Age Of Obesity Onset Research Articles

Age of obesity onset affects subcutaneous adipose tissue cellularity differently in the abdominal and femoral region.

We aimed to examine the effect of age of obesity onset, sex, and their interaction on abdominal and femoral subcutaneous adipose tissue (SAT) morphology (degree of adipocyte hyperplasia or hypertrophy). In this cross-sectional study, we isolated adipocytes via collagenase digestion from abdominal and femoral SAT biopsies taken from maleand femaleadults with childhood-onset obesity (CO; n = 8 males, n = 16 females) or adult-onset obesity (AO; n = 8 males, n = 13 females). Regional body composition was measured with dual-energy x-ray absorptiometry and a single-slice abdominal computed tomography scan. Mean adipocyte size was measured in abdominal and femoral SAT and was used to quantify morphology in android and gynoid subcutaneous fat, respectively. Abdominal SAT morphology was more hyperplastic in females with CO than females with AO (p = 0.004) but did not differ between males with CO and males with AO (p = 0.996). Conversely, femoral SAT morphology was more hypertrophic in males and females with CO than those with AO. Age of obesity onset appears to affect SAT morphology differently in the abdominal and femoral regions of male and female adults. Our findings challenge the notion that SAT is uniformly hyperplastic in CO and hypertrophic in AO.

Adipocyte size, adipose tissue fibrosis, macrophage infiltration and disease risk are different in younger and older individuals with childhood versus adulthood onset obesity.

The timing of obesity onset and age have been shown to affect the risk of obesity-related comorbidities, although the impact of each of these factors on markers of adipose tissue function remains unclear. The aim of this study was to determine whether differences in regional adipose tissue characteristics vary with age and age of obesity onset, and whether these differences are associated with the markers of cardiometabolic health. Adipose tissue samples were obtained from 80 female bariatric surgery candidates who were classified by age of obesity onset and age into 4 groups: (1) younger adults (<40 y) with childhood-onset obesity (<18 y) (Child-Young); (2) younger adults with adulthood-onset obesity (>18 y) (Adult-Young); (3) older adults (>55 y) with childhood-onset obesity (Child-Old); and (4) older adults with adulthood-onset obesity (Adult-Old). Adipocyte diameter, adipose tissue fibrosis, and macrophage infiltration were determined in subcutaneous (SAT) and visceral adipose tissue (VAT). Clinical parameters were obtained from participants' medical records. Visceral adipocyte size in the Child-Young group was the smallest of all the groups. Age affected visceral infiltration of M1-like cells with greater percent of M1-like cells in the Adult-Old and Child-Old groups. Though not significant, a stepwise increase in M2-like macrophages in VAT was observed with Adult-Young having the smallest followed by Adult-Old, Child-Young, and Child-Old having the greatest percent of M2-like macrophages. Pericellular fibrosis accumulation in SAT and VAT varied with both age and onset, particularly in the Child-Old group, which had the lowest fibrosis levels. Markers of cardiometabolic health (fasting glucose, glycated hemoglobin, total, HDL- and LDL-cholesterol and triglyceride concentrations) were positively and well-associated with adipose tissue characteristics of the Child-Old group but not of the Adult-Young group. Older adults with childhood-onset obesity, who had the greatest duration of obesity exposure, were particularly vulnerable to the cardiometabolic effects associated with perturbations in adipose tissue characteristics. These results suggest that age and age of obesity onset may have independent and cumulative effects on obesity pathology.

