Spinal fluid evacuation may provide temporary relief for patients with unexplained widespread pain and fibromyalgia.

Fibromyalgia (FM) exhibits characteristics of a neurological disorder, and similarities have been identified between FM and idiopathic intracranial hypertension (IICH). When intracranial pressure rises, the drainage of excess cerebrospinal fluid (CSF) through the subarachnoid space of the cranial and spinal nerves increases. Higher CSF pressure irritates nerve fibers inside nerve root sheaths and may consequently cause radicular pain, as was reported in patients with IICH. Moreover, the cut-off of 20-25 cm H20 used to define IICH may be too high, as has been suggested in patients with chronic fatigue syndrome. We hypothesize that the neurological symptoms of FM are caused by the dysregulation of cerebrospinal pressure (CSP) and that spinal fluid drainage can relieve this pain. Exploring the processes underlying increased CSP may provide an alternative explanation for the generation of unexplained widespread pain (WSP) and FM as opposed to central sensitization. Additionally, when performing a lumbar puncture for diagnostic reasons, it is useful to measure opening pressure in patients with chronic WSP.

Fibromyalgia and unexplained widespread pain: The idiopathic cerebrospinal pressure dysregulation hypothesis.

Fibromyalgia (FM) is a debilitating, widespread pain disorder that is assumed to originate from inappropriate pain processing in the central nervous system. Psychological and behavioral factors are both believed to underlie the pathogenesis and complicate the treatment. This hypothesis, however, has not yet been sufficiently supported by scientific evidence and accumulating evidence supports a peripheral neurological origin of the symptoms. We postulate that FM and several unexplained widespread pain syndromes are caused by chronic postural idiopathic cerebrospinal hypertension. Thus, the symptoms originate from the filling of nerve root sleeves under high pressure with subsequent polyradiculopathy from the compression of the nerve root fibers (axons) inside the sleeves. Associated symptoms, such as bladder and bowel dysfunction, result from compression of the sacral nerve root fibers, and facial pain and paresthesia result from compression of the cranial nerve root fibers. Idiopathic Intracranial Hypertension, Normal Pressure Hydrocephalus and the clinical entity of symptomatic Tarlov cysts share similar central and peripheral neurological symptoms and are likely other manifestations of the same condition. The hypothesis presented in this article links the characteristics of fibromyalgia and unexplained widespread pain to cerebrospinal pressure dysregulation with support from scientific evidence and provides a conclusive explanation for the multitude of symptoms associated with fibromyalgia.

Maternal and neonatal outcome after laparoscopic adjustable gastric banding: a systematic review.

The number of women of reproductive age undergoing bariatric surgery, including laparoscopic adjustable gastric banding (LAGB), has increased in recent years. The objective of this study was to list both maternal and neonatal outcomes in pregnancies in obese women (BMI ≥ 30 kg/m(2)) after LAGB and compare them with pregnancies in obese or normal weight women without LAGB. Studies showed a lower incidence of gestational diabetes, pregnancy-induced hypertension (PIH), pre-eclampsia, caesarean section (CS), macrosomia, and low birth weight babies in post-LAGB pregnancies compared to pregnancies in obese women without LAGB. Gestational weight gain was also lower in post-LAGB pregnancies. However, the incidence of PIH, pre-eclampsia, CS, preterm birth, large for gestational age, spontaneous abortion, and NICU admission was higher in post-LAGB pregnancies than in normal weight pregnancies. In conclusion, LAGB seems to improve pregnancy outcomes in obese women, even when obesity is still present at the onset of pregnancy. However, further research is needed and pregnant women with a gastric band should always be closely monitored by a multidisciplinary team.

Lifestyle after bariatric surgery: a multicenter, prospective cohort study in pregnant women.

