intervention and make recommendations for future intervention efforts.

Myocutaneous revascularization following graded ischemia in lean and obese mice

Directory of Open Access Journals (Sweden)

Clark RM

2016-09-01

Full Text Available Ross M Clark,1 Brittany Coffman,2 Paul G McGuire,3 Thomas R Howdieshell1,3 1Department of Surgery, 2Department of Pathology, 3Department of Cell Biology and Vascular Physiology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA Background: Murine models of diabetes and obesity have provided insight into the pathogenesis of impaired epithelialization of excisional skin wounds. However, knowledge of postischemic myocutaneous revascularization in these models is limited. Materials and methods: A myocutaneous flap was created on the dorsum of wild type (C57BL/6, genetically obese and diabetic (ob/ob, db/db, complementary heterozygous (ob+/ob− , db+/db−, and diet-induced obese (DIO mice (n=48 total; five operative mice per strain and three unoperated mice per strain as controls. Flap perfusion was documented by laser speckle contrast imaging. Local gene expression in control and postoperative flap tissue specimens was determined by quantitative reverse transcription polymerase chain reaction (RT-PCR. Image analysis of immunochemically stained histologic sections confirmed microvascular density and macrophage presence. Results: Day 10 planimetric analysis revealed mean flap surface area necrosis values of 10.8%, 12.9%, 9.9%, 0.4%, 1.4%, and 23.0% for wild type, db+/db−, ob+/ob−, db/db, ob/ob, and DIO flaps, respectively. Over 10 days, laser speckle imaging documented increased perfusion at all time points with revascularization to supranormal perfusion in db/db and ob/ob flaps. In contrast, wild type, heterozygous, and DIO flaps displayed expected graded ischemia with failure of perfusion to return to baseline values. RT-PCR demonstrated statistically significant differences in angiogenic gene expression between lean and obese mice at baseline (unoperated and at day 10. Conclusion: Unexpected increased baseline skin perfusion and augmented myocutaneous revascularization accompanied by a control proangiogenic transcriptional

Technical specifications (replaces note T.62). Irradiation of graphite at ambient temperature, Note T. 76; Specification technique, (Annule et remplace la note T. 62), Irradiation de graphite a temperature ambiante, Note T. 76

Energy Technology Data Exchange (ETDEWEB)

Reseau, R A [Services des grandes piles experimentales, Section ' Physique et Experimentation, Saclay (France)

1962-12-15

The objective is to study the effects of fast neutron irradiation of different graphite samples. The irradiation conditions should be as follows: integral fast neutron flux should be higher than 10{sup 20} neutrons/cm{sup 2}, the reactor should operate at steady state for 15 days, the temperature od samples should not be higher than 100 deg C, preferably 80 deg C. Note T. 62 which is replaced by this Note is attached.

Physical activity does not attenuate the obesity risk of TV viewing in youth.

Science.gov (United States)

Rey-López, J P; Ruiz, J R; Vicente-Rodríguez, G; Gracia-Marco, L; Manios, Y; Sjöström, M; De Bourdeaudhuij, I; Moreno, L A

2012-06-01

This study aimed to examine the association of television (TV) time, the frequency of meals while watching TV and the presence of TV set in the bedroom with total and abdominal obesity and to assess whether physical activity (PA) attenuates the obesity risk of TV viewing. Cross-sectional data were obtained from 2200 adolescents (46% boys) from 10 European cities, The Healthy Lifestyle in Europe by Nutrition in Adolescence study, between 2006 and 2007. TV viewing, PA (by accelerometry) and body composition were measured. Binary logistic regression analyses were performed. Even adjusting by vigorous PA, TV in the bedroom (odds ratio [OR]: 1.33, 95% confidence interval [CI], 1.01-1.74) and >4 h d(-1) TV during week days (OR: 1.30, 95% CI, 1.02-1.67) (in boys) and eating every day with TV (OR: 1.18, 95% CI, 1.07-1.30) and >2 h d(-1) TV during weekend days (OR: 1.68, 95% CI, 1.25-2.26) (in girls) were significantly associated with total obesity. Likewise, in both sexes, having a TV set at bedroom was significantly associated with abdominal obesity. Adolescents spending excessive TV time are prone to obesity independently of their PA levels. Families should put TV sets out of adolescents' bedroom and keep TV sets off during meal times. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.

LONG TERM EFFECT OF CHROMIUM ON LIPID PROFILE AND SOME HORMONES IN OBESE RATS

International Nuclear Information System (INIS)

GABR, S.A.; ABDEL-KHALEK, L.G.; GHAREIB, S.A.

2008-01-01

In the present study, the long term effect of chromium picolinate (intake 30 and 60 days) on lipid profile, testosterone, thyroid hormones, corticosterone and insulin was studied in obese male rats. A total of 48 male albino rats were arranged into four equal groups. The rats were distributed into four equal main groups: 1- Normal rats left without any treatment and served as a control group. 2- Normal rats treated with chromium picolinate at a dose of 40 μg/kg/day. 3-Obese rats (after the induction of obesity) using fed high fat diet. 4- Obese rats treated with chromium picolinate. The results obtained showed that normal rats treated with chromium picolinate for 30 or 60 days had no changes in total cholesterol, triglycerides, total lipids, LDL-cholesterol, HDL-cholesterol, triiodothyronine (T 3 ) and thyroxine (T 4 ) when compared with the control group. The testosterone and corticosterone levels were significantly decreased in rats treated with chromium picolinate for 60 days. Insulin level was significantly increased in treated rats for 60 days when compared with the control ones. In obese rats, the lipid profile and corticosterone were significantly increased at 30 and 60 days, while the insulin levels were increased in obese rats fed on high fat diet for 30 days as compared with the control rats. The administration of chromium picolinate to obese rats succeeded to decrease the lipid profile, corticosterone (at 60 days) and insuline (at 30 days) when compared with the obese rats. It could be concluded from this study that chromium picolinate possess beneficial effects in decreasing lipid profile in obese rats. Therefore, additional of chromium picolinate may be useful in obese rats to burn excess body fat and in treatment of hypercholesterolemia. Since it cause decrease in testosterone level, its use was advised to restrict to relatively old age

Intake and Dietary Food Sources of Fibre in Spain: Differences with Regard to the Prevalence of Excess Body Weight and Abdominal Obesity in Adults of the ANIBES Study.

Science.gov (United States)

González-Rodríguez, Liliana G; Perea Sánchez, José Miguel; Aranceta-Bartrina, Javier; Gil, Ángel; González-Gross, Marcela; Serra-Majem, Lluis; Varela-Moreiras, Gregorio; Ortega, Rosa M

2017-03-25

The aim was to study the intake and food sources of fibre in a representative sample of Spanish adults and to analyse its association with excess body weight and abdominal obesity. A sample of 1655 adults (18-64 years) from the ANIBES ("Anthropometric data, macronutrients and micronutrients intake, practice of physical activity, socioeconomic data and lifestyles") cross-sectional study was analysed. Fibre intake and dietary food sources were determined by using a three-day dietary record. Misreporters were identified using the protocol of the European Food Safety Authority. Mean (standard deviation) fibre intake was 12.59 (5.66) g/day in the whole sample and 15.88 (6.29) g/day in the plausible reporters. Mean fibre intake, both in the whole sample and the plausible reporters, was below the adequate intake established by European Food Safety Authority (EFSA) and the Institute of Medicine of the United States (IOM). Main fibre dietary food sources were grains, followed by vegetables, fruits, and pulses. In the whole sample, considering sex, and after adjusting for age and physical activity, mean (standard error) fibre intake (adjusted by energy intake) was higher in subjects who had normal weight (NW) 13.40 (0.184) g/day, without abdominal obesity 13.56 (0.192) g/day or without excess body weight and/or abdominal obesity 13.56 (0.207) g/day compared to those who were overweight (OW) 12.31 (0.195) g/day, p obese (OB) 11.83 (0.266) g/day, p obesity 12.09 (0.157) g/day, p obesity 12.22 (0.148) g/day, p obesity or excess body weight and/or abdominal obesity in the plausible reporters. Fibre from afternoon snacks was higher in subjects with NW (6.92%) and without abdominal obesity (6.97%) or without excess body weight and/or abdominal obesity (7.20%), than those with OW (5.30%), p obesity (5.18%), p obesity (5.21%), p association with excess body weight and abdominal obesity only when the whole sample was considered.

Intake and Dietary Food Sources of Fibre in Spain: Differences with Regard to the Prevalence of Excess Body Weight and Abdominal Obesity in Adults of the ANIBES Study

Science.gov (United States)

González-Rodríguez, Liliana G.; Perea Sánchez, José Miguel; Aranceta-Bartrina, Javier; Gil, Ángel; González-Gross, Marcela; Serra-Majem, Lluis; Varela-Moreiras, Gregorio; Ortega, Rosa M.

2017-01-01

The aim was to study the intake and food sources of fibre in a representative sample of Spanish adults and to analyse its association with excess body weight and abdominal obesity. A sample of 1655 adults (18–64 years) from the ANIBES (“Anthropometric data, macronutrients and micronutrients intake, practice of physical activity, socioeconomic data and lifestyles”) cross-sectional study was analysed. Fibre intake and dietary food sources were determined by using a three-day dietary record. Misreporters were identified using the protocol of the European Food Safety Authority. Mean (standard deviation) fibre intake was 12.59 (5.66) g/day in the whole sample and 15.88 (6.29) g/day in the plausible reporters. Mean fibre intake, both in the whole sample and the plausible reporters, was below the adequate intake established by European Food Safety Authority (EFSA) and the Institute of Medicine of the United States (IOM). Main fibre dietary food sources were grains, followed by vegetables, fruits, and pulses. In the whole sample, considering sex, and after adjusting for age and physical activity, mean (standard error) fibre intake (adjusted by energy intake) was higher in subjects who had normal weight (NW) 13.40 (0.184) g/day, without abdominal obesity 13.56 (0.192) g/day or without excess body weight and/or abdominal obesity 13.56 (0.207) g/day compared to those who were overweight (OW) 12.31 (0.195) g/day, p obese (OB) 11.83 (0.266) g/day, p obesity 12.09 (0.157) g/day, p obesity 12.22 (0.148) g/day, p obesity or excess body weight and/or abdominal obesity in the plausible reporters. Fibre from afternoon snacks was higher in subjects with NW (6.92%) and without abdominal obesity (6.97%) or without excess body weight and/or abdominal obesity (7.20%), than those with OW (5.30%), p obesity (5.18%), p obesity (5.21%), p obesity only when the whole sample was considered. PMID:28346353

Can mHealth Revolutionize the Way We Manage Adult Obesity?

Science.gov (United States)

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.

Obesity Prevention in the Military.

Science.gov (United States)

Shams-White, Marissa; Deuster, Patricia

2017-06-01

The objective was to review prevention efforts and approaches attempting to limit the problem of obesity in the military. Various individual-level initiatives have emerged, including programs promoting healthy cooking, meal planning, and other behavior changes among service members. Importantly, the military is attempting to tackle environmental factors contributing to the rise of obesity, by focusing on many recent environmental-level interventions and initiatives to improve military dining facilities and examine and modify other aspects of installations' built environments. Although published research within the military setting directed towards obesity prevention is limited, many innovative programs have been launched and need to be followed forward. The review of past and ongoing efforts can be an important step in identifying specific areas needing improvement, gaps that should be considered, lessons learned, and characteristics of successful programs that should be disseminated as best practices and further expanded.

Do pediatric gastroenterology doctors address pediatric obesity?

OpenAIRE

Batra, Suruchi; Yee, Caitlin; Diez, Bernadette; Nguyen, Nicholas; Sheridan, Michael J; Tufano, Mark; Sikka, Natalie; Townsend, Stacie; Hourigan, Suchitra

2017-01-01

Objectives: To assess how often obesity is acknowledged at pediatric gastroenterology outpatient visits. Methods: A retrospective chart review was performed to identify obese children seen at a gastroenterology subspecialty clinic over a 1-year period of time; 132 children were identified. Demographics, obesity comorbidities, reasons for referral, diagnosis of obesity, and a plan to address obesity were abstracted. Chi-square or Fisher?s exact tests were used to examine statistical associatio...

Effects of ear acupuncture therapy for obesity on the depression of obese women.

Science.gov (United States)

Set, Turan; Cayir, Yasemin; Pirim, Asuman Bihter Guven

2014-10-01

Obesity is one of the leading health risks worldwide, and depression is among the leading causes of the burden of disease. These disorders are increasingly prevalent as comorbidities. Depressive symptoms are associated with obesity, and are more common in women. To evaluate the effectiveness of ear acupuncture for obesity on the depression of obese women. After baseline testing, 30 eligible patients with body mass index (BMI) >29.9 kg/m(2) were included. The Beck Depression Inventory for Primary Care (BDI-PC) was used to assess changes in depression. BMI was also measured. Patients had six ear acupuncture sessions, every 15 days and were followed up for 3 months. Twenty four patients completed the study. The mean±SD age of patients was 42.9±9.0 years. Their mean±SD BMI was 39.0±4.7 kg/m(2) before acupuncture, decreasing to 37.2±4.3 kg/m(2) after acupuncture therapy (pacupuncture, decreasing to 2.7±1.4 (pacupuncture therapy (p=0.104). After acupuncture therapy, no significant correlation was found between the percentage reduction of BMI and percentage reduction of the depression score (p=0.119). Further research into the effects of ear acupuncture in the management of obesity and depression is justified. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The Status of Billing and Reimbursement in Pediatric Obesity Treatment Programs

Science.gov (United States)

Gray, Jane Simpson; Filigno, Stephanie Spear; Santos, Melissa; Ward, Wendy L.; Davis, Ann M.