Adipocyte Size, Adipose Tissue Fibrosis, Macrophage Infiltration and Disease Risk Are Different in Younger and Older Individuals with Childhood and Adulthood Onset Obesity

ObjectivesThe timing of obesity onset and age have been shown to affect the risk of obesity-related comorbidities, although the impact of each of these factors on markers of adipose tissue function remains unclear. The aim of this study is to determine whether differences in regional adipose tissue characteristics vary with age and age of obesity onset, and whether these differences are associated with the markers of cardiometabolic health.MethodsAdipose tissue samples were from 80 female bariatric surgery candidates who were classified by age of obesity onset and age into 4 groups: 1) younger adults (<40 y) with childhood-onset obesity (< 18 y) (Childhood-Young); 2) younger adults with adulthood-onset obesity (>18 y) (Adulthood-Young); 3) older adults (>55 y) with childhood-onset obesity (Childhood-Old); and 4) older adults with adulthood-onset obesity (Adulthood-Old). Adipocyte diameter, adipose tissue fibrosis and macrophage infiltration were determined in subcutaneous (SAT) and visceral adipose tissue (VAT). Clinical parameters were obtained from participants’ medical records.ResultsVisceral adipocyte size in the Childhood-Young group was the smallest of all the groups. Age affected visceral infiltration of M1-like cells in both older groups, whereas onset, specifically childhood-onset, was related to visceral infiltration of M2-like cells in the Childhood-Old group. Fibrosis accumulation in SAT and VAT varied with age and onset, particularly in the Childhood-Old group having the lowest fibrosis levels. Markers of cardiometabolic health (fasting glucose, glycated hemoglobin, total, HDL- and LDL-cholesterol and triglyceride concentrations) were positively and well associated with adipose tissue characteristics of the Childhood-Old group but not of the Adulthood-Young group.ConclusionsOlder adults with childhood onset obesity, who had the greatest duration of obesity exposure, were particularly vulnerable to the cardiometabolic effects associated with perturbations in adipose tissue characteristics. These results, suggest that age and age of obesity onset may have independent and cumulative effects on obesity pathology.Funding SourcesSylvia Santosa holds a Canada Research Chair – Tier 2 in Clinical Nutrition. This research is also supported by a Discovery Grant from The Natural Science and Engineering Research Council of Canada.

Statin Therapy Among Bariatric Patients: The Impact on Metabolic Outcomes and Diabetes Status.

Statin therapy is associated with an increased risk of developing diabetes. Among bariatric patients, the influence of this therapy on various metabolic outcomes, such as diabetes status and its remission, is largely unknown. This was a retrospective study of 1710 patients who underwent bariatric surgery at our hospital between January/2010 and June/2017. We compared patients with and without statin therapy at baseline, 12 and 24 months after surgery regarding statin use and its impact on several clinical and analytical parameters. Multiple linear regression was performed, adjusting differences for age, sex, surgery type, antidiabetic drugs at baseline, hypertension at baseline, LDL cholesterol ˃ 130 mg/dL, weight variation one year after surgery, and age of obesity onset. The overall prevalence of statin use was 20.2% before, 13.6% 12 months after surgery, and 15.0% 24 months after surgery. There was a larger reduction in fasting glucose and HbA1c at 12 and 24 months after surgery among statin-treated patients, with the opposite trend for weight reduction and BMI. Statin-treated patients with diabetes had lower diabetes remission rates (45.3 vs 68.5%) 12 months after surgery, with the highest reduction in HbA1c (1.3±1.3 vs -1.1±1.2%; p=0.042), fasting glucose (-40.8±48.8 vs -30.9±41.6 mg/dL; p=0.028), and insulin (-21.7±28.2 vs -13.4±14.2 mIU/L; p=0.039). The proportion of new-onset cases of diabetes was equal between statin-treated vs non-treated individuals at 12 months (1.9%) and 24 months (1.0%) after surgery. Bariatric surgery seems to lead to diabetes remission more frequently in patients not treated with statins. A larger reduction was observed in fasting glucose and HbA1c among statin-treated patients. Statin did not contribute to an increased proportion of new-onset diabetes after surgery.

Duration of obesity exposure between ages 10 and 40 years and its relationship with cardiometabolic disease risk factors: A cohort study.