BACKGROUND: To ensure a good pregnancy outcome after bariatric surgery, a healthy life-style and a multidisciplinary prenatal follow-up is recommended. The aim of this prospective multicenter trial was to compare diet quality and physical activity (PA) of pregnant women with bariatric surgery with current lifestyle recommendations. METHODS: Pregnant women (>18 years, prepregnancy BMI 28 ± 6 kg/m², 39 % nulliparae, 25 % smokers) with a history of bariatric surgery were recruited and allocated to two groups according to surgery type: restrictive (N = 18) and bypass group (N = 31). One 7-day dietary record and one Kaiser questionnaire on PA were collected during the first and second trimester. Dietary quality was assessed using the Healthy Eating Index. RESULTS: The diet quality did not change during pregnancy (restrictive group p = 0.050; bypass group p = 0.975) and was comparable between groups (first trimester p = 0.426; second trimester p = 0.937). During the first trimester, 15 % of the pregnant women had a healthy diet quality, 82 % had a diet that needed improvement, and 3 % had a poor diet quality. This was independent of surgery type and was comparable in the second trimester (p = 0.525). No difference between groups was observed for the PA level, but the PA level in the bypass group significantly decreased from the first to the second trimester (p = 0.033). CONCLUSIONS: Nutritional advice and lifestyle coaching in this high-risk population seems recommendable since only 15 % of the pregnant women had a healthy diet quality, 25 % was smoking at the beginning of pregnancy, and the reported PA levels were low.

Dietary patterns and socioeconomic position.

BACKGROUND/OBJECTIVES: To test a socioeconomic hypothesis on three dietary patterns and to describe the relation between three commonly used methods to determine dietary patterns, namely Healthy Eating Index, Mediterranean Diet Score and principal component analysis. SUBJECTS/METHODS: Cross-sectional design in 1852 military men. Using mailed questionnaires, the food consumption frequency was recorded. RESULTS: The correlation coefficients between the three dietary patterns varied between 0.43 and 0.62. The highest correlation was found between Healthy Eating Index and Healthy Dietary Pattern (principal components analysis). Cohen's kappa coefficient of agreement varied between 0.10 and 0.20. After age-adjustment, education and income remained associated with the most healthy dietary pattern. Even when both socioeconomic indicators were used together in one model, higher income and education were associated with higher scores for Healthy Eating Index, Mediterranean Diet Score and Healthy Dietary Pattern. The least healthy quintiles of dietary pattern as measured by the three methods were associated with a clustering of unhealthy behaviors, that is, smoking, low physical activity, highest intake of total fat and saturated fatty acids, and low intakes of fruits and vegetables. CONCLUSIONS: The three dietary patterns used indicated that the most healthy patterns were associated with a higher socioeconomic position, while lower patterns were associated with several unhealthy behaviors.

Pregnancies complicated by obesity: clinical approach and nutritional management.

This PhD thesis indicated by a literature review and a prospective study that maternal obesity is associated with serious complications for both mother and child. This is a problem since already 9% of the pregnant women at the antenatal department of the University Hospital Leuven was obese during 2006. A prospective study with 142 women showed that maternal obesity is also associated with a lower diet quality during pregnancy compared to normal weight pregnant women. To reduce the high prevalence of excessive gestational weight gain among obese pregnant women and to improve their low diet quality, a randomized controlled trial with 2 intervention groups with a different intensity of nutritional guidance was set up. Both interventions improved dietary habits, but affecting physical activity level and gestational weight gain remains a challenge. During this thesis 2 practical tools for all pregnant women and their health care providers were developed: weight gain percentile charts for each body mass index category and a website giving information on nutrition, physical activity, and weight gain during pregnancy. Besides obese pregnant women, pregnant women with a history of bariatric surgery are also a high-risk population. Even though the obesity related pregnancy complications decrease after the surgery induced weight loss, other complications such as internal hernias and nutritional deficiencies with potential lethal consequences have been identified. A multidisciplinary follow-up during pregnancy with routine screening for nutritional deficiencies with attention for the fat-soluble vitamins and patient tailored nutritional supplementation seems required.

Construction of weight gain charts in a low-risk obstetric Belgian population.

