Stress-Induced Suppression of Food Intake in Overweight and Obese Adolescents.

OBJECTIVE: Overweight adolescents exhibit greater cortisol reactivity in response to acute stress and are more likely to eat in response to emotional cues, which suggest an increased susceptibility to stress-induced eating. The purpose of this study was to examine the biological (cortisol and α-amylase reactivity) and behavioral (caloric intake) responses to an acute stressor in overweight adolescents. METHODS: Fifty-one adolescents ages 14 to 19 years (47% female, 55% white; body mass index, 31.2 ± 0.8 kg/m) were exposed to the Trier Social Stress Test and a control condition on separate days. Immediately after each condition, participants were provided with snacks to eat at their leisure. Reactivity was assessed via salivary cortisol and α-amylase area under the curve (AUC), and adolescents were categorized as high or low reactors. RESULTS: Cortisol AUC was higher during the stress condition (19.6 ± 0.2 µg/dl · min) compared with the control condition (11.4 ± 0.9 µg/dl · min, p < .001). α-Amylase AUC was not different during the stress condition (9999 ± 987 U/ml · min) compared with the control condition (8762 ± 865 U/ml · min, p = .145). Overall, adolescents consumed fewer calories during the stress condition (488 ± 51 kcal) compared with the control condition (637 ± 42 kcal, p = .007). High cortisol reactors decreased their calorie consumption from the control condition (716 ± 52 kcal) to the stress condition (457 ± 53 kcal, p = .001), whereas low cortisol reactors did not change their consumption (stress: 518 ± 87 kcal versus control: 561 ± 62 kcal, p = .574). CONCLUSION: High cortisol reactivity in overweight adolescents resulted in decreased calorie consumption after an acute stressor. Further research is needed to understand the mechanisms underlying stress-induced suppression of food intake in overweight adolescents.

Weight Stigma and Hypothalamic-Pituitary-Adrenocortical Axis Reactivity in Individuals Who Are Overweight.

BACKGROUND: Stigmatized people exhibit blunted cortisol responses to many stressors. PURPOSE: To examine the cortisol responses of individuals who are overweight to a stigma-related stressor involving interviewing for a weight-discriminatory company. METHODS: We recruited 170 men and women (mean age = 35.01) from towns located within about a 30-min drive of the study center. Weight was assessed using body mass index (BMI) and self-perceptions about being overweight. Participants were exposed to a laboratory stressor, modeled after the Trier Social Stress Test. In the stigmatizing condition, participants gave a supposedly videotaped speech about what makes them a good candidate for a job at a company that was described as having a weight-discriminatory health insurance benefit. Participants in the nonstigmatizing condition made a supposedly audiotaped speech for a company whose health insurance benefit was not described. Cortisol reactivity was then assessed. RESULTS: Participants who rated themselves as overweight or who were overweight according to their BMI evidenced a blunted cortisol response in the weight-stigmatizing condition, whereas lean participants in the weight-stigmatizing condition showed the rise in cortisol levels that typically occurs following the Trier Social Stress Test. CONCLUSIONS: People who experience the chronic stress of being stigmatized due to their weight show blunted cortisol responses just as other chronically stressed people do.

Evaluation of masticatory parameters in overweight and obese children.

OBJECTIVES: Mastication is an essential function that prepares the food for swallowing and digestion and may be related to nutritional status. Thus, the aims of this study were to evaluate the masticatory parameters in overweight and obese children and the relation between bite force and anthropometric evaluation, food consistency, breast/bottle-feeding, and occlusion. MATERIALS AND METHODS: The sample consisted of 204 children of both genders, age range 8-10 years, divided into normal weight, overweight, and obese. Unilateral bite force was measured using a digital gnatodynamometer with 10mm force fork. Anthropometric and nutritional evaluation involved the measurements of body mass index and skeletal muscle mass using bioelectric impedance analysis. Occlusion was evaluated as regards orthodontic treatment need and food consistency was analysed using a structured questionnaire. In addition, the time of breast- and bottle-feeding was investigated. The results were submitted to chi-square and correlation tests, analysis of variance, and multiple linear regression to determine the relation between bite force and the independent variables under study (α = 0.05). RESULTS: Statistical analysis showed that the time of breast- and bottle-feeding and food consistency did not differ among groups. The regression model showed that body mass index, orthodontic treatment need, and body skeletal muscle mass contributed significantly to the variation in bite force. CONCLUSIONS: Breast- and bottle-feeding behaviour and food consistency did not differ in normal-weight, overweight, and obese children. However, bite force was dependent on body skeletal muscle mass, body mass index, and orthodontic treatment need.

