http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2013 , Hindawi Publishing Corporation . All rights reserved. Wed, 22 May 2013 12:57:00 +0000 http://www.hindawi.com/journals/jobes/2013/384167/ Heart rate recovery (HRR) is an indicator of all-cause mortality in children and adults. We aimed to determine the effect of adiposity and Prader-Willi Syndrome (PWS), a congenital form of obesity, on HRR. Sixteen children of normal weight (NW = body fat % ≤85th percentile, 9.4 ± 1.1 y), 18 children with obesity (OB = body fat % >95th percentile, 9.3 ± 1.1 y), and 11 PWS youth (regardless of body fat %; 11.4 ± 2.5 y) completed peak and submaximal bike tests on separate visits. HRR was recorded one minute following peak and submaximal exercises. All groups displayed similar HRR from peak exercise, while NW (54 ± 16 beats) and OB (50 ± 12 beats) exhibited a significantly faster HRR from submaximal exercise than PWS (37 ± 14 beats). These data suggest that excess adiposity does not influence HRR in children, but other factors such as low cardiovascular fitness and/or autonomic dysfunction might be more influential. Diobel M. Castner, Daniela A. Rubin, Daniel A. Judelson, and Andrea M. Haqq Copyright © 2013 Diobel M. Castner et al. All rights reserved. Wed, 15 May 2013 16:35:37 +0000 http://www.hindawi.com/journals/jobes/2013/628428/ Background. Research shows obesity to be more prevalent amongst individuals with intellectual disability (ID) making correct measurement of body composition crucial. This study reviewed the validity and reliability of methods used for assessing body composition in individuals with ID. Methods. Authors conducted electronic searches through PubMed (1990 to present) and PsycINFO (1990 to present) and assessed relevant articles independently based on scoping review guidelines. Reviewers included primary research related to the validity and reliability of body composition measures on individuals with ID. Results. Searches identified six articles assessing body composition methods used on individuals with ID including body mass index (BMI), skinfold thickness, bioelectrical impedance analysis (BIA), waist circumference, tibia length, and anthropometric girth measurements. BMI and waist circumference appear suitable measures but skinfold thickness measurements may not be advisable due to participants' noncompliance resulting in a lack of precision and inaccurate results. Conclusions. The current literature contains too few well-conducted studies to determine the precision and validity of body composition measures on individuals with ID. There may be a need to devise further regression equations that apply to individuals with specific types of ID in order to increase the reliability and validity of body composition measurements. Amanda Faith Casey Copyright © 2013 Amanda Faith Casey. All rights reserved. Wed, 15 May 2013 09:59:38 +0000 http://www.hindawi.com/journals/jobes/2013/715618/ Background. The current study examined parental factors related to risk of adolescent obesity within the context of a family systems framework. Methods. Seventy predominantly African American, low-income caregiver-adolescent dyads participated in the study. Validated measures of parental perceived child risk for development of type 2 diabetes mellitus, parental limit setting for sedentary behavior, and parental nurturance were evaluated as predictors of adolescent body mass index. Results. In this cross-sectional study, multiple linear regression demonstrated that parents of adolescents with higher zBMI reported worrying more about their child's risk of developing type 2 diabetes mellitus. Parent limit setting was also a significant predictor of adolescent zBMI. Contrary to expectations, higher levels of nurturance were associated with higher adolescent zBMI. Post hoc analyses revealed a trend towards a significant interaction between nurturance and limit setting, such that high levels of both parental nurturance and limit setting were associated with lower adolescent zBMI. Conclusions. Current findings suggest the importance of authoritative parenting and monitoring of adolescent health behaviors in the treatment of obesity. Elizabeth M. Schneider, Dawn K. Wilson, Heather Kitzman-Ulrich, Sara M. St. George, and Kassandra A. Alia Copyright © 2013 Elizabeth M. Schneider et al. All rights reserved. Mon, 13 May 2013 14:35:00 +0000 http://www.hindawi.com/journals/jobes/2013/483017/ Objective. Assess the adherence to the Physical Education (PE) requirements per California Education Code in San Diego area schools. Methods. Surveys were administered anonymously to children and adolescents capable of physical activity, visiting a specialty clinic at Rady Children's Hospital San Diego. The main questions asked were their gender, grade, PE classes per week, and time spent doing PE. Results. 324 surveys were filled, with 36 charter-school students not having to abide by state code excluded. We report on 288 students (59% females), mostly Hispanic (43%) or Caucasian (34%). In grades 1–6, 66.7% reported under the 200 min per 10 school days required by the PE code. Only 20.7% had daily PE. Average PE days/week was 2.6. In grades 7–12, 42.2% had reported under the 400 min per 10 school days required. Daily PE was noted in 47.8%. Average PE days/week was 3.4. Almost 17% had no PE, more so in the final two grades of high school (45.7%). Conclusions. There is low adherence to the California Physical Education mandate in the San Diego area, contributing to poor fitness and obesity. Lack of adequate PE is most evident in grades 1–6 and grades 11-12. Better resources, awareness, and enforcement are crucial. G. Consiglieri, L. Leon-Chi, and R. S. Newfield Copyright © 2013 G. Consiglieri et al. All rights reserved. Mon, 