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Henry S. Kahn - One of the best experts on this subject based on the ideXlab platform.
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comparison of adiposity indicators associated with fasting state insulinemia triglyceridemia and related risk biomarkers in a nationally representative adult population
Diabetes Research and Clinical Practice, 2018Co-Authors: Henry S. Kahn, Yiling J ChengAbstract:Abstract Aims We hypothesized that height-corrected Abdominal size (supine Sagittal Abdominal Diameter/height ratio [SADHtR] or waist circumference/height ratio [WHtR]) would associate more strongly than body mass index (BMI, weight/height2) with levels of fasting insulin, triglycerides, and three derived biomarkers of insulin resistance. Methods Anthropometry, including SAD by caliper, was collected on 4398 adults in the 2011–2014 National Health and Nutrition Examination Survey. For comparison purposes, each adiposity indicator was scaled to its population-based, sex-specific, interquartile range (IQR). For each biomarker we created four outcome groups based on equal-sized populations with ascending values. Multivariable polytomous logistic regression modeled the relationships between the adiposity indicators and each biomarker. Results Highest-group insulin was associated with a one-IQR increment of BMI (RR 4.3 [95% CI 3.9–4.9]), but more strongly with a one-IQR increment of SADHtR (RR 5.7 [5.0–6.6]). For highest-group HOMA-IR the RR for BMI (4.2 [3.7–4.6]) was less than that of SADHtR (6.0 [5.1–7.0]). Similarly, RRs for BMI were smaller than those for SADHtR applying to highest-group triglycerides (RR 1.6 vs 2.1), triglycerides/HDL-cholesterol (RR 1.9 vs 2.4) and TyG index (RR 1.7 vs 2.2) (all p Conclusions Relative Abdominal size rather than relative weight may better define adiposity associated with homeostatic insulin resistance. These population-based, cross-sectional findings could improve anthropometric prediction of cardiometabolic risk.
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Indicators of Abdominal size relative to height associated with sex, age, socioeconomic position and ancestry among US adults
2017Co-Authors: Henry S. Kahn, Kai Mckeever BullardAbstract:Background/ObjectivesThe supine Sagittal Abdominal Diameter (SAD) and standing waist circumference (WC) describe Abdominal size. The SAD/height ratio (SADHtR) or WC/height ratio (WHtR) may better identify cardiometabolic disorders than BMI (weight/height2), but population-based distributions of SADHtR and WHtR are not widely available. Abdominal adiposity may differ by sociodemographic characteristics.Subjects/MethodsAnthropometry, including SAD by sliding-beam caliper, was performed on 9894 non-pregnant adults ≥20 years in the US National Health and Nutrition Examination Surveys of 2011–2014. Applying survey design factors and sampling weights, we estimated nationally representative SADHtR and WHtR distributions by sex, age, educational attainment, and four ancestral groups.ResultsThe median (10th percentile, 90th percentile) for men’s SADHtR was 0.130 (0.103, 0.165) and WHtR 0.569 (0.467, 0.690). For women, median SADHtR was 0.132 (0.102, 0.175) and WHtR 0.586 (0.473, 0.738). Medians for SADHtR and WHtR increased steadily through age 79. The median BMI, however, reached maximum values at ages 40–49 (men) or 60–69 (women) and then declined. Low educational attainment, adjusted for age and ancestry, was associated with elevated SADHtR more strongly than elevated BMI. While non-Hispanic Asians had substantially lower BMI compared to all other ancestral groups (adjusted for sex, age and education), their relative reductions in SADHtR and WHtR, were less marked.ConclusionsThese cross-sectional data are consistent with monotonically increasing Abdominal adipose tissue through the years of adulthood but decreasing mass in non-Abdominal regions beyond middle age. They suggest also that visceral adipose tissue, estimated by SADHtR, expands differentially in association with low socioeconomic position. Insofar as Asians have lower BMIs than other populations, employing Abdominal indicators may attenuate the adiposity differences reported between ancestral groups. Documenting the distribution and sociodemographic features of SADHtR and WHtR supports the clinical and epidemiologic adoption of these adiposity indicators.