Association between being overweight and oral health in Serbian schoolchildren.

BACKGROUND: Childhood obesity, dental caries, and periodontal disease are major public health problems due to their adverse impact on the growth and development of children. AIM: To examine the association between nutritional status, oral health, and lifestyle habits among schoolchildren in Serbia. DESIGN: This cross-sectional study assessed 422 children and adolescents aged 6-18 years with the following dental indexes analyzed: DMF/dmf (decayed, missed, and filled teeth), plaque index (PI), and gingival index (GI). Depending on their nutritional status, the subjects were categorized, as being 'normal weight,' 'at risk of overweight,' and 'overweight.' Logistic regression was applied to study the association between the dental indexes and independent variables: gender, age, toothbrushing, nutritional status, and lifestyle factors. RESULTS: Being overweight positively correlated with GI, but negatively correlated with the DMF/dmf index among the participants. Multivariate analysis showed a strong association between the weight category and toothbrushing with GI and PI. Overweight children (6-11 years) were less likely to have caries, whereas in older children/adolescents (12-18 years), caries was associated with the intake of sugar-sweetened juices. CONCLUSIONS: Being overweight was found to be significantly associated with a higher probability of developing gingivitis and negatively associated with caries prevalence in Serbian children and adolescents.

Effects of an exercise and hypocaloric healthy eating intervention on indices of psychological health status, hypothalamic-pituitary-adrenal axis regulation and immune function after early-stage breast cancer: a randomised controlled trial.

INTRODUCTION: Many women experience emotional distress, depression and anxiety after a diagnosis of breast cancer. Psychological stress and depression have been associated with hypothalamic-pituitary-adrenal (HPA) axis dysregulation that may adversely affect immune system functioning and impact upon survival. This study investigated the effects of a lifestyle intervention on indices of psychological health status, HPA axis regulation and immune function in overweight women recovering from early-stage breast cancer treatment. METHODS: A total of 85 women treated for breast cancer 3 to 18 months previously were randomly allocated to a 6-month exercise and hypocaloric healthy eating program plus usual care or usual care alone (control group). Women in the intervention group received three supervised exercise sessions per week and individualized dietary advice, supplemented by weekly nutrition seminars. Depressive symptoms (Beck Depression Inventory version II: BDI-II), perceived stress (Perceived Stress Scale: PSS), salivary diurnal cortisol rhythms; inflammatory cytokines (IL-6 and Tumor necrosis factor-α), leukocyte phenotype counts, natural killer (NK) cell cytotoxicity and lymphocyte proliferation following mitogenic stimulation were assessed at baseline and 6-month follow up. RESULTS: Compared with the control group, the intervention group exhibited a reduction in depressive symptoms (adjusted mean difference, 95% confidence intervals (95% CI): -3.12, -1.03 to -5.26; P = 0.004) at the 6-month follow-up but no significant decrease in PSS scores (-2.07, -4.96 to 0.82; P = 0.16). The lifestyle intervention also had a significant impact on diurnal salivary cortisol rhythm compared with usual care alone, as evidenced by an increase in morning salivary cortisol at the 6-month follow-up (P <0.04), indicating a change in HPA axis regulation. Women in the control group had higher total leukocyte, neutrophil and lymphocyte counts in comparison to the intervention group at the 6-month follow-up (P ≤0.05), whereas there was no difference in NK cell counts (P = 0.46), NK cell cytotoxicity (P = 0.85) or lymphocyte proliferation responses (P = 0.11) between the two groups. CONCLUSION: Our results show that the lifestyle intervention resulted in a reduction in depressive symptoms and a normalisation of HPA axis regulation. Such changes could have important implications for long-term survival in women recovering from early-breast cancer treatment. TRIAL REGISTRATION: Current Controlled Trials: ISRCTN08045231.

Characteristics of salivary secretion in normal-weight, overweight and obese children: a preliminary study: salivary composition and excessive fat tissue.