Individuals with obesity do not represent a homogeneous group in terms of cardiometabolic risk. Using 3 nationally representative British birth cohorts, we investigated whether the duration of obesity was related to heterogeneity in cardiometabolic risk. We used harmonised body mass index (BMI) and cardiometabolic disease risk factor data from 20,746 participants (49.1% male and 97.2% white British) enrolled in 3 British birth cohort studies: the 1946 National Survey of Health and Development (NSHD), the 1958 National Child Development Study (NCDS), and the 1970 British Cohort Study (BCS70). Within each cohort, individual life course BMI trajectories were created between 10 and 40 years of age, and from these, age of obesity onset, duration spent obese (range 0 to 30 years), and cumulative obesity severity were derived. Obesity duration was examined in relation to a number of cardiometabolic disease risk factors collected in mid-adulthood: systolic (SBP) and diastolic blood pressure (DBP), high-density-lipoprotein cholesterol (HDL-C), and glycated haemoglobin (HbA1c). A greater obesity duration was associated with worse values for all cardiometabolic disease risk factors. The strongest association with obesity duration was for HbA1c: HbA1c levels in those with obesity for <5 years were relatively higher by 5% (95% CI: 4, 6), compared with never obese, increasing to 20% (95% CI: 17, 23) higher in those with obesity for 20 to 30 years. When adjustment was made for obesity severity, the association with obesity duration was largely attenuated for SBP, DBP, and HDL-C. For HbA1c, however, the association with obesity duration persisted, independent of obesity severity. Due to pooling of 3 cohorts and thus the availability of only a limited number harmonised variables across cohorts, our models included adjustment for only a small number of potential confounding variables, meaning there is a possibility of residual confounding. Given that the obesity epidemic is characterised by a much earlier onset of obesity and consequently a greater lifetime exposure, our findings suggest that health policy recommendations aimed at preventing early obesity onset, and therefore reducing lifetime exposure, may help reduce the risk of diabetes, independently of obesity severity. However, to test the robustness of our observed associations, triangulation of evidence from different epidemiological approaches (e.g., mendelian randomization and negative control studies) should be obtained.

Perception Of Moderate Intensity Physical Activity By Onset Of Obesity: A Randomized Crossover Trial

Moderate intensity physical activity is typically recommended for inactive adults with overweight or obesity. However, it is unknown whether there is a difference in the perception of moderate intensity by onset of obesity (childhood versus adulthood). PURPOSE: To determine if there was a difference in selection of moderate intensity between inactive adults with juvenile-onset (JO) and adult-onset (AO) overweight or obesity. METHODS:Participants (N=38; JO=18 and AO=20) completed an initial study visit where height, weight, fitness (time to 85% of age predicted HRmax), and weight history (modified Cincinnati Weight History Questionnaire) were assessed. After stratification by age of obesity onset, participants were randomly assigned the order to complete 20-minute moderate intensity exercise sessions on the treadmill and cycle ergometer (separate visits). A standardized script was used to instruct participants to exercise at a moderate intensity. Participants were given an opportunity to change the speed of the treadmill or cycler ergometer power output every 5 minutes of the session. VO2, METs, and HR were measured continually during exercise sessions. Multiple linear regression was used to determine whether exercise intensity (average MET value and % age-predicted HRmax) differed significantly between onset groups while controlling for age and gender. RESULTS: On the treadmill, JO and AO participants selected an average intensity of (mean ± sd) 3.5 ± 0.9 vs. 3.7 ± 0.9 METS which equated to 64.0 ± 7.7 and 64.9 ± 7.5 % of their age-predicted HRmax, respectively. On the cycle ergometer, JO and AO participants selected an average intensity of 3.3 ± 0.9 vs. 3.3 ± 1.0 METS. This represented 65.2 ± 8.8 and 60.7 ± 7.2 % of their age-predicted HRmax, respectively. After adjusting for age and gender, AO participants expended on average 0.13 more METS on the ergometer (0.03 METS on the treadmill) than JO participants (p=0.50, 0.90, respectively). For HRmax, findings were similar (β=0.34, -0.01; p=0.08, 0.95) for the ergometer and treadmill, respectively. CONCLUSION: Perception of moderate intensity did not differ by onset of obesity. However, inactive individuals with obesity selected an intensity at the low end of moderate intensity for both treadmill and cycle exercise resulting in lower overall energy expenditure.