AIM: To generate reference charts for weight gain during pregnancy for the different BMI categories (underweight, normal weight, overweight, obesity), based on recent data in a homogeneous, Caucasian, low-risk obstetric population. METHODS: Weight gain and prepregnancy BMI were retrospectively gathered from 605 pregnant Belgian women with accurately dateable, uncomplicated singleton pregnancies. Percentile curves for the different BMI categories were constructed using the linear mixed model, based on absolute weight gain. The effect of parity on weight gain was examined. RESULTS: Overall mean weight gain was 14.8 kg (+/-4.7). Weight gain differed significantly between underweight (15.4 +/- 4.1 kg) and obese patients (12.0 +/- 5.9 kg), between patients with normal weight (15.1 +/- 4.5 kg) and overweight patients (13.7 +/- 5.3 kg), and between normal-weight and obese patients. Parity had a statistical, but no clinically significant, influence on amount and evolution of weight gain. CONCLUSION: By using strict inclusion criteria, BMI-category-specific reference charts were generated representing, in terms of outcome, the optimal weight gain during pregnancy rather than the mean observed weight gain. This enables the weight charts to be used as a clinical tool during the counseling of pregnant women.

Cultural, socioeconomic and nutritional determinants of functional food consumption patterns.

OBJECTIVES: The aim of our research was to describe cultural, socioeconomic and nutritional determinants associated with functional food consumption. METHODS: Cross-sectional design in 5000 military men. Using mailed questionnaires, the functional food consumption frequency was recorded. RESULTS: Margarines fortified with phytosterols or phytostanols were used on a daily basis by 26.3% of the responders. Only 4.7% took a daily portion of probiotics, whereas 14.0% consumed one or more portions of nuts a week. One man out of three consumed one cup of tea daily, whereas 10.2% consumed one glass of red wine daily. Three or more portions of fruit a day were consumed by 19.1%, and two or more portions of vegetables a day by 26.6%. Only 12.3% consumed a portion of fatty fish weekly. After adjustment for age, body mass index, physical activity, use of vitamin supplements, smoking, marital status, cultural background, educational and income level, the daily consumption of fortified margarines increased with age. The consumption of fermented dairy products increased with physical activity and with the use of vitamin supplements. The consumption of fortified margarines, nuts, tea and fatty fish was strongly influenced by cultural background, with higher consumptions for Flemish-speaking men compared with French-speaking persons. Daily consumption of red wine was higher in French-speaking men and in higher educated men. Finally, functional food consumption was associated with a healthy dietary pattern. CONCLUSION: Age, physical activity, level of education, use of vitamin supplements and cultural background are predictors of functional food consumption patterns.

Maternal obesity: pregnancy complications, gestational weight gain and nutrition.

The obesity epidemic affects all, including women of reproductive age. One in five women attending prenatal care in the UK is obese. Prepregnancy obesity is associated with serious short- and long-term complications for mother and child. Furthermore, gestational weight gain (GWG) of obese pregnant women generally exceeds the Institute of Medicine recommended ranges. This observation can partially be explained by an unbalanced diet and lack of daily physical activity. Despite this, few lifestyle intervention trials in obese pregnant women are available. Two out of seven intervention trials focusing on GWG, nutrition and physical activity, reached a significant decrease in GWG. Developing guidelines to promote appropriated weight gain and healthy lifestyle in overweight and obese pregnant women remains a challenge. This review aims to summarize the complications associated with maternal prepregnancy overweight and obesity and to discuss possible strategies to improve the lifestyle habits of pregnant women.

Further investigations on the role of diet-induced thermogenesis in the regulation of feed intake in chickens: comparison of adult cockerels of lines selected for high or low residual feed intake.