13 May 2013 08:27:35 +0000 http://www.hindawi.com/journals/jobes/2013/512914/ Purpose. It is unclear whether sociocultural and socioeconomic factors are directly linked to type 2 diabetes risk in overweight/obese ethnic minority children and adolescents. This study examines the relationships between sociocultural orientation, household social position, and type 2 diabetes risk in overweight/obese African-American () and Latino-American () children and adolescents. Methods. Sociocultural orientation was assessed using the Acculturation, Habits, and Interests Multicultural Scale for Adolescents (AHIMSA) questionnaire. Household social position was calculated using the Hollingshead Two-Factor Index of Social Position. Insulin sensitivity (SI), acute insulin response (AIRG) and disposition index (DI) were derived from a frequently sampled intravenous glucose tolerance test (FSIGT). The relationships between AHIMSA subscales (i.e., integration, assimilation, separation, and marginalization), household social position and FSIGT parameters were assessed using multiple linear regression. Results. For African-Americans, integration (integrating their family’s culture with those of mainstream white-American culture) was positively associated with AIRG (, , ) and DI (, , ). For Latino-Americans, household social position was inversely associated with AIRG (, , ) and DI (, , ). Conclusions. Sociocultural orientation and household social position play distinct and opposing roles in shaping type 2 diabetes risk in African-American and Latino-American children and adolescents. Rebecca E. Hasson, Tanja C. Adam, Jay Pearson, Jaimie N. Davis, Donna Spruijt-Metz, and Michael I. Goran Copyright © 2013 Rebecca E. Hasson et al. All rights reserved. Wed, 08 May 2013 17:41:08 +0000 http://www.hindawi.com/journals/jobes/2013/454285/ This study examines intercorrelations among waist circumference (WC), intraperitoneal fat (IPF), and subcutaneous abdominal fat (SAF) in ethnically diverse Dallas Heart Study consisting of 1538 women and 1212 men (50% Black). Correlations between fat depots and triglyceride or HOMA2-IR, biomarkers of metabolic syndrome, are also reported. Total abdominal fat (TAF), ASF, and IPF masses were measured by magnetic resonance imaging. The highest correlations with WC according to ethnicity and gender were noted for TAF with progressively lower correlations with ASF (0.65–0.82) and IPF (0.29–0.85). The percentage of IPF relative to TAF was not significantly correlated with WC. For all WC categories, higher IPF/ASF ratios were associated with higher triglyceride levels. In contrast, differences in ratios had little or no association with HOMA2-IR. However, when all data were pooled, IPF was positively correlated with both triglyceride ( (men) and 0.363 (women)) and HOMA2-IR ( (men) and 0.517 (women)); after adjustment for ASF, IPF was still correlated with triglyceride ( (men) and 0.348 (women)) and HOMA2-IR ( (men) and 0.221 (women)). WC measures TAF reliably, but its association with IPF depends on IPF/ASF ratios that vary by gender and ethnicity. Scott M. Grundy, Ian J. Neeland, Aslan T. Turer, and Gloria Lena Vega Copyright © 2013 Scott M. Grundy et al. All rights reserved. Sun, 28 Apr 2013 16:43:17 +0000 http://www.hindawi.com/journals/jobes/2013/172035/ Although pediatric providers have traditionally assessed and treated childhood obesity and associated health-related conditions in the clinic setting, there is a recognized need to expand the provider role. We reviewed the literature published from 2005 to 2012 to (1) provide examples of the spectrum of roles that primary care providers can play in the successful treatment and prevention of childhood obesity in both clinic and community settings and (2) synthesize the evidence of important characteristics, factors, or strategies in successful community-based models. The review identified 96 articles that provide evidence of how primary care providers can successfully prevent and treat childhood obesity by coordinating efforts within the primary care setting and through linkages to obesity prevention and treatment resources within the community. By aligning the most promising interventions with recommendations published over the past decade by the Institute of Medicine, the American Academy of Pediatrics, and other health organizations, we present nine areas in which providers can promote the prevention and treatment of childhood obesity through efforts in clinical and community settings: weight status assessment and monitoring, healthy lifestyle promotion, treatment, clinician skill development, clinic infrastructure development, community program referrals, community health education, multisector community initiatives, and policy advocacy. Michaela Vine, Margaret B. Hargreaves, Ronette R. Briefel, and Cara Orfield Copyright © 2013 Michaela Vine et al. All rights reserved. Wed, 24 Apr 2013 17:25:21 +0000 http://www.hindawi.com/journals/jobes/2013/937572/ The expression profiles of adiponectin, resistin, 5′-AMP-activated protein kinase α (AMPKα), hypoxia-inducible factor-1α (HIF-1α), and key enzymes of glucose and fatty acid metabolism and oxidative phosphorylation in rat retroperitoneal white adipose tissue (RpWAT) during 45-day cold acclimation were examined. After transient suppression on day 1, adiponectin protein level increased following sustained cold exposure. In parallel, on day 1, the protein level of HIF-1α was strongly induced and AMPKα suppressed, while afterwards the reverse was seen. What is more, after an initial decrease on day 1, a sequential increase in pyruvate dehydrogenase, acyl-CoA dehydrogenase, cytochrome c oxidase, and ATP synthase and a decrease in acetyl-CoA carboxylase (from day 3) were observed. Similar to