Posts Tagged ‘adipose tissue’

The Obesity Society Meeting-Day Two

October 26th, 2009

Today’s sessions of the Obesity Society’s annual scientific meeting covered a lot of ground.  I think the most interesting  was the session on the relationship of cancer and obesity organized by Ruth Ballard-Barash of the National Cancer Institute and Ted Adams of the University of Utah School of Medicine. Christine Friedenreich, Ph.D. of the Alberta Health Services presented a comprehensive overview of the association between specific cancers and obesity, reviewing the published literature for each cancer. At the end, she proposed that obesity was responsible for about 20% of all cancers. If (in an ideal world) obesity levels could be resolved to normal BMIs, she speculated 1.6 million deaths due to cancer could be saved, 2.2 million new cancer cases could be avoided and we could avoid having 5 million persons living with cancer.

Other key presentations addressed the powerful influence of sleep and circadian rhythms, or the lack thereof, on rising rates of obesity. This led one presenter to suggest that we should have our biggest meals at breakfast and gradually reduce caloric input throughout the day to a light salad at dinner. Rena Wing reported on the 4 year results of the Look Ahead Trial which provided persuasive information for intensive lifestyle counseling over less intensive interventions in reductions in body fat and related metabolic indicators.

Sometimes these meetings morph into abstract, perhaps irrelevant, discussions of minutia   among researchers.  At other times, you feel you are witnessing an emerging new insight into obesity and its effects. So it was today in a session, Is There Good and Bad Body Fat? chaired by Richard Bergman, editor of Obesity, and including prominent researchers, Tamara Harris, Michael Jensen (who readers may remember from our conference at the 2008 Republican National Convention) and Sam Klein. Their task was to unravel which fat was bad and which was good. Their presentations covered detailed, precise research into these tangled issues.  Why are there some obese individuals who were, nevertheless, metabolically normal? Why did bariatric surgery resolve diabetes in some cases but not others?  Why does weight loss resolve some metabolic disorders but not others? For many in the audience, these are the cutting edge questions – today – to understand the metabolic sequela of weight gain, insulin resistance, diabetes and cardiovascular disease. The presenters provided exciting new data interspersed with a camaraderie and jocularity which is the realm of highly accomplished and competitive scientists who admire each other’s works but are not going to give them an inch. Bottom line: adipose cell build up in the liver may explain many of the inconsistencies in present views of the obesity-insulin resistance-metabolic disorders axis. But, build up of adipose cell in the liver is hard to measure given today’s technology and bio-statistical resources. On the other hand, there may well be another factor, not yet identified (kind of like dark matter in astrophysics), which modulates the effects of obesity, insulin resistance and metabolic disorders. The large, enthusiastic audience no doubt left with many possible research proposals in mind to unravel this conundrum. Stay tuned, as they say, “we wait with bated breath,” for the next insight.

Downey Fact Sheet 1 – About Obesity

September 27th, 2009

pdficon_small Printable PDF

Obesity is a global epidemic and a major health concern because of its premature mortality and extensive comorbidities. Obesity is a common, complex, multifactorial disease with a high degree of heritability. Between 25 and 40% of person with obesity have a parent who is obese. There are several significant facts to bear in mind when discussing obesity:

By Julie Snider for the Downey Obesity Report

By Julie Snider for the Downey Obesity Report

Every individual inherits a certain number of fat cells or adipose tissue. Obesity requires (a) a large number of fat cells or (b) a large volume in each fat cell or (c) both. Adipose tissue continues throughout the lifespan. Weight loss, including surgically-induced weight loss, does not remove fat cells. This is why weight regain is so common. Individuals with obesity have significantly more fat cells than the non-obese, 23-65 billion compared to 37-237 billion for persons with obesity . Early onset obesity is associated with increase adipose cell number while adult obesity is associated with normal cell number. There are two phases of life in which growth of adipose cells are likely to develop: very early, within the first few years of life and between the ages of 9-13 years of age. Those who become very obese early in life are the ones who have nearly normal cell size but have the greatest increase in cell number; whereas those with onset of obesity between 9-13 have more change in cell size than cell number. Salans LB, Cushman SW, Weisman RE, Studies of human adipose tissue. Adipose cell size and number in non0bese and obese patients. J. Clin Invest. 1973 Apr’ 52(4): 929-41)

Extremely obese individuals may have four times the number of fat cells as lean counterparts. http://www.jpp.krakow.pl/journal/archive/1205_s6/pdf/5_1205_s6_article.pdf

Human food intake and energy expenditure are controlled by complex, redundant and distributed neural systems that reflect fundamental biological reaction to food supply and energy balance. The hypothalamus and caudal brainstem play a critical role. The limbic system is important for processing information regarding previous experience with food, reward and emotion. The predisposition to store considerable amounts of energy as fat for later use is now a major health risk. Brain, appetite and obesity – PubMed Results