The main objective of this study was to investigate the role of diet-induced thermogenesis (DIT) in feed intake regulation in cockerels selected for high (R+) or low (R-) residual feed intake. The selection criterion was defined as the difference between observed feed intake and feed intake predicted by regression between feed intake and BW, BW gain, and egg mass production. Furthermore, the effect of genotype on postprandial oxidation of U-(13)C(6)-glucose, decarboxylation of 1-(13)C(1)-Leu, and key metabolites and hormones was analyzed. Thirty 24-wk-old cockerels of both lines were kept in battery cages under standard conditions on a commercial diet. Three cockerels per genotype were examined twice weekly from wk 30 through 34 in open-circuit respiratory cells. After adaptation, cockerels were feed deprived for 24 h and heat production was measured. During the subsequent 7-h refeeding period, DIT and feed intake, as well as glucose oxidation and Leu decarboxylation were assessed by using breath tests. Blood samples were collected after fasting and refeeding. Finally, 10 animals per genotype were killed to record abdominal fat weight. Body composition of 6 different chickens per genotype was determined by using dual-energy x-ray absorptiometry. During feed deprivation, the R+ cockerels had a significantly higher heat production than their R- counterparts, which was even more pronounced during refeeding. Consequently, the R+ cockerels had a significantly increased DIT and a higher feed intake than the R- cockerels. Thus, no evidence of a feedback effect of DIT on feed intake was observed. The oxidation of U-(13)C(6)-glucose was significantly higher in the R+ cockerels, confirming their higher respiratory quotient values and the augmented fat deposition in the R- chickens, as assessed by abdominal fat weight and dual-energy x-ray absorptiometry measurements. No significant genotype effect on 1-(13)C(1)-Leu decarboxylation was observed, despite increased circulating uric acid levels in the R+ chickens. Genotype did not influence plasma levels of triglycerides, free fatty acids, glucose, triiodothyronine, or thyroxine after refeeding, whereas plasma leptin levels were significantly higher in the R+ cockerels.

Propofol hemisuccinate suppression of experimental autoimmune encephalomyelitis.

Propofol hemisuccinate is a prodrug water soluble form of the lipophilic, phenolic compound propofol (2,6-di-isopropylphenol), that is the active ingredient in the widely used anesthetic agent Diprovan. Propofol binds to GABA(A) receptors but also has a phenolic structure that confers antioxidant properties to the molecule. The effects of propofol hemisuccinate in rat experimental autoimmune encephalomyelitis (EAE) were studied using different doses and time regimes. Propofol hemisuccinate, 100 mg/kg given three times a day from day 7 or day 12 until day 16 after disease initiation, significantly reduced maximal EAE score. Histology studies supported the clinical findings demonstrating reduction in the inflammatory response in the lumbar spinal cord in animals treated with propofol hemisuccinate. Decreased levels of nitrotyrosine and unchanged levels of induced nitric oxide synthase suggest propofol hemisuccinate crossed the blood brain barrier and exerted its effects by lowering reactive oxygen species levels. The results suggest that propofol hemisuccinate may provide an alternative mode of treatment for acute exacerbations of multiple sclerosis.

Effects of substitution between fat and protein on feed intake and its regulatory mechanisms in broiler chickens: endocrine functioning and intermediary metabolism.

The aim of this study was to investigate the influence of dietary macronutrient ratio on postprandial (5 or 48 h after refeeding) endocrine functioning and metabolites of the intermediary metabolism and to relate these parameters with dietary-induced alterations in energy, protein, and lipid metabolism. Male broilers were reared from 1 to 7 wk of age on isoenergetic diets with substitutions between fat and protein but similar carbohydrate contents [low protein (LP): 126 vs. 242 g protein/ kg; low fat (LF): 43 vs. 106 g fat/kg]. The LP chickens had significantly increased postprandial plasma triglyceride levels. This was likely the result of stimulated hepatic lipogenesis, as corroborated by their significantly higher respiratory quotients. Plasma free fatty acid concentrations were higher in LP broilers, whereas glucose levels were unaffected by dietary composition, suggesting that these chickens preferred carbohydrates as an energy source over free fatty acids. Plasma uric acid levels were lower in LP compared with LF chickens, indicating a more efficient protein retention in the former group. LP birds that were fasted and refed at 48 h had higher plasma 3,5,3'-triiodothyronine (T3) levels, corroborating their increased heat production. The postprandial T3 increase was more pronounced in the LF chickens, possibly induced by their higher protein consumption. In conclusion, diet-induced changes in heat production and energy partitioning are reflected in circulating levels of intermediary metabolites and hormones. Furthermore, nutritional studies should consider the ability of organisms to habituate to changed diet compositions and that alterations in feeding status follow higher-order responses.