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beyond body mass index advantages of Abdominal measurements for recognizing cardiometabolic disorders
The American Journal of Medicine, 2016Co-Authors: Henry S. Kahn, Kai Mckeever BullardAbstract:Abstract Background The clinical recognition of cardiometabolic disorders might be enhanced by anthropometry based on the Sagittal Abdominal Diameter (SAD; also called "Abdominal height") or waist circumference rather than on weight. Direct comparisons of body mass index (BMI, weight/height 2 ) with SAD/height ratio (SADHtR) or waist circumference/height ratio (WHtR) have not previously been tested in nationally representative populations. Methods Nonpregnant adults without diagnosed diabetes (ages 20-64 years; n = 3071) provided conventional anthropometry and supine SAD (by sliding-beam caliper) in the 2011-2012 US National Health and Nutrition Examination Survey. Population-weighted, logistic models estimated how strongly each anthropometric indicator was associated with 5 cardiometabolic disorders: Dysglycemia (glycated hemoglobin ≥5.7%), HyperNonHDLc (non-high-density-lipoprotein [HDL] cholesterol ≥4.14 mmol/L, or taking anticholesteremic medications), Hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg, or taking antihypertensive medications), HyperALT (alanine transaminase ≥p75 [75th percentile, sex-specific]), and HyperGGT (gamma-glutamyltransferase ≥p75 [sex-specific]). Results After scaling each indicator, adjusted odds ratios (aORs) tended to be highest for SADHtR and lowest for BMI when identifying each disorder except dysglycemia. When SADHtR entered models simultaneously with BMI, the aORs for BMI no longer directly identified any condition, whereas SADHtR identified persons with HyperNonHDLc by aOR 2.78 (95% confidence interval [CI], 1.71-4.51), Hypertension by aOR 2.51 (95% CI, 1.22-5.15), HyperALT by aOR 2.89 (95% CI, 1.56-5.37), and HyperGGT by aOR 5.43 (95% CI, 3.01-9.79). WHtR competed successfully against BMI with regard to Dysglycemia, HyperNonHDLc, and HyperGGT. c-Statistics of SADHtR and WHtR were higher than those of BMI ( P Conclusions Among nonelderly adults, SADHtR or WHtR recognized cardiometabolic disorders better than did the BMI.
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population distribution of the Sagittal Abdominal Diameter sad from a representative sample of us adults comparison of sad waist circumference and body mass index for identifying dysglycemia
PLOS ONE, 2014Co-Authors: Henry S. Kahn, Qiuping Gu, Kai Mckeever Bullard, David S Freedman, Namanjeet Ahluwalia, Cynthia L OgdenAbstract:Background The Sagittal Abdominal Diameter (SAD) measured in supine position is an alternative adiposity indicator that estimates the quantity of dysfunctional adipose tissue in the visceral depot. However, supine SAD’s distribution and its association with health risk at the population level are unknown. Here we describe standardized measurements of SAD, provide the first, national estimates of the SAD distribution among US adults, and test associations of SAD and other adiposity indicators with prevalent dysglycemia. Methods and Findings In the 2011–2012 National Health and Nutrition Examination Survey, supine SAD was measured (“Abdominal height”) between arms of a sliding-beam caliper at the level of the iliac crests. From 4817 non-pregnant adults (age ≥20; response rate 88%) we used sample weights to estimate SAD’s population distribution by sex and age groups. SAD’s population mean was 22.5 cm [95% confidence interval 22.2–22.8]; median was 21.9 cm [21.6–22.4]. The mean and median values of SAD were greater for men than women. For the subpopulation without diagnosed diabetes, we compared the abilities of SAD, waist circumference (WC), and body mass index (BMI, kg/m2) to identify prevalent dysglycemia (HbA1c ≥5.7%). For age-adjusted, logistic-regression models in which sex-specific quartiles of SAD were considered simultaneously with quartiles of either WC or BMI, only SAD quartiles 3 (p<0.05 vs quartile 1) and 4 (p<0.001 vs quartile 1) remained associated with increased dysglycemia. Based on continuous adiposity indicators, analyses of the area under the receiver operating characteristic curve (AUC) indicated that the dysglycemia model fit for SAD (age-adjusted) was 0.734 for men (greater than the AUC for WC, p<0.001) and 0.764 for women (greater than the AUC for WC or BMI, p<0.001). Conclusions Measured inexpensively by bedside caliper, SAD was associated with dysglycemia independently of WC or BMI. Standardized SAD measurements may enhance assessment of dysfunctional adiposity.
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Population mean and median (50th percentile) values with selected percentiles of the Sagittal Abdominal Diameter in US adults, from NHANES 2011–2012.
