Heritability of objectively assessed and self-reported sedentary behavior.

Understanding the sources of the large individual differences in sedentary behavior is of great importance as this behavior is associated with pre-mature mortality and non-communicable diseases. Here, we report on the contribution of genetic and environmental factors to the variation in objectively assessed (accelerometer) sedentary behavior and self-reported sitting and their shared genetic basis. In addition, the overlap of the genetic risk factors influencing sedentary time and moderate-to-vigorous physical activity (MVPA) was estimated. A sample of 800 individuals (twins and their siblings) was equipped with an Actigraph accelerometer for 7 days and reported on their sitting time and time spent on MVPA on those days using the IPAQ-SF. Genetic factors explained 56% (CI: 44%, 65%) of the individual differences in objective sedentary behavior (Actigraph) and 26% (CI: 0%, 51%) of the individual differences in self-reported sedentary behavior (IPAQ-SF). A modest correlation (0.33) was found between these measures, which was for 45% accounted for by genetic influences. The genetic correlation was 0.49 reflecting a partly overlapping set of genes that influenced both measurements. A modest correlation (-0.27) between Actigraph-derived sedentary time and MVPA was found, which was 13% accounted for by genetic effects. The genetic correlation was -0.31, indicating that there are overlapping genetic variants that increase sedentary time and decrease MVPA or vice versa. To conclude, more than half of the individual differences in objective sedentary time could be attributed to genetic differences, while for self-reported sitting this was much lower. In addition, using objective measurements, this study confirms that sedentary time is not simply the inverse of MVPA. Future studies are needed to understand the pathways translating genomic variation into variation in these behaviors and how this knowledge might feed into the development of health promotion interventions.

Metataxonomic Analysis of Individuals at BMI Extremes and Monozygotic Twins Discordant for BMI.

OBJECTIVE: The human gut microbiota has been demonstrated to be associated with a number of host phenotypes, including obesity and a number of obesity-associated phenotypes. This study is aimed at further understanding and describing the relationship between the gut microbiota and obesity-associated measurements obtained from human participants. SUBJECTS/METHODS: Here, we utilize genetically informative study designs, including a four-corners design (extremes of genetic risk for BMI and of observed BMI; N = 50) and the BMI monozygotic (MZ) discordant twin pair design (N = 30), in order to help delineate the role of host genetics and the gut microbiota in the development of obesity. RESULTS: Our results highlight a negative association between BMI and alpha diversity of the gut microbiota. The low genetic risk/high BMI group of individuals had a lower gut microbiota alpha diversity when compared to the other three groups. Although the difference in alpha diversity between the lean and heavy groups of the BMI-discordant MZ twin design did not achieve significance, this difference was observed to be in the expected direction, with the heavier participants having a lower average alpha diversity. We have also identified nine OTUs observed to be associated with either a leaner or heavier phenotype, with enrichment for OTUs classified to the Ruminococcaceae and Oxalobacteraceae taxonomic families. CONCLUSION: Our study presents evidence of a relationship between BMI and alpha diversity of the gut microbiota. In addition to these findings, a number of OTUs were found to be significantly associated with host BMI. These findings may highlight separate subtypes of obesity, one driven by genetic factors, the other more heavily influenced by environmental factors.

Overweight is associated with lower resting state functional connectivity in females after eliminating genetic effects: A twin study.