Age of obesity onset, cumulative obesity exposure over early adulthood and risk of type 2 diabetes.

Obesity is a risk factor for type 2 diabetes, yet little is known about how timing and cumulative exposure of obesity are related to disease risk. The aim of this study was to examine the associations between BMI trajectories, age of onset of obesity and obese-years (a product of degree and duration of obesity) over early adulthood and subsequent risk of type 2 diabetes. Women aged 18-23years at baseline (n = 11,192) enrolled in the Australian Longitudinal Study on Women's Health (ALSWH) in 1996 were followed up about every 3years via surveys for up to 19years. Self-reported weights were collected up to seven times. Incident type 2 diabetes was self-reported. A growth mixture model was used to identify distinct BMI trajectories over the early adult life course. Cox proportional hazards regression models were used to examine the associations between trajectories and risk of diabetes. One hundred and sixty-two (1.5%) women were newly diagnosed with type 2 diabetes during a mean of 16years of follow-up. Six distinct BMI trajectories were identified, varying by different initial BMI and different slopes of increase. Initial BMI was positively associated with risk of diabetes. We also observed that age at onset of obesity was negatively associated with risk of diabetes (HR 0.87 [95% CI 0.79, 0.96] per 1year increment), and number of obese-years was positively associated with diabetes (p for trend <0.0001). Our data revealed the importance of timing of obesity, and cumulative exposure to obesity in the development of type 2 diabetes in young women, suggesting that preventing or delaying the onset of obesity and reducing cumulative exposure to obesity may substantially lower the risk of developing diabetes.

BIRTHWEIGHT, LIFETIME OBESITY, AND PHYSICAL FUNCTIONING IN MID-ADULTHOOD: A NATIONWIDE BIRTH COHORT STUDY

Evidence is scant on long-term implications of body mass index (BMI) gains over the life-course for poor physical functioning (PF). Using the 1958 British birth cohort (N=8,674) we examine whether i) birthweight and BMI across the life-course; ii) BMI gains at specific life-stages; and iii) age of obesity onset, were associated with PF at 50y. At each adult age, obesity was associated with poor PF (e.g. for males at 23y adjusted-ORs for poor PF was 2.28(1.34,3.91)). BMI gains were associated with poor PF (e.g. for females, adjusted-OR per SD BMI gain 16-23y was 1.28(1.13,1.46)). Longer obesity duration was associated with poor PF (e.g. for males, adjusted-OR was 2.32(1.26,4.29) for childhood obesity onset, and 1.50(1.16,1.96) for mid-adulthood onset); associations were abolished with further adjustment for 50y BMI. Obesity, BMI gains, and earlier obesity onset were associated with poor PF in mid-adulthood reinforcing the importance of preventing obesity early in the lifecourse.

Birthweight, lifetime obesity and physical functioning in mid-adulthood: a nationwide birth cohort study.

Evidence is scant on long-term implications of childhood obesity and body mass index (BMI) gains over the life-course for poor physical functioning (PF). The objective was to establish whether (i) birthweight and BMI across the life-course, (ii) BMI gains at specific life-stages and (iii) age of obesity onset were associated with PF at 50 y. In the 1958 British birth cohort (n = 8674), BMI (kg/m2) was calculated using height and weight [measured (7, 11, 16, 33 and 45 y); self-reported (23 and 50 y)]. PF was assessed at 50 y using the validated PF subscale of the Short-form 36 survey; the bottom (gender-specific) 10% was classified as poor PF. Missing data were imputed via multiple imputation. Associations were examined using logistic regression, adjusting for health and social factors. Birthweight was not associated with PF. At each adult age, odds of poor PF were highest for obese (vs normal), e.g. for 23 y obesity the odds ratio (OR)adjusted for poor PF was 2.28 (1.34, 3.91) and 2.67 (1.72, 4.14) in males and females respectively. BMI gains were associated with poor PF, e.g. for females, ORadjusted per standard deviation (SD) in BMI gain 16-23 y was 1.28 (1.13, 1.46); for BMI gains 45-50 y it was 1.36 (1.11, 1.65). Longer duration of obesity was associated with poor PF, e.g. in males, ORadjusted was 2.32 (1.26, 4.29) for childhood obesity onset and 1.50 (1.16, 1.96) for mid-adulthood onset (vs never obese, P-trend < 0.001). Obesity, BMI gains, and earlier obesity onset were associated with poor PF in mid-adulthood, reinforcing the importance of preventing and delaying obesity onset.