Extensive research over the past 10 years has shown that appetite is regulated by a complex system of central and peripheral signals which interact in order to modulate the individual response to nutrient ingestion. Satiety signals include cholecystokinin, glucagon-like peptide and peptide YY which originate from the gastrointestinal tract during a meal and through the vagus nerve reach the caudal brainstem. Here the signals move to the arcuate nucleus where satiety signals are integrated with adiposity signals, namely leptin and insulin, and with several other inputs create a neural circuit which controls the individual’s response to a meal, i.e. keep eating or stop. Neuro-hormonal control of food intake: basic mecha…[J Physiol Pharmacol. 2005] – PubMed Result

Adipose tissue, rather than some inert, jello-like, substance is an active hormonal tissue, secreting many hormones which are involved in creating signals from the gut to the brain, indicating hunger or satiety. These hormones include insulin, leptin, ghrelin, PYY-33-6, adiponctin, resistin and visfatin as well as cytokines and chemokines, such as tumor necrosis factor-alpha, interleukin-6 and others. These can lead to a chronic sub-inflammatory state which plays a critical role in the development of insulin resistance, type 2 diabetes, increased risk of cardiovascular disease associated with obesity. Adipokines: the missing link between insulin resis…[Diabetes Metab. 2008] – PubMed Result

Downey Fact Sheet 2 – Quick Facts

September 27th, 2009
The Downey Obesity Report

The Downey Obesity Report

Printable PDF

ADULT OBESITY

The adult obesity rates have risen dramatically from 1960 to today; rates of overweight (BMI >30) have doubled, rates of obesity (BMI 30-39.9) have nearly tripled and rates of extreme or morbid obesity (BMI >40) have nearly increased seven fold.

ADULT (age 20-74) Prevalence 1

Overweight (BMI 25-30) Percentage

1960-1962 31.5%

2005-2006 33%

Obese (BMI>30)

1960-1962 13.4%

2005-2006 35.1%

Extreme or Morbid Obese( BMI>40)

1960-1962 0.9%

2005-2006 6.2%

The rates of obesity only tell half the story. During this period, the total US population has also increased. Therefore, the raw numbers of Americans affected have also increased. Looking at the numbers of people affected, the overweight population has doubled, the obese population has increased 5 fold and the population with extreme or morbid obesity as increased by a factor of nearly 12!

Number of Americans Overweight in 1960: 56.5 million

Number of Americans Overweight in 2006: 94.5 million

Number of Americans Obese in 1960: 24 million

Number of Americans Obese in 2006:
40 million

Number of American with extreme or morbid obesity in 1960:
1.6 million

Number of Americans with extreme or morbid obesity in 2006: 18.6 million

Since 1960-61 to 2006, the number of American adults who became obese or extremely obese*: 61.1 million

Average number per year: 1.3 million

Average number per month: 110,779

Average number per day: 3,693

Average number per hour: 153

Average increase per minute: 2.5

Since 1960-61 to 2006, the number of American adults who became  extremely obese*: 11 million

Average number per year: 240,217

Average number per month: 20,018

Average number per day: 667

Average number per hour: 27

Adolescents Obesity age 12-19 3

Percent overweight/obese 2005-2006 18%

Young adult Obesity
Ages 18-29

Percent obese 1971-1974 8%

Percent obese 2005 24%

Childhood 2

Ages 6-11 15%

Ages 2-5 11%

Year at which each group will reach 80% obesity 4

All 2072

Men 2077

Women
2058

African American Women 2035

African American Men 2079

Mexican American Women 2073

Mexican American Men 20 91

White Women 2082

White Men
2073

Adipose Tissue (Fat Cells) 5

Age at which typical body has acquired its full number of fat cells: 13

Number of fat cells in average American Adult: 23-65 billion

Number of fat cells in persons with morbid obesity: 37-237 billion

Number of fat cells lost in weight-loss efforts: 0

By Julie Snider for the Downey Obesity Report

By Julie Snider for the Downey Obesity Report

 

Daily Calories Needed and Available 6

Recommended calories per day by typical American adult:

Men 2,400 to 2,800

Women 2,000 to 2,200

Mean (meaning half were above and half below) adult daily calorie intake per day 7 :

Men

1971 2,450

2001-2004 2,593

Women

1971 1,542

2001-2004 1,886

Percent increase in food available for consumption per person from
1970 to 2003: 16%

Amount of food available for each person increase from
1.67 pounds in 1970 to 1.95 pounds in 2003

Daily caloric intake has grown by 523 calories from 1970 to 2003. Leading the way were fats, oils, grains, vegetables and sugars and sweeteners.