UNLABELLED: Information on salivary characteristics of young subjects with different body composition is scarce. Thus, the aim of this pilot study was to assess salivary characteristics of normal-weight, overweight and obese children. This is a basic research design in which 68 children (5-12 years) were recruited and anthropometric measurements consisted of body mass index (BMI = Kg/m(2)), body perimeters (waist/arm circumferences) and subcutaneous fat tissue (triceps/subscapular thicknesses). Stimulated (SS) and unstimulated morning saliva (US) were collected to determine flow rate, pH and triglycerides, urea, alpha-amylase, total protein, phosphate and calcium concentrations. Data were analyzed using normality tests, t test/Wilcoxon, one-way ANOVA/Kruskal-Wallis and Pearson's/Spearman's correlation tests, where appropriate. RESULTS: Age, household income, parents' education, saliva flow and pH did not differ among groups. Waist circumference and subscapular skinfold differed significantly between normal-weight and obese groups; only waist circumference showed significant correlation with BMI in all groups. pH increased significantly from US to SS in all groups; but flow rate increased from US to SS only in normal-weight and overweight groups. Total protein, amylase, urea, phosphate, triglyceride and calcium concentrations did not differ among groups. However, urea, phosphate and calcium concentrations differed significantly between US and SS in the normal-weight and overweight groups, with the lowest values for SS. In the overweight group, total protein also differed between saliva samples and obese group showed no difference in biochemical parameters between US and SS. Finally, some salivary characteristics may vary among normal-weight, overweight and obese children; thus, future studies in a larger sample are needed to fully understand salivary secretion and composition of these subjects.

Gastric emptying, mouth-to-cecum transit, and glycemic, insulin, incretin, and energy intake responses to a mixed-nutrient liquid in lean, overweight, and obese males.

Observations relating to the impact of obesity on gastric emptying (GE) and the secretion of gut hormones are inconsistent, probably because of a lack of studies in which GE, gastrointestinal hormone release, and energy intake (EI) have been evaluated concurrently with previous patterns of nutrient intake. GE is known to be a major determinant of postprandial glycemia and incretin secretion in health and type 2 diabetes. The aims of this study were to determine the effects of a mixed-nutrient drink on GE, oro-cecal transit, blood glucose, insulin and incretin concentrations and EI, and the relationship between the glycemic response to the drink with GE in lean, overweight, and obese subjects. Twenty lean, 20 overweight, and 20 obese males had measurements of GE, oro-cecal transit, and blood glucose, insulin, GLP-1, and GIP concentrations for 5 h after ingestion of a mixed-nutrient drink (500 ml, 532 kcal); EI at a subsequent buffet lunch was determined. Habitual EI was also quantified. Glycemic and insulinemic responses to the drink were greater in the obese (both P < 0.05) when compared with both lean and overweight, with no significant differences in GE, intragastric distribution, oro-cecal transit, incretins, or EI (buffet lunch or habitual) between groups. The magnitude of the rise in blood glucose after the drink was greater when GE was relatively more rapid (r = -0.55, P < 0.05). In conclusion, in the absence of differences in habitual EI, both GE and incretin hormones are unaffected in the obese despite greater glucose and insulin responses, and GE is a determinant of postprandial glycemia.

Dairy food consumption and meal-induced cortisol response interacted to influence weight loss in overweight women undergoing a 12-week, meal-controlled, weight loss intervention.