2014-01-01

Pediatric psychologists provide behavioral health services to children and adolescents diagnosed with medical conditions. Billing and reimbursement have been problematic throughout the history of pediatric psychology, and pediatric obesity is no exception. The challenges and practices of pediatric psychologists working with obesity are not well understood. Health and behavior codes were developed as one potential solution to aid in the reimbursement of pediatric psychologists who treat the behavioral health needs of children with medical conditions. This commentary discusses the current state of billing and reimbursement in pediatric obesity treatment programs and presents themes that have emerged from discussions with colleagues. These themes include variability in billing practices from program to program, challenges with specific billing codes, variability in reimbursement from state to state and insurance plan to insurance plan, and a general lack of practitioner awareness of code issues or reimbursement rates. Implications and future directions are discussed in terms of research, training, and clinical service. PMID:23224661

The status of billing and reimbursement in pediatric obesity treatment programs.

Science.gov (United States)

Gray, Jane Simpson; Spear Filigno, Stephanie; Santos, Melissa; Ward, Wendy L; Davis, Ann M

2013-07-01

Pediatric psychologists provide behavioral health services to children and adolescents diagnosed with medical conditions. Billing and reimbursement have been problematic throughout the history of pediatric psychology, and pediatric obesity is no exception. The challenges and practices of pediatric psychologists working with obesity are not well understood. Health and behavior codes were developed as one potential solution to aid in the reimbursement of pediatric psychologists who treat the behavioral health needs of children with medical conditions. This commentary discusses the current state of billing and reimbursement in pediatric obesity treatment programs and presents themes that have emerged from discussions with colleagues. These themes include variability in billing practices from program to program, challenges with specific billing codes, variability in reimbursement from state to state and insurance plan to insurance plan, and a general lack of practitioner awareness of code issues or reimbursement rates. Implications and future directions are discussed in terms of research, training, and clinical service.

Action, prevention and epidemiology of paediatric obesity

DEFF Research Database (Denmark)

Lissau, Inge

2005-01-01

prevention studies, all of which are performed outside Denmark. Thus, this paper is not a classical review but rather a highlight of some aspects that the author finds important. The latest Danish national figures show a marked increase in the prevalence of obesity, especially among young men-a sevenfold...... regarding a national action plan against obesity. CONCLUSION: This paper highlights some important aspects of the epidemiology, prevention and actions in the field of paediatric obesity with special focus on Denmark.......UNLABELLED: The overall aim of this paper is to describe important issues regarding paediatric obesity as a public health problem. This paper focuses on actions taken, and on the prevalence of obesity in children, teens and adults in Denmark. In addition, the paper describes some important...

The Impact of Abdominal Obesity Status on Cardiovascular Response to the Mediterranean Diet

Directory of Open Access Journals (Sweden)

Alexandra Bédard

2012-01-01

Full Text Available We investigated the impact of abdominal obesity status on the cardiovascular response to a fully controlled 4-week isoenergetic Mediterranean diet (MedDiet. Thirty-eight abdominally obese individuals (waist circumference >102 cm in men and >88 cm in women and thirty-one nonabdominally obese individuals were recruited and studied before and after the MedDiet. All analyses were adjusted for the slight decrease in body weight, which occurred during the MedDiet (mean: 0.9±1.2 kg. A group by time interaction was noted for waist circumference (P=0.02, abdominally obese subjects showing a significant decrease and nonabdominally obese subjects a nonsignificant increase (resp., −1.1 and +0.3%. The MedDiet resulted in decreases in total cholesterol, LDL-C, HDL-C, apolipoprotein B, A-1, and A-2, total cholesterol/HDL-C ratio, LDL-C/HDL-C ratio, and systolic and diastolic blood pressure (time effect: P<0.05. For all variables related to glucose/insulin homeostasis, no change was observed except for a decrease in 2 h glucose concentrations (time effect: P=0.03. No group by time interaction was observed in any of the metabolic variables studied. Results from our study suggest that the adoption of the MedDiet leads to beneficial metabolic effects, irrespective of the abdominal obesity status.

Meal planning is associated with food variety, diet quality and body weight status in a large sample of French adults.

Science.gov (United States)

Ducrot, Pauline; Méjean, Caroline; Aroumougame, Vani; Ibanez, Gladys; Allès, Benjamin; Kesse-Guyot, Emmanuelle; Hercberg, Serge; Péneau, Sandrine

2017-02-02

Meal planning could be a potential tool to offset time scarcity and therefore encourage home meal preparation, which has been linked with an improved diet quality. However, to date, meal planning has received little attention in the scientific literature. The aim of our cross-sectional study was to investigate the association between meal planning and diet quality, including adherence to nutritional guidelines and food variety, as well as weight status. Meal planning, i.e. planning ahead the foods that will be eaten for the next few days, was assessed in 40,554 participants of the web-based observational NutriNet-Santé study. Dietary measurements included intakes of energy, nutrients, food groups, and adherence to the French nutritional guidelines (mPNNS-GS) estimated through repeated 24-h dietary records. A food variety score was also calculated using Food Frequency Questionnaire. Weight and height were self-reported. Association between meal planning and dietary intakes were assessed using ANCOVAs, while associations with quartiles of mPNNS-GS scores, quartiles of food variety score and weight status categories (overweight, obesity) were evaluated using logistic regression models. A total of 57% of the participants declared to plan meals at least occasionally. Meal planners were more likely to have a higher mPNNS-GS (OR quartile 4 vs. 1 = 1.13, 95% CI: [1.07-1.20]), higher overall food variety (OR quartile 4 vs. 1 = 1.25, 95% CI: [1.18-1.32]). In women, meal planning was associated with lower odds of being overweight (OR = 0.92 [0.87-0.98]) and obese (OR = 0.79 [0.73-0.86]). In men, the association was significant for obesity only (OR = 0.81 [0.69-0.94]). Meal planning was associated with a healthier diet and less obesity. Although no causality can be inferred from the reported associations, these data suggest that meal planning could potentially be relevant for obesity prevention.

The evolution of policy and actions to tackle obesity in England.

Science.gov (United States)

Jebb, S A; Aveyard, P N; Hawkes, C

2013-11-01

Tackling obesity has been a policy priority in England for more than 20 years. Two formal government strategies on obesity in 2008 and 2011 drew together a range of actions and developed new initiatives to fill perceived gaps. Today, a wide range of policies are in place, including support for breastfeeding and healthy weaning practices, nutritional standards in schools, restrictions on marketing foods high in fat, sugar and salt to children, schemes to boost participation in sport, active travel plans, and weight management services. Data from annual surveys show that the rate of increase in obesity has attenuated in recent years, but has not yet been reversed. This paper considers the actions taken and what is known about the impact of individual policies and the overarching strategy to tackle obesity in England. © 2013 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.

Clinical Implementation of an Online Adaptive Plan-of-the-Day Protocol for Nonrigid Motion Management in Locally Advanced Cervical Cancer IMRT

Energy Technology Data Exchange (ETDEWEB)

Heijkoop, Sabrina T., E-mail: s.heijkoop@erasmusmc.nl; Langerak, Thomas R.; Quint, Sandra; Bondar, Luiza; Mens, Jan Willem M.; Heijmen, Ben J.M.; Hoogeman, Mischa S.

2014-11-01

Purpose: To evaluate the clinical implementation of an online adaptive plan-of-the-day protocol for nonrigid target motion management in locally advanced cervical cancer intensity modulated radiation therapy (IMRT). Methods and Materials: Each of the 64 patients had four markers implanted in the vaginal fornix to verify the position of the cervix during treatment. Full and empty bladder computed tomography (CT) scans were acquired prior to treatment to build a bladder volume-dependent cervix-uterus motion model for establishment of the plan library. In the first phase of clinical implementation, the library consisted of one IMRT plan based on a single model-predicted internal target volume (mpITV), covering the target for the whole pretreatment observed bladder volume range, and a 3D conformal radiation therapy (3DCRT) motion-robust backup plan based on the same mpITV. The planning target volume (PTV) combined the ITV and nodal clinical target volume (CTV), expanded with a 1-cm margin. In the second phase, for patients showing >2.5-cm bladder-induced cervix-uterus motion during planning, two IMRT plans were constructed, based on mpITVs for empty-to-half-full and half-full-to-full bladder. In both phases, a daily cone beam CT (CBCT) scan was acquired to first position the patient based on bony anatomy and nodal targets and then select the appropriate plan. Daily post-treatment CBCT was used to verify plan selection. Results: Twenty-four and 40 patients were included in the first and second phase, respectively. In the second phase, 11 patients had two IMRT plans. Overall, an IMRT plan was used in 82.4% of fractions. The main reasons for selecting the motion-robust backup plan were uterus outside the PTV (27.5%) and markers outside their margin (21.3%). In patients with two IMRT plans, the half-full-to-full bladder plan was selected on average in 45% of the first 12 fractions, which was reduced to 35% in the last treatment fractions. Conclusions: The implemented

Glucose metabolism disorder in obese children assessed by continuous glucose monitoring system.

Science.gov (United States)

Zou, Chao-Chun; Liang, Li; Hong, Fang; Zhao, Zheng-Yan

2008-02-01

Continuous glucose monitoring system (CGMS) can measure glucose levels at 5-minute intervals over a few days, and may be used to detect hypoglycemia, guide insulin therapy, and control glucose levels. This study was undertaken to assess the glucose metabolism disorder by CGMS in obese children. Eighty-four obese children were studied. Interstitial fluid (ISF) glucose levels were measured by CGMS for 24 hours covering the time for oral glucose tolerance test (OGTT). Impaired glucose tolerance (IGT), impaired fasting glucose (IFG), type 2 diabetic mellitus (T2DM) and hypoglycemia were assessed by CGMS. Five children failed to complete CGMS test. The glucose levels in ISF measured by CGMS were highly correlated with those in capillary samples (r=0.775, Pobese children who finished the CGMS, 2 children had IFG, 2 had IGT, 3 had IFG + IGT, and 2 had T2DM. Nocturnal hypoglycemia was noted during the overnight fasting in 11 children (13.92%). Our data suggest that glucose metabolism disorder including hyperglycemia and hypoglycemia is very common in obese children. Further studies are required to improve the precision of the CGMS in children.

Process evaluation of a community-based adolescent obesity prevention project in Tonga.

Science.gov (United States)

Fotu, Kalesita F; Moodie, Marj M; Mavoa, Helen M; Pomana, Siosifa; Schultz, Jimaima T; Swinburn, Boyd A

2011-05-09

The rising burden of obesity in Tonga is alarming. The promotion of healthy behaviours and environments requires immediate urgent action and a multi-sectoral approach. A three-year community based study titled the Ma'alahi Youth Project (MYP) conducted in Tonga from 2005-2008 aimed to increase the capacity of the whole community (schools, churches, parents and adolescents) to promote healthy eating and regular physical activity and to reduce the prevalence of overweight and obesity amongst youth and their families. This paper reflects on the process evaluation for MYP, against a set of Best Practice Principles for community-based obesity prevention. MYP was managed by the Fiji School of Medicine. A team of five staff in Tonga were committed to planning, implementation and evaluation of a strategic plan, the key planks of which were developed during a two day community workshop. Intervention activities were delivered in villages, churches and schools, on the main island of Tongatapu. Process evaluation data covering the resource utilisation associated with all intervention activities were collected, and analysed by dose, frequency and reach for specific strategies. The action plan included three standard objectives around capacity building, social marketing and evaluation; four nutrition; two physical activity objectives; and one around championing key people as role models. While the interventions included a wide mix of activities straddling across all of these objectives and in both school and village settings, there was a major focus on the social marketing and physical activity objectives. The intervention reach, frequency and dose varied widely across all activities, and showed no consistent patterns. The adolescent obesity interventions implemented as part of the MYP program comprised a wide range of activities conducted in multiple settings, touched a broad spectrum of the population (wider than the target group), but the dose and frequency of activities were

Statistics and the statistician in nuclear site decontamination and decommissioning: lecture notes for a 4-day short course

International Nuclear Information System (INIS)

Barnes, M.G.

1981-04-01

This course provides information on statistical aspects of radiological surveys and the remedial action (RA) process to enable statisticians to serve effectively in Decommissioning and Decontamination (D and D) projects. The material covered is pertinent both to a statistician working onsite and handling day-to-day data analysis and to a statistical member of project planning and management teams. Participants will learn the types of statistical problems that can arise and the kinds of questions that must be answered to enable efficient statistical designs and analyses to be developed. The ultimate goal is to help extract the maximum benefit from statistical contributions to D and D projects. Among the topics covered are: Nature of the D and D Problem: Measuring Devices and Sampling Methods; Estimating Activity in or on Soil, Buildings, Equipment and Other Materials; Estimating Isotope Ratios and Error Variances; Acceptance Sampling as a General Method; Special Estimation Problems; Non-Statistical Consdierations; Challenge Problems

The Effects of Obesity and Age on Balance Recovery After Slipping

OpenAIRE

Allin, Leigh Jouett

2014-01-01

Falls due to slipping are a serious occupational concern. Slipping is estimated to cause 40-50% of all fall-related injuries. In 2011, falls resulted in 22% of injuries requiring days away from work. Epidemiological data indicates that older and obese adults experience more falls than young, non-obese individuals. An increasingly heavier and older workforce may be exacerbating the problem of slip-induced falls in the workplace. The purpose of this study was to examine the effects of obesity a...