U.S. Government Biomedical Research 8

2008 Budget of National Institutes of Health $29.6 billion

NIH Spending 2008 on selected diseases:

Cancer
$5.6 billion

HIV/AIDS funding $2.9 billion

Cardiovascular Disease
$2.0 billion

Heart Disease $1.2 billion

Obesity
$664 million

U. S. Government Infrastructure on Combating Obesity

Name of coordinator of U.S. global anti-obesity efforts:

(Trick question: no such position exists)

Name of White House coordinator of federal anti-obesity efforts:

(Another trick question: no such position exists)

Name of coordinator of Department of Health and Human Services***anti-obesity efforts:

(No such position exists)

*Calculations were made by taking the CDC prevalence figures for 1960-1962 and 2005-2006and multiplying them against US census data for 1960 and census data for 2006,respectively. See Census Bureau Home Page

**Available in this context means the total US calories available for consumption, less spoilage and waste. See ERS/USDA Data – Food Availability (Per Capita) Data System)

*** Department of Health and Human Services includes the National Institutes of Health, the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, the Food and Drug Administration, Office of the Surgeon General, the Agency for Healthcare Research and Quality among others.)

Notes

1. N C H S – Health E Stats – Prevalence of overweight, obesity and exreme obesity among adults: United States, trends 1960-62 through 2005-2006

2. FASTSTATS – Overweight Prevalence

3. http://www.cdc.gov/nchs/data/hus/hus08.pdf

4. Studies of human adipose tissue. Adipose cell size…[J Clin Invest. 1973] – PubMed Result

5. Will all Americans become overweight or obese? est…[Obesity (Silver Spring). 2008] – PubMed Result. In this estimate, by 2030, 86.3% of adults will be overweight or obese and 51% obese; black women at a level of 96.9% will be the most effected, followed by Mexican-American men (91.1%). By 2048, all American adults would be overweight or obese but black women would reach that milestone by 2034. In children, the authors estimate, rates will nearly double by 2030.

6. http://www.usdaplate.com/

7. http://www.ers.usda.gov/AmberWaves/November05/pdf/FindingsDHNovember2005.pdf

8. NIH Research Portfolio Online Reporting Tool (RePORT) – Estimates of Funding for Various Research, Condition, and Disease Categories (RCDC)

By Julie Snider for the Downey Obesity Report

By Julie Snider for the Downey Obesity Report

Understanding Obesity

September 26th, 2009

While body weight is made up of several components – bone, muscle, etc. when we talk about obesity we are referring to excess fat tissue, also called adipose tissue. There are two kinds of fat tissue, brown and white (like rice come to think of it). Brown tissue is mainly found in newborn babies which serves to protect babies by releasing heat. It is converted into white cells in adults. (Scientists are looking at whether white can be converted back into brown tissue and burnt off.) White adipose tissue is made up of cells called adipocytes. These contain fat made of triglycerides and other compounds. White fat cells secrete resistin, adiponectin and leptin. The average adult has 30 billion fat cells weighting about 30 pounds. Fat cells can increase in size about 4 fold before dividing and increasing the total number of fat cells present. Adipocytes also secrete estrogen which probably accounts for higher rates of some cancers in obese persons. Adipose tissue also secrete cytokines. Among the most interesting cytokines identified has been leptin, a molecule considered to send signals to the brain of satiety, i.e. the signal to the brain to stop eating.

Brain and Gut

September 26th, 2009

Frequently, when persons with obesity are depicted in the media, they are headless forms (butts and guts I call the pictures) for we think of obesity in terms of body fat accumulation. But obesity really starts in the brain with multiple signals coming from the gut. Adipose tissue itself generates hormones such as leptin and adiponectin; the GI tract generates ghrelin which signals the brain to initiate feeding . Other products which may stimulate feeding or signal time to stop feeding include leptin, insulin neuropeptide Y among others. Parts of the brain involved are the hypothalamus, the dorsal vagal complex and the reward system.

Researchers now appreciate that food acquisition, preparation, and intake are the result of a several physical signals by which the body communicates to the brain that it is hungry and needs to start feeding or full and needs to stop. MD

Brain

So, just how does the body regulate its weight? The body needs to get its weight just right. Too little nourishment and the body becomes ill and cannot reproduce. Too much also a problem. Look at the precision needed. If one ate the recommended 2,200 calories per day (and a lot eat a lot more) they would consumer 792,000 calories in a year. If they are just 1% more calories, they would add 2 pounds per year or 20 pounds over a decade of life. That’s just an extra 22 calories a day – about half a lower fat Oreo cookie. 100 extra calories a day – about 2/3 of 1 ounce of potato chips – can result in a 5-pound weight gain a year. To keep within these narrow boundaries of health body weight, our bodies have evolved a sophisticated, redundant system to gauge its body weight and when to feed and when to stop feeding.