2014Co-Authors: Henry S. Kahn, Kai Mckeever Bullard, David S Freedman, Namanjeet Ahluwalia, Cynthia L OgdenAbstract:* p
Bengt Vessby - One of the best experts on this subject based on the ideXlab platform.
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Treatment With Dietary trans10cis12 Conjugated Linoleic Acid Causes Isomer- Specific Insulin Resistance in Obese Men With the Metabolic Syndrome
2016Co-Authors: Ulf Risérus Mmed, Kerstin Brismar, Peter Arner, Bengt VessbyAbstract:OBJECTIVE — Conjugated linoleic acid (CLA) is a group of dietary fatty acids with antiobe-sity and antidiabetic effects in some animals. The trans10cis12 (t10c12) CLA isomer seems to cause these effects, including improved insulin sensitivity. Whether such isomer-specific effects occur in humans is unknown. The aim of this study was to investigate whether t10c12 CLA or a commercial CLA mixture could improve insulin sensitivity, lipid metabolism, or body compo-sition in obese men with signs of the metabolic syndrome. RESEARCH DESIGN AND METHODS — In a randomized, double-blind controlled trial, Abdominally obese men (n 60) were treated with 3.4 g/day CLA (isomer mixture), purified t10c12 CLA, or placebo. Euglycemic-hyperinsulinemic clamp, serum hormones, lipids, and anthropometry were assessed before and after 12 weeks of treatment. RESULTS — Baseline metabolic status was similar between groups. Unexpectedly, t10c12 CLA increased insulin resistance (19%; P 0.01) and glycemia (4%; P 0.001) and reduced HDL cholesterol (4%; P 0.01) compared with placebo, whereas body fat, Sagittal Abdominal Diameter, and weight decreased versus baseline, but the difference was not significantly different from placebo. The CLA mixture did not change glucose metabolism, body composition, o
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treatment with dietary trans10cis12 conjugated linoleic acid causes isomer specific insulin resistance in obese men with the metabolic syndrome
Diabetes Care, 2002Co-Authors: Ulf Risérus, Kerstin Brismar, Peter Arner, Bengt VessbyAbstract:OBJECTIVE —Conjugated linoleic acid (CLA) is a group of dietary fatty acids with antiobesity and antidiabetic effects in some animals. The trans 10 cis 12 ( t 10 c 12) CLA isomer seems to cause these effects, including improved insulin sensitivity. Whether such isomer-specific effects occur in humans is unknown. The aim of this study was to investigate whether t 10 c 12 CLA or a commercial CLA mixture could improve insulin sensitivity, lipid metabolism, or body composition in obese men with signs of the metabolic syndrome. RESEARCH DESIGN AND METHODS —In a randomized, double-blind controlled trial, Abdominally obese men ( n = 60) were treated with 3.4 g/day CLA (isomer mixture), purified t 10 c 12 CLA, or placebo. Euglycemic-hyperinsulinemic clamp, serum hormones, lipids, and anthropometry were assessed before and after 12 weeks of treatment. RESULTS —Baseline metabolic status was similar between groups. Unexpectedly, t 10 c 12 CLA increased insulin resistance (19%; P < 0.01) and glycemia (4%; P < 0.001) and reduced HDL cholesterol (−4%; P < 0.01) compared with placebo, whereas body fat, Sagittal Abdominal Diameter, and weight decreased versus baseline, but the difference was not significantly different from placebo. The CLA mixture did not change glucose metabolism, body composition, or weight compared with placebo but lowered HDL cholesterol (−2%; P < 0.05). CONCLUSIONS —These results reveal important isomer-specific metabolic actions of CLA in Abdominally obese humans. A CLA-induced insulin resistance has previously been described only in lipodystrophic mice. Considering the use of CLA-supplements among obese individuals, it is important to clarify the clinical consequences of these results, but they also provide physiological insights into the role of specific dietary fatty acids as modulators of insulin resistance in humans.