Dairy food enhances weight loss in animal models, possibly by modifying the metabolic effects of cortisol. This study determined in overweight women (ages 20.0-45.9 y; n = 51) whether including dairy food in an energy-restricted diet affects cortisol concentrations and whether differences in provoked cortisol explain the magnitude of weight loss. Women received either an adequate amount of dairy food (AD), the equivalent of ≥711 mL/d milk, or a low amount of dairy food (LD), the equivalent to ≤238 mL/d milk, in a 12-wk, energy-restricted dietary intervention. Participants were tested in a 12-h laboratory visit, which included 2 standard meals and a dinner buffet that was consumed ad libitum. Salivary cortisol was measured from waking to bedtime. Energy restriction increased (P ≤ 0.04) the minimum and decreased (P ≤ 0.02) the diurnal amplitude in the salivary cortisol concentration from baseline to postintervention. Energy restriction enhanced the dinner meal-stimulated salivary cortisol response (DMR) (P ≤ 0.02) but only in the LD group. Compared with the LD treatment, the AD treatment induced (P ≤ 0.04) greater reductions in body weight and fat, but only in women characterized as having a baseline DMR (responders) (n = 26); weight and fat lost in the AD and LD groups were similar in nonresponders (n = 25). Overall, energy restriction dampened diurnal salivary cortisol fluctuations [symptomatic of hypothalamic-pituitary-adrenal (HPA) axis dysfunction] and enhanced dinner meal-stimulated salivary cortisol concentrations. The AD treatment prevented the latter. Furthermore, certain phenotypic markers of HPA axis function may help to expose the weight-reducing effects of consuming dairy food.

Relationship between body fat and masticatory function.

PURPOSE: The aim of this cross-sectional study was to investigate the relationship between body fat and masticatory function. MATERIALS AND METHODS: One hundred dentate and partially edentulous participants (33 male; mean age, 39.7 ± 16.6 years) were selected. Body fat was established through body mass index (BMI). Masticatory function was evaluated by quantifying occlusal pairs and determining masticatory efficiency and swallowing threshold with the sieving method. During the swallowing threshold test, chewing rate was registered. Masticatory ability was also evaluated with a 5-point Likert scale questionnaire. Data were analyzed with Spearman and chi-square tests, as well as binary logistic regression analysis for the presence of increased BMI (α= 0.05). RESULTS: Age (rho = 0.517), occlusal pairs (chi-square = 26.353), masticatory efficiency (chi-square = 30.935), masticatory ability (chi-square = 25.132; p < 0.001), and swallowing threshold (chi-square = 8.730; p < 0.005) were related to BMI. Age (odds ratio, OR = 1.048, 95% CI = 1.008 to 1.089) and lower masticatory efficiency (OR = 4.792, 95% CI = 1.419 to 16.183) were predictive of increased body fat (p < 0.05). Gender (chi-square = 0.402, p= 0.526) and chewing rate (rho =-0.158, p= 0.117) were not related to BMI. CONCLUSIONS: These results suggest that people with lower masticatory efficiency may be at risk for increased body fat.

Childhood obesity and skeletal-dental maturity.

AIM: The aim of this cross-sectional study was to evaluate the skeletal maturation assessed through cervical vertebral maturation (CVM) and dental age, in normal weight, pre-obese and obese patients, using the Body Mass Index (BMI) and the Dual energy X-ray Absorptiometry (DXA). MATERIALS AND METHODS: A group of 107 healthy patients, aged between 6 and 12 years (mean age 8.77∓1.79), underwent anthropometric measurements, BMI calculation, and DXA exam at the Department of Neuroscience, Human Nutrition Unit, University of Rome "Tor Vergata" and the assessment of skeletal and dental age at the Paediatric Dentistry Unit of PTV Hospital, University of Rome "Tor Vergata". The subjects were classified as underweight, normal weight, pre-obese and obese according to FM% McCarthy cut-offs classification and BMI classification. STATISTICS: The analyses were performed using the SPSS software (version 16; SPSS Inc., Chicago IL, USA). The assessment of differences through the means of continuous variables among the different groups were analysed using the One-Way-Anova test. The Student's t test was also applied for each group of children (using McCarthy and BMI classifications) between chronological and skeletal-dental age; the Fisher's exact test was performed between the gender categorical variable and McCarthy cut-offs classification, and between McCarthy and BMI classifications. Besides, to evaluate the association between skeletal and dental age, a Pearson correlation coefficient was calculated. In all the assessments a significant level of alpha = 0.05 was considered. RESULTS: The comparison between BMI and DXA data shows statistically significant differences between BMI- FM% (McCarthy cut-offs) classifications (p≤0.001). According to FM% (McCarthy cut-offs) classification, from the Anova analysis among the groups a statistically significant difference between skeletal age (p=0.03) and dental age (p=0.02) was observed, while the difference related to the chronological age (p=0.22) among the groups, was not significant. The correlation between dental and skeletal age is almost the highest (Pearson correlation coefficient=0.994) and statistically significant (p=0.01). According to FM% McCarthy classification, it is observed that with an increase in the FM% , that is passing from normal weight to obese children, the skeletal-dental age always increases with respect to the chronological age. The difference between chronological and skeletal-dental age is statistically significant for pre-obese (p=0.01) and obese (p<0.001) children, while it is not significant for underweight (p=0.46) and normal weight (p=0.33) children. According to the BMI classification, from the Anova analysis no statistically significant differences were observed among the groups as for chronological, dental and skeletal age. Applying the same inferential analyses and taking into account the BMI classification, in the obese subjects were observed not statistically significant differences as for chronological and skeletal-dental age (p=0.09). CONCLUSION: The results highlighted a relation between skeletal-dental age acceleration and body fat percentage measured by DXA.