adiponectin, protein level of resistin showed a biphasic profile: it increased after days 1, 3, and 7 and decreased below the control after 21 days of cold-acclimation. In summary, the data suggest that adiponectin and resistin are important integrators of RpWAT metabolic response and roles it plays during cold acclimation. It seems that AMPKα mediate adiponectin effects on metabolic remodeling RpWAT during cold acclimation. Aleksandra Jankovic, Aleksandra Korac, Biljana Buzadzic, Vesna Otasevic, Ana Stancic, Milica Vucetic, Milica Markelic, Ksenija Velickovic, Igor Golic, and Bato Korac Copyright © 2013 Aleksandra Jankovic et al. All rights reserved. Tue, 23 Apr 2013 14:05:14 +0000 http://www.hindawi.com/journals/jobes/2013/129193/ As a public health problem, childhood obesity operates at multiple levels, ranging from individual health behaviors to school and community characteristics to public policies. Examining obesity, particularly childhood obesity, from any single perspective is likely to fail, and systems science methods offer a possible solution. We systematically reviewed studies that examined the causes and/or consequences of obesity from a systems science perspective. The 21 included studies addressed four general areas of systems science in obesity: (1) translating interventions to a large scale, (2) the effect of obesity on other health or economic outcomes, (3) the effect of geography on obesity, and (4) the effect of social networks on obesity. In general, little research addresses obesity from a true, integrated systems science perspective, and the available research infrequently focuses on children. This shortcoming limits the ability of that research to inform public policy. However, we believe that the largely incremental approaches used in current systems science lay a foundation for future work and present a model demonstrating the system of childhood obesity. Systems science perspective and related methods are particularly promising in understanding the link between childhood obesity and adult outcomes. Systems models emphasize the evolution of agents and their interactions; such evolution is particularly salient in the context of a developing child. Asheley Cockrell Skinner and E. Michael Foster Copyright © 2013 Asheley Cockrell Skinner and E. Michael Foster. All rights reserved. Tue, 23 Apr 2013 11:24:09 +0000 http://www.hindawi.com/journals/jobes/2013/695496/ The aim of the present study was to analyze the anthropometric changes in a home-based cohort of Brazilian older adults who participated in the SABE Survey, conducted in 2000 and 2006. A total of 1030 men and women were examined by age group: 60–69, 70–79, and ≥80 years. This representative sample consists of the survivors of the 2000 cohort. The following anthropometric variables were assessed: body mass, arm muscle, waist and calf circumferences, triceps skinfold thickness, body mass index, waist-hip ratio, and arm muscle area according to mean values and percentile distribution. Except for body mass and body mass index, a significant difference was observed among the assessed anthropometric variables during the follow-up period. The older adults ≥80 years presented the lowest values. The reduction in the mean values of triceps skinfold thickness was greater (30%) than that of waist circumference (9%) and was more pronounced in women (21%) than in men (9%). Arm muscle circumference and area reduced by 8% and 19%, respectively, in men and 1% and 3%, correspondingly, in women. Our findings revealed reductions in the mean values for all anthropometric variables in the follow-up period from 2000 to 2006 among older adults. Manuela Ferreira de Almeida, Maria de Fátima Nunes Marucci, Luís Alberto Gobbo, Luciana Silva Ferreira, Daiana Aparecida Quintiliano Scarpelli Dourado, Yeda Aparecida de Oliveira Duarte, and Maria Lucia Lebrão Copyright © 2013 Manuela Ferreira de Almeida et al. All rights reserved. Mon, 22 Apr 2013 10:35:45 +0000 http://www.hindawi.com/journals/jobes/2013/325464/ We examined the effects of a 10–14-weeks inpatient lifestyle modification program, including minimum 90 min of physical activity (PA) five days/week, on body composition, CVD risk factors, and eating behavior in 139 obese subjects (BMI  kg/m2). Completion rate was 71% in the intensive lifestyle intervention (ILI) group and 85% among waiting list controls. Compared to controls body weight ( (95% CI: , ) kg, ), fat mass ( (95% CI: , ) kg, ), fat free mass ( (95% CI: , ) kg, ) and visceral fat ((95% CI: , ) cm2, ) were reduced in the ILI-group after 10–14 weeks. Within the ILI-group weight loss was (95% CI: , ) kg, and (95% CI: , ) kg, , after six and 12 months, respectively. Systolic BP, glucose, triglycerides, and LDL-C were reduced, and HDL-C was increased (all ) after 10–14 weeks within the ILI group. The reduction in glucose and increase in HDL-C were sustained after 12 months (all ). After one year, weight loss was related to increased cognitive restraint and decreased uncontrolled eating (all ). Thus, ILI including high volume of PA resulted in weight loss with almost maintenance of fat-free mass, favorable changes in CVD risk factors, and eating behavior in subjects with severe obesity. Kjersti Karoline Danielsen, Mette Svendsen, Sverre Mæhlum, and Jorunn Sundgot-Borgen Copyright © 2013 Kjersti Karoline Danielsen et al. All rights reserved. Wed, 17 Apr 2013 15:31:20 +0000 http://www.hindawi.com/journals/jobes/2013/951954/ Other imaging techniques to quantify internal-abdominal adiposity (IA-AT) and subcutaneous-abdominal adiposity (SCA-AT) are frequently impractical in infants. The aim of this study was twofold: (a) to validate ultrasound (US) visceral and subcutaneous-abdominal depths in assessing IA-AT and SCA-AT from MRI as the