History matters: childhood weight trajectories as a basis for planning community-based obesity prevention to adolescents.

Science.gov (United States)

Ekberg, J; Angbratt, M; Valter, L; Nordvall, M; Timpka, T

2012-04-01

To use epidemiological data and a standardized economic model to compare projected costs for obesity prevention in late adolescence accrued using a cross-sectional weight classification for selecting adolescents at age 15 years compared with a longitudinal classification. All children born in a Swedish county (population 440 000) in 1991 who participated in all regular measurements of height and weight at ages 5, 10 and 15 years (n=4312) were included in the study. The selection strategies were compared by calculating the projected financial load resulting from supply of obesity prevention services from providers at all levels in the health care system. The difference in marginal cost per 1000 children was used as the primary end point for the analyses. Using the cross-sectional selection strategy, 3.8% of adolescents at age 15 years were selected for evaluation by a pediatric specialist, and 96.2% were chosen for population-based interventions. In the trajectory-based strategy, 2.4% of the adolescents were selected for intensive pediatric care, 1.4% for individual clinical interventions in primary health care, 14.0% for individual primary obesity prevention using the Internet and 82.1% for population-based interventions. Costs for the cross-sectional selection strategy were projected to USD463 581 per 1000 adolescents and for the trajectory-based strategy were USD 302 016 per 1000 adolescents. Using projections from epidemiological data, we found that by basing the selection of adolescents for obesity prevention on weight trajectories, the load on highly specialized pediatric care can be reduced by one-third and total health service costs for obesity management among adolescents reduced by one-third. Before use in policies and prevention program planning, our findings warrant confirmation in prospective cost-benefit studies.

PREVALENCE AND DETERMINANT OF OBESITY AMONGST SCHOOL GOING ADOLESCENT OF ASSAM

Directory of Open Access Journals (Sweden)

Tulika Goswami Mahanta

2017-08-01

Full Text Available BACKGROUND The risk factors of cardiovascular diseases (CVD in India are increasing at an alarming rate for the last few decades. Obesity is one major risk factor of CVD which start very early in life, hence there is a need to determine prevalence and risk factor of obesity among younger age group so as to plan preventive strategies. MATERIALS AND METHODS A cluster sample with cluster size of 50 was taken from 16 schools to cover sample size of 800 with consideration of design effect. Socio-demographic, environmental, dietary, and anthropometric and laboratory risk factors were assessed in the studied population. RESULTS Obesity was prevalent in 5%, while overweight in 10%. Overweight and obesity was found to be more amongst students having educated parents (p<0.05. Strong association was seen amongst tobacco product users with overweight (p=0.000 and obesity (p=0.001, secondhand smoke exposures and depression (p<0.05, alcohol consumption, less fruit intake (weekly (p<0.05, frequent animal food product consumer with both overweight (p=0.007 and obesity (p=0.008. Maximum obese (2.0% students were daily consumer of sweet snacks (p=0.030. Overweight and obesity were strongly associated with number of meals served per day (p<0.05. Significant mean difference of systolic blood pressure, diastolic blood pressure and waist circumference between overweight and non-overweight and obese and non obese was seen. Second hand smoke exposure was associated with a statistically significant risk of overweight (OR=3.30, 95% CI = 1.754-6.210, p<0.05. Also hypertension was significantly associated with overweight and obesity with (OR=.30, 95% CI = 0.175-0.522, p<0.05 and (OR=0.25, 95% CI = 0.126-0.513, p<0.05 respectively. CONCLUSION There is a need to reduce the risk factor prevalence of CVD to address the future epidemic of non communicable disease amongst this group of population. Different health promotional activities can be implemented with implementation

Hypothalamic expression of anorexigenic and orexigenic hormone receptors in obese females Neotomodon alstoni: effect of fasting.

Science.gov (United States)

Báez-Ruiz, Adrián; Luna-Moreno, Dalia; Carmona-Castro, Agustín; Cárdenas-Vázquez, René; Díaz-Muñoz, Mauricio; Carmona-Alcocer, Vania; Fuentes-Granados, Citlalli; Manuel, Miranda-Anaya

2014-01-01

Obesity is a world problem that requires a better understanding of its physiological and genetic basis, as well as the mechanisms by which the hypothalamus controls feeding behavior. The volcano mouse Neotomodon alstoni develops obesity in captivity when fed with regular chow diet, providing a novel model for the study of obesity. Females develop obesity more often than males; therefore, in this study, we analysed in females, in proestrous lean and obese, the differences in hypothalamus expression of receptors for leptin, ghrelin (growth hormone secretagogue receptor GHS-R), and VPAC, and correlates for plasma levels of total ghrelin. The main comparisons are between mice fed ad libitum and mice after 24 hours of fasting. Mice above 65 g body weight were considered obese, based on behavioral and physiological parameters such as food intake, plasma free fatty acids, and glucose tolerance. Hypothalamic tissue from obese and lean mice was analysed by western blot. Our results indicate that after ad libitum food access, obese mice show no significant differences in hypothalamic leptin receptors, but a significant increase of 60% in the GHS-R, and a nearly 62% decrease in VPAC2 was noted. After a 24-hour fast, plasma ghrelin increased nearly two fold in both lean and obese mice; increases of hypothalamic leptin receptors and GHS-R were also noted, while VPAC2 did not change significantly; levels of plasma free fatty acids were 50% less after fasting in obese than in lean animals. Our results indicate that in obese N. alstoni mice, the levels of orexigenic receptors in the hypothalamus correlate with overfeeding, and the fact that lean and obese females respond in different ways to a metabolic demand such as a 24-hour fast.

Evaluation of an electronic health record-supported obesity management protocol implemented in a community health center: a cautionary note.

Science.gov (United States)

Steglitz, Jeremy; Sommers, Mary; Talen, Mary R; Thornton, Louise K; Spring, Bonnie

2015-07-01

Primary care clinicians are well-positioned to intervene in the obesity epidemic. We studied whether implementation of an obesity intake protocol and electronic health record (EHR) form to guide behavior modification would facilitate identification and management of adult obesity in a Federally Qualified Health Center serving low-income, Hispanic patients. In three studies, we examined clinician and patient outcomes before and after the addition of the weight management protocol and form. In the Clinician Study, 12 clinicians self-reported obesity management practices. In the Population Study, BMI and order data from 5000 patients and all 40 clinicians in the practice were extracted from the EHR preintervention and postintervention. In the Exposure Study, EHR-documented outcomes for a sub-sample of 46 patients actually exposed to the obesity management form were compared to matched controls. Clinicians reported that the intake protocol and form increased their performance of obesity-related assessments and their confidence in managing obesity. However, no improvement in obesity management practices or patient weight-loss was evident in EHR records for the overall clinic population. Further analysis revealed that only 55 patients were exposed to the form. Exposed patients were twice as likely to receive weight-loss counseling following the intervention, as compared to before, and more likely than matched controls. However, their obesity outcomes did not differ. Results suggest that an obesity intake protocol and EHR-based weight management form may facilitate clinician weight-loss counseling among those exposed to the form. Significant implementation barriers can limit exposure, however, and need to be addressed. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Probiotics for experimental obesity prevention: focus on strain dependence and viability of composition.

Science.gov (United States)

Kobyliak, Nazarii; Falalyeyeva, Tetyana; Beregova, Tetyana; Spivak, Mykola

2017-01-01

a comparative animal study of the efficacy of intermittent short-course administration of lyophilised single-, three-, and live multistrain probiotic on obesity. We included 70 rats divided into seven groups (n = 10 in each). Rats of group I were intact. Newborn rats of groups II-VII were injected with monosodium glutamate (MSG) (4 mg/g). Rats of group II (MSG-obesity group) were untreated. The group III-V received lyophilised monoprobiotics B. animalis VKL, B. animalis VKB, and L. casei IMVB-7280, respectively. Group VI received the mix of these three probiotic strains. Group VII was treated with multiprobiotic "Symbiter", which contains 14 live probiotic strains (Lactobacillus, Bifi-dobacterium, Propionibacterium, Acetobacter genera). Neonatal treatment with MSG caused stunted growth, which is why, despite the lack of weight gain dynamics and absence of significant food consumption rate and body weight changes at day 120, we noted the development of obesity in all MSG-obesity rats and in up to 20-70% after probiotic administration. Supplementation of probiotic composition, with preference to live strains, led to a significantly lower prevalence of obesity, and reduction of VAT weight and serum lipid levels as compared to single-strain probiotic. In our comparative single-strain analysis a trend towards more pronounced hypolipidaemic effect and VAT weight reduction was observed for lyophilised L. casei IMVB-7280 as compared to B. animalis VKL and VKB strains. Multistrain formed mutualistic interactions in mixtures and therefore able to share with different metabolites, affect differ-ent receptors and produced various of biologically active compounds which synergistic overall effect greater than the sum of the single effects.

Discrepancies Between Planned and Actual Operating Room Turnaround Times at a Large Rural Hospital in Germany

Directory of Open Access Journals (Sweden)

Regula Morgenegg

2018-01-01

retrospective study examined the OR turnaround data of 875 elective surgery cases scheduled at the Marienhospital, Vechta, Germany, between July and October 2014. The frequency distributions of planned and actual OR turnaround times were compared and correlations between turnaround times and various factors were established, including the time of day of the procedure, patient age and the planned duration of the surgery. Results: There was a significant difference between mean planned and actual OR turnaround times (0.32 versus 0.64 hours; P <0.001. In addition, significant correlations were noted between actual OR turnaround times and the time of day of the surgery, patient age, actual duration of the procedure and staffing changes affecting the surgeon or the medical specialty of the surgery (P <0.001 each. The quotient of actual/planned OR turnaround times ranged from 1.733–3.000. Conclusion: Significant discrepancies between planned and actual OR turnaround times were noted during the study period. Such findings may be potentially used in future studies to establish a tool to improve OR planning, measure OR management performance and enable benchmarking.

Designing Insurance to Promote Use of Childhood Obesity Prevention Services

Directory of Open Access Journals (Sweden)

Kimberly J. Rask

2013-01-01

Full Text Available Childhood obesity is a recognized public health crisis. This paper reviews the lessons learned from a voluntary initiative to expand insurance coverage for childhood obesity prevention and treatment services in the United States. In-depth telephone interviews were conducted with key informants from 16 participating health plans and employers in 2010-11. Key informants reported difficulty ensuring that both providers and families were aware of the available services. Participating health plans and employers are beginning new tactics including removing enrollment requirements, piloting enhanced outreach to selected physician practices, and educating providers on effective care coordination and use of obesity-specific billing codes through professional organizations. The voluntary initiative successfully increased private health insurance coverage for obesity services, but the interviews described variability in implementation with both best practices and barriers identified. Increasing utilization of obesity-related health services in the long term will require both family- and provider-focused interventions in partnership with improved health insurance coverage.

The Association between Obesity and Cognitive Function in Otherwise Healthy Premenopausal Arab Women.

Science.gov (United States)

Farooq, Abdulaziz; Gibson, Ann-Marie; J Reilly, John; Gaoua, Nadia

2018-01-01

To examine the association between obesity and cognitive function in healthy premenopausal women. From a cohort of 220 women, 98 were randomly selected that provided complete data. Body composition was examined by dual-energy X-ray scan. All participants completed the Cambridge Neuropsychological Test Automated Battery (CANTAB) to assess cognitive performance in three domains: attention, memory, and planning executive function. The Reaction Time (RTI) test was used to assess motor and mental response speeds; the Stockings of Cambridge (SOC) test was used to assess planning executive function. For memory assessment, the Delayed Match to Sample (DMS), Pattern Recognition Memory (PRM), and Spatial Span (SSP) tests were used to assess forced choice recognition memory, visual pattern recognition memory, and working memory capacity, respectively. 36 (36.7%) were morbidly obese, 22 (22.4%) obese, and 23 (23.5%) overweight. Performance on RTI and SOC planning ability were not associated with body mass index (BMI). DMS mean time to correct response, when stimulus is visible or immediately hidden (0 ms delay), was higher by 785 ± 302 ms (milliseconds) ( p =0.011) and 587 ± 259 ms ( p =0.026) in morbidly obese women compared to normal weight women. Memory span length was significantly lower in overweight (5.5 ± 1.3, p =0.008) and obese women (5.6 ± 1.6, p =0.007) compared to normal weight (6.7 ± 0.9). DEXA-assessed body fat (%) showed similar associations as BMI, and latency to correct response on DMS and PRM was positively correlated with percentage of body fat, but not with VO 2 max. In otherwise healthy premenopausal women, obesity did not impact accuracy on cognitive tasks related to attention, memory, or planning executive function, but morbid obesity was associated with higher latency to correct response on memory-specific tasks and lower memory span length.

Can the Theory of Planned Behavior predict dietary intention and future dieting in an ethnically diverse sample of overweight and obese veterans attending medical clinics?