Dental maturity of Caucasian children in the Indianapolis area.

PURPOSE: The purpose of this study was to compare chronologic and dental age using Demirjian's method. METHODS: Two hundred and fifty-seven panoramic radiographs of healthy 5- to 17.5-year-old Caucasian children in the Indianapolis area were evaluated using Demirjian's 7 tooth method. RESULTS: The intraclass correlation coefficient (ICC) for agreement with Demirjian was 0.94 (95% confidence interval [CI]: 0.87, 0.97). The ICC for repeatability of the investigator was 0.97 (95% CI=0.95, 0.99). Calculated dental age was significantly greater than chronologic age by 0.59 years (P<.001). There was no significant difference in the mean difference in ages between sexes (P=.73). Medicaid subjects had a significantly higher (P<.001) mean difference (0.82 years) than private insurance subjects (0.32 years). There was a significant negative correlation between the chronologic age and the difference in ages (r=-0.29, P<.001). Overweight (P<.001) and obese (P=.004) subjects were significantly more dentally advanced than normal (P=.35) and underweight (P=.42) subjects. CONCLUSIONS: Demirjian's method has high inter- and intraexaminer repeatability. Caucasian children in the Indianapolis area are more advanced dentally than the French-Canadian children studied by Demirjian. Difference between dental age and chronologic age varies depending on the age of the child, socioeconomic status, and body mass index.

The effect of dairy products and non-dairy snacks on food intake, subjective appetite and cortisol levels in children: a randomized control study.

Dairy snacks are available in various physical forms and their consumption is linked to improved metabolic health. The objective of this study was to determine the effect of dairy snacks of different physical forms on short-term food intake (FI), subjective appetite, and the stress hormone, cortisol, in children. Following a repeated-measures crossover design, 40 children aged 9-14 years randomly consumed 1 of 5 isoenergetic (180 kcal) snacks per study session. These snacks included solid (potato chips, cookies, and cheese), semi-solid (Greek yogurt), and fluid (2% fat milk) snacks. FI was measured 120 min after snack consumption. Subjective appetite was measured at 0 (immediately before the snack), 15, 30, 45, 60, 90, and 120 min. Salivary cortisol (n = 18) was measured after the Greek yogurt and cookie snacks at 0, 30, 60, 90, and 120 min. FI did not differ between snacks (P = 0.15). The Greek yogurt (P < 0.0001) and cheese (P = 0.0009) snacks reduced average appetite compared with the 2% fat milk snack. Salivary cortisol levels were not affected by snack (P = 0.84). This study demonstrates that dairy snacks are as effective as other popular snacks at influencing subsequent FI. However, solid and semi-solid dairy snacks are more effective at repressing subjective appetite than a fluid dairy snack. Registered at ClinicalTrials.gov (NCT02484625). Novelty: Milk, Greek yogurt and cheese have a similar effect on short-term food intake in children as popular potato chips and cookie snacks. Solid, semi-solid and liquid snacks have a similar effect on short-term food intake in children.

Efficacy and Safety of Phentermine/Topiramate in Adults with Overweight or Obesity: A Systematic Review and Meta-Analysis.

