Extreme Leanness Research Articles

Manufacturing and Fraud: Evidence from Price Competition and Lean Inventories

ABSTRACT We examine fraud from an industry competition perspective, oriented from inventory theory. We find that fraud occurs among manufacturers more than nonmanufacturers and that the association between price competition and fraud is significantly more pronounced in the manufacturing sector. Aggregating inventory and cash flow patterns to the industry level, we report that industry inventory imbalance rates, from either excessive stockpiling or inventory leanness, associate with increased future price competition, which subsequently associates with more fraud. However, for manufacturers, the industry-wide prevalence of either excess or leanness amplifies future price competition, which is observed as a U-shaped association that ultimately ties to more fraud. These effects are stronger when extreme leanness is the manufacturing industry’s standard. We also provide evidence that the association between price competition and fraud is comparable to managerial incentives’ association with fraud. Together, our findings contribute to the literature on price competition, inventory management, and corporate misconduct. Data Availability: Data are available from the public sources cited in the text. JEL Classifications: M11; M21; M41; L60.

Extreme leanness, lower skeletal muscle quality, and loss of muscle mass during treatment are predictors of poor prognosis in cervical cancer treated with concurrent chemoradiation therapy.

Human papillomavirus vaccination is not widespread in Japan, and the low screening rates result in many cases of locally advanced cervical cancer. We investigated the prognostic significance of sarcopenia in patients with cervical cancer to guide healthcare policies to improve treatment outcomes. This retrospective study included 83 patients with cervical cancer without distant metastasis who underwent primary concurrent chemoradiotherapy between 2013 and 2018. We analyzed the indicators of physical condition and muscle quantity using the SYNAPSE VINCENT software. Muscle mass and the relationship between treatment toxicity and prognosis were evaluated. The patients' median age was 60 (range 33‒80) years. Cancer stage distribution was as follows: cT2b or higher, 84.3%; N1, 65.1%; and MA, 27.7%. The overall sarcopenia (skeletal muscle index [SMI] < 38.5) rate was 30.1%, and the rate was 33.9 and 22.2% in patients aged < 64 and ≥ 65years, respectively. No correlation was observed between clinical stage and musculoskeletal indices. Treatment resulted in decreased body weight and SMI; after treatment, the sarcopenia rate increased to 37.3%. A higher intramuscular adipose tissue content (IMAC) reduced the number of chemotherapy cycles needed. Treatment-associated SMI decreases of ≥ 7% indicated poor prognosis, with significant differences in progression-free survival and overall survival (p = 0.013 and p = 0.012, respectively). Patients who were very lean (body mass index < 18.5kg/m2) before treatment had a poor prognosis (p = 0.016 and p < 0.001). Our findings emphasize the importance of assessing original nutritional status and maintaining muscle mass and quality during the treatment of patients with cervical cancer.

ASPROSIN: A NOVEL BIOMARKER OF TYPE 2 DIABETES MELLITUS

Type 2 diabetes mellitus has a deadly toll on human health. Therefore, more attention needs to be paid for the creation of biomarker to indicate the newly diagnostic type 2 diabetes and effective therapy. It well known that adipose tissue of mammals can store energy and secrete such hormones. Therefore, obesity is associated with hyperinsulinemia and insulin resistance. Recently, newly identified glucogenic hormone named “asprosin” has been developed in white adipose tissue, encoded by the gene Fibrillin 1 (Fbn1). Fbn1 is a 230-kb gene with 65 coding exons. These exons encode a 2,871-amino-acid long proprotein called proFibrillin which is proteolytically cleaved near its C-terminus by the enzyme furin convertase to give Fbn1, a member of the fibrillin family, in addition the 140-amino-acid long protein hormone asprosin. It has a metabolic role during fasting condition as it induces liver to secrete glucose for maintaining homeostasis as well as centrally stimulates appetite. It was reported that plasma asprosin concentrations increased in human/mice with type 2 diabetes compared with controls. However, it was significantly reduced in patients with neonatal progeriod syndrome who had characteristic features of low appetite and extreme leanness. This syndrome is due to the truncated mutation in Fbn1. Although the great biological role of asprosin in vivo, it still limited in research, particularly in the therapy of type 2 diabetes. This study aimed to provide an overview of asprosin and its possibility to be used as a novel biomarker of type 2 diabetes and obesity.