Science.gov (United States)

Lash, Denise N; Smith, Jane Ellen; Rinehart, Jenny K

2016-04-01

Obesity has become a world-wide epidemic; in the United States (U.S.) approximately two-thirds of adults are classified as overweight or obese. Military veterans' numbers are even higher, with 77% of retired or discharged U.S. veterans falling in these weight categories. One of the most common methods of changing one's weight is through dieting, yet little is known regarding the factors that facilitate successful dieting behavior. The current investigation tested the Theory of Planned Behavior's (TPB) ability to predict dietary intention and future dieting in a sample of 84 overweight and obese patients attending medical clinics at a Veterans Affairs Hospital in the southwestern part of the U.S. Participants primarily were male (92%) and ethnic/racial minorities (58%). Perceived need and anticipated regret were added to the standard TPB model. While the TPB predicted dietary intention, it did not significantly account for improved dietary behaviors. Anticipated regret significantly enhanced the basic TPB's ability to predict intention to diet, while perceived need did not. These findings highlight the difficulty in predicting sustained change in a complex behavior such as dieting to lose weight. The need for more work with older, overweight/obese medical patients attending veterans' facilities is stressed, as is the need for such work with male patients and ethnic minorities in particular. Copyright © 2016 Elsevier Ltd. All rights reserved.

Can the Theory of Planned Behavior Predict Dietary Intention and Future Dieting in an Ethnically Diverse Sample of Overweight and Obese Veterans Attending Medical Clinics?

Science.gov (United States)

Lash, Denise N.; Smith, Jane Ellen; Rinehart, Jenny K.

2016-01-01

Obesity has become a world-wide epidemic; in the United States (U.S.) approximately two-thirds of adults are classified as overweight or obese. Military veterans’ numbers are even higher, with 77% of retired or discharged U.S. veterans falling in these weight categories. One of the most common methods of changing one’s weight is through dieting, yet little is known regarding the factors that facilitate successful dieting behavior. The current investigation tested the Theory of Planned Behavior’s (TPB) ability to predict dietary intention and future dieting in a sample of 84 overweight and obese patients attending medical clinics at a Veterans Affairs Hospital in the southwestern part of the U.S. Participants primarily were male (92%) and ethnic/racial minorities (58%). Perceived need and anticipated regret were added to the standard TPB model. While the TPB predicted dietary intention, it did not significantly account for improved dietary behaviors. Anticipated regret significantly enhanced the basic TPB’s ability to predict intention to diet, while perceived need did not. These findings highlight the difficulty in predicting sustained change in a complex behavior such as dieting to lose weight. The need for more work with older, overweight/obese medical patients attending veterans’ facilities is stressed, as is the need for such work with male patients and ethnic minorities in particular. PMID:26792774

Recommendations related to the strategic environmental assessment. Methodological note

International Nuclear Information System (INIS)

Le Bris, Charlotte; Brivadier, Isabelle; Fournie, Sebastien; Godart, Angelique; Hubert, Severine; Ille, Yann-Mikiel; Le Mitouard, Eric; Phelep, Michele; Delduc, Paul; Poitevin, Florent; Lemaitre, Valery; Bataille, Tristan; Noulin, Alice; Fevre, Cecile; Kervella, Frederic; Orefici, Christine; Rambaud, Lucile; Antoine, Stephanie; Wormser, Veronique; Garrigou, Olivier; Vinay, Catherine; Cretin, Benedicte; Le Saout, Michaele; Pagnucco, Fabrice; Meinier, Yves; Nicolas, Veronique; Thiolliere, Blandine; Guilbert, Sebastien; Billant, Claude; Saingenest, Patrick

2015-05-01

This methodological note aims at giving commissioners and project managers of plans, schemes and programmes or other planning documents related to strategic environmental assessment a comprehensive vision of the approach to be adopted, as well as useful advices and operational recommendations. The first part recalls the main principles of environmental assessment, addresses general issues of organisation of the approach, and clarifies its articulation with the plan/scheme/programme elaboration or other approaches such as the assessment of incidences on the Natura 2000 network. The second part addresses the different chapters which are foreseen by the regulation for the environmental report. Some sheets are proposed on SDAGEs (Water Development and Management Master Plans) and PGIRs (flood risk management plans), on SRCs (quarry regional plan) and SAGEs (Water Development and Management Scheme)

PS2-15: Coding for Obesity in a Health Plan Claims Database

OpenAIRE

Shainline, Michael; Carter, Shelley; Von Worley, Ann; Gunter, Margaret

2010-01-01

Background and Aims: The Centers for Disease Control estimated the obesity rate in New Mexico for 2008 to be 25.2%. Sources estimate the following associations between obesity and type 2 diabetes (80%); cardiovascular disease (70%); hypertension (26 %). Yet obesity is infrequently coded as a secondary diagnosis among providers submitting claims. This study examines the frequency with which obesity is documented on claims forms, the relationship between age, gender, and obesity coding, and the...

Overweight and Obese Humans Overeat Away from Home

Science.gov (United States)

de Castro, John M.; King, George A.; Duarte-Gardea, Maria; Gonzalez-Ayala, Salvador; Kooshian, Charles H.

2012-01-01

The built environment has been implicated in the development of the epidemic of obesity. We investigated the differences in the meal patterns of normal weight vs. overweight/obese individuals occurring at home vs. other locations. The location of meals and their size in free-living participants were continuously recorded for 7 consecutive days. Study 1: 81 males and 84 females recorded their intake in 7-d diet diaries and wore a belt that contained a GPS Logger to record their location continuously for 7 consecutive days. Study 2: 388 males and 621 females recorded their intake in diet diaries for 7 consecutive days. In both studies, compared to eating at home, overweight/obese participants ate larger meals away from home in both restaurants and other locations than normal weight participants. Overweight/obese individuals appear to be more responsive to environmental cues for eating away from home. This suggests that the influence of the built environment on the intake of overweight/obese individuals may contribute to the obesity epidemic. PMID:22565154

Obesity is Not Associated with Increased Short-term Complications After Primary Total Shoulder Arthroplasty.

Science.gov (United States)

Jiang, Jimmy J; Somogyi, Jason R; Patel, Pranay B; Koh, Jason L; Dirschl, Douglas R; Shi, Lewis L

2016-03-01

Class 2 or greater relative risk: 0.54 [95% CI, 0.25-1.17], p = 0.117). However, greater BMI was associated with longer surgical times (for normal BMI control group: 110 minutes, SD, 42 minutes; overweight group: 115 minutes, SD, 46 minutes, mean difference to control: 5 minutes [95% CI, -1 to 10 minutes], p = 0.096; obesity Class 1: 120 minutes, SD, 43 minutes, mean difference: 10 minutes [95% CI, 5-15 minutes], p < 0.001; obesity Class 2 or greater: 122 minutes, SD, 45 minutes, mean difference: 12 minutes [95% CI, 6-18 minutes], p < 0.001). Although the surgical time increased for patients with greater BMI, the 30-day complications and perioperative hospitalization data after TSA were not different in patients with increased BMI levels. Obesity alone should not be a contraindication for TSA, and obese patients can expect similar incidences of postoperative complications. The preoperative medical optimization plan should be consistent with that of patients who are not obese who undergo TSA. Level III, therapeutic study.

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

Science.gov (United States)

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.

Technical Note: Improving the VMERGE treatment planning algorithm for rotational radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Gaddy, Melissa R., E-mail: mrgaddy@ncsu.edu; Papp, Dávid, E-mail: dpapp@ncsu.edu [Department of Mathematics, North Carolina State University, Raleigh, North Carolina 27695-8205 (United States)

2016-07-15

Purpose: The authors revisit the VMERGE treatment planning algorithm by Craft et al. [“Multicriteria VMAT optimization,” Med. Phys. 39, 686–696 (2012)] for arc therapy planning and propose two changes to the method that are aimed at improving the achieved trade-off between treatment time and plan quality at little additional planning time cost, while retaining other desirable properties of the original algorithm. Methods: The original VMERGE algorithm first computes an “ideal,” high quality but also highly time consuming treatment plan that irradiates the patient from all possible angles in a fine angular grid with a highly modulated beam and then makes this plan deliverable within practical treatment time by an iterative fluence map merging and sequencing algorithm. We propose two changes to this method. First, we regularize the ideal plan obtained in the first step by adding an explicit constraint on treatment time. Second, we propose a different merging criterion that comprises of identifying and merging adjacent maps whose merging results in the least degradation of radiation dose. Results: The effect of both suggested modifications is evaluated individually and jointly on clinical prostate and paraspinal cases. Details of the two cases are reported. Conclusions: In the authors’ computational study they found that both proposed modifications, especially the regularization, yield noticeably improved treatment plans for the same treatment times than what can be obtained using the original VMERGE method. The resulting plans match the quality of 20-beam step-and-shoot IMRT plans with a delivery time of approximately 2 min.

Pediatric Obesity: It's Time for Prevention before Conception Can Maternal Obesity Program Pediatric Obesity?

Directory of Open Access Journals (Sweden)

Zach Ferraro

2008-01-01

Full Text Available Global increases in obesity have led public health experts to declare this disease a pandemic. Although prevalent in all ages, the dire consequences associated with maternal obesity have a pronounced impact on the long-term health of their children as a result of the intergenerational effects of developmental programming. Previously, fetal under-nutrition has been linked to the predisposition to pediatric obesity explained by the adiposity rebound and ‘catch-up’ growth that occurs when a child born to a nutrient deprived mother is exposed to the obesogenic environment of present day. Given the recent increase in maternal overweight/obesity (OW/OB our attention has shifted from nutrient restriction to overabundance and excess during pregnancy. Consideration must now be given to interventions that could mitigate pregravid body mass index (BMI, attenuate gestational weight gain (GWG and reduce postpartum weight retention (PPWR in an attempt to prevent the downstream signaling of pediatric obesity and halt the intergenerational cycle of weight related disease currently plaguing our world. Thus, this paper will briefly review current research that best highlights the proposed mechanisms responsible for the development of child OW/OB and related sequalae (e.g. type II diabetes (T2D and cardiovascular disease (CVD resulting from maternal obesity.

Governing obesity policies from England, France, Germany and Scotland

DEFF Research Database (Denmark)

Vallgårda, Signild

2015-01-01

for the development? What are the suggested remedies and who is considered responsible for acting? All plans state that obesity is a po- litical issue because it causes health problems; in fact, weight is almost equated to health. The English and Scottish plans present a bio-political argument, characterising obesity...

Planning ahead: Improving escalation plans before the weekend.

Science.gov (United States)

Zarkali, Angeliki; Black, Duncan; Smee, Elizabeth; Deshraj, Anshul; Smallwood, Nicholas

2014-01-01

Handover is the system by which responsibility for patient care is transferred between healthcare professionals. A significant aspect of handover is the existence of an escalation plan for each patient in case of deterioration over the weekend. According to the Royal College of Physicians, all patients should have a clear escalation plan documented in the notes before a weekend, since parent medical teams (Consultant team in charge of care) are best placed to make these decisions. If left to on-call teams, at a time of deterioration over a weekend, they might not have all available information, the patient might be unable to be involved in the decisions, and the family might not be consulted. With this is mind, we decided to analyse the existing handover process in a medium sized district general hospital, with the aim of improving the process and the documentation of escalation plans. The results from our retrospective analysis of the system in place revealed a significant lack of documentation of escalation plans in the medical notes. Three sample wards were selected to analyse the current handover system and test proposed measures before hospital-wide implementation. After trialling of a physical handover meeting in addition to the existing intranet system and a proforma for the Friday ward round, the documentation of escalation plans in the patients' notes improved from 9.1% to 41.1%. Based on these results, as well as formal feedback from junior doctors and informal feedback from other staff, the physical handover meeting and Friday ward round proforma will be implemented throughout the Trust. Our interventions led to an improvement in the documentation of escalation plans in our hospital, thus saving precious time in the event of a patient's deterioration. This also ensures that families and patients are involved in the decision making process and kept informed, and reduces the burden for the weekend on-call teams.

Animal product consumption and subsequent fatal breast cancer risk among Seventh-day Adventists.

Science.gov (United States)

Mills, P K; Annegers, J F; Phillips, R L

1988-03-01

Seventh-day Adventist women experience lower mortality rates from breast cancer than other white females in the United States. To evaluate the role of diet in relation to breast cancer within this unique population (more than one-half of all Adventist women are lacto-ovo-vegetarians), a nested case-control study was conducted including 142 cases of fatal breast cancer and 852 matched controls among California Seventh-day Adventist women in 1960-1980. No significant relations between the consumption of animal products (meat, milk, cheese, and eggs) and breast cancer were evident. Odds ratios of 1.00, 1.22, and 1.03 were observed for meat consumption categories of none or occasional, 1-3 days/week, and 4+ days/week, respectively. However, among those women who experienced a relatively early age at natural menopause (less than or equal to 48 years), a suggestive though nonsignificant, positive association between meat consumption and risk was noted. These relations remained unchanged after simultaneously controlling for the effects of other covariates (menstrual characteristics and obesity) via conditional logistic regression analysis. Risk was not related to age at first exposure to the vegetarian lifestyle nor to duration of exposure to the vegetarian lifestyle.