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conjugated linoleic acid supplementation in humans metabolic effects
Lipids, 2001Co-Authors: Annika Smedman, Bengt VessbyAbstract:Supplementation with conjugated linoleic acid (CLA) induces a number of physiological effects in experimental animals, including reduced body fat content, decreased aortic lipid deposition, and improved serum lipid profile. Controlled trials on the effects of CLA in humans have hitherto been scarce. The aim of this study was to evaluate the effects of supplementation with CLA in healthy humans on anthropometric and metabolic variables and on the fatty acid composition of serum lipids and thrombocytes. Fifty-three healthy men and women, aged 23–63 yr, were randomly assigned to supplementation with CLA (4.2 g/d) or the same amount of olive oil during 12 wk in a double-blind fashion. The proportion of body fat decreased (−3.8%, P<0.001) in the CLA-treated group, with a significant difference from the control group (P=0.050). Body weight, body mass index, and Sagittal Abdominal Diameter were unchanged. There were no major differences between the groups in serum lipoproteins, nonesterified fatty acids, plasma insulin, blood glucose, or plasminogen activator inhibitor 1 (PAI-1). In the CLA group the proportions of stearic, docosatetraenoic, and docosapentaenoic acids increased in serum lipids and thrombocytes, while proportions of palmitic, oleic, and dihomoγ-linolenic acids decreased, causing a decrease of the estimated Δ-6 and Δ-9 and an increase in the Δ-5 desaturase activities. These results suggest that supplementation with CLA may reduce the proportion of body fat in humans and that CLA affects fatty acid metabolism. No effects on body weight, serum lipids, glucose metabolism, or PAI-1 were seen.
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conjugated linoleic acid cla reduced Abdominal adipose tissue in obese middle aged men with signs of the metabolic syndrome a randomised controlled trial
International Journal of Obesity, 2001Co-Authors: Ulf Risérus, Lars Berglund, Bengt VessbyAbstract:BACKGROUND: Abdominal obesity is strongly related to metabolic disorders. Recent research suggests that dietary conjugated linoleic acid (CLA) reduces body fat and may improve metabolic variables in animals. The metabolic effects of CLA in Abdominally obese humans have not yet been tested. OBJECTIVE: To investigate the short-term effect of CLA on Abdominal fat and cardiovascular risk factors in middle-aged men with metabolic disorders. METHODS: Twenty-five Abdominally obese men (waist-to-hip ratio (WHR), 1.05 0.05; body mass index (BMI), 32 2.7 kg=m 2 (mean s.d.)) who were between 39 and 64-y-old participated in a double-blind randomised controlled trial for 4 weeks. Fourteen men received 4.2 g CLA=day and 10 men recieved a placebo. The main endpoints were differences between the two groups in Sagittal Abdominal Diameter (SAD), serum cholesterol, low-density lipoprotein, high-density lipoprotein, triglycerides, free fatty acids, glucose and insulin. RESULTS: At baseline, there were no significant differences between groups in anthropometric or metabolic variables. After 4 weeks there was a significant decrease in SAD (cm) in the CLA group compared to placebo (Pa 0.04, 95% CI; 71.12, 70.02). Other measurements of anthropometry or metabolism showed no significant differences between the groups. CONCLUSIONS: These results indicate that CLA supplementation for 4 weeks in obese men with the metabolic syndrome may decrease Abdominal fat, without concomitant effects on overall obesity or other cardiovascular risk factors. Because of the limited sample size, the effects of CLA in Abdominal obesity need to be further investigated in larger trials with longer duration. International Journal of Obesity (2001) 25, 1129 ‐ 1135
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reliability of anthropometric measurements in overweight and lean subjects consequences for correlations between anthropometric and other variables
International Journal of Obesity, 2000Co-Authors: Karin Nordhamn, Bengt Vessby, Eva Sodergren, Erika Olsson, Brita Karlstrom, Lars BerglundAbstract:OBJECTIVE: To estimate the reliability of anthropometric measurements in overweight and lean subjects, and to examine the influence of this reliability on correlations to other variables, since low reliability leads to underestimation of correlations. DESIGN: Replicate measurements by two observers in 26 overweight and 25 lean subjects measured at two occasions. MEASUREMENTS: Sagittal Abdominal Diameter (SAD), waist circumference (waist), waist-to-hip ratio (W/H) and skinfold measurements. RESULTS: Intra-class correlation coefficients (ICCs) for SAD and waist were higher than for W/H (0.98 vs 0.90, P<0.001, and 0.97 vs 0.90, P=0.001, respectively). For waist, the ICC was lower for overweight than for lean subjects (0.85 vs 0.95, P=0.030), but the ICC values were comparable for SAD and W/H (0.92 vs 0.95 and 0.78 vs 0.83, respectively). Intra-observer variations (IOV) for SAD and waist were lower than for W/H (coefficients of variation; 1.6%, 1.4% and 2.3%, respectively), as were intra-subject variations (ISV) (2.7%, 3.0% and 3.4%, respectively). ICC values ranged from 0.84 to 0.93 and were lower for overweight than for lean subjects for biceps, subscapular and umbilical skinfolds (P=0.031, P<0.001 and P=0.048, respectively). Coefficients of variations for skinfold measurements ranged between 7.3% and 16.0% for IOV and between 14.9% and 20.8% for ISV. CONCLUSIONS: The low ICC values imply that correlations can be underestimated in overweight groups. We propose that, because of their higher reliability, SAD and waist have a higher predictive capacity for cardiovascular risk than W/H. SAD is the only measurement with high reliability in both weight groups and its use is recommended.