Asprosin is a centrally acting orexigenic hormone.

Asprosin is a recently discovered fasting-induced hormone that promotes hepatic glucose production. Here, we demonstrate that plasma asprosin crosses the blood-brain-barrier and directly activates orexigenic AgRP+ neurons via a cAMP-dependent pathway. This signaling results in inhibition of downstream anorexigenic POMC+ neurons in a GABA-dependent manner, resulting in appetite stimulation and a drive to accumulate adiposity and body weight. Genetic deficiency of asprosin in humans results in a syndrome characterized by low appetite and extreme leanness, which is phenocopied by mice carrying similar mutations, and one that can be fully rescued by asprosin expression. Further, we found that obese humans and mice display pathologically elevated circulating asprosin concentrations, and neutralization of plasma asprosin using a monoclonal antibody reduces appetite and body weight in obese mice, in addition to improving their glycemic profile. Thus, asprosin, in addition to performing a glucogenic function, is a centrally-acting orexigenic hormone, and one that represents a potential therapeutic target to treat both obesity and diabetes.

Establishing the optimal body mass index - body esteem relationship in young adolescents

BackgroundThis study sought to compare the utility of either inverted body mass index or body mass index to optimise the relationship with body esteem in young adolescents Design: The study was cross sectional in design and assessed body esteem and weight status in756 young adolescents (394 boys, 362 girls, mean age ± S.D. 11.4 ± 1.6 years).MethodsBody esteem was determined using the body esteem scale for children. Height and body mass were measured directly. Body mass index was determined as kg/m2 and iBMI as cm2/kg.ResultsResults indicated that the association between iBMI and body esteem was curvilinear in nature and iBMI was the better predictor of body esteem (P = .001) predicting 21.3% of the variance in body esteem scores compared to 20.5% using BMI (P = .001). When split by gender, the curvilinear relationship was still evident but significantly different between boys and girls although iBMI remained a better predictor of body esteem compared to BMI in both boys and girls. The peak differed between gender groups with the association between iBMI and body esteem peaking at 642 cm2/kg for boys and 800.64 cm2/kg for girls.ConclusionThis study suggests that iBMI is a better predictor of body esteem in young adolescents, and that the association between body esteem and iBMI is curvilinear in nature. However, the peak of body esteem scores occured at a lower degree of leanness for boys compared to girls and indicated that the point at which body esteem scores are highest for girls is at a point of extreme leanness whereas the peak for boys was within the values considered as ‘normal’ on the leanness to obesity continuum. iBMI may therefore be a useful measure of leanness for future studies examining the association between overweight/obesity and body esteem in young adolescents.

Diabetes mellitus and its correlates in an Iranian adult population.

The rising epidemic of diabetes imposes a substantial economic burden on the Middle East. Using baseline data from a population based cohort study, we aimed to identify the correlates of diabetes mellitus (DM) in a mainly rural population from Iran. Between 2004 and 2007, 50044 adults between 30 and 87 years old from Golestan Province located in Northeast Iran were enrolled in the Golestan Cohort Study. Demographic and health-related information was collected using questionnaires. Individuals' body sizes at ages 15 and 30 were assessed by validated pictograms ranging from 1 (very lean) to 7 in men and 9 in women. DM diagnosis was based on the self-report of a physician's diagnosis. The accuracy of self-reported DM was evaluated in a subcohort of 3811 individuals using fasting plasma glucose level and medical records. Poisson regression with robust variance estimator was used to estimate prevalence ratios (PR's). The prevalence of self-reported DM standardized to the national and world population was 5.7% and 6.2%, respectively. Self-reported DM had 61.5% sensitivity and 97.6% specificity. Socioeconomic status was inversely associated with DM prevalence. Green tea and opium consumption increased the prevalence of DM. Obesity at all ages and extreme leanness in childhood increased diabetes prevalence. Being obese throughout life doubled DM prevalence in women (PR: 2.1; 95% CI: 1.8, 2.4). These findings emphasize the importance of improving DM awareness, improving general living conditions, and early lifestyle modifications in diabetes prevention.