reference method in infants and (b) to analyze the association between US abdominal adiposity and anthropometric measures at ages 3 months and 12 months. Twenty-two infants underwent MRI and US measures of abdominal adiposity. Abdominal US parameters and anthropometric variables were assessed in the Cambridge Baby Growth Study (CBGS), infants (23 girls) at age 3 months and infants (237 girls) at 12 months. US visceral and subcutaneous-abdominal depths correlated with MRI quantified IA-AT (, ) and SCA-AT (, ) volumes, respectively. In CBGS, mean US-visceral depths increased by 20 % between ages 3 and 12 months () and at both ages were lower in infants breast-fed at 3 months than in other infants. US-visceral depths at both 3 and 12 months were inversely related to skinfold thickness at birth ( and at 3 and 12 months, resp.; adjusted for current skinfold thickness). In contrast, US-subcutaneous-abdominal depth at 3 months was positively related to skinfold thickness at birth (). US measures can rank infants with higher or lower IA-AT and SCA-AT. Contrasting patterns of association with visceral and subcutaneous-abdominal adiposities indicate that they may be differentially regulated in infancy. Emanuella De Lucia Rolfe, Neena Modi, Sabita Uthaya, Ieuan A. Hughes, David B. Dunger, Carlo Acerini, Ronald P. Stolk, and Ken K. Ong Copyright © 2013 Emanuella De Lucia Rolfe et al. All rights reserved. Wed, 17 Apr 2013 14:25:30 +0000 http://www.hindawi.com/journals/jobes/2013/204094/ The function ascribed to brown adipose tissue in humans has long been confined to thermoregulation in neonates, where this thermogenic capacity was thought lost with maturation. Recently, brown adipose tissue depots have been identified in adult humans. The significant oxidative capacity of brown adipocytes and the ability of their mitochondria to respire independently of ATP production, has led to renewed interest in the role that these adipocytes play in human energy metabolism. In our view, there is a need for robust physiological studies determining the relationship between molecular signatures of brown adipose tissue, adipose tissue mitochondrial function, and whole body energy metabolism, in order to elucidate the significance of thermogenic adipose tissue in humans. Until such information is available, the role of thermogenic adipose tissue in human metabolism and the potential that these adipocytes may prevent or treat obesity and metabolic diseases in humans will remain unknown. In this article, we summarize the recent literature pertaining to brown adipose tissue function with the aims of drawing the readers’ attention to the lack of data concerning the role of brown adipocytes in human physiology, and to the potential limitations of current research strategies. Craig Porter, Elisabet Børsheim, and Labros S. Sidossis Copyright © 2013 Craig Porter et al. All rights reserved. Wed, 17 Apr 2013 11:40:51 +0000 http://www.hindawi.com/journals/jobes/2013/408582/ To understand the rising prevalence of childhood obesity in affluent societies, it is necessary to take into account the growing obesity infrastructure, which over past decades has developed into an obesogenic environment. This study examines the effects of one of the constituent factors of consumer societies and a potential contributory factor to childhood obesity: commercial food communication targeted to children. Specifically, it investigates the impact of TV advertising on children’s food knowledge and food preferences and correlates these findings with their weight status. Evaluations of traditional information- and education-based interventions suggest that they may not sustainably change food patterns. Based on prior consumer research, we propose five hypotheses, which we then test using a subsample from the IDEFICS study, a large-scale pan-European intervention study on childhood obesity. The results indicate that advertising has divergent effects on children’s food knowledge and preferences and that food knowledge is unrelated to food preferences. This finding has important implications for both future research and public policy. Lucia A. Reisch, Wencke Gwozdz, Gianvincenzo Barba, Stefaan De Henauw, Natalia Lascorz, and Iris Pigeot Copyright © 2013 Lucia A. Reisch et al. All rights reserved. Tue, 16 Apr 2013 09:49:07 +0000 http://www.hindawi.com/journals/jobes/2013/632540/ The childhood obesity epidemic can be best tackled by means of an integrated approach, which is enabled by integrated public health policies, or Health in All Policies. Integrated policies are developed through intersectoral collaboration between local government policy makers from health and nonhealth sectors. Such intersectoral collaboration has been proved to be difficult. In this study, we investigated which resources influence intersectoral collaboration. The behavior change wheel framework was used to categorize motivation-, capability-, and opportunity-related resources for intersectoral collaboration. In-depth interviews were held with eight officials representing 10 non-health policy sectors within a local government. Results showed that health and non-health policy sectors did not share policy goals, which decreased motivation for intersectoral collaboration. Awareness of the linkage between health and nonhealth policy sectors was limited, and management was not involved in creating such awareness, which reduced the capability for intersectoral collaboration. Insufficient organizational resources and structures reduced opportunities for intersectoral collaboration. To stimulate intersectoral collaboration to prevent childhood obesity, we recommend that public health professionals should reframe health goals in the terminology of nonhealth policy sectors, that municipal