The four parts of this system are (1) the nervous system which connects the brain, gut and adipose tissue, (2) hormones, including those made by fat cells, (3) neuropeptides which act as messengers and (4) messenger molecules in the immune system called cytokines. These molecules control body weight. The pancreas and adipose tissue make leptin, insulin, adiponectin, visfatin and resistin. The brain makes NPY, melanocortin and cocaine and amphetamine regulated transcript called CART. The stomach makes ghrelin, PYY and CCK.

The process can begin before you eat. Even the sight, smell or thought of food can trigger the “cephalic response.” This can start the production of insulin. Ghrelin increases the desire to eat. PYY can signal an end to feeding. Under stress, the sympathetic nervous system is activiated. This promotes storage of fat, decreases metabolism and promotes insulin resistance. Weight increases and metabolism slows down when this system is activated. The key hormone is insulin which is produced in the pancreas. It is designed to use carbohydrates or store them for later use.

The signals to the brain come from both the central nervous system and the peripheral nervous system Central and peripheral regulation of food intake a…[Obesity (Silver Spring). 2008] – PubMed Result

They appear to converge in the hypothalamus region of the brain.Hypothalamic control of energy balance. [Curr Drug Targets. 2004] – PubMed Result

No fewer than ten possible automatic and largely uncontrollable responses to the modern food environment have been proposed to understand why people can consume more calories than they need without their full awareness or control over their behavior Neurophysiological pathways to obesity: below awar…[Diabetes. 2008] – PubMed Result

Obese individuals appear to respond differently to food visual cues Obese adults have visual attention bias for food c…[Int J Obes (Lond). 2009] – PubMed Result

Obese and overweight persons appear to have lower brain volume Brain structure and obesity. [Hum Brain Mapp. 2009] – PubMed Result

Gut Hormones

Leptin has been identified as one of the most powerful hormones involved in appetite regulation. Appetite control and energy balance regulation in …[Int J Obes (Lond). 2009] – PubMed Result Now, newer techniques like brain imaging can be used to understand the role the brain and central nervous system play in eating behaviours.Leptin regulates striatal regions and human eating…[Science. 2007] – PubMed Result and Neuroimaging and obesity: mapping the brain respon…[Ann N Y Acad Sci. 2002] – PubMed Result

Another class of signaling substances are neuropeptides. Orexin is one of several currently of interest to scientists. Orexin/Hypocretin: a neuropeptide at the interface…[Pharmacol Rev. 2009] – PubMed Result and Orexin neuronal circuitry: role in the regulation …[Front Neuroendocrinol. 2008] – PubMed Result

Chronic stress and obesity: a new view of “comfort…[Proc Natl Acad Sci U S A. 2003] – PubMed Result

Maternal corticotropin-releasing hormone levels du…[Obesity (Silver Spring). 2006] – PubMed Result

The role of gut hormones in the regulation of body…[Mol Cell Endocrinol. 2009] – PubMed Result

Gut hormones: a weight off your mind. [J Neuroendocrinol. 2008] – PubMed Result

Gut hormones and appetite control. [Gastroenterology. 2007] – PubMed Result

Cord blood leptin and adiponectin as predictors of…[Pediatrics. 2009] – PubMed Result

The leptin/adiponectin ratio in mid-infancy correl…[J Pediatr Endocrinol Metab. 2008] – PubMed Result

As research progresses, new theories of evolutionary development are looking at Build-ups in the supply chain of the brain: on the…[Front Neuroenergetics. 2009] – PubMed Result

Ghrelin is a gut hormone which appears to be very significant and is the subject of much research.Lean Mean Fat Reducing “Ghrelin” Machine: Hypothal…[Neuropharmacology. 2009] – PubMed Result

Appetite

Viewing photographs of fattening foods, compared to non-food objects can result in greater activiation in parts of the brain. Activation in brain energy regulation and reward c…[Int J Obes (Lond). 2009] – PubMed Result In one study, obese women had greater brain activity in response to pictures of high fat foods than did non-obese women. Widespread reward-system activation in obese women…[Neuroimage. 2008] – PubMed Result and Effective connectivity of a reward network in obes…[Brain Res Bull. 2009] – PubMed Result

Gut peptides and the regulation of appetite. [Obes Rev. 2006] – PubMed Result

Obesity A-Z

September 26th, 2009

There are numerous issues involved in understanding, preventing and treating obesity. Specific diseases are treated in the Health Effects section. Below are a number of other issues. The citations are not meant to be exhaustive but merely to help the reader begin the search for various sources of information. MD

Adherence

Adherence can also be called willpower or compliance. It refers to individual behavior continuing a program of recommended advice, from following a diet to taking medications. Adherence or compliance is a major issue in health care.