Stress neuroendocrine profiles in five pig breeding lines and the relationship with carcass composition

Stress neuroendocrine systems (hypothalamic–pituitary–adrenal axis and sympathetic nervous system) were studied in 100 female pigs from each of the five main genetic lines used in Europe for pork production: Piétrain, Large White, Landrace, Duroc and Meishan. Levels of cortisol and catecholamines were measured in urine collected at the farm, after transportation to the slaughterhouse and the next morning before slaughter. With the exception of the Piétrain line that showed intermediate levels of cortisol despite its extreme leanness, a significant positive relationship was found between basal cortisol levels and fatness, both across and within (except in Piétrain and Duroc) lines. Basal cortisol levels were 2.46-fold higher in Meishan (20.46 ng/mg creatinine) than in Large White pigs (8.30 ng/mg creatinine), the two extreme breeds. Post-transportation levels were highest but proportional to basal levels, suggesting that the adrenal reactivity to adrenocorticotropic hormone is a major source of variability between lines. Levels of catecholamines were less variable between lines but correlated also with fatness, partlyviapartial correlations with cortisol levels. In serum collected at exsanguination, creatine kinase activity was correlated with muscularity across the five breeds. However, this was due to a much larger activity than expected in Piétrain pigs, although all animals were negative for the allele of the ryanodine receptor gene responsible for stress sensitivity. Serum glucose levels were inversely related to fatness. These data show that the differences between breeds or lines can be utilised by cross-breeding and that this can lead to changes in stress hormones and in turn to some degree of changes in carcass traits.

Age relations of cardiovascular risk factors in a traditional Melanesian society: the Kitava Study

This study examined cross-sectional age relations of blood pressure, anthropometric indexes, serum lipids, and hemostatic variables in 203 subsistence horticulturists aged 20-86 y in Kitava, Trobriand Islands, Papua New Guinea. The population is characterized by extreme leanness (despite food abundance), low blood pressure, low plasma plasminogen activator inhibitor 1 activity, and rarity of cardiovascular disease. Tubers, fruit, fish, and coconut are dietary staples whereas dairy products, refined fat and sugar, cereals, and alcohol are absent and salt intake is low. Although diastolic blood pressure was not associated with age in Kitavans, systolic blood pressure increased linearly after 50 y of age in both sexes. Body mass index decreased with age in both sexes. Serum total cholesterol, triacylglycerol, low-density-lipoprotein cholesterol, and apolipoprotein B increased in males between 20 and 50 y of age, whereas high-density-lipoprotein cholesterol and apolipoprotein A-I decreased. There were no significant differences in these indexes with age in the few females studied. A slight linear age-related increase of lipoprotein(a) was present in males. Plasma fibrinogen, factor VII clotting activity, factor VIII clotting activity, and von Willebrand factor antigen increased with age in both sexes but plasminogen activator inhibitor 1 activity did not. The modest or absent relations between the indexes measured and age are apparently important explanations of the virtual nonexistence of stroke and ischemic heart disease in Kitava.

Body Composition, Energy Intake and Expenditure, and Body Weight Dissatisfaction in Female Child Gymnasts and Controls