Peroxisome proliferator-activated receptor gamma coactivator 1α variation: a closer look at obesity onset age and its related metabolic status and body composition.

There is a lack of knowledge regarding the effect of polymorphisms of the peroxisome proliferator-activated receptor gamma coactivator 1α (PGC-1α) gene on the age of obesity onset. Hence, 3 polymorphisms of the PGC-1α gene (PGC-1α rs17574213, rs8192678, and rs3755863) were examined in association with obesity onset age. Also, obesity onset age-related metabolic status and body composition were evaluated. This cross-sectional study was conducted with a total of 321 obese participants. Anthropometric and biochemical information, body composition, and PGC-1α gene sequences were analyzed. The rs17574213 polymorphism was associated with obesity onset in children aged <1 years and 10-18 years. The rs8192678 polymorphism was associated with obesity onset in adulthood. Body mass index, body fat percent, and trunk fat were higher in groups whose obesity began at age <1 year or 10-18 years than in other groups. Serum levels of high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total cholesterol were lowest in the group with obesity onset between the ages of 10 and 18 years. Visceral fat and fasting blood glucose were highest in those whose obesity began in adulthood. In conclusion, 2 polymorphisms of the PGC-1α gene were associated with obesity onset age.

EFFECT OF OBESITY ON ACTIVE LIFE EXPECTANCY IN THE UNITED STATES: CHANGES OVER TIME

In recent decades, life expectancy increase has slowed in the United States. Also, there have been striking increases in the prevalence of obesity, decreases in the age of obesity onset, and increases in the length of time people are living with obesity. In addition, the link between obesity and mortality appears to have weakened in more recent years. These trends indicate value in revisiting the links between obesity and active life expectancy. Building on earlier work using HRS data from 1993 to 1998 for the 70 plus population in the United States, we use HRS data from 2004 through 2008 to examine how the links between obesity, mortality, disability and subsequent active life expectancy have changed. We find that in the later cohort obesity is less related to mortality, more to disability, and remains a strong determinant of active life.

Bariatric surgery: is it reasonable before the age of 16?