http://obssr.od.nih.gov/pdf/Workshop_final_report.pdf

In spite of many efforts to improve Americans life style, the percentage of Americans following all five recommendations has dropped to an all time low – just 8% Adherence to healthy lifestyle habits in US adults…[Am J Med. 2009] – PubMed Result

For more information, see NIH Office of Behavioral and Social Sciences Research (OBSSR) – Adherence

Adiponectin

Higher adiponectin levels associated with lower risk of type 2 diabetes Adiponectin levels and risk of type 2 diabetes: a …[JAMA. 2009] – PubMed Result

Adipose Tissue

Obesity is about excess adipose tissue. However, adipose tissue is essential for survival and reproduction of the species. In excess amounts, it can, of course cause poor health and early mortality. Researchers have made great strides in understanding this tissue.

The perfect storm: obesity, adipocyte dysfunction,…[Clin Chem. 2008] – PubMed Result

Impact of increased adipose tissue mass on inflamm…[Curr Diab Rep. 2009] – PubMed Result

The role of adipose tissue dysfunction in the path…[Physiol Behav. 2008] – PubMed Result

Fat storage and the biology of energy expenditure. [Transl Res. 2009] – PubMed Result

Adiposity Rebound

Adiposity or fatness increases in the first of year of life and then decreases. About age 6, fatness increases again. This is called adiposity rebound and it is considered to be a critical time when the conditions for adult obesity can become established.

Early adiposity rebound: review of papers linking …[Curr Opin Clin Nutr Metab Care. 2005] – PubMed Result

Adolescence

Food companies targeting adolescence in the digital age Interactive food and beverage marketing: targeting…[J Adolesc Health. 2009] – PubMed Result

Maternal gestational weight gain and offspring wei…[Obstet Gynecol. 2008] – PubMed Result

Adolescent pregnancy and subsequent obesity in Afr…[J Adolesc Health. 1994] – PubMed Result

Changes in physiology with increasing fat mass. [Semin Pediatr Surg. 2009] – PubMed Result

Drugs shown to have efficacy, safety for adolescents Efficacy of weight loss drugs on obesity and cardi…[Obes Rev. 2009] – PubMed Result

No difference between obese and non-obese adolescent food consumption Comparison of high-calorie, low-nutrient-dense foo…[Obes Res. 1999] – PubMed Result

Problem eating behaviors Problem eating behaviors related to social factors…[Int J Behav Nutr Phys Act. 2007] – PubMed Result

Changes in adolescent beverage consumption Five-year longitudinal and secular shifts in adole…[J Am Diet Assoc. 2009] – PubMed Result

And in physical activity Longitudinal and secular trends in physical activi…[Pediatrics. 2006] – PubMed Result

International Journal of Obesity – Clinical research in adolescents: challenges and opportunities using obesity as a model

Comorbidities of overweight/obesity experienced in…[Arch Dis Child. 2009] – PubMed Result

Longitudinal and secular trends in weight-related …[Obesity (Silver Spring). 2008] – PubMed Result

Overweight, obesity, and health-related quality of…[Pediatrics. 2005] – PubMed Result

Depression in adolescents A prospective study of the role of depression in t…[Pediatrics. 2002] – PubMed Result

Agricultural subsidies

No effect on obesity, from USDA http://www.agecon.ucdavis.edu/extension/update/articles/v11n2_1.pdf

EconPapers: Farm subsidies and obesity in the United States: National evidence and international comparisons

Are rising obesity rates linked to U.S. farm aid? | McClatchy

Farm Subsidies Over Time

ScienceDirect – Food Policy : Farm subsidies and obesity in the United States: National evidence and international comparisons

Alcohol Calorie Calculator

http://www.collegedrinkingprevention.gov/CollegeStudents/calculator/alcoholcalc.aspx

Basal Metabolic Rate

The basal metabolic rate (closely related to the resting metabolic rate) is the amount of calories our bodies need to just maintain their normal functions, like metabolism, breathing, blood flow, etc. It is the baseline for determining one’s caloric input.

Basal Metabolism Rate Calculator (note: BMR calculators can have a high degree of variation : BMR Calculator

Breakfast

Is consumption of breakfast associated with body m…[J Am Diet Assoc. 2005] – PubMed Result

Breast-feeding

Mothers more likely to cease breastfeeding The association of maternal overweight and obesity…[J Pediatr. 2006] – PubMed Result

Overweight obese mothers less likely to breastfeed. A systematic review of maternal obesity and breast…[BMC Pregnancy Childbirth. 2007] – PubMed Result

Breastfeeding in infancy and adult cardiovascular …[Am J Med. 2009] – PubMed Result

Australian study shows mothers with obesity more likely to cease breastfeeding Maternal obesity and initiation and duration of br…[Matern Child Nutr. 2008] – PubMed Result