Predictors of 6-minute walk test results in lean, obese and morbidly obese women.

The aim of this study was first, to assess the presence of medical conditions that might interfere with walking; second, to assess the differences in walking capacity, perceived exertion and physical complaints between lean, obese and morbidly obese women; and third, to identify anthropometric, physical fitness and physical activity variables that contribute to the variability in the distance achieved during a 6-minute walk test in lean and obese women. A total of 85 overweight and obese females (18-65 years, body mass index (BMI) > or = 27.5 kg m(-2)), 133 morbidly obese females (BMI > or = 35 kg m-2) and 82 age-matched sedentary lean female volunteers (BMI < or = 26 kg m(-2)) were recruited. Patients suffering from severe musculoskeletal and cardiopulmonary disease were excluded from the study. Prior to the test, conditions that might interfere with walking and hours of TV watching were asked for. Physical activity pattern was assessed using the Baecke questionnaire. Weight, height, body composition (bioelectrical impedance method), isokinetic concentric quadriceps strength (Cybex) and peak oxygen uptake (peakVO2_bicycle ergometer) were measured. A 6-minute walk test was performed and heart rate, walking distance, Borg rating scale of perceived exertion (RPE) and physical complaints at the end of the test were recorded. In obese and particularly in morbidly obese women suffering from skin friction, urinary stress incontinence, varicose veins, foot static problems and pain, wearing insoles, suffering from knee pain, low back pain or hip arthritis were significantly more prevalent than in lean women (P < 0.05). Morbidly obese women (BMI > 35 kg m(-2)N = 133) walked significantly slower (5.4 km h(-1)) than obese (5.9 km h(-1)) and lean women (7.2 km h(-1), P < 0.05), were more exerted (RPE 13.3, 12.8 and 12.4, respectively, P < 0.05) and complained more frequently of dyspnea (9.1%, 4.7% and 0% resp., P < 0.05) and musculoskeletal pain (34.9%, 17.7% and 11.4% resp., P < 0.05) at the end of the walk. In a multiple regression analysis, 75% of the variance in walking distance could be explained by BMI, peakVO2, quadriceps muscle strength age, and hours TV watching or sports participation. These data suggest that in contrast with lean women, walking ability of obese women is hampered not only by overweight, reduced aerobic capacity and a sedentary life style, but also by perceived discomfort and pain. Advice or programs aimed at increasing walking for exercise also need to address the conditions that interfere with walking, as well as perceived symptoms and walking difficulties in order to improve participation and compliance.

Health-related quality of life in physically active and sedentary obese women.

The aim was to assess dimensions of health-related quality of life (HRQL) in women attending an obesity clinic, and to rate differences in HRQL in those with the highest and lowest levels of physical activity (PA). The sample included 113 sedentary and 101 physically active subjects from a total sample of 375 overweight women 16-65 years, with a body mass index (BMI) > or =27.5 kg/m(2) consulting at an outpatient Endocrinology Clinic, and 82 lean female volunteers who served as a reference. Weight, height, body composition, PA, physical medical conditions, depression, body image, cognitive-behavioral conceptualization of obesity, eating behavior, functional status, walking ability, exercise capacity, social functioning, and general health and perceived quality of life were assessed cross-sectionally. The prevalence of medical conditions and depression was not statistically different (P < 0.05) in sedentary and active women. In sedentary obese women, body attitude, walking ability, and aerobic fitness were poorer; the number of people to turn to for social support was smaller; physical attributions about the basis of the subjects obesity were less pronounced; and eating was more the consequence of external triggers or diffuse emotions than in physically active obese women (P < 0.05). The findings indicate that a higher level of PA in an obese female clinical population was positively associated with diverse dimensions of HRQL. However, it was not possible to determine if these favorable aspects of HRQL are the cause or the consequence of a higher PA level.