Obesity Treatment Strategies

Directory of Open Access Journals (Sweden)

Simona Ianosi Edith

2015-12-01

Full Text Available Obesity is a disease with severe health consequences and increased risk of mortality. The most commonly used criteria to assess the presence and the severity of obesity are body mass index, waist circumference, waist-to-height ratio and the presence of the health conditions caused or worsened by obesity. Worldwide obesity has more than doubled in the last 4 decades. Obesity is the second of the leading preventable causes of death worldwide (after smoking. Obesity has a plurifactorial pathogenesis. The central perturbation consists in the imbalance between calories intake and calories consumption (by inappropriate diet and sedentary lifestyle. Identification of all the ethiological factors is important for treatment and prophylaxis. Weight loss benefits are multiple and important: improvement in glicemic control and in plasma lipid levels, blood presure control, obstructiv sleep apneea reduction, improvement in management of daily activities and profesional performances, increase quality of life, reduction in mortality. Overweight or obese patient will complete a diagnostic and a treatment program. Treatment of obesity claims a targeted multidimensional therapy: weight and lifestyle management, diet, sustained physical activity in daily life, exercise, decrease life stressors, smoking cessation, drug therapy, bariatric surgery psichological, familial and social suport. Weight loss program must be carefully planned, adapted to the patient’s abilities and comorbidities and supervised by a nutritionist and a physiotherapist.

Obesity and television watching in preschoolers in Greece: the GENESIS study.

Science.gov (United States)

Manios, Yannis; Kourlaba, Georgia; Kondaki, Katerina; Grammatikaki, Evangelia; Anastasiadou, Anastasia; Roma-Giannikou, Eleytheria

2009-11-01

The aim of the current work was to evaluate the effect of preschoolers' television (TV) watching time on the prevalence of obesity even after controlling for their total energy intake and their physical activity status. A representative sample of 2,374 Greek children aged 1-5 years was examined ("Growth, Exercise and Nutrition Epidemiological Study in preSchoolers", GENESIS study). Children's TV watching time on a usual weekday and at a usual weekend was recorded. The overall mean of children's TV viewing time was 1.32 h/day. The majority of participants (74.0%) spent 4 h/day in front of a TV set. Overall, 65.2% of participants were normal weight, 17.2% were overweight, and the rest 17.6% were obese. The prevalence of obesity was significantly higher among those with TV viewing time >or=2 h/day (21.7%) compared to those watching TV characteristics and physical activity status) only among children aged 3-5 years. However, further adjusting for children's total energy intake revealed that the association between the TV viewing time and the probability of being obese was no longer statistically significant. On the other hand, physical activity status continued to be an independent factor of being obese. The current findings support the hypothesis that the effect of TV viewing time on childhood obesity is independent of physical activity status and may be attributed to the increased total energy intake during TV watching.

Multi-day activity scheduling reactions to planned activities and future events in a dynamic model of activity-travel behavior

NARCIS (Netherlands)

Nijland, L.; Arentze, T.A.; Timmermans, H.J.P.

2014-01-01

Modeling multi-day planning has received scarce attention in activity-based transport demand modeling so far. However, new dynamic activity-based approaches are being developed at the current moment. The frequency and inflexibility of planned activities and events in activity schedules of

Multi-Day Activity Scheduling Reactions to Planned Activities and Future Events in a Dynamic Model of Activity-Travel Behavior

NARCIS (Netherlands)

Nijland, L.; Arentze, T.; Timmermans, H.

2014-01-01

Modeling multi-day planning has received scarce attention in activity-based transport demand modeling so far. However, new dynamic activity-based approaches are being developed at the current moment. The frequency and inflexibility of planned activities and events in activity schedules of

Daily Rhythms of Feeding in the Genetically Obese and Lean Zucker Rats

NARCIS (Netherlands)

Alingh Prins, Ab; Jong-Nagelsmit, Annemarie de; Keijser, Jan; Strubbe, Jan H.

1986-01-01

Feeding patterns were examined in obese (fa/fa) and lean (Fa/-) adult Zucker rats over the light-dark cycle during 14 days. Obese rats eat more than lean rats especially during the dark phase. Light and dark feeding expressed as percentage of 24 hr intake showed no significant differences between

Perception of childhood obesity in mothers of preschool children.

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Kim, Hae Ok; Kim, Gyo Nam; Park, Euna

2015-04-01

The purpose of this study was to identify the perception of childhood obesity in mothers of preschool children using Q methodology. A total of 38 Q statements about childhood obesity were obtained from 41 participants. The QUANL PC program was used to analyze the results. There were three types of perception toward obesity in mothers of preschool children: the "authoritative discipline type," the "generous home meal focused type," and the "home meal based on household financial situation type." The perception of mothers toward childhood obesity can affect the extent of maternal interaction with children or meal preparation for the family. Based on these results, it is necessary to plan specific programs according to the types of maternal perception toward childhood obesity.

The effect of poverty-influenced, food-related consumer behaviors on obesity: An analysis of the NHANES flexible consumer behavioral module.

Science.gov (United States)

O'Dare Wilson, Kellie

2017-01-01

Despite extensive research investigating obesity, the problem continues to increase, particularly in poor, minority, and under-resourced communities. However, the literature continues to demonstrate many obesity-predicating variables are outside of personal volitional control, such as food-related consumer behaviors, which are strongly influenced by income and environment. This cross-sectional study (n = 5,109) employed secondary data analysis to quantitatively examine the effect of food-related consumer variables on obesity while controlling for covariates. Participants answered questions regarding money spent on food, time preparing meals, number of meals eaten at home and away from home, and types of food products consumed (frozen/fast foods, sodas, salty snacks, etc.) In this study, 48.9% of respondents were either overweight or obese. No significant differences were noted between the contextual variables examined and BMI scores. However, given the sample's limitations illuminated in the study, further research regarding the relationship between obesity and poverty-influenced, food-related consumer behaviors is warranted.

The role of managed care organizations in obesity management.

Science.gov (United States)

Schaecher, Kenneth L

2016-06-01

In the United States, obesity is characterized as this century's greatest healthcare threat. The American Medical Association and several other large organizations now classify obesity as a disease. Several federal initiatives are in the planning stages, have been approved, or are being implemented to address the disease. Obesity poses challenges for all healthcare stakeholders. Diet and exercise often are insufficient to create the magnitude of change patients and their attending healthcare providers need. Managed care organizations (MCOs) have 3 tools that can help their members: health and wellness programs focusing on lifestyle changes, prescription weight-loss drugs, and bariatric surgical interventions. MCOs are addressing changes with national requirements and are responding to the availability of new weight-loss drugs to help their members achieve better health. A number of factors either deter or stimulate the progress of weight loss therapy. Understanding how MCOs are key to managing obesity at the local level is important for healthcare providers. It can help MCOs and individual healthcare providers develop and coordinate strategies to educate stakeholders and better manage overall care.

Outcome of deliveries in healthy but obese women: obesity and delivery outcome

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Kaplan-Sturk Rebecka

2013-02-01

Full Text Available Abstract Background Obesity among fertile women is a global problem. 25% of pregnant Swedish women are overweight at admission to the antenatal clinic and 12% of them are considered as obese. Previous studies have shown an increased risk of delivery complications with an elevated maternal BMI. The aim of this study was to evaluate delivery outcomes in relation to maternal BMI on admission to the antenatal clinic. A healthy group of 787 women with full-term pregnancies and spontaneous onset of labor were included in the study. Delivery outcome was assessed in relation to maternal BMI when attending the antenatal clinic. Results The results indicated that in deliveries where the maternal BMI was >30 a high frequency of abnormal CTG trace during the last 30 minutes of labor was shown. A blood sample for evaluation of risk of fetal hypoxia was performed in only eight percent of these deliveries. A spontaneous vaginal delivery without intervention was noted in 85.7%, and 12% of neonates were delivered with an adverse fetal outcome compared to 2.8% in the group with a maternal BMI Conclusion These results indicate an increased risk at delivery for healthy, but obese women in labor. Furthermore, the delivery management may not always be optimal in these deliveries.

Math-A-Day A Book of Days for Your Mathematical Year

CERN Document Server

Pappas, Theoni

1999-01-01

Pappas has come up with yet another way to make math part of your life. MATH -A-DAY is not a calendar and not a reference book, but a compendium of mathematical information that will give you your math fix everyday.Each day -kick starts your brain with a problem or puzzle with detailed solutions includedhas a mathematical quote to inspire the other side of your brainfeatures a historical or current math note on a host of mathematica ideashas its date expressed in another number systemStart off your day with it. · Take it to meetings. · Share it with friends.

Living with childhood obesity: the experience of children enrolled in a multidisciplinary monitoring program

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Silvia Veridiana Zamparoni Victorino

2015-02-01

Full Text Available This study aimed to understand the perceptions of obesity from the perspective of obese children enrolled in a multidisciplinary monitoring program. Descriptive exploratory study of qualitative nature. Data collection occurred in December 2013, along with eight children accompanied by a child and adolescent obesity group in a municipality in northwestern Paraná, Brazil, through semi-structured interviews. Data were submitted to content analysis, from which four categories emerged: “Obesity in children’s perspective”; “Being an obese child”; “Eating and the practice of physical exercise in the routine of obese children”; and “Living with obesity: social and family implications for children.” It was verified the negative impact of obesity on children’s lives, justifying the importance of multidisciplinary follow-up through group activities, seeking a comprehensive care. Nursing is accountable for planning activities of health promotion and control of this disease, in order to improve the quality of life.

Childhood Obesity Research Demonstration (CORD): Evaluation plan

Science.gov (United States)

The Childhood Obesity Research Demonstration (CORD) project evaluation will determine the extent to which the CORD model of linking primary care (PC) interventions to public health (PH) interventions in multiple community sectors affects BMI and behavior in children (2 to 12 years). The evaluation c...

A Hamster Model of Diet-Induced Obesity for Preclinical Evaluation of Anti-Obesity, Anti-Diabetic and Lipid Modulating Agents.

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Louise S Dalbøge

Full Text Available Unlike rats and mice, hamsters develop hypercholesterolemia, and hypertriglyceridemia when fed a cholesterol-rich diet. Because hyperlipidemia is a hallmark of human obesity, we aimed to develop and characterize a novel diet-induced obesity (DIO and hypercholesterolemia Golden Syrian hamster model.Hamsters fed a highly palatable fat- and sugar-rich diet (HPFS for 12 weeks showed significant body weight gain, body fat accumulation and impaired glucose tolerance. Cholesterol supplementation to the diet evoked additional hypercholesterolemia. Chronic treatment with the GLP-1 analogue, liraglutide (0.2 mg/kg, SC, BID, 27 days, normalized body weight and glucose tolerance, and lowered blood lipids in the DIO-hamster. The dipeptidyl peptidase-4 (DPP-4 inhibitor, linagliptin (3.0 mg/kg, PO, QD also improved glucose tolerance. Treatment with peptide YY3-36 (PYY3-36, 1.0 mg/kg/day or neuromedin U (NMU, 1.5 mg/kg/day, continuously infused via a subcutaneous osmotic minipump for 14 days, reduced body weight and energy intake and changed food preference from HPFS diet towards chow. Co-treatment with liraglutide and PYY3-36 evoked a pronounced synergistic decrease in body weight and food intake with no lower plateau established. Treatment with the cholesterol uptake inhibitor ezetimibe (10 mg/kg, PO, QD for 14 days lowered plasma total cholesterol with a more marked reduction of LDL levels, as compared to HDL, indicating additional sensitivity to cholesterol modulating drugs in the hyperlipidemic DIO-hamster. In conclusion, the features of combined obesity, impaired glucose tolerance and hypercholesterolemia in the DIO-hamster make this animal model useful for preclinical evaluation of novel anti-obesity, anti-diabetic and lipid modulating agents.

Women in Guam consume more calories during feast days than during non-feast days.

Science.gov (United States)

Paulino, Yvette C; Leon Guerrero, Rachael T; Novotny, Rachel

2011-03-01

Parties (feast days) have become increasingly frequent and abundant, in terms of food, on the island of Guam. Considering the potential impact of this frequency and abundance on food intake, this study compared food intake during feast days and non-feast days of women in Guam (25 Chamorros; 24 Filipinas). The women (≥40 yr) recalled foods they usually consumed during feast days. Subsequently, a 24-hour dietary recall for a non-feast day was completed by a subsample (n=25). Height, weight, and waist circumference were measured to assess obesity status. Statistical analyses (paired t-test, ANOVA, and chi-square test) were performed with SPSS. Compared to a non-feast day, the women reported higher intakes of dietary energy (2645.0 ± 1125.8 versus 1654.0 ± 718.8 kcal/day), carbohydrates (43.8 ± 11.5% versus 51.8 ± 10.2% of kcal), total fat (34.1 ± 7.8% versus 27.5 ± 9.6% of kcal), saturated fat (11.4 ± 4.7% versus 7.9 ± 3.4% of kcal), and sugar (89.5 ± 62.8 versus 47.3 ± 42.2 g/day) on feast days. Chamorros, compared to Filipinas, reported higher dietary energy density (1.7 ± 0.4 versus 1.4 ± 0.3 kcal/g), total fat (35.3 ± 8.9% versus 30.7 ± 6.8% of kcal), and saturated fat (12.4 ± 4.9% versus 9.4 ± 3.3% of kcal); and lower servings of fruit (0.5 ± 1.0 versus 2.7 ± 1.8) on feast days. Fourteen Chamorros (56.0%) and one Filipina (4.1%) were classified as obese. Current feasting behaviors of women in Guam may contribute to obesity if continued for a long period. The women would benefit by choosing more fruit and vegetable dishes in place of high-energy dishes. Chamorro women would particularly benefit by reducing saturated fat intake. Traditional foods, such as taro, breadfruit, seafood, fruits, and vegetables, would help accomplish this and thus should be promoted at parties on Guam.