Ulf Risérus - One of the best experts on this subject based on the ideXlab platform.
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Serum Fatty Acids, Desaturase Activities and Abdominal Obesity – A Population-Based Study of 60-Year Old Men and Women
2017Co-Authors: Zayed D. Alsharari, Axel C. Carlsson, Ulf Risérus, Karin Leander, Bruna Gigante, Max Vikström, Per Sjögren, Federica Laguzzi, Tommy Cederholm, Ulf De FaireAbstract:Abdominal obesity is a key contributor of metabolic disease. Recent trials suggest that dietary fat quality affects Abdominal fat content, where palmitic acid and linoleic acid influence Abdominal obesity differently, while effects of n-3 polyunsaturated fatty acids are less studied. Also, fatty acid desaturation may be altered in Abdominal obesity. We aimed to investigate cross-sectional associations of serum fatty acids and desaturases with Abdominal obesity prevalence in a population-based cohort study. Serum cholesteryl ester fatty acids composition was measured by gas chromatography in 60-year old men (n = 1883) and women (n = 2015). Cross-sectional associations of fatty acids with Abdominal obesity prevalence and anthropometric measures (e.g., Sagittal Abdominal Diameter) were evaluated in multivariable-adjusted logistic and linear regression models, respectively. Similar models were employed to investigate relations between desaturase activities (estimated by fatty acid ratios) and Abdominal obesity. In logistic regression analyses, palmitic acid, stearoyl-CoA-desaturase and Δ6-desaturase indices were associated with Abdominal obesity; multivariable-adjusted odds ratios (95% confidence intervals) for highest versus lowest quartiles were 1.45 (1.19–1.76), 4.06 (3.27–5.05), and 3.07 (2.51–3.75), respectively. Linoleic acid, α-linolenic acid, docohexaenoic acid, and Δ5-desaturase were inversely associated with Abdominal obesity; multivariable-adjusted odds ratios (95% confidence intervals): 0.39 (0.32–0.48), 0.74 (0.61–0.89), 0.76 (0.62–0.93), and 0.40 (0.33–0.49), respectively. Eicosapentaenoic acid was not associated with Abdominal obesity. Similar results were obtained from linear regression models evaluating associations with different anthropometric measures. Sex-specific and linear associations were mainly observed for n3-polyunsaturated fatty acids, while associations of the other exposures were generally non-linear and similar across sexes. In accordance with findings from short-term trials, Abdominal obesity was more common among individuals with relatively high proportions of palmitic acid, whilst the contrary was true for linoleic acid. Further trials should examine the potential role of linoleic acid and its main dietary source, vegetable oils, in Abdominal obesity prevention.
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Differences in anthropometric measures in immigrants and Swedish-born individuals: Results from two community-based cohort studies.
Preventive medicine, 2014Co-Authors: Axel C. Carlsson, Per Wändell, Ulf Risérus, Johan Ärnlöv, Yan Borné, Gunnar Engström, Karin Leander, Bruna Gigante, Mai-lis Hellénius, Ulf De FaireAbstract:To study differences in body mass index (BMI), waist-hip ratio (WHR), waist circumference (WC), Sagittal Abdominal Diameter (SAD), waist-hip-height ratio (WHHR) and percent body fat in immigrants and Swedish-born men and women in two large population-based samples.