Exclusive breastfeeding of Swedish children and it…[BMC Pediatr. 2008] – PubMed Result

Calculators

Calories Burned UMMS: Calories Burned Calculator

Canada

See Canadian Obesity Network – Obesity Canada

Quality of life of patients with obesity The health status of obese individuals in Canada. [Int J Obes Relat Metab Disord. 2001] – PubMed Result

Prevalence of obesity in Canada. [Obes Rev. 2005] – PubMed Result

BMI and Mortality: Results From a National Longitu…[Obesity (Silver Spring). 2009] – PubMed Result

Child Abuse

Childhood maltreatment in extremely obese male and…[Obes Res. 2005] – PubMed Result

Relation of childhood sexual abuse and other forms…[Obes Surg. 2006] – PubMed Result

Childhood sexual abuse and obesity. [Obes Rev. 2004] – PubMed Result

Child abuse is associated with both obesity and depression in middle age women

Associations of child sexual and physical abuse wi…[Child Abuse Negl. 2008] – PubMed Result

Obesity risk for female victims of childhood sexua…[Pediatrics. 2007] – PubMed Result

Obesity and type 2 diabetes risk in midadult life:…[Pediatrics. 2008] – PubMed Result

Common Sense

‘Common sense’ when used to describe some obesity intervention usually is short for “there’s no data to support this.” Usually within 18 to 24 months there is study showing the ‘common sense’ recommendation didn’t work.

Cuba

Cuba presents an interesting case study. With the fall of the Soviet Union, Cuba, faced with reduction of subsidies from their former patron, went into an economic crisis, known as the “Special Period.” As a result, calories consumed per day dropped, physical activity increased and there was a modest 1.5 unit shift in BMI with reductions in obesity prevalence and increases in overweight and normal weight. Deaths attributed to diabetes, coronary heart disease, stroke and all causes declined as well, suggesting population wide measures might reduce disease and increase mortality. Obesity reduction and its possible consequences: w…[CMAJ. 2008] – PubMed Result and Impact of energy intake, physical activity, and po…[Am J Epidemiol. 2007] – PubMed Result (While the Cuban experience is an extremely interesting situation, the question must be asked whether a democratic government not in extreme economic peril could impose such a draconian situation on its people. MD)

Disparities

While rates of obesity are increasing in all demographic categories, large difference between groups are very evident, leading researchers to ask why different groups in the same environment should have such divergent outcomes.

Obesity, Gynecological Factors, and Abnormal Mammo…[J Womens Health (Larchmt). 2009] – PubMed Result

State of disparities in cardiovascular health in t…[Circulation. 2005] – PubMed Result

Disparities in preventive care by body mass index …[Women Health. 2008] – PubMed Result

The obesity epidemic in the United States–gender,…[Epidemiol Rev. 2007] – PubMed Result

Racial divergence in adiposity during adolescence:…[Pediatrics. 2001] – PubMed Result

Gender-ethnic disparity in BMI and waist circumfer…[Obesity (Silver Spring). 2009] – PubMed Result

Women Obesity in black women. [Epidemiol Rev. 1987] – PubMed Result

Eating Behavior

The psychology of food craving. [Proc Nutr Soc. 2007] – PubMed Result

RAND | RAND Health | Eating as an Automatic Behavior

Food cravings and energy regulation: the character…[Int J Obes (Lond). 2007] – PubMed Result

Eating Disorders

[Night eating syndrome and nocturnal eating–what …[Psychother Psychosom Med Psychol. 2009] – PubMed Result

Teasing history, onset of obesity, current eating …[Obes Res. 2000] – PubMed Result

Childhood psychological, physical, and sexual malt…[Obes Res. 2001] – PubMed Result

Eating disorders and obesity: two sides of the sam…[Epidemiol Psichiatr Soc. 2009 Apr-Jun] – PubMed Result

http://www.womenshealth.gov/BodyImage/bodyworks/CompanionPiece.pdf

Does talking about weight lead to eating disorders? A Parent’s Innocent Word Can Trigger a Dangerous Eating Disorder – washingtonpost.com

Role of parents: Risk Factors for Full- and Partial-Syndrome Early …[J Am Acad Child Adolesc Psychiatry. 2009] – PubMed Result

Elderly

Obesity: What is an elderly population growing int…[Maturitas. 2009] – PubMed Result

Elderly risk for obese men Overweight and obesity and the burden of disease a…[Int J Obes Relat Metab Disord. 2004] – PubMed Result

Applicability of Federal Guidelines An evidence-based assessment of federal guidelines…[Arch Intern Med. 2001] – PubMed Result

Fat or Fit Debate

Relationship between low cardiorespiratory fitness…[JAMA. 1999] – PubMed Result

Fitness and abdominal obesity are independently as…[J Intern Med. 2009] – PubMed Result