Contribution of temporal data to predictive performance in 30-day readmission of morbidly obese patients

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Petra Povalej Brzan

2017-04-01

Full Text Available Background Reduction of readmissions after discharge represents an important challenge for many hospitals and has attracted the interest of many researchers in the past few years. Most of the studies in this field focus on building cross-sectional predictive models that aim to predict the occurrence of readmission within 30-days based on information from the current hospitalization. The aim of this study is demonstration of predictive performance gain obtained by inclusion of information from historical hospitalization records among morbidly obese patients. Methods The California Statewide inpatient database was used to build regularized logistic regression models for prediction of readmission in morbidly obese patients (n = 18,881. Temporal features were extracted from historical patient hospitalization records in a one-year timeframe. Five different datasets of patients were prepared based on the number of available hospitalizations per patient. Sample size of the five datasets ranged from 4,787 patients with more than five hospitalizations to 20,521 patients with at least two hospitalization records in one year. A 10-fold cross validation was repeted 100 times to assess the variability of the results. Additionally, random forest and extreme gradient boosting were used to confirm the results. Results Area under the ROC curve increased significantly when including information from up to three historical records on all datasets. The inclusion of more than three historical records was not efficient. Similar results can be observed for Brier score and PPV value. The number of selected predictors corresponded to the complexity of the dataset ranging from an average of 29.50 selected features on the smallest dataset to 184.96 on the largest dataset based on 100 repetitions of 10-fold cross-validation. Discussion The results show positive influence of adding information from historical hospitalization records on predictive performance using all

What Is the Effect on Obesity Indicators from Replacing Prolonged Sedentary Time with Brief Sedentary Bouts, Standing and Different Types of Physical Activity during Working Days? A Cross-Sectional Accelerometer-Based Study among Blue-Collar Workers.

Science.gov (United States)

Gupta, Nidhi; Heiden, Marina; Aadahl, Mette; Korshøj, Mette; Jørgensen, Marie Birk; Holtermann, Andreas

2016-01-01

The aim of the study was to investigate if (a) substituting total sedentary time or long sedentary bouts with standing or various types of physical activity and (b) substituting long sedentary bouts with brief sedentary bouts; is associated with obesity indicators using a cross sectional isotemporal substitution approach among blue-collar workers. A total of 692 workers from transportation, manufacturing and cleaning sectors wore an Actigraph GT3X+ accelerometer on the thigh for 1-4 working days. The sedentary (sit and lie), standing, walking, and moderate to vigorous physical activity (MVPA) time on working days was computed using validated Acti4 software. The total sedentary time and uninterrupted sedentary time spent in brief (≤5 mins), moderate (>5 and ≤30 mins), and long (>30mins) bouts, were determined for the whole day and during work and non-work time separately. The obesity indicators, BMI (kg/m2), waist circumference (cm) and fat percentage were objectively measured. Isotemporal substitution modelling was utilized to determine the linear association with obesity indicators of replacing 30 min of total sedentary time or long sedentary bouts with standing, walking or MVPA and separately replacing 30 min of long sedentary bouts with brief sedentary bouts. Workers [mean (standard deviation, SD); age = 45.1 (9.9) years, BMI = 27.5 (4.9) kg/m2, %BF = 29.6 (9.5), waist circumference = 94.4 (13.0) cm] sat for 2.4 hours (~32% of the measured time, SD = 1.8 hours) across the day during work period and 5.5 hours (~62% of the measured time, SD = 1.5 hours) during non-work period. Most of the sedentary time was accrued in moderate bouts [work = 1.40 (SD = 1.09) hours] during work and in long bouts during non-work [2.7 (SD = 1.4) hours], while least in long sedentary bouts during work [work = 0.5 (SD = 0.9)] and in brief sedentary bouts [0.5 hours (SD = 0.3)] during non-work. Significant associations with all obesity indicators were found when 30 min of total

Obesity And Laboratory Diets Affects Tissue Malondialdehyde (MDA) Levels In Obese Rats

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Chowdhury, Parimal; Scott, Joseph; Holley, Andy; Hakkak, Reza

2010-04-01

This study was conducted to investigate the interaction of obesity and laboratory diets on tissue malondialdehyde levels in rats. Female Zucker obese and lean rats were maintained on either regular grain-based diet or purified casein diet for two weeks, orally gavaged at day 50 with 65 mg/kg DMBA and sacrificed 24 hrs later. Malondialdehyde (MDA) levels were measured in blood and harvested tissues. Data were recorded as mean ± SEM and analyzed statistically. Results show that the obese group on purified casein diet had reduction of MDA levels in the brain, duodenum, liver, lung and kidney tissues as compared to lean group, p <0.05. Obese group on grain-based diet showed significant increase in MDA levels only in the duodenum, p <0.05. We conclude that dietary intervention differentially affects the oxidative markers in obese rats. It appears that purified casein diets were more effective than grain-based diet in reduction of oxidative stress in obese rats.

Latest data on obesity

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Evangelos Fousteris

2017-01-01

Full Text Available Obesity is a chronic and morbid disease which has reached epidemic dimensions nowadays, becoming the springboard for the emergence of other unfavorable metabolic diseases such as type 2 diabetes mellitus. In 2014 overweight and obese people in the world were estimated at 2.022 billion while prediction for 2025 is to reach 2.693 billion. Regarding the statistical data from Greece, we should note that overweight and obese individuals are estimated at 5.266 million for 2014. Obesity is a systemic disease with significant impact on human health, such as increased incidence of type 2 diabetes, osteoarthritis ( knee, hip, cancers (mostly breast and endometrium for women and colon and kidney for men, cognitive disorders (dementia, Alzheimer's, mood disorders (anxiety, depression, emotional eating disorders, sleep apnea syndrome, cardiovascular disease (myocardial infarction, stroke and increased incidence of all-cause mortality, reducing in this patern the overall life expectancy. The underlying pathophysiological disorders of obesity are complex and mostly not understood well. The main disorder is the disturbance of the human energy balance when intake calories are more than the calories consumed, thus an excess of energy is generated daily, which is stored by the body in the form of triglycerides in adipose tissue of the body. On the other hand, weight loss is very important since even moderate weight loss significantly reduces the comorbidities of obesity. For the treatment of obesity, we have dietary interventions (hypocaloric diets, very low calorie diets, special diets, exercise interventions, pharmacological interventions (Orlistat, Liraglutide, Naltrexone / Boupropion, Phentermine / Topiramate, Lorcaserin and bariatric surgery (gastric banding, gastric Roux-en-Y by pass, sleeve gastrectomy. Despite all these, obesity remains an unsolved problem of our time with unmet needs that need combined global awareness from both the scientific community

[Obesity in Mexico].

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Dávila-Torres, Javier; González-Izquierdo, José Jesús; Barrera-Cruz, Antonio

2015-01-01

Excess body weight (overweight and obesity) is currently recognized as one of the most important challenges of public health in the world, given its size, speed of growth and the negative effect it has on the health of the population that suffers. Overweight and obesity significantly increases the risk of chronic no communicable diseases, premature mortality and the social cost of health. An estimated 90 % of cases of type 2 diabetes mellitus attributable to overweight and obesity. Today, Mexico is second global prevalence of obesity in the adult population, which is ten times higher than that of countries like Japan and Korea. With regard to children, Mexico ranks fourth worldwide obesity prevalence, behind Greece, USA and Italy. In our country, over 70 % of the adult population, between 30 and 60 years are overweight. The prevalence of overweight is higher in men than females, while the prevalence of obesity is higher in women than men. Until 2012, 26 million Mexican adults are overweight and 22 million obese, which represents a major challenge for the health sector in terms of promoting healthy lifestyles in the population and development of public policies to reverse this scenario epidemiology. Mexico needs to plan and implement strategies and action cost effective for the prevention and control of obesity of children, adolescents and adults. Global experience shows that proper care of obesity and overweight, required to formulate and coordinate multisectoral strategies and efficient for enhancing protective factors to health, particularly to modify individual behavior, family and community.

The Association between Obesity and Cognitive Function in Otherwise Healthy Premenopausal Arab Women

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Abdulaziz Farooq

2018-01-01

Full Text Available Objective. To examine the association between obesity and cognitive function in healthy premenopausal women. Methods. From a cohort of 220 women, 98 were randomly selected that provided complete data. Body composition was examined by dual-energy X-ray scan. All participants completed the Cambridge Neuropsychological Test Automated Battery (CANTAB to assess cognitive performance in three domains: attention, memory, and planning executive function. The Reaction Time (RTI test was used to assess motor and mental response speeds; the Stockings of Cambridge (SOC test was used to assess planning executive function. For memory assessment, the Delayed Match to Sample (DMS, Pattern Recognition Memory (PRM, and Spatial Span (SSP tests were used to assess forced choice recognition memory, visual pattern recognition memory, and working memory capacity, respectively. Results. 36 (36.7% were morbidly obese, 22 (22.4% obese, and 23 (23.5% overweight. Performance on RTI and SOC planning ability were not associated with body mass index (BMI. DMS mean time to correct response, when stimulus is visible or immediately hidden (0 ms delay, was higher by 785 ± 302 ms (milliseconds (p=0.011 and 587 ± 259 ms (p=0.026 in morbidly obese women compared to normal weight women. Memory span length was significantly lower in overweight (5.5 ± 1.3, p=0.008 and obese women (5.6 ± 1.6, p=0.007 compared to normal weight (6.7 ± 0.9. DEXA-assessed body fat (% showed similar associations as BMI, and latency to correct response on DMS and PRM was positively correlated with percentage of body fat, but not with VO2 max. Conclusion. In otherwise healthy premenopausal women, obesity did not impact accuracy on cognitive tasks related to attention, memory, or planning executive function, but morbid obesity was associated with higher latency to correct response on memory-specific tasks and lower memory span length.

Getting to grips with the obesity epidemic in Europe

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Sarah Cuschieri

2016-09-01

Full Text Available Obesity is a global epidemic. It is responsible for increased patient morbidity and mortality. Significant related pathologies including diabetes mellitus compound the overall risks. Obesity is a significant financial burden. This includes direct and indirect medical costs, amounting to millions of euros each year. Multiple European studies have outlined a steady incline in obesity prevalence rates. Tackling obesity is no easy task. Policy makers aiming to reduce obesity rates should adopt an evidence-based approach. This entails adopting both micro- and macro-interventions tweaked to each country’s individual requirements. The ideal way forward would be to tackle obesity from the individual, population-wide and food industry angles. The key towards a successful intervention is for each country to carry out well-planned health examination studies, in an attempt to pin point local risk factors. Having a correct individualized picture, each country can move forward and draw policies and interventional procedures. The aim should be to primarily improve the quality of life. Second, the country’s capital expenditure is also reduced.

Process and impact evaluation of the Romp & Chomp obesity prevention intervention in early childhood settings: lessons learned from implementation in preschools and long day care settings.

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de Silva-Sanigorski, Andrea M; Bell, Andrew C; Kremer, Peter; Park, Janet; Demajo, Lisa; Smith, Michael; Sharp, Sharon; Nichols, Melanie; Carpenter, Lauren; Boak, Rachel; Swinburn, Boyd

2012-06-01

The Romp & Chomp controlled trial, which aimed to prevent obesity in preschool Australian children, was recently found to reduce the prevalence of childhood overweight and obesity and improve children's dietary patterns. The intervention focused on capacity building and policy implementation within various early childhood settings. This paper reports on the process and impact evaluation of this trial and the lessons learned from this complex community intervention. Process data was collected throughout and audits capturing nutrition and physical activity-related environments and practices were completed postintervention by directors of Long Day Care (LDC) centers (n = 10) and preschools (n = 41) in intervention and comparison (n = 161 LDC and n = 347 preschool) groups. The environmental audits demonstrated positive impacts in both settings on policy, nutrition, physical activity opportunities, and staff capacity and practices, although results varied across settings and were more substantial in the preschool settings. Important lessons were learned in relation to implementation of such community-based interventions, including the significant barriers to implementing health-promotion interventions in early childhood settings, lack of engagement of for-profit LDC centers in the evaluation, and an inability to attribute direct intervention impacts when the intervention components were delivered as part of a health-promotion package integrated with other programs. These results provide confidence that obesity prevention interventions in children's settings can be effective; however, significant efforts must be directed toward developing context-specific strategies that invest in policies, capacity building, staff support, and parent engagement. Recognition by funders and reviewers of the difficulties involved in implementing and evaluating such complex interventions is also critical to strengthening the evidence base on the effectiveness of such public health

Length of stay and associated costs of obesity related hospital admissions in Ireland.

LENUS (Irish Health Repository)

Vellinga, Akke

2008-01-01

BACKGROUND: Obesity is the cause of other chronic diseases, psychological problems, obesity shortens the lifespan and puts strain on health systems. The risk associated with childhood obesity in particular, which will accelerate the development of adult morbidity and mortality, has been identified as an emerging public health problem. METHODS: To estimate the length of stay and associated hospital costs for obesity related illnesses a cost of illness study was set up. All discharges from all acute hospitals in the Republic of Ireland from 1997 to 2004 with a principal or secondary diagnostic code for obesity for all children from 6 to 18 years of age and for adults were collected.A discharge frequency was calculated by dividing obesity related discharges by the total number of diagnoses (principal and secondary) for each year. The hospital costs related to obesity was calculated based on the total number of days care. RESULTS: The discharge frequency of obesity related conditions increased from 1.14 in 1997 to 1.49 in 2004 for adults and from 0.81 to 1.37 for children. The relative length of stay (number of days in care for obesity related conditions per 1000 days of hospital care given) increased from 1.47 in 1997 to 4.16 in 2004 for children and from 3.68 in 1997 to 6.74 in 2004 for adults.Based on the 2001 figures for cost per inpatient bed day, the annual hospital cost was calculated to be 4.4 Euromillion in 1997, increasing to 13.3 Euromillion in 2004. At a 20% variable hospital cost the cost ranges from 0.9 Euromillion in 1997 to 2.7 Euromillion in 2004; a 200% increase. CONCLUSION: The annual increase in the proportion of hospital discharges related to obesity is alarming. This increase is related to a significant increase in economic costs. This paper emphasises the need for action at an early stage of life. Health promotion and primary prevention of obesity should be high on the political agenda.