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treatment with dietary trans10cis12 conjugated linoleic acid causes isomer specific insulin resistance in obese men with the metabolic syndrome
Diabetes Care, 2002Co-Authors: Ulf Risérus, Kerstin Brismar, Peter Arner, Bengt VessbyAbstract:OBJECTIVE —Conjugated linoleic acid (CLA) is a group of dietary fatty acids with antiobesity and antidiabetic effects in some animals. The trans 10 cis 12 ( t 10 c 12) CLA isomer seems to cause these effects, including improved insulin sensitivity. Whether such isomer-specific effects occur in humans is unknown. The aim of this study was to investigate whether t 10 c 12 CLA or a commercial CLA mixture could improve insulin sensitivity, lipid metabolism, or body composition in obese men with signs of the metabolic syndrome. RESEARCH DESIGN AND METHODS —In a randomized, double-blind controlled trial, Abdominally obese men ( n = 60) were treated with 3.4 g/day CLA (isomer mixture), purified t 10 c 12 CLA, or placebo. Euglycemic-hyperinsulinemic clamp, serum hormones, lipids, and anthropometry were assessed before and after 12 weeks of treatment. RESULTS —Baseline metabolic status was similar between groups. Unexpectedly, t 10 c 12 CLA increased insulin resistance (19%; P < 0.01) and glycemia (4%; P < 0.001) and reduced HDL cholesterol (−4%; P < 0.01) compared with placebo, whereas body fat, Sagittal Abdominal Diameter, and weight decreased versus baseline, but the difference was not significantly different from placebo. The CLA mixture did not change glucose metabolism, body composition, or weight compared with placebo but lowered HDL cholesterol (−2%; P < 0.05). CONCLUSIONS —These results reveal important isomer-specific metabolic actions of CLA in Abdominally obese humans. A CLA-induced insulin resistance has previously been described only in lipodystrophic mice. Considering the use of CLA-supplements among obese individuals, it is important to clarify the clinical consequences of these results, but they also provide physiological insights into the role of specific dietary fatty acids as modulators of insulin resistance in humans.
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conjugated linoleic acid cla reduced Abdominal adipose tissue in obese middle aged men with signs of the metabolic syndrome a randomised controlled trial
International Journal of Obesity, 2001Co-Authors: Ulf Risérus, Lars Berglund, Bengt VessbyAbstract:BACKGROUND: Abdominal obesity is strongly related to metabolic disorders. Recent research suggests that dietary conjugated linoleic acid (CLA) reduces body fat and may improve metabolic variables in animals. The metabolic effects of CLA in Abdominally obese humans have not yet been tested. OBJECTIVE: To investigate the short-term effect of CLA on Abdominal fat and cardiovascular risk factors in middle-aged men with metabolic disorders. METHODS: Twenty-five Abdominally obese men (waist-to-hip ratio (WHR), 1.05 0.05; body mass index (BMI), 32 2.7 kg=m 2 (mean s.d.)) who were between 39 and 64-y-old participated in a double-blind randomised controlled trial for 4 weeks. Fourteen men received 4.2 g CLA=day and 10 men recieved a placebo. The main endpoints were differences between the two groups in Sagittal Abdominal Diameter (SAD), serum cholesterol, low-density lipoprotein, high-density lipoprotein, triglycerides, free fatty acids, glucose and insulin. RESULTS: At baseline, there were no significant differences between groups in anthropometric or metabolic variables. After 4 weeks there was a significant decrease in SAD (cm) in the CLA group compared to placebo (Pa 0.04, 95% CI; 71.12, 70.02). Other measurements of anthropometry or metabolism showed no significant differences between the groups. CONCLUSIONS: These results indicate that CLA supplementation for 4 weeks in obese men with the metabolic syndrome may decrease Abdominal fat, without concomitant effects on overall obesity or other cardiovascular risk factors. Because of the limited sample size, the effects of CLA in Abdominal obesity need to be further investigated in larger trials with longer duration. International Journal of Obesity (2001) 25, 1129 ‐ 1135
Seema Gulati - One of the best experts on this subject based on the ideXlab platform.