OBJECTIVE: The study objective was to examine the association between phentermine/topiramate therapy and weight loss and adverse events in adults with overweight or obesity by meta-analysis and systematic review. METHODS: Medical Subject Headings and free-text terms were selected to search for eligible trials in PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Embase up to April 18, 2020. The quality of randomized controlled trials was evaluated by the Cochrane risk-of-bias tool. Meta-analysis was performed using random-effect models. RESULTS: Phentermine/topiramate therapy resulted in an average weight loss of 7.73 kg (95% CI: 6.60-8.85) in general compared with placebo. The weight loss was related to the dose of phentermine/topiramate. Compared with placebo, the average weight loss was 3.55 kg (95% CI: 2.22-4.88) for 3.75/23 mg, 7.27 kg (95% CI: 6.40-8.13) for 7.5/46 mg, and 8.25 kg (95% CI: 6.92-9.79) for 15/92 mg. For phentermine/topiramate participants in different weight-loss subgroups, the weight loss of participants with ≥5%, ≥10%, and ≥15% baseline weight loss was 3.18 (95% CI: 2.75-3.67), 5.32 (95% CI: 4.53-6.25), and 5.65 (95% CI: 3.55-9.01), respectively. Compared with placebo, the adverse events associated with the treatment mainly included dysgeusia (odds ratio [OR] = 8.86, 95% CI: 5.65-13.89), paresthesia (OR = 8.51, 95% CI: 6.20-11.67), dry mouth (OR = 6.71, 95% CI: 5.03-8.94), disturbance in attention (OR = 4.48, 95% CI: 2.39-8.41), irritability (OR = 4.10, 95% CI: 2.29-7.33), hypoesthesia (OR = 3.81, 95% CI: 1.32-11.00), constipation (OR = 2.43, 95% CI: 2.02-2.93), and dizziness (OR = 2.26, 95% CI: 1.72-2.98). Phentermine/topiramate also reduced waist circumference, blood pressure, blood sugar levels, and lipid levels. CONCLUSIONS: Phentermine/topiramate has considerable benefit in reducing body weight, and the efficacy was closely related to the dosage. However, it increased the risk of nervous system-related adverse events.

Salivary uric acid is a predictive marker of body fat percentage in adolescents.

As saliva showed to be a noninvasive source of markers useful to monitor clinical status, the hypothesis tested was that saliva may provide reliable markers able to predict the body fat accumulation in young subjects. The salivary characteristics of 248 adolescent scholars (119 girls; 14-17 years) of flow rate, pH, phosphorus, urea, and calcium concentrations were assessed in stimulated saliva (colorimetric automated technique). The concentrations of cholesterol, 7-ketocholesterol, 25-hydroxyvitamin D2 and D3, and uric acid (UA) were measured with high-performance liquid chromatography in saliva collected at home (12-hour fast). Physical examination included height, weight, and body fat percentage (%BF) measured using bioelectric impedance to classify groups in below/above the %BF cutoff. Data were evaluated using 2-way analysis of variance and multiple linear regression. No significant difference was found in the levels of 25-hydroxyvitamin D2 and D3, cholesterol, 7-ketocholesterol, phosphorus, calcium, and urea between groups above and below %BF cutoff, and the variation in salivary flow was small. Significant sex and group effects were observed for salivary UA, which was increased in adolecents with higher %BF and in males (compared to females), without sex group interaction (power = 99.8%). Sex showed a significant effect on salivary urea, with lower levels in females. A predictive model was obtained, with salivary UA and sex explaining the variation of %BF (P < .001; power = 84%). Salivary UA showed to be an important marker of body fat accumulation in adolescents, demonstrating the clinical relevance of saliva to detect early changes and to monitor the nutritional status using a noninvasive and accurate method.

IGOB131, a novel seed extract of the West African plant Irvingia gabonensis, significantly reduces body weight and improves metabolic parameters in overweight humans in a randomized double-blind placebo controlled investigation.