department managers should increase awareness of public health in non-health policy sectors, and that flatter organizational structures should be established. Anna-Marie Hendriks, Stef P. J. Kremers, Jessica S. Gubbels, Hein Raat, Nanne K. de Vries, and Maria W. J. Jansen Copyright © 2013 Anna-Marie Hendriks et al. All rights reserved. Thu, 11 Apr 2013 14:00:00 +0000 http://www.hindawi.com/journals/jobes/2013/437369/ We performed a systematic review of the behavioral lifestyle intervention trials conducted in the United States published between 1990 and 2011 that included a maintenance phase of at least six months, to identify intervention features that promote weight loss maintenance in African American women. Seventeen studies met the inclusion criteria. Generally, African American women lost less weight during the intensive weight loss phase and maintained a lower % of their weight loss compared to Caucasian women. The majority of studies failed to describe the specific strategies used in the delivery of the maintenance intervention, adherence to those strategies, and did not incorporate a maintenance phase process evaluation making it difficult to identify intervention characteristics associated with better weight loss maintenance. However, the inclusion of cultural adaptations, particularly in studies with a mixed ethnicity/race sample, resulted in less % weight regain for African American women. Studies with a formal maintenance intervention and weight management as the primary intervention focus reported more positive weight maintenance outcomes for African American women. Nonetheless, our results present both the difficulty in weight loss and maintenance experienced by African American women in behavioral lifestyle interventions. Lisa M. Tussing-Humphreys, Marian L. Fitzgibbon, Angela Kong, and Angela Odoms-Young Copyright © 2013 Lisa M. Tussing-Humphreys et al. All rights reserved. Wed, 10 Apr 2013 16:01:09 +0000 http://www.hindawi.com/journals/jobes/2013/140743/ Background. Few studies have examined racial and educational disparities in recent population-based trends. Methods. We analyzed data of a nationally representative sample of 174,228 US-born adults in the National Health Interview Survey from 1997 to 2008. We determined mean BMI trends by educational attainment and race and black-white prevalence ratios (PRs) for overweight/obesity (BMI > 25 kg/m2) using adjusted Poisson regression with robust variance. Results. From 1997 to 2008, BMI increased by ≥1 kg/m2 in all race-sex groups, and appeared to increase faster among whites. Blacks with greater than a high school education (GHSE) had a consistently higher BMI over time than whites in both women (28.3 ± 0.14 to 29.7 ± 0.18 kg/m2 versus 25.8 ± 0.58 to 26.5 ± 0.08 kg/m2) and men (28.1 ± 0.17 kg/m2 to 29.0 ± 0.20 versus 27.1 ± 0.04 kg/m2 to 28.1 ± 0.06 kg/m2). For participants of all educational attainment levels, age-adjusted overweight/obesity was greater by 44% (95% CI: 1.42–1.46) in black versus white women and 2% (1.01–1.04) in men. Among those with GHSE, overweight/obesity prevalence was greater (PR: 1.52; 1.49–1.55) in black versus white women, but greater (1.07; 1.05–1.09) in men. Conclusions. BMI increased steadily in all race-sex and education groups from 1997 to 2008, and blacks (particularly women) had a consistently higher BMI than their white counterparts. Overweight/obesity trends and racial disparities were more prominent among individuals with higher education levels, compared to their counterparts with lower education levels. Chandra L. Jackson, Moyses Szklo, Hsin-Chieh Yeh, Nae-Yuh Wang, Rosemary Dray-Spira, Roland Thorpe, and Frederick L. Brancati Copyright © 2013 Chandra L. Jackson et al. All rights reserved. Tue, 09 Apr 2013 15:55:03 +0000 http://www.hindawi.com/journals/jobes/2013/379513/ 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. Kimberly J. Rask, Julie A. Gazmararian, Susan S. Kohler, Jonathan N. Hawley, Jenny Bogard, and Victoria A. Brown Copyright © 2013 Kimberly J. Rask et al. All rights reserved. Mon, 08 Apr 2013 18:10:47 +0000 http://www.hindawi.com/journals/jobes/2013/790654/ Obesity prevalence and average body composition vary by US race and gender. Asian Americans have the lowest prevalence of obesity. Relying on body-mass index (BMI) to estimate obesity prevalence may misclassify subgroups that appear normally weighted but have excess body fat. We evaluated percentage body fat (PBF) and BMI to determine whether BMI reflects PBF consistently across different races. 940 college students were recruited from a local public university over four consecutive years. We measured PBF by bioelectrical impedance analysis (BIA), weight by physicians’ scales, and height with stadiometers. Our sample comprised Asians (49%), Caucasians (23%), Hispanics (7%), and Other (21%). Participants averaged 21.4 years old; BMI was 22.9 kg/m2; PBF was 24.8%. BMI and PBF varied significantly by race and gender (P value = 0.002 and 0.005 for men; 0.0009 and 0.0008 for women). Asian-American women had the lowest BMI (21.5 kg/m2) but the second highest PBF (27.8%). Linear association between BMI and PBF was the weakest () among Asian-American women and BMI had the poorest sensitivity (37%) to detect PBF. The high PBF with low BMI pattern exhibited by Asian-American women suggests that they could escape detection for obesity-related disease if BMI is the sole measure that estimates body composition. Catherine L. Carpenter, Eric Yan, Steve Chen, Kurt Hong, Adam Arechiga, Woo S. Kim, Max Deng, Zhaoping Li, and David Heber Copyright © 2013 Catherine L. Carpenter et al. All rights reserved. Thu, 04 Apr 2013 13:09:17 +0000 http://www.hindawi.com/journals/jobes/2013/393192/ The metabolic syndrome (MetS) confers an increased