Psychological Vulnerability among Overweight/Obese Minority Adolescents

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Martyn-Nemeth, Pamela A.; Penckofer, Sue

2012-01-01

Depression is associated with obesity among adolescents, with racial/ethnic variability noted. Psychological correlates that may influence this relationship have not been adequately explored. The primary objective of this secondary analysis was to compare levels of stress, self-esteem, coping, social support, and depressive mood between normal…

Parent-child behavioural patterns related to pre-schoolers' overweight/obesity

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Dagmar Sigmundová

2017-06-01

Full Text Available Background: The increasing prevalence of childhood obesity is a global concern. Although childhood obesity has grown as a result of a complex array of interactions among multiple behavioural, biological, and environmental factors, excessive screen time (ST and low levels of physical activity (PA are often discussed as causal factors. Therefore, it is beneficial to identify risky family behavioural patterns contributing to the increasing prevalence of obesity even in pre-schoolers. Objective: The main aim of the study was to assess whether parental obesity and parent-child behavioural patterns (PA and ST affect the odds of overweight/obesity in 4-to-7-year-old preschool children. Methods: We analysed seven-day PA and ST behaviour among families with pre-schoolers that included 194 preschool children (88 girls and 106 boys and their parents (165 mothers and 111 fathers. PA was monitored by means of unsealed Yamax pedometers for at least eight hours a day over seven consecutive days during spring (April/May and autumn (September/October of 2015. ST was recorded by parents on family log book sheets. To assess the odds of parents' obesity and PA/ST variables in relation to child overweight/obesity, a logistic regression (backward method was used. Results: Most children (n = 157 reported normal weight (87 boys, 70 girls, 37 children were overweight or obese (19 boys, 18 girls. Children's excessive ST (> 1 hour/day (OR: 5.65/33.19 on weekdays/weekends, mothers' obesity (OR: 13.80/28.84 on weekdays/weekends, mothers' excessive ST (> 2 hours/ day (OR: 32.46 at weekends, and children's male gender (OR: 38.69 at weekends were significantly (p < .05 associated with higher odds of overweight/obesity in the preschool children. Conclusions: Uncovering parent-child behavioural patterns provides insight into the lifestyle of families with pre-schoolers and is a source of valuable information for designing and implementing family-based intervention

Coffee Consumption and the Risk of Obesity in Korean Women.

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Lee, Jeonghee; Kim, Hye Young; Kim, Jeongseon

2017-12-08

Instant coffee mixes that contain sugar and non-dairy creamer account for 80-90% of the total coffee market in Korea. The objective of this study was to investigate the relationship between coffee consumption and obesity in Korean women. We included 5995 women who participated in a health screening examination at the Korean National Cancer Center between 2007 and 2016. Daily coffee consumption and the use of sugar and creamer in coffee was evaluated using a 106-item food frequency questionnaire. Obesity was assessed by body mass index (BMI), and abdominal obesity was assessed by waist circumference (WC). A multiple logistic regression model was used to calculate the odds ratio (OR) of obesity according to coffee consumption. After multivariate adjustment, high coffee consumption was positively associated with obesity as measured by BMI (≥3 cups vs. no drinks, OR = 2.52; 95% confidence interval (CI) = 1.91-3.34; p for the trend coffee consumption and obesity prevalence was not altered by menopause. The amount of coffee with additives consumed per day by Korean women was positively correlated with the prevalence of obesity, but causation cannot be determined due to the cross-sectional nature of the study design. The mechanism underlying the observed relationship is yet to be elucidated.

Obesity Preserves Myocardial Function During Blockade of the Glycolytic Pathway

International Nuclear Information System (INIS)

Campos, Dijon Henrique Salomé de; Leopoldo, André Soares; Lima-Leopoldo, Ana Paula; Nascimento, André Ferreira do; Oliveira-Junior, Silvio Assis de; Silva, Danielle Cristina Tomaz da; Sugizaki, Mario Mateus; Padovani, Carlos Roberto; Cicogna, Antonio Carlos

2014-01-01

Obesity is defined by excessive accumulation of body fat relative to lean tissue. Studies during the last few years indicate that cardiac function in obese animals may be preserved, increased or diminished. Study the energy balance of the myocardium with the hypothesis that the increase in fatty acid oxidation and reduced glucose leads to cardiac dysfunction in obesity. 30-day-old male Wistar rats were fed standard and hypercaloric diet for 30 weeks. Cardiac function and morphology were assessed. In this paper was viewed the general characteristics and comorbities associated to obesity. The structure cardiac was determined by weights of the heart and left ventricle (LV). Myocardial function was evaluated by studying isolated papillary muscles from the LV, under the baseline condition and after inotropic and lusitropic maneuvers: myocardial stiffness; postrest contraction; increase in extracellular Ca2+ concentration; change in heart rate and inhibitor of glycolytic pathway. Compared with control group, the obese rats had increased body fat and co-morbities associated with obesity. Functional assessment after blocking iodoacetate shows no difference in the linear regression of DT, however, the RT showed a statistically significant difference in behavior between the control and the obese group, most notable being the slope in group C. The energy imbalance on obesity did not cause cardiac dysfunction. On the contrary, the prioritization of fatty acids utilization provides protection to cardiac muscle during the inhibition of glycolysis, suggesting that this pathway is fewer used by obese cardiac muscle

Obesity Preserves Myocardial Function During Blockade of the Glycolytic Pathway

Energy Technology Data Exchange (ETDEWEB)

Campos, Dijon Henrique Salomé de, E-mail: dijoncampos@gmail.com [Departamento de Clínica Médica - Faculdade de Medicina de Botucatu da Universidade Estadual Paulista (UNESP), Botucatu, SP (Brazil); Leopoldo, André Soares; Lima-Leopoldo, Ana Paula [Departamento de Esportes - Centro de Educação Física e Desportos da Universidade Federal do Espírito Santo (UFES), Vitória, ES (Brazil); Nascimento, André Ferreira do [Instituto de Ciências da Saúde da Universidade Federal do Mato Grosso (UFMT), Sinop, MT (Brazil); Oliveira-Junior, Silvio Assis de [Escola de Fisioterapia da Universidade Federal do Mato Grosso do Sul (UFMS), Campo Grande, MS (Brazil); Silva, Danielle Cristina Tomaz da [Departamento de Clínica Médica - Faculdade de Medicina de Botucatu da Universidade Estadual Paulista (UNESP), Botucatu, SP (Brazil); Sugizaki, Mario Mateus [Instituto de Ciências da Saúde da Universidade Federal do Mato Grosso (UFMT), Sinop, MT (Brazil); Padovani, Carlos Roberto [Departamento de Bioestatística, Instituto de Ciências Biológicas da Universidade Estadual Paulista (UNESP), Botucatu, SP (Brazil); Cicogna, Antonio Carlos, E-mail: dijoncampos@gmail.com [Departamento de Clínica Médica - Faculdade de Medicina de Botucatu da Universidade Estadual Paulista (UNESP), Botucatu, SP (Brazil)

2014-10-15

Obesity is defined by excessive accumulation of body fat relative to lean tissue. Studies during the last few years indicate that cardiac function in obese animals may be preserved, increased or diminished. Study the energy balance of the myocardium with the hypothesis that the increase in fatty acid oxidation and reduced glucose leads to cardiac dysfunction in obesity. 30-day-old male Wistar rats were fed standard and hypercaloric diet for 30 weeks. Cardiac function and morphology were assessed. In this paper was viewed the general characteristics and comorbities associated to obesity. The structure cardiac was determined by weights of the heart and left ventricle (LV). Myocardial function was evaluated by studying isolated papillary muscles from the LV, under the baseline condition and after inotropic and lusitropic maneuvers: myocardial stiffness; postrest contraction; increase in extracellular Ca2+ concentration; change in heart rate and inhibitor of glycolytic pathway. Compared with control group, the obese rats had increased body fat and co-morbities associated with obesity. Functional assessment after blocking iodoacetate shows no difference in the linear regression of DT, however, the RT showed a statistically significant difference in behavior between the control and the obese group, most notable being the slope in group C. The energy imbalance on obesity did not cause cardiac dysfunction. On the contrary, the prioritization of fatty acids utilization provides protection to cardiac muscle during the inhibition of glycolysis, suggesting that this pathway is fewer used by obese cardiac muscle.

Hatha-yoga in physical rehabilitation at initial degrees of exogenous obesity.

Directory of Open Access Journals (Sweden)

Yurchenko O. E.

2010-12-01

Full Text Available In article the author notes importance of treatment exogenous obesity and use of nonconventional method in physical rehabilitation, namely medical hatha-yoga is offered. Features of influence of yoga on human life, rules of performance of exercises, their influence on health of the person and an organism as a whole are considered. It is made accent on features of a mental fortune sick of obesity and positive influence of hatha-yoga on this condition, improvement of outlook and the relation to.

SU-E-J-73: Extension of a Clinical OIS/EMR/R&V System to Deliver Safe and Efficient Adaptive Plan-Of-The-Day Treatments Using a Fully Customizable Plan-Library-Based Workflow

Energy Technology Data Exchange (ETDEWEB)

Akhiat, A. [Erasmus MC Cancer Institute, Radiation Oncology, Rotterdam (Netherlands); Elekta, Sunnyvale, CA (United States); Kanis, A.P.; Penninkhof, J.J.; Sodjo, S.; O’Neill, T.; Quint, S.; Doorn, X. van; Schillemans, W.; Heijmen, B.; Hoogeman, M. [Erasmus MC Cancer Institute, Radiation Oncology, Rotterdam (Netherlands); Linton, N.; Coleman, A. [Elekta, Sunnyvale, CA (United States)

2015-06-15

Purpose: To extend a clinical Record and Verify (R&V) system to enable a safe and fast workflow for Plan-of-the-Day (PotD) adaptive treatments based on patient-specific plan libraries. Methods: Plan libraries for PotD adaptive treatments contain for each patient several pre-treatment generated treatment plans. They may be generated for various patient anatomies or CTV-PTV margins. For each fraction, a Cone Beam CT scan is acquired to support the selection of the plan that best fits the patient’s anatomy-of-the-day. To date, there are no commercial R&V systems that support PotD delivery strategies. Consequently, the clinical workflow requires many manual interventions. Moreover, multiple scheduled plans have a high risk of excessive dose delivery. In this work we extended a commercial R&V system (MOSAIQ) to support PotD workflows using IQ-scripting. The PotD workflow was designed after extensive risk analysis of the manual procedure, and all identified risks were incorporated as logical checks. Results: All manual PotD activities were automated. The workflow first identifies if the patient is scheduled for PotD, then performs safety checks, and continues to treatment plan selection only if no issues were found. The user selects the plan to deliver from a list of candidate plans. After plan selection, the workflow makes the treatment fields of the selected plan available for delivery by adding them to the treatment calendar. Finally, control is returned to the R&V system to commence treatment. Additional logic was added to incorporate off-line changes such as updating the plan library. After extensive testing including treatment fraction interrupts and plan-library updates during the treatment course, the workflow is running successfully in a clinical pilot, in which 35 patients have been treated since October 2014. Conclusion: We have extended a commercial R&V system for improved safety and efficiency in library-based adaptive strategies enabling a wide

SU-E-J-73: Extension of a Clinical OIS/EMR/R&V System to Deliver Safe and Efficient Adaptive Plan-Of-The-Day Treatments Using a Fully Customizable Plan-Library-Based Workflow

International Nuclear Information System (INIS)

Akhiat, A.; Kanis, A.P.; Penninkhof, J.J.; Sodjo, S.; O’Neill, T.; Quint, S.; Doorn, X. van; Schillemans, W.; Heijmen, B.; Hoogeman, M.; Linton, N.; Coleman, A.

2015-01-01

Purpose: To extend a clinical Record and Verify (R&V) system to enable a safe and fast workflow for Plan-of-the-Day (PotD) adaptive treatments based on patient-specific plan libraries. Methods: Plan libraries for PotD adaptive treatments contain for each patient several pre-treatment generated treatment plans. They may be generated for various patient anatomies or CTV-PTV margins. For each fraction, a Cone Beam CT scan is acquired to support the selection of the plan that best fits the patient’s anatomy-of-the-day. To date, there are no commercial R&V systems that support PotD delivery strategies. Consequently, the clinical workflow requires many manual interventions. Moreover, multiple scheduled plans have a high risk of excessive dose delivery. In this work we extended a commercial R&V system (MOSAIQ) to support PotD workflows using IQ-scripting. The PotD workflow was designed after extensive risk analysis of the manual procedure, and all identified risks were incorporated as logical checks. Results: All manual PotD activities were automated. The workflow first identifies if the patient is scheduled for PotD, then performs safety checks, and continues to treatment plan selection only if no issues were found. The user selects the plan to deliver from a list of candidate plans. After plan selection, the workflow makes the treatment fields of the selected plan available for delivery by adding them to the treatment calendar. Finally, control is returned to the R&V system to commence treatment. Additional logic was added to incorporate off-line changes such as updating the plan library. After extensive testing including treatment fraction interrupts and plan-library updates during the treatment course, the workflow is running successfully in a clinical pilot, in which 35 patients have been treated since October 2014. Conclusion: We have extended a commercial R&V system for improved safety and efficiency in library-based adaptive strategies enabling a wide

Utility and applicability of the "Childhood Obesity Risk Evaluation" (CORE)-index in predicting obesity in childhood and adolescence in Greece from early life: the "National Action Plan for Public Health".