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effects of controlled school based multi component model of nutrition and lifestyle interventions on behavior modification anthropometry and metabolic risk profile of urban asian indian adolescents in north india
European Journal of Clinical Nutrition, 2010Co-Authors: Neha Singhal, Anoop Misra, Priyali Shah, Seema GulatiAbstract:BACKGROUND/OBJECTIVES: To study the effectiveness of a multi-component intervention model of nutrition and lifestyle education on behavior modification, anthropometry and metabolic risk profile of urban Asian-Indian adolescents in North India. SUBJECTS/METHODS: Two schools matched for student strength and middle socioeconomic strata were randomly allocated to intervention and control group. Changes in nutrition-related knowledge, attitude, lifestyle practices, food frequency and body image of eleventh-grade students (15-17 years) in both schools were tested using a validated questionnaire. Anthropometric and biochemical measurements were made using standard methods. Segmental body composition analysis was carried out using an 8-electrode multifrequency bioelectrical impedance method of body fat estimation. RESULTS: At 6 months follow-up, significant improvement in several domains of knowledge was observed in intervention children (n=99; males=60; females=39) as compared with control school children (n=102; males=61; females=41). In the intervention group, significantly lower proportion of children consumed aerated drinks (15.1%; P<0.001) and energy-dense unhealthy foods (8.9%; P=0.03), whereas significantly higher proportion brought tiffin (packed lunch) to school (14.9%; P=0.004) and brought a fruit in their tiffin (30.7%; P<0.001) as compared with the control group. Significant decrease in mean waist circumference (P=0.02, 95% confidence interval (CI)=-2.43,-0.17), Sagittal Abdominal Diameter (P<0.001, 95% CI=-0.82,-0.09), waist-to-hip ratio (P=0.02, 95% CI=-0.03,-0.004) and fasting blood glucose (P=0.05, 95% CI=-0.09, 5.00) was seen in intervention as compared with control school children. CONCLUSIONS: Multi-component model of nutrition and lifestyle education was successful in improving the nutrition-related knowledge, eating habits and lifestyle practices, and resulted in beneficial changes in anthropometric and biochemical profiles of the Asian Indian adolescents. This model should be applied on countrywide basis to prevent obesity and diabetes.
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effects of controlled school based multi component model of nutrition and lifestyle interventions on behavior modification anthropometry and metabolic risk profile of urban asian indian adolescents in north india
European Journal of Clinical Nutrition, 2010Co-Authors: Neha Singhal, Anoop Misra, Priyali Shah, Seema GulatiAbstract:To study the effectiveness of a multi-component intervention model of nutrition and lifestyle education on behavior modification, anthropometry and metabolic risk profile of urban Asian-Indian adolescents in North India. Two schools matched for student strength and middle socioeconomic strata were randomly allocated to intervention and control group. Changes in nutrition-related knowledge, attitude, lifestyle practices, food frequency and body image of eleventh-grade students (15–17 years) in both schools were tested using a validated questionnaire. Anthropometric and biochemical measurements were made using standard methods. Segmental body composition analysis was carried out using an 8-electrode multifrequency bioelectrical impedance method of body fat estimation. At 6 months follow-up, significant improvement in several domains of knowledge was observed in intervention children (n=99; males=60; females=39) as compared with control school children (n=102; males=61; females=41). In the intervention group, significantly lower proportion of children consumed aerated drinks (15.1%; P<0.001) and energy-dense unhealthy foods (8.9%; P=0.03), whereas significantly higher proportion brought tiffin (packed lunch) to school (14.9%; P=0.004) and brought a fruit in their tiffin (30.7%; P<0.001) as compared with the control group. Significant decrease in mean waist circumference (P=0.02, 95% confidence interval (CI)=−2.43,−0.17), Sagittal Abdominal Diameter (P<0.001, 95% CI=−0.82,−0.09), waist-to-hip ratio (P=0.02, 95% CI=−0.03,−0.004) and fasting blood glucose (P=0.05, 95% CI=−0.09, 5.00) was seen in intervention as compared with control school children. Multi-component model of nutrition and lifestyle education was successful in improving the nutrition-related knowledge, eating habits and lifestyle practices, and resulted in beneficial changes in anthropometric and biochemical profiles of the Asian Indian adolescents. This model should be applied on countrywide basis to prevent obesity and diabetes.
Harvey J Sugerman - One of the best experts on this subject based on the ideXlab platform.
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effects of surgically induced weight loss on urinary bladder pressure Sagittal Abdominal Diameter and obesity co morbidity
International Journal of Obesity, 1998Co-Authors: Harvey J Sugerman, A Windsor, M Bessos, John M Kellum, H Reines, Eric J DemariaAbstract:OBJECTIVE: Evaluate the effects of surgically induced weight loss on intra-Abdominal pressure at one year, reflected in urinary bladder pressure, central obesity, measured by Sagittal Abdominal Diameter and obesity co-morbidity. DESIGN: Prospective, non-randomized trial. SETTING: University Hospital, Operating Room, In-patient, Outpatient Clinics. SUBJECTS: Gastric bypass in 15 severely obese patients. MEASUREMENTS: Patients underwent pre-operative assessment of weight, body mass index (BMI), co-morbid history, urinary bladder pressure and Sagittal Abdominal Diameter. Patients were reassessed one year after gastric bypass with repeat measurement of weight, bladder pressure, and Sagittal Abdominal Diameter and assessment of co-morbidity. RESULTS: There were significant (P<0.001) decreases in weight (140±8–87±6 kg), BMI (52±3–33±2 kg/m2), Sagittal Abdominal Diameter (32±1–20±2 cm), urinary bladder pressure (17±2–10±1 cm H2O) and obesity related problems per patient (2.9±0.4–1±0.2) one year after gastric bypass, with 69±4% loss of excess weight. CONCLUSIONS: Increased Sagittal Abdominal Diameter is associated with increased intra-Abdominal pressure which contributes to obesity related co-morbidity. Weight loss following gastric bypass decreases Abdominal pressure, Sagittal Abdominal Diameter and obesity co-morbidity.