risk for both type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Moreover, studies on adipose tissue biology in nascent MetS uncomplicated by T2DM and/or CVD are scanty. Recently, we demonstrated that adipose tissue dysregulation and aberrant adipokine secretion contribute towards the syndrome’s low-grade chronic proinflammatory state and insulin resistance. Specifically, we have made the novel observation that subcutaneous adipose tissue (SAT) in subjects with nascent MetS has increased macrophage recruitment with cardinal crown-like structures. We have also shown that subjects with nascent MetS have increased the levels of SAT-secreted adipokines (IL-1, IL-6, IL-8, leptin, RBP-4, CRP, SAA, PAI-1, MCP-1, and chemerin) and plasma adipokines (IL-1, IL-6, leptin, RBP-4, CRP, SAA, and chemerin), as well as decreased levels of plasma adiponectin and both plasma and SAT omentin-1. The majority of these abnormalities persisted following correction for increased adiposity. Our data, as well as data from other investigators, thus, highlight the importance of subcutaneous adipose tissue dysfunction in subjects with MetS and its contribution to the proinflammatory state and insulin resistance. This adipokine profile may contribute to increased insulin resistance and low-grade inflammation, promoting the increased risk of T2DM and CVD. Andrew A. Bremer and Ishwarlal Jialal Copyright © 2013 Andrew A. Bremer and Ishwarlal Jialal. All rights reserved. Thu, 04 Apr 2013 09:04:02 +0000 http://www.hindawi.com/journals/jobes/2013/489187/ Burden of obesity has increased significantly in the United States over last few decades. Association of obesity with insulin resistance and related cardiometabolic problems is well established. Traditionally, adipose tissue in visceral fat depot has been considered a major culprit in development of insulin resistance. However, growing body of the literature has suggested that adipose tissue in subcutaneous fat depot, not only due to larger volume but also due to inherent functional characteristics, can have significant impact on development of insulin resistance. There are significant differences in functional characteristics of subcutaneous abdominal/truncal versus gluteofemoral depots. Decreased capacity for adipocyte differentiation and angiogenesis along with adipocyte hypertrophy can trigger vicious cycle of inflammation in subcutaneous adipose tissue and subsequent ectopic fat deposition. It is important to shift focus from fat content to functional heterogeneity in adipose tissue depots to better understand the relative role of subcutaneous adipose tissue in metabolic complications of obesity. Therapeutic lifestyle change continues to be the most important intervention in clinical practice at any level of increased adiposity. Future pharmaceutical interventions aimed at improving adipose tissue function in various subcutaneous depots have potential to help maintain adequate insulin sensitivity and reduce risk for development of insulin resistance complications. Pavankumar Patel and Nicola Abate Copyright © 2013 Pavankumar Patel and Nicola Abate. All rights reserved. Wed, 03 Apr 2013 11:52:23 +0000 http://www.hindawi.com/journals/jobes/2013/920270/ Background. Findings from previous studies on an association between obesity and colorectal cancer (CRC) screening are inconsistent and very few studies have utilized national level databases in the United States (US). Methods. A cross-sectional study was conducted using data from the 2005 Medicare Current Beneficiary Survey to describe CRC screening rate by obesity status. Results. Of a 15,769 Medicare beneficiaries sample aged 50 years and older reflecting 39 million Medicare beneficiaries in the United States, 25% were classified as obese, consisting of 22.4% “obese” (30 ≤ body mass index (BMI) < 35) and 3.1% “morbidly obese” (BMI ≥ 35) beneficiaries. Almost 38% of the beneficiaries had a body mass index level equivalent to overweight (25 ≤ BMI < 30). Of the study population, 65.3% reported having CRC screening (fecal occult blood testing or colonoscopy). Medicare beneficiaries classified as “obese” had greater odds of CRC screening compared to “nonobese” beneficiaries after controlling for other covariates ( = 1.25; 95% CI: 1.12–1.39). Conclusions. Findings indicate that obesity was not a barrier but rather an assisting factor to CRC screening among Medicare beneficiaries. Future studies are needed to evaluate physicians’ ordering of screening tests compared to screening claims among Medicare beneficiaries to better understand patterns of patients’ and doctors’ adherence to national CRC screening guidelines. Karima A. Kendall, Euni Lee, Ilene H. Zuckerman, Linda Simoni-Wastila, Marlon Daniel, Pauline M. Green, Beatrice Adderley-Kelly, and Anthony K. Wutoh Copyright © 2013 Karima A. Kendall et al. All rights reserved. Sun, 31 Mar 2013 18:22:26 +0000 http://www.hindawi.com/journals/jobes/2013/206715/ Childhood overweight and obesity, a worldwide problem, is generally identified using BMI (body mass index). However, this application of BMI has been little investigated in children below 5 years of age due to a lack of appropriate methods to assess body composition. Therefore, we used air displacement plethysmography (ADP) to study 4.4-year old boys and girls since this method is accurate in young children if they accept the requirements of the measurement. The purpose was to analyze the relationship between BMI and body fat in these children. Body composition was assessed in 76 (43 boys, 33 girls) of the 84 children brought to the measurement session. Boys and girls contained and % body fat, respectively. BMI-based cut-offs for overweight could not effectively identify children with a high body fat content. There was