to assess the severity of obesity in children and adolescents through the presence of comorbidities and the potential indication of bariatric surgery. we conducted a cross-sectional study with clinical and laboratory data of the first consultation of patients at the childhood obesity clinic at a tertiary hospital from 2005 to 2013. We divided the patients into groups with or without potential indication for surgery, and recorded age, gender, birth weight, age of obesity onset, BMI Z score, presence of acanthosis nigricans, blood pressure, total cholesterol and fractions, triglycerides, blood glucose and fasting insulin, HOMA1-IR, CRP and ESR. The group with potential indication for surgery included: BMI > 40 or between 35-40 with comorbidities (Triglycerides >130mg/dl, glucose levels >100mg/dl, HOMA1-IR >3.16, Total Cholesterol >200mg/dl, LDL >130mg/dl and HDL <45mg/dl), regardless of age, epiphysis consolidation and previous treatment. of the 296 patients included in the study, 282 (95.3%) were younger than 16 years. The most frequent change was the HDL (63.2%), followed by HOMA1-IR (37.5%). Of the group of 66 patients with potential indication for surgery (22.3%), only ten (15.1%) had more than 16 years. Acanthosis nigricans, the average HOMA1-IR, insulin, CRP, ESR, age, BMI Z score and systolic and diastolic blood pressure were significant in the group with potential surgical indication. bariatric surgery might be indicated by BMI and comorbidities in children and adolescents under 16 years. avaliar a gravidade da obesidade em crianças e adolescentes pela presença de comorbidades e pela potencial indicação de cirurgia bariátrica. estudo transversal com dados clínicos e laboratoriais da primeira consulta de pacientes do ambulatório de obesidade infantil em um hospital terciário no período de 2005 a 2013. Os pacientes foram divididos em grupos com ou sem potencial indicação cirúrgica, e associados com idade, sexo, peso de nascimento, idade de início da obesidade, escore z de IMC, presença de acantose nigricans, pressão arterial, colesterol total e frações, triglicérides, glicemia e insulina de jejum, HOMA1-IR, PCR e VHS. O grupo com potencial indicação cirúrgica incluiu: IMC >40 ou IMC entre 35-40 com comorbidades (Triglicérides >130mg/dl, Glicemia >100mg/dl, HOMA1-IR >3,16, Colesterol total >200mg/dl, LDL >130mg/dl e HDL <45mg/dl), independente da idade, consolidação das epífises e tratamento prévio. de 296 pacientes incluídos no estudo, 282 (95,3%) tinham menos de 16 anos. A alteração mais frequente foi a do HDL (63,2%), seguido do HOMA1-IR (37,5%). Do grupo de 66 pacientes com potencial indicação cirúrgica (22,3%), apenas dez (15,1%) tinham mais de 16 anos. Acantose nigricans, as médias de HOMA1-IR, insulina, PCR, VHS, idade, escore z de IMC e pressões sistólica e diastólica foram significantes no grupo com potencial indicação cirúrgica. os resultados sugerem que a cirurgia bariátrica, poderia estar indicada pelo IMC e presença de comorbidades, em crianças e adolescentes com menos de 16 anos.

Age of obesity onset in MC4R mutation carriers.

The mutations in gene for the melanocortin-4 receptor (MC4R) are the most common etiology factors of monogenic obesity development. Recently, it has been shown that current life style has a significant impact on the phenotype of MC4R mutation carriers - increases the penetrance of the mutations. We aimed to study the impact of the current age on the time of obesity onset among MC4R mutation carriers. DNA analysis of the MC4R gene was performed in 268 unrelated Slovak and Moravian obese children and adolescents 18 years and 28 blood relatives >18 years of the probands with a mutation. Three different previously described heterozygous loss of function MC4R mutations (p.Ser19Alafs*34, p.Ser127Leu, and p.Gly181Asp) were found in 3 <18 years probands, 3 adult probands, and 6 adult obese/overweight family relatives. The age of obesity onset in mutation carriers was 1 year in all probands in the children group and 1-35 years (median 11 years) in adults. The age of the obesity onset significantly correlated (R=0.809, p=0.028) with the current age in all of the MC4R mutation carriers. The age of obesity onset in the present child generation of MC4R mutation carriers is decreasing compared to the age of onset in their parents' generation. This is in agreement with similarly increasing penetrance of obesity in MC4R mutation carriers and it points out to escalation of obesogenic potential of environment.

Effect of obesity onset on pendular energy transduction at spontaneous walking speed: Prader–willi versus nonsyndromal obese individuals