Exercise capacity in lean versus obese women.

The aim of this study was to assess the nature and magnitude of the differences in submaximal and maximal exercise capacity parameters between lean and obese women. A total of 225 healthy obese women 18-65 years (BMI> or=30 kg/m(2)) and 81 non-athletic lean women (BMI< or=26 kg/m(2)) were selected. Anthropometric measurements (weight and height), body composition assessment (bioelectrical impedance method) and a maximal exercise capacity test on a bicycle ergometer were performed. Oxygen uptake (VO(2)), carbon dioxide production (VCO(2)), expired ventilation (VE), respiratory quotient (RQ), breathing efficiency (VE/VO(2)), mechanical efficiency (ME) and anaerobic threshold (AT) were calculated. At a submaximal intensity load of 70 W, VO(2) (l/min) was larger in the obese women and was already 78% of their peak VO(2), whereas in the non-obese it was only 69% (P=0.0001). VE (l/min) was larger, VE/VO(2) did not differ and ME was lower in obese compared to the lean women. AT occurred at the same percentage of peak VO(2) in both lean and obese women. At peak effort, achieved load, terminal VO(2) (l min(-1) kg(-1)), VE, heart rate, RQ respiratory exchange ratio and perceived exertion were lower in obese subjects compared to the non-obese. Obese subjects mentioned significantly more musculoskeletal pain as a reason to end the test, whereas in lean subjects it was leg fatigue. Lean women recovered better as after 2 min they were already at 35% of the peak VO(2), whereas in the obese women it was 47% (P=0.0001). Our results confirm that exercise capacity is decreased in obesity, both at submaximal and peak intensity, and during recovery. Moreover, at peak effort musculoskeletal pain was an important reason to end the test and not true leg fatigue. These findings are important when designing exercise programs for obese subjects.

The effect of atorvastatin on postprandial lipaemia in overweight or obese women homozygous for apo E3.

OBJECTIVE: To determine the effect of atorvastatin on postprandial lipaemia in overweight or obese women with the apoprotein (apo) E3/E3 genotype. DESIGN: Double-blind randomised, placebo-controlled 8-week single-centre study. SUBJECTS: Twenty-two healthy women, homozygous for apo E3 with a BMI ranging from 27.6 to 41.1 kg/m2 and normal or moderately elevated fasting triglycerides (53-184 mg/dl). TREATMENT: After a 4-week isocaloric single-blind, placebo lead-in period, subjects were randomly assigned to receive either placebo (n = 7) or atorvastatin 20 mg once daily in the evening (n = 15) for 4 weeks. RESULTS: Atorvastatin significantly reduces fasting total cholesterol, LDL-cholesterol and postprandial triglycerides in obese women, homozygous for apo E3 with normal or near-normal fasting triglyceride levels. No significant effect on fasting triglycerides was observed. CONCLUSION: Atorvastatin decreases postprandial hyperlipidaemia, an independent cardiovascular risk factor, in normolipidaemic obese women. This effect of atorvastatin may, therefore, represent a cardioprotective mechanism.

Study of differences in peripheral muscle strength of lean versus obese women: an allometric approach.