Food

The obesity-by-choice debate. Effect of nutrient composition Obesity by choice revisited: effects of food avail…[Physiol Behav. 2007] – PubMed Result

Biology trumps knowledge in model of food choices Is Dietary Knowledge Enough? Hunger, Stress, and Other Roadblocks to Healthy Eating

USDA Food Plans: Cost of Food Cost of Food at Home

Eating and Health Module (ATUS)

Food and Beverage Marketing

See Institute of Medicine Report, Food Marketing and the Diets of Children and Youth – Institute of Medicine

CDC Congressional Testimony CDC Washington Testimony September 23, 2008

Use of branded web sites Food and beverage brands that market to children a…[J Nutr Educ Behav. 2009 Sep-Oct] – PubMed Result

Use of cartoon and other characters Marketing foods to children and adolescents: licen…[Public Health Nutr. 2009] – PubMed Result

The ‘Sydney Principles’ for reducing the commercia…[Public Health Nutr. 2008] – PubMed Result

Glycemic Index

Low glycaemic index or low glycaemic load diets fo…[Cochrane Database Syst Rev. 2007] – PubMed Result

Hunger

Hunger as powerful, primordial emotion The role of primordial emotions in the evolutionar…[Conscious Cogn. 2009] – PubMed Result

Ireland

Prevalence of overweight and obesity on the island…[BMC Public Health. 2007] – PubMed Result

Intensive Care

Effect of obesity on intensive care morbidity and …[Crit Care Med. 2008] – PubMed Result

Menu Labeling

Menu Labeling in Food Chains http://www.yaleruddcenter.org/resources/upload/docs/what/reports/RuddMenuLabelingReport2008.pdf

Microorganisms

Fat Factors – New York Times

Obesity – Extending the Hygiene Hypothesis. [Nestle Nutr Workshop Ser Pediatr Program. 2009] – PubMed Result

Interplay between obesity and associated metabolic…[Curr Opin Pharmacol. 2009] – PubMed Result

Gut microbiota and its possible relationship with …[Mayo Clin Proc. 2008] – PubMed Result

Military

Military family physician attitudes toward treatin…[Mil Med. 2008] – PubMed Result

Attitudes and practices of military family physici…[Mil Med. 2001] – PubMed Result

Mortality

For many years, the issue of whether obesity causes an increase in premature deaths has been hotly debated. The public frequently receives conflicting information on the topic. Is it ok to be overweight? Are only persons with severe obesity at risk? In the final analysis, I think the American Heart Association’s Scientific Consensus gets it right…at some point (the curve of body weight) the heavier have higher rates of premature deaths. At what exact point on the BMI scale that takes place is open to discussion, but the curve always goes up. MD)

See Mortality, health outcomes, and body mass index in…[Circulation. 2009] – PubMed Result

An August 2009 study shows obesity is responsible for about 95 million Years-of-Life-Lost. White femals account for more than 2/3 of that amount. Without changes in the obesity prevalence, the life expectancy of US adults may decrease. Individual and Aggregate Years-of-life-lost Associ…[Obesity (Silver Spring). 2009] – PubMed Result

New: Study estimates overweight/obesity and physical inactivity each responsible for 1 in 10 deaths in the US.The preventable causes of death in the United Stat…[PLoS Med. 2009] – PubMed Result

Will the rise in obesity affect future mortality rates? Trends in Health Behaviors and Health Outcomes

The preventable causes of death in the United Stat…[PLoS Med. 2009] – PubMed Result

Optimal Body Weight for the Prevention of Coronary…[Obesity (Silver Spring). 2009] – PubMed Result

Will the rise in obesity affect future mortality rates? Trends in Health Behaviors and Health Outcomes

Does intentional weight loss increase longevity? Long-term weight loss effects on all cause mortali…[Obes Rev. 2007] – PubMed Result

Obesity and Mortality after Stroke The Impact of Body Mass Index on Mortality After S…[Stroke. 2009] – PubMed Result

Preventable causes of death The preventable causes of death in the United Stat…[PLoS Med. 2009] – PubMed Result

Effect of physical inactivity Effects of physical inactivity and obesity on morb…[Med Sci Sports Exerc. 1999] – PubMed Result

Obesity, Mortality and Nursing Home Residents Obesity and mortality in elderly nursing home resi…[J Gerontol A Biol Sci Med Sci. 2005] – PubMed Result

Morbid obesity is an independent determinant of de…[Crit Care Med. 2006] – PubMed Result

The body mass index paradox and an obesity, inflam…[Semin Dial. 2004 May-Jun] – PubMed Result

Overweight, obesity, and mortality from cancer in …[N Engl J Med. 2003] – PubMed Result