Science.gov (United States)

Manios, Yannis; Vlachopapadopoulou, Elpis; Moschonis, George; Karachaliou, Feneli; Psaltopoulou, Theodora; Koutsouki, Dimitra; Bogdanis, Gregory; Carayanni, Vilelmine; Hatzakis, Angelos; Michalacos, Stefanos

2016-12-01

Early identification of infants being at high risk to become obese at their later childhood or adolescence can be of vital importance in any obesity prevention initiative. The aim of the present study was to examine the utility and applicability of the "Childhood Obesity Risk Evaluation (CORE)" index as a screening tool for the early prediction of obesity in childhood and adolescence. Anthropometric, socio-demographic data were collected cross-sectionally and retrospectively from a representative sample of 5946 children, and adolescents and were combined for calculating the CORE-index score. Logistic regression analyses were performed to examine the associations of the CORE-index score with obesity by gender and age group, and cut-off point analysis was also applied to identify the optimal value of the CORE-index score that differentiates obese from non-obese children. Mean CORE-index score in the total sample was 3.06 (sd 1.92) units (range 0-11 units). Each unit increase in the CORE-index score was found to be associated with a 30 % (95 % C.I. 1.24-1.36) increased likelihood for obesity in childhood or adolescence, while the optimal cut-off value of the CORE-index score that predicted obesity with the highest possible sensitivity and specificity was found to be 3.5. The present study supports the utility and applicability of the CORE-index as a screening tool for the early identification of infants that are potentially at a higher risk for becoming obese at their childhood and adolescence. This tool could be routinely used by health professionals to identify infants at high risk and provide appropriate counselling to their parents and caregivers so as to maximize the effectiveness of early obesity prevention initiatives. What is known? • Childhood obesity has reached epidemic proportions worldwide. • Certain perinatal and socio-demographic indices that were previously identified as correlates of childhood obesity in children were combined to develop the

The effect of triiodothyronine (L-T3) and weight loss on sex-hormone binding globulin (SHBG) in hirsute obese women

International Nuclear Information System (INIS)

Cavaliere, H.; Medeiros Neto, G.A.

1984-01-01

The effect of a 60-day period of treatment with L-T 3 (200 μg/day) was evaluated in hirsute obese women and normal controls. The obese patients were also submitted to a low calorie high protein. Mean initial weight significantly declined with a significant lowering of the mean DHEA-S leves. There was changes in serum T 3 rose in both obese and normal patients. Serum sex-hormone binding globulin levels at baseline studies were significantly higher in normal controls than in obese patients. At the end of de 60-day period of L-T 3 administration it was observed in both groups a 2-4 fold increase in serum SHBG levels but normal controls had significantly higher mean values than obese individuals. (M.A.C.) [pt

Obesity, inflammation, and exercise training: relative contribution of iNOS and eNOS in the modulation of vascular function in the mouse aorta

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Josiane Fernandes da Silva

2016-09-01

Full Text Available Background - The understanding of obsesity-related vascular dysfunction remains controversial mainly because of the diseases associated with vascular injury. Exercise training is known to prevent vascular dysfunction. Using an obesity model without comorbidities, we aimed at investigating the underlying mechanism of vascular dysfunction and how exercise interferes with this process.Methods - High-sugar diet was used to induce obesity in mice. Exercise training was performed 5 days/week. Body weight, energy intake, and adipose tissues were assessed; blood metabolic and hormonal parameters were determined; and serum TNFα was measured. Blood pressure and heart rate were assessed by plethysmography. Changes in aortic isometric tension were recorded on myograph. Western blot was used to analyze protein expression. Nitric oxide (NO was evaluated using fluorescence microscopy. Antisense oligodeoxynucleotides were used for inducible nitric oxide synthase isoform (iNOS knockdown.Results - Body weight, fat mass, total cholesterol, low-density lipoprotein cholesterol fraction, insulin, and leptin were higher in the sedentary obese group (SD than in the sedentary control animals (SS. Exercise training prevented these changes. No difference in glucose tolerance, insulin sensitivity, blood pressure, and heart rate was found. Decreased vascular relaxation and reduced endothelial nitric oxide synthase (eNOS functioning in the SD group were prevented by exercise. Contractile response to phenylephrine was decreased in the aortas of the wild SD mice, compared with that of the SS group; however, no alteration was noted in the SD iNOS-/- animals. The decreased contractility was endothelium-dependent, and was reverted by iNOS inhibition or iNOS silencing. The aortas from the SD group showed increased basal NO production, serum TNFα, TNF receptor-1, and phospho-IκB. Exercise training attenuated iNOS-dependent reduction in contractile response in high-sugar diet�

Process evaluation of a community-based adolescent obesity prevention project in Tonga

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Pomana Siosifa

2011-05-01

Full Text Available Abstract Background The rising burden of obesity in Tonga is alarming. The promotion of healthy behaviours and environments requires immediate urgent action and a multi-sectoral approach. A three-year community based study titled the Ma'alahi Youth Project (MYP conducted in Tonga from 2005-2008 aimed to increase the capacity of the whole community (schools, churches, parents and adolescents to promote healthy eating and regular physical activity and to reduce the prevalence of overweight and obesity amongst youth and their families. This paper reflects on the process evaluation for MYP, against a set of Best Practice Principles for community-based obesity prevention. Methods MYP was managed by the Fiji School of Medicine. A team of five staff in Tonga were committed to planning, implementation and evaluation of a strategic plan, the key planks of which were developed during a two day community workshop. Intervention activities were delivered in villages, churches and schools, on the main island of Tongatapu. Process evaluation data covering the resource utilisation associated with all intervention activities were collected, and analysed by dose, frequency and reach for specific strategies. The action plan included three standard objectives around capacity building, social marketing and evaluation; four nutrition; two physical activity objectives; and one around championing key people as role models. Results While the interventions included a wide mix of activities straddling across all of these objectives and in both school and village settings, there was a major focus on the social marketing and physical activity objectives. The intervention reach, frequency and dose varied widely across all activities, and showed no consistent patterns. Conclusions The adolescent obesity interventions implemented as part of the MYP program comprised a wide range of activities conducted in multiple settings, touched a broad spectrum of the population (wider

RELATIONSHIP BETWEEN FRUCTOSE CONTENT OF A NORMAL KUWAITI DIET AND THE OBESITY EPIDEMIC

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Dana Al-Salem

2012-06-01

Full Text Available This project investigates the prevalence of fructose intake in a normal Kuwaiti diet. The prevalence of metabolic syndrome and obesity in Kuwait has been on the rise in the last 2 decades; at the moment just over 74 percent of the population is overweight or obese, according to the World Health Organization. Fructose intake has recently received considerable negative media attention, as the use of high fructose corn syrups has become more widely used. Fructose intake has been believed to be linked with a rise in Metabolic Syndrome and an increase in obesity. It has been considered that moderate fructose consumption of ≤50g/day or ∼10% of total energy has no harmful effect on lipids and of ≤100g/day does not influence body weight. In this study 60 adult participants filled out a two day detailed food diary including quantities. The diaries were then analyzed by a dietitian using the USDA nutrient database and the Food Processor program version 9.9.0, and the total fructose intake per day of the normal Kuwaiti diet was calculated. In addition a 24- hour urine collection for fructose was measured to correlate the results with the food diaries. Once the results were tabulated and verified, a mean fructose intake of 27.9 grams was calculated, ranging in daily fructose intakes from 2.8 g to 101.6g per day. In conclusion the results showed an average daily intake of 27.9 grams of fructose, which is lower than the estimated moderate intake therefore, cannot be the major cause of metabolic syndrome or obesity in Kuwait.

Low Caloric Sweeteners for Diabetes and Obesity Care and Their

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Mohammad Asif

2015-10-01

Full Text Available Diabetes and obesity are two common human disorders that affecting human health and invite various diseases and disorders in normal body functions. These diseases are very common worldwide. Diabetes occurs when high blood sugar levels develop. This happens when body can’t make and use all of the insulin it needs to blood sugar normally to keep blood sugar levels as normal as possible to control diabetes. Diabetic patients will need to follow a diet plan, do exercise and possibly take insulin injections. As part of eating plan, health care provider, and dietitian may ask to limit the amount of carbohydrates eat each day. Low-calorie sweeteners are one easy tool to help for follow eating plan. Obesity is more susceptible and often been associated with frequent ingestion of high energy food in high amount and high intake of sugars such as fermentable sugars such as sucrose, fructose, glucose, and maltose. Both diseases are may be genetically or due to hormonal imbalances. High energy sweeteners may causes caries in the teeth particularly susceptible to the children. Increased calorie intake associated with sugars and carbohydrates, especially when associated with physical inactivity, has been implicated in obesity. Fortunately, low calorie artificial and natural alternatives of sugars have been developed as alternatives to fermentable sugars and have shown promise in these health issues. Although there are only few artificial sweeteners (saccharin, aspartame, acesulfam potassium, sucralose, cyclamate that have been approved as food additives by the Food and Drug Administration and additional other low-caloric sweeteners (sugar alcohols, neotame, stevia, erythritol, xylitol, tagatose that have FDA-generally recognized as safe. Given the health impact of sugars and other carbohydrates, professionals should be aware of the marketed available low caloric sweeteners and both their benefits and potential risks.

Predicting actual weight loss: A review of the determinants according to the theory of planned behaviour.

Science.gov (United States)

Chung, Louisa Ming Yan; Fong, Shirley Siu Ming

2015-01-01

Weight reduction that corresponds with lifestyle modification is difficult to foster. The theory of planned behaviour has been actively cited in explaining health-related behaviour. This review evaluated the application of the theory of planned behaviour to weight-loss behaviour. Among the three reviewed papers, cross-sectional survey designs and subjective outcome measurements were commonly applied. All of the studies recruited obese female adults as participants, limiting the generalisability of the studies' findings. The theory of planned behaviour can be effectively applied in weight-reduction programmes targeting female obese patients. This review confirmed critiques citing the limitations of experimental studies, the subjective measurement of behaviour and short follow-up periods.

Gender and obesity specific MicroRNA expression in adipose tissue from lean and obese pigs

DEFF Research Database (Denmark)

Mentzel, Caroline M. Junker; Anthon, Christian; Jacobsen, Mette Juul

2015-01-01

Obesity is a complex condition that increases the risk of life threatening diseases such as cardiovascular disease and diabetes. Studying the gene regulation of obesity is important for understanding the molecular mechanisms behind the obesity derived diseases and may lead to better intervention...... and treatment plans. MicroRNAs (miRNAs) are short non-coding RNAs regulating target mRNA by binding to their 3'UTR. They are involved in numerous biological processes and diseases, including obesity. In this study we use a mixed breed pig model designed for obesity studies to investigate differentially...... expressed miRNAs in subcutaneous adipose tissue by RNA sequencing (RNAseq). Both male and female pigs are included to explore gender differences. The RNAseq study shows that the most highly expressed miRNAs are in accordance with comparable studies in pigs and humans. A total of six mi...

Healthy incentive scheme in the Irish full-day-care pre-school setting.

LENUS (Irish Health Repository)

Molloy, C Johnston

2013-12-16

A pre-school offering a full-day-care service provides for children aged 0-5 years for more than 4 h\\/d. Researchers have called for studies that will provide an understanding of nutrition and physical activity practices in this setting. Obesity prevention in pre-schools, through the development of healthy associations with food and health-related practices, has been advocated. While guidelines for the promotion of best nutrition and health-related practice in the early years\\' setting exist in a number of jurisdictions, associated regulations have been noted to be poor, with the environment of the child-care facility mainly evaluated for safety. Much cross-sectional research outlines poor nutrition and physical activity practice in this setting. However, there are few published environmental and policy-level interventions targeting the child-care provider with, to our knowledge, no evidence of such interventions in Ireland. The aim of the present paper is to review international guidelines and recommendations relating to health promotion best practice in the pre-school setting: service and resource provision; food service and food availability; and the role and involvement of parents in pre-schools. Intervention programmes and assessment tools available to measure such practice are outlined; and insight is provided into an intervention scheme, formulated from available best practice, that was introduced into the Irish full-day-care pre-school setting.

Dietary patterns of obese high school girls: snack consumption and energy intake

OpenAIRE

Yoon, Jin-Sook; Lee, Nan-Jo

2010-01-01

In order to develop an obesity management program for teenagers, we compared obese and non-obese girls attending high schools in terms of their dietary practices related to snack consumption. Dietary records were collected for 7 days. No significant differences were found for the average daily energy intake between obese and non-obese girls. However, the highest energy intake was greater for obese girls while not much difference was found for the lowest amount of energy intake. Obese girls ha...

Open notes: doctors and patients signing on.

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