OBJECTIVE: To investigate whether peripheral muscle strength is significantly different between lean and obese women controlled for age and physical activity, using an allometric approach. DESIGN: Cross-sectional study of isometric handgrip and isokinetic leg and trunk muscle strength. SUBJECTS: 173 obese (age 39.9+/-11.4 y, body mass index (BMI) 37.8+/-5.3 kg/m(2)) and 80 lean (age 39.7+/-12.2 y, BMI 22.0+/-2.2 kg/m(2)) women. MEASUREMENTS: Anthropometric measures (weight, height) and body composition (bioelectrical impedance method), isometric handgrip (maximal voluntary contraction on the Jamar dynamometer), isokinetic trunk flexion-extension, trunk rotation, and knee flexion-extension (Cybex dynamometers). RESULTS: Absolute isokinetic strength output (that is, strength uncorrected for fat-free mass) was larger in obese compared to lean women, except for knee flexion and isometric handgrip, which were not significantly different (P>0.05). Pearson correlation coefficients between strength measures and fat-free mass (kg) were low to moderate both in lean (r=0.28-0.53, P<0.05) and in obese (r=0.29-0.49, P<0.001) women. There was no correlation with fat mass (kg) in the lean, whereas in the obese women a weak positive relation could be observed for most isokinetic data (r=0.21-0.39, P<0.01). When correcting for fat-free mass (raised to the optimal exponent determined by allometric scaling), all strength measurements were at least 6% lower in obese when compared to the lean women, except for trunk flexion, which was at least 8% stronger in obese women. DISCUSSION: The higher absolute knee extension strength measures of leg and the similar extension strength of the trunk in the obese sample compared to the lean might be explained by the training effect of weight bearing and support of a larger body mass. However when the independent effect of fat-free mass is removed, these strength measures, as well as oblique abdominal muscle and handgrip strength, turned out to be lower in obese women. These observations could be the reflection of the overall impairment of physical fitness as a consequence of obesity and its metabolic complications.

Trends in BMI among Belgian children, adolescents and adults from 1969 to 1996.

OBJECTIVE: To document secular data on changes in the distribution of body mass index (BMI), to determine the probability of overweight at 40 y of age in Belgian males in relation to the presence or absence of overweight at different ages in adolescence, and to estimate tracking of BMI in Belgian males in Belgium aged 12-40 y. DESIGN: Cross-sectional and mixed longitudinal surveys in nationally representative samples of Belgian males and females. SUBJECTS: Cross-sectional-more than 21 000 boys and 9698 girls; to examine secular trends-3164 boys and 5140 girls; to examine tracking-161 males. MEASURES: Body mass and height to determine BMI. RESULTS: In Belgian children the degree of overweight has increased between 1969 and 1993. Tracking of BMI is high in adolescence (r=0.77) and adulthood (r=0.69-0.91) and moderate from adolescence to adulthood (r=0.49). In Belgian males, the probability of overweight at 40 y of age in the presence of overweight at different ages in adolescence is important (odds ratios 5.0-6.9). CONCLUSIONS: Cross-sectional and longitudinal data, trends and tracking of BMI from 1969 until 1996 in Belgium indicate an increase in the degree of childhood overweight and obesity. Moreover, the risk of an overweight male adolescent becoming an overweight adult is substantial. Measures to restrict the Belgian overweight and obesity epidemic should be taken.

Gene expression monitoring for gene discovery in models of peripheral and central nervous system differentiation, regeneration, and trauma.

Gene expression monitoring using gene expression microarrays represents an extremely powerful technology for gene discovery in a variety of systems. We describe the results of seven experiments using Incyte GEM technology to compile a proprietary portfolio of data concerning differential gene expression in six different models of neuronal differentiation and regeneration, and recovery from injury or disease. Our first two experiments cataloged genes significantly up- or down-regulated during two phases of the retinoic acid-induced differentiation of the embryonal carcinoma line Ntera-2. To identify genes involved in neuronal regeneration we performed three GEM experiments, which included changes in gene expression in rat dorsal root ganglia during the healing of experimentally injured sciatic nerve, in regenerating neonatal opossum spinal cord, and during lipopolysaccharide stimulation of primary cultures of rat Schwann cells. Finally we have monitored genes involved in the recovery phase of the inflammatory disease of the rat spinal cord, experimental allergic encephalomyelitis, as well as those responsible for protection from oxidative stress in a glutamate-resistant rat hippocampal cell line. Analysis of the results of the approximately 70,000 data points collected is presented.