Nursing Homes

Elderly in nursing homes Obesity in nursing homes: an escalating problem. [J Am Geriatr Soc. 2005] – PubMed Result

Oral Bacteria

Is obesity caused by an oral bacteria? Is obesity an oral bacterial disease? [J Dent Res. 2009] – PubMed Result

Pets

The young and old, rich and poor, black and white are becoming more obese. Is it any wonder that our pets would also see increases in their weight? As a matter of fact, veterinarians are very concerned about obesity in pets and have even formed a society to address the problem. See Pet Obesity Facts and Risks

Overweight in dogs, but not in cats, is related to…[Public Health Nutr. 2009] – PubMed Result

Portion Size/Control

The contribution of expanding portion sizes to the…[Am J Public Health. 2002] – PubMed Result

The influence of food portion size and energy dens…[Am J Clin Nutr. 2005] – PubMed Result

Energy density and portion size: their independent…[Physiol Behav. 2004] – PubMed Result

Public Health

Prevalence of selected risk behaviors and chronic …[MMWR Surveill Summ. 2008] – PubMed Result

Reimbursement

Should medicare reimburse providers for weight los…[Am Psychol. 2007] – PubMed Result

http://www.obesityaction.org/advocacytools/insurance/OAC%20Insurance%20Piece.pdf

Social Networks

In the past couple of years, researchers have been exploring new theories for the rapid spread of obesity. One of these areas is social networks of individuals, i.e. their close friends and relatives.

One of the earlier studies can be found here The spread of obesity in a large social network ov…[N Engl J Med. 2007] – PubMed Result but also see Adolescent obesity and social networks. [Prev Chronic Dis. 2009] – PubMed Result

Weight loss may positively impact spouses Weight loss treatment influences untreated spouses…[Int J Obes (Lond). 2008] – PubMed Result

Stress

Shaping the stress response: interplay of palatabl…[Mol Cell Endocrinol. 2009] – PubMed Result

Chronic stress and comfort foods: self-medication …[Brain Behav Immun. 2005] – PubMed Result

Role of stress and weight gain Stress and obesity: the role of the hypothalamic-p…[Curr Opin Endocrinol Diabetes Obes. 2009] – PubMed Result

Sugar sweetened Beverages

Sugar-sweetened soft drinks and obesity: a systema…[Nutr Res Rev. 2008] – PubMed Result

Soft drinks and weight gain: how strong is the lin…[Medscape J Med. 2008] – PubMed Result

Intake of sugar-sweetened beverages and weight gai…[Am J Clin Nutr. 2006] – PubMed Result

Soft drinks and weight gain: how strong is the lin…[Medscape J Med. 2008] – PubMed Result

Sugary soda consumption and albuminuria: results f…[PLoS One. 2008] – PubMed Result

Soft drinks and ‘desire to drink’ in preschoolers. [Int J Behav Nutr Phys Act. 2008] – PubMed Result

Taxing Soft Drinkshttp://www.yaleruddcenter.org/resources/upload/docs/what/reports/RuddReportSoftDrinkTaxFeb2009.pdf

Taste

What is role of taste and obesity Taste and weight: is there a link? [Am J Clin Nutr. 2009] – PubMed Result

Technology

Smartphone apps for weight loss Smartphone Training Apps Help You Sweat the Details – NYTimes.com

Computerized BMI prompt increases counseling Effect of a computerized body mass index prompt on…[Fam Med. 2009 Jul-Aug] – PubMed Result

Television Viewing

According to this study, food advertising on TV is a major contributor to childhood obesity By how much would limiting TV food advertising red…[Eur J Public Health. 2009] – PubMed Result

http://www.nber.org/digest/aug06/aug06.pdf

Association between television viewing and poor di…[Int J Pediatr Obes. 2008] – PubMed Result

The association of television and video viewing wi…[Obesity (Silver Spring). 2006] – PubMed Result

Television viewing and television in bedroom assoc…[Pediatrics. 2002] – PubMed Result

Association of maternal obesity and depressive sym…[Arch Pediatr Adolesc Med. 2003] – PubMed Result

Time

USDA: Why working parents outsource children’s meals 2008 Farm Act Makes It Easier for Food Assistance Households To Save – Amber Waves March 2009

Eating and Health, USDA time use study data Eating and Health Module (ATUS) – ERS/USDA Data

Who has time to cook? Who Has Time To Cook? How Family Resources Influence Food Preparation

Americans of different weights spend same amount of time eating How Much Time Do Americans Spend Eating? – June 2008

United Kingdom

Tackling Obesities: Future Choices Project

Vending Machines

Vending machine offerings unhealthy The food and beverage vending environment in healt…[Pediatrics. 2009] – PubMed Result

Virus

Adenovirus Picture: adenovirus Ad-36 (implicated in obesity epidemic) by Russell Kightley MediaOb