a significant () but weak () correlation between BMI and body fat (%). In conclusion, requirements associated with a successful assessment of body composition by means of ADP were accepted by most 4-year-olds. Furthermore, BMI-based cut-offs for overweight did not effectively identify children with a high body fatness and BMI explained only a small proportion of the variation in body fat (%) in this age group. Elisabet Forsum, Eva Flinke Carlsson, Hanna Henriksson, Pontus Henriksson, and Marie Löf Copyright © 2013 Elisabet Forsum et al. All rights reserved. Sun, 31 Mar 2013 14:29:25 +0000 http://www.hindawi.com/journals/jobes/2013/298675/ Introduction. An increasing number of studies are utilizing different magnetic resonance (MR) methods to quantify bone marrow fat due to its potential role in osteoporosis. Our aim is to compare the measurements of bone marrow fat among T1-weighted magnetic resonance imaging (MRI), modified Dixon method (also called fat fraction MRI (FFMRI)), and magnetic resonance spectroscopy (MRS). Methods. Contiguous MRI scans were acquired in 27 Caucasian postmenopausal women with a modified Dixon method (i.e., FFMRI). Bone marrow adipose tissue (BMAT) of T1-weighted MRI and bone marrow fat fraction of the L3 vertebra and femoral necks were quantified using SliceOmatic and Matlab. MRS was also acquired at the L3 vertebra. Results. Correlation among the three MR methods measured bone marrow fat fraction and BMAT ranges from 0.78 to 0.88 in the L3 vertebra. Correlation between BMAT measured by T1-weighted MRI and bone marrow fat fraction measured by modified FFMRI is 0.86 in femoral necks. Conclusion. There are good correlations among T1-weighted MRI, FFMRI, and MRS for bone marrow fat quantification. The inhomogeneous distribution of bone marrow fat, the threshold segmentation of the T1-weighted MRI, and the ambiguity of the FFMRI may partially explain the difference among the three methods. Wei Shen, Xiuqun Gong, Jessica Weiss, and Ye Jin Copyright © 2013 Wei Shen et al. All rights reserved. Sun, 31 Mar 2013 11:24:33 +0000 http://www.hindawi.com/journals/jobes/2013/276318/ Understanding correlates of physical activity (PA) can help inform and improve programs that promote PA among youth. We analyzed data from the 2010 National Youth Physical Activity and Nutrition Study, a representative sample of US students in grades 9–12. Logistic regression was used to examine associations between PA correlates (obesity, physical education classes, sports team participation, attitude toward PA, adult support for PA, and environmental support for PA) and participation in daily PA (DPA), vigorous PA (VPA), muscle-strengthening activity (MSA), viewing television (TV), and using computers or video games (C/VG). A positive attitude toward PA and adult support for PA were both associated with increased PA and decreased sedentary behavior. However, among students who lived in neighborhoods that were not safe for PA, a positive attitude toward PA was not associated with increased DPA or decreased sedentary behavior and was less strongly associated with VPA and MSA. Efforts to increase PA among youth should promote a positive attitude toward PA among youth and encourage adult family members to support their efforts to be active. Policies that promote safe neighborhoods may work synergistically with a positive attitude toward PA to increase participation in PA and decrease sedentary behaviors. Richard Lowry, Sarah M. Lee, Janet E. Fulton, Zewditu Demissie, and Laura Kann Copyright © 2013 Richard Lowry et al. All rights reserved. Thu, 28 Mar 2013 14:50:09 +0000 http://www.hindawi.com/journals/jobes/2013/837989/ Obesity is associated with a relatively high prevalence of psychopathological conditions, which may have a significant negative impact on the quality of life. Bariatric surgery is an effective intervention in the morbidly obese to achieve marked weight loss and improve physical comorbidities, yet its impact on psychological health has yet to be determined. A review of the literature identified a trend suggesting improvements in psychological health after bariatric surgery. Majority of mental health gain is likely attributed to weight loss and resultant gains in body image, self-esteem, and self-concept; however, other important factors contributing to postoperative mental health include a patient’s sense of taking control of his/her life and support from health care staff. Preoperative psychological health also plays an important role. In addition, the literature suggests similar benefit in the obese pediatric population. However, not all patients report psychological benefits after bariatric surgery. Some patients continue to struggle with weight loss, maintenance and regain, and resulting body image dissatisfaction. Severe preoperative psychopathology and patient expectation that life will dramatically change after surgery can also negatively impact psychological health after surgery. The health care team must address these issues in the perioperative period to maximize mental health gains after surgery. Jeremy F. Kubik, Richdeep S. Gill, Michael Laffin, and Shahzeer Karmali Copyright © 2013 Jeremy F. Kubik et al. All rights reserved. Tue, 26 Mar 2013 14:33:17 +0000 http://www.hindawi.com/journals/jobes/2013/575016/ Adolescents Committed to Improvement of Nutrition and Physical Activity (ACTION) was undertaken to determine feasibility of a school-based health center (SBHC) weight management program. Two urban New Mexico SBHCs were randomized to deliver ACTION or standard care. ACTION consisted of eight visits using motivational interviewing to improve eating and physical activity behavior. An educational nutrition and physical activity DVD for students and a clinician toolkit were