BACKGROUND: A recent in vitro study indicates that IGOB131, a novel seed extract of the traditional West African food plant Irvingia gabonensis, favorably impacts adipogenesis through a variety of critical metabolic pathways including PPAR gamma, leptin, adiponectin, and glycerol-3 phosphate dehydrogenase. This study was therefore aimed at evaluating the effects of IGOB131, an extract of Irvingia gabonensis, on body weight and associated metabolic parameters in overweight human volunteers. METHODS: The study participants comprised of 102 healthy, overweight and/or obese volunteers (defined as BMI > 25 kg/m2) randomly divided into two groups. The groups received on a daily basis, either 150 mg of IGOB131 or matching placebo in a double blinded fashion, 30-60 minutes before lunch and dinner. At baseline, 4, 8 and 10 weeks of the study, subjects were evaluated for changes in anthropometrics and metabolic parameters to include fasting lipids, blood glucose, C-reactive protein, adiponectin, and leptin. RESULTS: Significant improvements in body weight, body fat, and waist circumference as well as plasma total cholesterol, LDL cholesterol, blood glucose, C-reactive protein, adiponectin and leptin levels were observed in the IGOB131 group compared with the placebo group. CONCLUSION: Irvingia gabonensis administered 150 mg twice daily before meals to overweight and/or obese human volunteers favorably impacts body weight and a variety of parameters characteristic of the metabolic syndrome. This is the first double blind randomized placebo controlled clinical trial regarding the anti-obesity and lipid profile modulating effects of an Irvingia gabonensis extract. The positive clinical results, together with our previously published mechanisms of gene expression modulation related to key metabolic pathways in lipid metabolism, provide impetus for much larger clinical studies. Irvingia gabonensis extract may prove to be a useful tool in dealing with the emerging global epidemics of obesity, hyperlipidemia, insulin resistance, and their co-morbid conditions.

Hemodialysis modality, percentage of body fat, and patient survival.

BACKGROUND: A number of studies have reported lower mortality of overweight hemodialysis patients. This post hoc analysis of an observational prospective single-center study was aimed at elucidating whether both being overweight and surviving longer could result from changes in the hemodialysis modality. METHODS: The study included a cohort of 242 patients who were gradually switched from cuprophane membrane and acetate dialysis to polysulfone (including high-flux) membranes and bicarbonate dialysis. The analysis involved 12 months of baseline data obtained during the first calendar year after the patients entered the study (1994-2001) and repeated measurements for up to 132 months of follow-up (until 2004). Anthropometric measurements were made during the winter season and the percentage of body fat (%fat) was calculated from triceps, biceps, subscapular, and suprailiac skinfolds (K/DOQI guidelines).Kt/V, normalized protein catabolic rate, and cardiovascular comorbidity were also determined and laboratory analyses undertaken. RESULTS: Significant correlations were found between %fat and bicarbonate dialysate as well as polysulfone membrane and high-flux membrane. The linear mixed model showed dependence of %fat on polysulfone and high-flux membrane (p<0.01) Multivariate Cox regression (time-dependent covariates) found %fat to be an independent factor for longer survival, in addition to polysulfone and high-flux membranes. CONCLUSION: Changes in hemodialysis modality were followed by both higher body fat percentage and patient survival. The reverse epidemiology of overweight patients might be at least partially the result of the influence of nonnutritional factors, such as a change in hemodialysis modality (introducing biocompatible high-flux and low-flux membranes and bicarbonate dialysis).

Relationship of body mass index to stability of mandibular advancement surgery with rigid fixation.

INTRODUCTION: Obesity is a growing problem in the United States. We examined patients undergoing orthognathic surgical correction for Class II skeletal malocclusions and assessed outcomes in relation to body mass index. METHODS: The patients (n = 78) were divided into 3 groups (obese, overweight, and normal or thin) based on body mass index score. They were treated with mandibular advancement (mean, 4.9 mm) with rigid fixation and evaluated cephalometrically for postsurgical changes over a 2-year period; a subset of 54 patients was followed for 5 years. RESULTS: Obese and overweight patients experienced relative postsurgical forward movements at B-point (means, 2.6 and 1.0 mm, respectively), whereas the normal or thin patients had relapses (mean, -0.7 mm) over the 2 years. This trend held up at 5 years, with the obese patients experiencing 3 mm of forward movement compared with the normal or thin patients. Potential reasons for this difference in postsurgical response are orthopedic effects of tongue posture and hormonal and biochemical differences caused by obesity. CONCLUSIONS: Obese and overweight patients have different responses to mandibular advancement with rigid fixation compared with normal or thin patients. These data should enable orthodontists and surgeons to more appropriately treat obese patients.

Maternal early pregnancy body mass index and diurnal salivary cortisol in young adult offspring.