To compare the mechanical external work (Wext ) and pendular energy transduction (Rstep ) at spontaneous walking speed (Ss ) in individuals with Prader-Willi syndrome (PWS) versus subjects with nonsyndromal obesity (OB) to investigate whether the early onset of obesity allows PWS subjects to adopt energy conserving gait mechanics. Wext and Rstep were computed using kinematic data acquired by an optoelectronic system and compared in 15 PWS (BMI = 39.5 ± 1.8 kg m(-2) ; 26.7 ± 1.5 year) and 15 OB (BMI = 39.3 ± 1.0 kg m(-2) ; 28.7 ± 1.9 year) adults matched for gender, age and BMI and walking at Ss . Ss was significantly lower in PWS (0.98 ± 0.03 m s(-1) ) than in OB (1.20 ± 0.02 m s(-1) ; P < 0.001). There were no significant differences in Wext per kilogram between groups (PWS: 0.37 ± 0.04 J kg(-1) m(-1) ; OB: 0.40 ± 0.05 J kg(-1) m(-1) ; P = 0.66) and in Rstep (PWS: 69.9 ± 2.9%; OB: 67.7 ± 2.4%; P = 0.56). However, Rstep normalized to Froude number (Rstep /Fr) was significantly greater in PWS (6.0 ± 0.6) than in OB (3.8 ± 0.2; P = 0.001). Moreover, Rstep /Fr was inversely correlated with age of obesity onset (r = -0.49; P = 0.006) and positively correlated with obesity duration (r = 0.38; P = 0.036). Individuals with PWS seem to alter their gait to improve pendular energy transduction as a result of precocious and chronic adaptation to loading.

A comparative analysis of Type 2 diabetes and binge eating disorder in a bariatric sample

An emerging literature has illuminated an important link between Type 2 diabetes mellitus (DM) and binge eating disorder (BED) within obese cohorts. However, prior work has not examined this relationship specifically in a weight loss surgery (WLS) sample or fully explored potential psychosocial factors associated with this co-occurrence. Therefore, the present investigation sought to identify socio-demographic (i.e. age, education, BMI, ethnicity, gender, age of obesity onset) and psychological (i.e. depressive symptoms, hedonic hunger/food locus of control beliefs, severity of binge eating-related cognitions) correlates of the co-occurrence of Type 2 DM and BED among bariatric surgery candidates. An archival sample of 488 patients seeking surgical treatment for clinical obesity completed a standard battery of pre-operative psychosocial measures. The presence of BED was evaluated using a semi-structured clinical interview based on the DSM-IV TR (APA, 2000) and was further corroborated by responses on the Questionnaire on Eating and Weight Patterns-Revised ( QEWP-R; Spitzer, Yanovski, & Marcus, 1993). Results indicated that 8.2% of the sample was classified as having both Type 2 DM and BED concurrently. A multivariate logistic regression model revealed that in addition to other psychological (e.g., binge eating-related cognitions, hedonic hunger) and demographic variables (i.e. male gender), African American ethnicity (OR = 3.3: 1.41–7.73) was a particularly robust indicator of comorbid status. Findings support and extend previous health disparity research urging greater attention to the needs of traditionally underserved, at-risk populations seeking treatment for obesity complicated by dysregulated eating and metabolism. Additionally, these preliminary results underscore the relevance of considering the potential benefits of providing quality comprehensive pre- and post-operative psychological care among bariatric patients towards optimizing both short- and long-term health and well-being.

Fatty acid composition as an early determinant of childhood obesity

Recent evidence from animal and human studies favor the possibility that changes in the balance of essential PUFAs are altering the early stages of adipose tissue development, not only during fetal life and infancy which are periods showing the highest adaptability and vulnerability to external factors but also afterwards. Consistent with these data, cellularity of human adipose tissue from obese patients depends on the age of obesity onset, particularily the adipocyte number more than the adipocyte size, in agreement with the fact that only precursor cells divide and that adipose tissue expands dramatically at early age [2]. Both in rodents and humans, long-chain fatty acids act at the preadipocyte stage and trigger the formation of adipo

Depressed Mood in Class III Obesity Predicted by Weight-Related Stigma

Greater depressed mood in Class III obese surgery-seeking clients may be due to weight-related stigma, weight-related physical disability (e.g. mobility) or the presence of binge-eating (BE). 60 Class III obese surgery-seeking adults were administered the Beck Depression Inventory (BDI), weight-related physical disability (IWQOL-PF) and another weight-related stigma (IWQOL-PD), and assessed for BE (SCID-1 or Questionnaire of Eating and Weight Patterns) before surgery. In a hierarchical regression analysis, BMI, gender, and age of obesity onset did not account for a significant portion of the variance in BDI scores in the first step. The second step of the model was statistically significant (F(3,53)=8.469, P<0.000), accounting for 33.6% of the variance in BDI scores. IWQOL-PD scores were the only significant predictor of BDI scores (b=0.518, P=0.001), and this independently contributed to 32.6% of the variance in BDI scores. This suggests that depressed mood seen in Class III obese surgery-seeking individuals may be most related to weight-related stigma rather than BE status, or weight-related physical disability.