LEARNING OUTCOME: To determine if percent body fat, energy intake and expenditure, and body weight dissatisfaction differ between age-, height-, and weight-matched female child gymnasts and controls. Among female college gymnasts, a significant number report dissatisfaction with current body weight. It is unclear, however, if female child gymnasts (GYM) differ from appropriately matched nongymnasts or controls (CON) on body weight dissatisfaction. The aim of this study was to compare female child GYM (n = 16, age = 10.5 ± 0.4 y, ht = 138.3 ± 2.4 cm, wt = 32.5 ± 1.4 kg, x̄ ± SEM) to age-, height-, and weight-matched nongymnast controls CON (n = 16, age = 10.5 ± 0.3 y, ht = 140.9 ± 2.8 cm, wt = 32.4 ± 1.6 kg) on body composition, energy intake and expenditure, and body weight dissatisfaction. Body weight was measured with a double-beam balance scale, and body fat percentage was assessed using dual-energy X-ray absorptiometry (QDR-1000W, Hologic, Inc., Waltham, MA). Energy intake and expenditure were measured from 3-day dietary records and the 7-day physical activity recall, respectively. Dissatisfaction with body weight was determined by the discrepancy between self-reported desired body weight from actual weight. Paired t-tests revealed that energy expenditure was significantly higher in GYM compared to CON (1,612 ± 101 vs. 1,215 ± 73 kcal d −1; p < 0.01, size of effect [Cohen's d] = 1.12 SD); energy intake exceeded expenditure for both groups but did not differ between groups (2,100 ± 80 vs. 2,054 ± 107 kcal d −1, respectively). Although both groups were lean for their age, the GYM exhibited significantly (p < 0.001, d = 1.51) lower percent body fat than the CON (14.9 ± 0.7 vs. 21.3 ± 1.3%, respectively). Despite their leanness and young age, all the participants were not satisfied with their body weight. Twice as many GYM (n = 4) as CON (n = 2) expressed a desired weight that was lower than their actual weight, and the magnitude of the difference, in desired lower body weight, between GYM and CON was moderate (5.3 ± 2.9 vs. 2.7 ± 2.4 kg, d = 0.54). Importantly, those GYM desiring a lower body weight were shorter (134.5 ± 6.3 cm, d = 0.54) and had a higher percent body fat (15.9 ± 1.8%, d = 0.47) than the GYM who were happy with their body weight or wanted to weigh more (n = 12, 139.6 ± 2.5 cm; 14.6 ± 0.7%). It is concluded that some female child gymnasts are dissatisfied with their body weight despite being characterized by extreme leanness. (Funded, in part, by the 1996 SCAN Practice Group Research Grant.)

Haemostatic Variables in Pacific Islanders Apparently Free from Stroke and Ischaemic Heart Disease – The Kitava Study

We cross-sectionally measured plasminogen activator inhibitor-1 (PAI-1) activity, fibrinogen, factor VII (FVII:C) and VIII (FVIII:C) coagulant activity, and von Willebrand factor antigen (VWF:Ag) in 162 traditional horticulturalists older than 40 years from the tropical island of Kitava, Papua New Guinea, where the intake of western food is negligible and where stroke and ischaemic heart disease appear to be absent. Identical analyses were made in Swedish subjects of comparable ages. Kitavams had markedly lower PAI-1 activity, with 85% of males and 100% of females having PAI-1 activity < or = 5 U/ml, as compared with 22 and 14% in Swedish males and females (p < 0.0001). Surprisingly, Kitavans also had higher FVII:C. FVIII:C and VWF:Ag. Fibrinogen was 10% lower in Kitavan males while 25% higher in Kitavan females. The very low PAI-1 activity in Kitavans may explain some of their apparent freedom from cardiovascular disease and probably relates to their extreme leanness.

CARDIOVASCULAR DISEASE RISK FACTORS IN AUSTRALIAN ABORIGINES

1. Aborigines from all over Australia develop unusually high prevalence rates for obesity, non-insulin dependent diabetes mellitus (NIDDM) and cardiovascular disease when they make the transition from their traditional hunter-gatherer lifestyle to a Westernized lifestyle. 2. There is no evidence that they experienced these diseases as hunter-gatherers. Data from the few extant traditionally orientated groups in very remote areas of northern Australia indicate that they were very lean (BMI less than 20 kg/m2), with low blood pressure, and that neither blood pressure nor BMI rose with age. 3. In addition, fasting glucose and cholesterol levels were low (usually below 4 mmol/L). However, in view of their extreme leanness and regular physical activity, fasting insulin and triglyceride levels were inappropriately elevated, suggestive of insulin resistance. 4. When Westernized diabetic Aborigines reverted temporarily to a traditional hunter-gatherer diet and lifestyle, all of the metabolic abnormalities of diabetes were greatly ameliorated (fasting glucose and triglyceride levels fell markedly and glucose tolerance and insulin secretion improved). In addition, they lost weight and there was a reduction in the major risk factors for cardiovascular disease (reduction in hypertriglyceridaemia and blood pressure, increase in bleeding time). 5. The hunter-gatherer lifestyle was associated with increased physical activity and a low-fat, high-fibre diet of low-energy density and high-nutrient density derived from very lean wild meat, and uncultivated vegetable foods. It has important therapeutic implications for the treatment and prevention of many of the chronic degenerative diseases of affluent Western societies.