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increased intra Abdominal pressure and cardiac filling pressures in obesity associated pseudotumor cerebri
Neurology, 1997Co-Authors: Harvey J Sugerman, Eric J Demaria, Warren L Felton, M Nakatsuka, Aristides SismanisAbstract:Objectives.: To determine whether intra-Abdominal pressure (as estimated from urinary bladder pressure) is elevated in patients with central obesity (as measured by Sagittal Abdominal Diameter) and pseudotumor cerebri and whether this increased intra-Abdominal pressure is associated with increased pleural pressure and cardiac filling pressure, implying a resistance to venous return from the brain. Design.: Nonrandomized, prospective. Setting.: University hospital, operating room. Main outcome measurements.: Intracranial pressure, urinary bladder pressure, Sagittal Abdominal Diameter, transesophageal pleural pressure, central venous pressure, pulmonary artery pressure, and pulmonary artery occlusion pressure. Subjects.: Six women with pseudotumor cerebri (one with CSF leak, one with lumboperitoneal shunt). Results.: Urinary bladder pressure (22 ± 3 cm H 2 O) and Sagittal Abdominal Diameter (29 ± 3 cm) were significantly elevated in these patients with elevated intracranial pressure (293 ± 80 mm H 2 O) compared with a previously reported group of nonobese control patients. The transesophageal pleural pressure (15 ± 10 mm Hg), central venous pressure (20 ± 6 mm Hg), mean pulmonary artery pressure (31 ± 6 mm Hg), and pulmonary artery occlusion pressure (21 ± 7 mm Hg) were all markedly elevated compared with published normal values and with previous data from obese patients without pseudotumor cerebri. Conclusions.: These data support the hypothesis that central obesity raises intra-Abdominal pressure, which increases pleural pressure and cardiac filling pressure, which impede venous return from the brain, leading to increased intracranial venous pressure and increased intracranial pressure associated with pseudotumor cerebri.
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intra Abdominal pressure Sagittal Abdominal Diameter and obesity comorbidity
Journal of Internal Medicine, 1997Co-Authors: Harvey J Sugerman, A Windsor, M Bessos, L WolfeAbstract:Objectives. To determine relationship of intraAbdominal pressure to central obesity and the comorbidity of obesity. Design. Non-randomized, prospective. Setting. University hospital, operating room. Subjects. Eighty-four anaesthetized consecutive patients prior to gastric bypass for morbid obesity and five non-obese patients before colectomy for ulcerative colitis. Main outcome measures. Weight, body mass index (BMI), co-morbid history, Sagittal Abdominal Diameter, waist:hip (W∶H) ratio and urinary bladder pressure, as an estimate of intra-Abdominal pressure. Results. Urinary bladder pressure was greater in the obese than the non-obese (18±0.7 vs. 7±1.6 cm H2O, P < 0.001), correlated with Sagittal Abdominal Diameter (r = +0.67, P < 0.001) and was greater (P < 0.05) in patients with, than those without, morbidity probably (hypoventilation, gastroesophageal reflux, venous stasis, stress incontinence, incisional hernia) or possibly (hypertension, diabetes) due to increased Abdominal pressure. W∶H ratio correlated with urinary bladder pressure in men (r = +0.6, P < 0.05) but not women (r = −0.3). Conclusions. Increased Sagittal Abdominal Diameter was associated with increased intraAbdominal pressure which contributed to obesity-related comorbidity. W∶H ratio was not a reliable indicator of intraAbdominal pressure for women who often have both peripheral and central obesity. Further studies are needed to evaluate the relationship between intraAbdominal pressure and Type II diabetes and hypertension.