Obesity is related to altered functional connectivity of resting state brain networks that are involved in reward and motivation. It is unknown to what extent these associations reflect genetic confounding and whether the obesity-related connectivity changes are associated with differences in dietary intake. In this study, resting state functional MRI was performed after an overnight fast in 16 female monozygotic twin pairs (aged 48.8 ± 9.8 years) with a mean BMI discordance of 3.96 ± 2.1 kg/m2 (range 0.7-8.2). Functional connectivity of the salience, basal ganglia, default mode and anterior cingulate-orbitofrontal cortex networks was examined by independent component analysis. Dietary intake was assessed using 3-day 24-hour recalls. Results revealed that within the basal ganglia network, heavier versus leaner co-twins have decreased functional connectivity strength in bilateral putamen (P < 0.05, FWE-corrected). There were no differences in connectivity in the other networks examined. In the overall group, lower functional connectivity strength in the left putamen was correlated with higher intake of total fat (P < 0.01). It was concluded that, after eliminating genetic effects, overweight is associated with lower resting state functional connectivity in bilateral putamen in the basal ganglia network. The association between lower putamen connectivity and higher fat intake suggests an important role of the putamen in appetitive mechanisms. The cross-sectional nature of our study cannot discriminate cause and consequence, but the findings are compatible with an effect of lower putamen connectivity on increased BMI and associated higher fat intake. Hum Brain Mapp 38:5069-5081, 2017. © 2017 Wiley Periodicals, Inc.

[Spurious hypertension in an athletic young man]. / Pseudohypertensie bij een sportieve jonge man.

Isolated systolic hypertension is typical for the elderly, but also occurs in younger adults. Increased pulse wave amplification between the elastic aorta and arteries to the arm can result in a higher peripheral (brachial) blood pressure, while central (aortic) systolic blood pressure is normal. A 21-year-old athletic man was referred because of an arterial blood pressure of 160/85 mmHg. Diagnostic work-up did not reveal secondary hypertension or organ damage such as left ventricular hypertrophy or microalbuminuria. Pulse wave analysis by arterial tonometry showed central blood pressure to be 29 mmHg lower than blood pressure at the brachial artery. This finding suggests 'spurious' or pseudohypertension. Isolated systolic hypertension in athletic young adults can reflect a discrepancy between a blood pressure measured at the upper limb and the 'true' central blood pressure at the central arteries, i.e. pseudohypertension.

A randomized controlled trial of four precolonoscopy bowel cleansing regimens.

BACKGROUND: The ideal bowel cleansing regimen for colonoscopy has yet to be determined. OBJECTIVE: To compare the cleansing efficacy, and patient tolerability and safety of four bowel preparation regimens. METHODS: A total of 834 patients undergoing outpatient colonoscopy were randomly assigned to one of four regimens: 4 L polyethylene glycol (PEG); 2 L PEG + 20 mg bisacodyl; 90 mL of sodium phosphate (NaP); or two sachets of a commercially available bowel cleansing solution (PSMC) + 300 mL of magnesium citrate (M). The primary outcome measure was cleansing efficacy, which was scored by blinded endoscopists using the Ottawa Bowel Preparation Scale. Secondary outcome measures were bowel preparation quality according to time of colonoscopy, and patient tolerability and safety. RESULTS: The mean total cleansing score was significantly worse in the NaP group compared with the other three groups (P<0.0001). The mean cleansing scores were worse in patients who underwent morning versus afternoon colonoscopy, a finding that was consistent in all four groups. PSMC + M was the best tolerated regimen. No clinically significant mean changes in creatinine or electrolyte levels were identified, although a significantly higher proportion of patients in the NaP group developed hypokelemia (P<0.0001). CONCLUSIONS: 2 L PEG + 20 mg bisacodyl, or PSMC + M was as efficacious as 4 L PEG and superior to NaP for bowel cleansing. A short interval between the completion of bowel preparation and the start of colonoscopy (ie, 'runway time'), irrespective of bowel preparation regimen, appeared to be a more important predictor of bowel cleanliness than the cathartic agents used.

Brain reward responses to food stimuli among female monozygotic twins discordant for BMI.