created for use as menu of options. Standard care consisted of one visit with the SBHC provider who prescribed recommendations for healthy weight. Sixty nondiabetic overweight/obese adolescents were enrolled. Measures included BMI percentile, waist circumference, insulin resistance by homeostasis model assessment (HOMA-IR), blood pressure, triglycerides, and HDL-C levels. Pre- to postchanges for participants were compared between groups. Fifty-one students (mean age 15 years, 62% female, 75% Hispanic) completed pre- and postmeasures. ACTION students () had improvements in BMI percentile () and waist circumference () as compared with students receiving standard care (). No differences were found between the two groups in blood pressure, HOMA-IR, triglycerides, and HDL-C. The ACTION SBHC weight management program was feasible and demonstrated improved outcomes in BMI percentile and waist circumference. Alberta S. Kong, Andrew L. Sussman, Carolina Yahne, Betty J. Skipper, Mark R. Burge, and Sally M. Davis Copyright © 2013 Alberta S. Kong et al. All rights reserved. Sun, 24 Mar 2013 09:11:57 +0000 http://www.hindawi.com/journals/jobes/2013/763624/ Introduction. The purpose of this study was to examine linkages between obesity, physical activity, and body image dissatisfaction, with consideration of socioeconomic status (SES) and urbanization in adolescents in Botswana. Materials and Methods. A nationally representative, cross-sectional survey in 707 secondary school students included measured height and weight to determine overweight (OW) or obesity (OB) using World Health Organization standards; physical activity (PA) using the International Physical Activity Questionnaire; and body image satisfaction using the Body Ideals Questionnaire. SES was described by private school versus public school attendance. Results and Discussion. OW/OB students felt farther from ideal and greater dissatisfaction with their weight and body proportions than optimal weight students. Boys felt greater difference from ideal and more dissatisfaction with muscle tone, chest size, and strength than girls. Lower SES students and those from rural villages had more minutes of PA than higher SES or urban students. In this rapidly developing African country, these trends reflect the nutrition transition and offer opportunity to motivate OW/OB students and boys for PA as a health promotion obesity prevention behavior. Conclusions. As urbanization and improved SES are desirable and likely to continue, the public health system will be challenged to prevent obesity while preserving a healthy body image. L. Malete, K. Motlhoiwa, S. Shaibu, B. H. Wrotniak, S. D. Maruapula, J. Jackson, and C. W. Compher Copyright © 2013 L. Malete et al. All rights reserved. Thu, 21 Mar 2013 15:50:16 +0000 http://www.hindawi.com/journals/jobes/2013/616193/ The innate immune system provides organisms with rapid and well-coordinated protection from foreign pathogens. However, under certain conditions of metabolic dysfunction, components of the innate immune system may be activated in the absence of external pathogens, leading to pathologic consequences. Indeed, there appears to be an intimate relationship between metabolic diseases and immune dysfunction; for example, macrophages are prime players in the initiation of a chronic inflammatory state in obesity which leads to insulin resistance. In response to increases in free fatty acid release from obese adipose depots, M1-polarized macrophages infiltrate adipose tissues. These M1 macrophages trigger inflammatory signaling and stress responses within cells that signal through JNK or IKKβ pathways, leading to insulin resistance. If overnutrition persists, mechanisms that counteract inflammation (such as M2 macrophages and PPAR signaling) are suppressed, and the inflammation becomes chronic. Although macrophages are a principal constituent of obese adipose tissue inflammation, other components of the immune system such as lymphocytes and mast cells also contribute to the inflammatory cascade. Thus it is not merely an increased mass of adipose tissue that directly leads to attenuation of insulin action, but rather adipose tissue inflammation activated by the immune system in obese individuals that leads to insulin resistance. Payal S. Patel, Eric D. Buras, and Ashok Balasubramanyam Copyright © 2013 Payal S. Patel et al. All rights reserved. Tue, 19 Mar 2013 11:04:25 +0000 http://www.hindawi.com/journals/jobes/2013/396416/ Obesity and type 2 diabetes are highly prevalent and lead to significant morbidity and mortality. In the United States, the impact of these conditions may be worse on historically underserved minorities, particularly African Americans. Genetic ancestry and differences in physiology are unlikely to be the sole or primary determinants of these disparities. In addition, research in this area has the ethically problematic possibility of conflating race with biology. Despite these important considerations and the challenges of conducting this work, population-based approaches for investigating the etiology of obesity and T2D may yield useful information about the pathophysiology of disease, and have implications that extend to all affected individuals. The purpose of this paper is to describe what is understood about the genetic variation that underlies obesity and T2D in African Americans and other individuals of more recent African descent and to highlight several examples that illustrate how ensuring adequate minority representation in genetic research improves its quality. For a variety of reasons a number of unique insights have been possible as a result of these efforts. Shana McCormack and Struan F. A. Grant Copyright © 2013 Shana McCormack and Struan F. A. Grant. All rights reserved.