N-6 Fatty acids and adipogenesis

There is evidence from animal and human studies that changes in the balance of essential polyunsaturated fatty acids may alter the early stages of adipose tissue development. Consistent with these observations, cellularity of human adipose tissue from obese patients depends on the age of obesity onset. Under isoenergetic conditions, pups from wild-type mice mothers fed a linoleic acid (LA) diet were 40% heavier 1 week after weaning than those from mothers fed a LA/?-linolenic acid (LNA) diet, and the weight difference was maintained at the adult age. The LA-induced enhancement of fat mass was abolished in mice invalidated for the cell-surface prostacyclin receptor (ip-1- mice), demonstrating the critical role of arachidonic acid and the prostacyclin receptor in excessive adipose tissue development. Changes observed over recent decades in the fatty acid composition of dietary fats observed in breast milk and formula milk, i.e. an increase in LAwith slight or no ch ange in LNA content, in concert with a positive energy balance, may be responsible at least in part for the dramatic rise in the prevalence of childhood overweight and obesity. Since prevention of obesity appears critical to avoid difficult if not insurmountable health problems in the future, the composition of dietary lipids should be reconsidered from the very beginning of the food chain. Keywords: adipose tissue; arachidonic acid; development; food; linoleic acid; milk

Ethnic Differences in Obesity and Surgical Weight Loss between African-American and Caucasian Females

In the general population, African-American females are more obese and resistant to weight loss than Caucasian women. In the present study, we examined the severity of obesity among morbidly obese African-American and Caucasian females, studied the effectiveness of Roux-en-Y gastric bypass (RYGBP), and sought to identify factors contributing to obesity and weight loss. The study population included 153 morbidly obese females randomly selected from our general bariatric patient population. Anthropometric measurements consisted of body weight, body mass index (BMI), excess weight, and waist, hip, thigh, and neck circumferences. Factors that may contribute to obesity included age, age of obesity onset, number of childbirths, calorie intake, diet composition, and degree of psychological distress. The effects of RYBGP were studied in weight-matched groups of African-American and Caucasian females (n=37 per group) at weight loss nadir, i.e. 12 to 18 months after surgery. We found that morbid obesity is more severe among African-American than Caucasian females. The greater degree of obesity of African-American, as compared to Caucasian, females is not due to ethnic differences in calorie intake, diet composition, age or age of obesity onset, number of childbirths, and psychological distress. RYGBP is less effective in reducing body fat and, consequently, excess body weight of the African-American than the Caucasian females, suggesting possible ethnic differences in fat metabolism. African-American females with morbid obesity have greater adiposity than do Caucasian women and lose significantly less body fat after RYGBP.

The relationship between eating behaviors and obesity in African American and Caucasian women

The primary goal of this study was to determine the relevance of four self-reported eating behaviors (eating before bedtime, eating between meals, feeling hungry within 3 h of eating, and eating beyond satiation) as risk factors for overweight and obesity. The sample consisted of 35- to 49-year-old, premenopausal African American ( n=580) and Caucasian ( n=398) women, randomly selected from the membership of a large urban prepaid health plan. Eating beyond satiation was the only behavior associated with body mass index (BMI). The odds of becoming obese increased 6-fold for Caucasian women and 15-fold for African American women who ate beyond satiation everyday compared to those who rarely or never ate beyond satiation. Additionally, eating beyond satiation was also the only eating behavior associated with the age of obesity onset. Focusing on this eating behavior in weight loss programs may be important.