Background Maternal early pregnancy overweight (body mass index [BMI] 25.0-29.9 kg/m2) and obesity (BMI ≥ 30 kg/m2) are associated with mental and physical health adversities in the offspring. Prenatal programming of the hypothalamic-pituitary-adrenal (HPA) axis has been put forward as one of the mechanisms that may play pathophysiological role. However, evidence linking maternal overweight and obesity with offspring HPA-axis activity is scarce. We studied if maternal early pregnancy BMI is associated with diurnal salivary cortisol, a marker of HPA-axis activity, in young adult offspring. Methods At a mean age of 25.3 (standard deviation [SD) = 0.6) years, 653 Arvo Ylppö Longitudinal Study participants collected saliva samples for cortisol analyses, at awakening, 15 and 30 min thereafter, 10:30AM, 12:00PM, 5:30PM and at bedtime. Maternal BMI was calculated from weight and height verified by a measurement in the first antenatal clinic visit before 12 weeks of gestation derived from healthcare records. Results Per each one kg/m2 higher maternal early pregnancy BMI offspring diurnal average salivary cortisol was -1.4% (95% CI:-2.6, -0.2, pFDR = 0.033) lower, at awakening it was -2.4% (95% CI:-4.0, -0.7, pFDR = 0.025) lower and the morning average salivary cortisol was -2.0% (95% CI:-3.4, -0.5, pFDR=0.017) lower. These associations were independent of the offspring's own young adulthood BMI, and other important covariates. Conclusion Our findings show that young adult offspring born to mothers with higher early pregnancy BMI show lower average levels of diurnal cortisol, especially in the morning. Whether these findings reflect prenatal programming of the offspring HPA-axis activity warrants further investigation.

Influence of Acute Physical Activity on Stress Reactivity in Obese and Normal Weight Children: A Randomized Controlled Trial.

OBJECTIVE: Physical activity (PA) may influence acute stress reactivity in children differently depending on their weight. This randomized controlled trial investigated the impact of acute PA and of BMI status (overweight/obese (OB/OW) and normal weight (NW) on stress reactivity. METHOD: 50 prepubertal children (24 OW/OB and 26 NW) were randomly assigned to the PA or sedentary arm (SED) for 30 min followed by a stress task. Salivary cortisol, blood pressure (BP), and heart rate (HR) were measured. RESULTS: An interaction effect between the randomization arms and weight status on salivary cortisol was found after the stress task (p = 0.04). Cortisol increased in the SED, but not in the PA arm (p = 0.004 for differences in time course) of NW children. Time course did not differ between both arms in OW/OB children (p = 0.7). OW/OB SED children had a flat cortisol course, and levels were reduced compared to the NW SED or the OW/OB PA children (p ≤ 0.03). Systolic BP increased only in the SED arm (p = 0.01). HR was higher in the PA than in the SED arm during stress (p < 0.001) and showed different time courses (p = 0.006). CONCLUSION: PA impacted on acute stress reactivity and influenced stress reactivity differently in NW and OW/OB children.

Timing of Permanent Tooth Emergence is Associated with Overweight/Obesity in Children from the Amazon Region.

The aim of this study was to evaluate the association between timing of permanent tooth emergence with overweight and obesity in children from Brazilian Amazon region. The studied population consisted of 192 children, 09 to 12 year-old, from public schools at Manaus, Amazonas-Brazil. Clinical examination was performed and the tooth emergence was evaluated according to the number of permanent erupted teeth. Body mass index z-score was calculated. For the statistical analysis 'Overweight/obese' group was compared with 'Normal weight' group in a case to control ratio 1:2. The t-test based on age was used for means comparison between the groups. A linear regression analysis using age and gender as co-variants was used. The established alpha was 5%. One hundred twenty-seven children were classified as normal weight and 65 were classified as overweight/obese (49 were overweight and 16 were obese). Overweight/obesity condition was associated with the gender, in which boys had a higher chance to present higher weight conditions (OR=1.84; CI 95% 1.06-3.37; p=0.04). The mean number of permanent teeth was higher in the overweight/obesity group (p<0.001). Linear regression analysis demonstrated that nutritional status, gender and age were strongly associated with number of permanent erupted teeth (p<0.05). In conclusion, our study demonstrated that timing of permanent tooth emergence is associated with overweigh/obesity in children from Manaus, Brazil.