Obese individuals are characterized by altered brain reward responses to food. Despite the latest discovery of obesity-associated genes, the contribution of environmental and genetic factors to brain reward responsiveness to food remains largely unclear. Sixteen female monozygotic twin pairs with a mean BMI discordance of 3.96 ± 2.1 kg/m2 were selected from the Netherlands Twin Register to undergo functional MRI scanning while watching high- and low-calorie food and non-food pictures and during the anticipation and receipt of chocolate milk. In addition, appetite ratings, eating behavior and food intake were assessed using visual analog scales, validated questionnaires and an ad libitum lunch. In the overall group, visual and taste stimuli elicited significant activation in regions of interest (ROIs) implicated in reward, i.e. amygdala, insula, striatum and orbitofrontal cortex. However, when comparing leaner and heavier co-twins no statistically significant differences in ROI-activations were observed after family wise error correction. Heavier versus leaner co-twins reported higher feelings of hunger (P = 0.02), cravings for sweet food (P = 0.04), body dissatisfaction (P < 0.05) and a trend towards more emotional eating (P = 0.1), whereas caloric intake was not significantly different between groups (P = 0.3). Our results suggest that inherited rather than environmental factors are largely responsible for the obesity-related altered brain responsiveness to food. Future studies should elucidate the genetic variants underlying the susceptibility to reward dysfunction and obesity. CLINICAL TRIAL REGISTRATION NUMBER: NCT02025595.

Lower birth weight is associated with alterations in dietary intake in adolescents independent of genetic factors: A twin study.

BACKGROUND & AIMS: Lower birth weight is associated with an increased risk of cardiovascular and metabolic disease. These associations may, at least in part, be explained by alterations in dietary intake in later life. The aim of this study is to examine whether lower birth weight is associated with alterations in dietary intake in later life, and whether this association is due to intrauterine environmental or genetic factors. METHODS: In this observational study birth weight and dietary intake were investigated in 78 dizygotic (DZ) and 94 monozygotic (MZ) adolescent same-sex twin subjects. Birth weight was obtained from the mothers. Dietary intake was assessed by two-day dietary records. RESULTS: In the total group of twins, lower birth weight was associated with higher intake of saturated fat after adjustment for current weight (1.2 per cent of total energy intake (E%) per kg increase in birth weight, P < 0.01). Intra-pair analysis in all twin pairs demonstrated that twins with the lower birth weight had a 115 kcal higher total energy intake and a 0.7 E% higher saturated fat intake compared to their co-twins with the higher birth weight (P < 0.05). Intra-pair differences in birth weight were negatively associated with differences in energy intake and differences in intake of saturated fat after adjustment for differences in current weight (P = 0.07 and P < 0.05, respectively). Intra-pair differences in birth weight were positively associated with intra-pair differences in intake of dietary fibres (P < 0.05). These intra-pair differences and associations were similar for DZ and MZ twins (P for difference > 0.6). CONCLUSIONS: Lower birth weight was related with higher intake of energy and saturated fat within twin pairs, and these associations were independent of zygosity, suggesting that the association between birth weight and alterations in dietary intake in later life is explained by intrauterine environmental rather than genetic factors.

Physical activity and dietary intake in BMI discordant identical twins.

OBJECTIVE: Despite the latest discovery of obesity-associated genes, the rapid rise in global obesity suggests a major role for environmental factors. This study investigated the influence of environmental factors on physical activity and dietary intake independent of genetic effects. METHODS: Sixteen female monozygotic twins aged 48.8 ± 9.8 years (range 37-70) with a mean BMI discordance of 3.96 ± 2.1 kg/m(2) (range 0.7-8.2) were studied. Physical activity was determined using 7-day accelerometry and dietary intake using 3-day 24-h recalls. RESULTS: Heavier cotwins were generally less physically active (mean activity counts × 1,000 per day ± SD; 505.5 ± 155.1 vs. 579.6 ± 185.4, P = 0.047) and tended to spend 6.1 min/day less in moderate to vigorous physical activity than leaner cotwins (P = 0.09). Energy intake did not significantly differ within pairs. Total fat intake (en%; P = 0.03), specifically monounsaturated fat (P < 0.01) and polyunsaturated fat (P = 0.08), was higher in the heavier cotwins. CONCLUSIONS: After eliminating genetic effects, higher BMI is associated with lower overall and moderate to vigorous physical activity and higher intake of total fat, although the direction of causality cannot be determined. Future identification of the environmental factors responsible for these findings might contribute to developing new strategies in managing obesity.