Correlated response in reproduction, growth and composition to selection in gilts for extremes in age at puberty and backfat

Females ( n=50) were selected for extremes in early vs. late sexual maturity (12 EP, 13 LP) based on age at first detectable estrus; or, high vs. low backfat (13 HF, 12 LF) based on backfat at the tenth rib adjusted to 105 kg basis. These selected females were then heat checked daily, bred during scheduled breeding periods and allowed to farrow. Reproductive performance was then monitored. More EP than LP females demonstrated a normal cycling pattern. Also, more HF than LF females had normal cycling patterns. Early puberty (EP) female farrowed more litters per sow ( P < 0.05) and more pigs per litter ( P < 0.10) than LP. Low-fat females farrowed fewer pigs alive ( P < 0.10) than HF. Early puberty (EP) and HF females had the highest Sow Productivity Indexes (SPI), while LP females were intermediate. Low-fat females had the lowest SPI ( P < 0.05). These results indicate that single-trait selection for extreme leanness or late puberty could be detrimental to reproductive performance. Progeny (371 gilts and 173 barrows) from these litters were then performance tested. The correlated responses in the offspring to selection for extremes for puberty in the dams indicates that selection for early puberty in the females will result in faster gaining offspring with an increased amount of backfat. The correlated responses in offspring of the backfat lines indicates that selection for low backfat thickness in cycling females will decrease fat and increase the amount of lean deposited by her offspring. Also, LF offspring reached puberty and market weight at an earlier age.

The Nutritional Status of Female Ballet Dancers 15-18 Years of Age

The demand for ultra-leanness imposed on today's ballerina has evolved over primarily the last thirty years, and did not characterize the traditional classical ballet that dominated the field during its preceding four hundred years. Evolving public taste has tended to prefer increasingly slender figures, and the more Olympian levels of performance dancers must now exhibit further reinforce the demand for extreme leanness.The author's forty years of dance education experience and performance of classical ballet have made her aware that excellent training has become ever more widely available to the younger members of our society. Their rigorous training— continued well into the high school years—supports the achievement of a high level of technical and aesthetic perfection. Today's elite classical dancers are trained to make ever more revolutions in ever more complex and faster paced turns, and to do quicker and more intricate allegro work. They are trained to execute more complex jumps with greater elevation, and to sustain their balances with less preparation time. Furthermore, as the quality and quantity of professionally-oriented ballet schools have increased dramatically, today's dancer is facing an exponentially increased level of competition.Increasingly demanding techniques and more intense levels of competition require today's dancers to meet what are, in the author's view, extreme standards of leanness. Each year among the hundreds of beautifully trained dancers who audition for the few vacancies available in professional ballet companies, many are rejected on sight because they do not project the proper, or ideal, body image: long legs, long arms, long neck, oval shaped head; a body of excellent proportions; and, perhaps of greatest importance, a “bone-thin” frame. Ballet masters recognize that extreme leanness enables the dancer to become more energy-efficient, physically articulate, and agile; it facilitates partnering and pointe dancing; and projects an aesthetically pleasing athletic, or sylph-like, image to the public that subsidizes the art.

Estimation of total water and fatness from weight and height: inaccurate for lean women.

Mellits and Cheek have provided a regression equation which predicts total water, and by extension, fat, from weight and height of women. The equation has been used by many researchers as a convenient means to estimate fat when more complicated body composition estimation techniques are not possible. It is an essential component of evidence provide by Frisch for the critical fat hypothesis. The equation has not been validated on another sample, however, and has a large standard error. I test the Mellits and Cheek equation on five samples of young women, two of which show a normal range of heights and weights. The other three are athletic samples composed of lean women. In the normal samples mean fat percent determined by density (from underwater weighing) is closely approximated by the weight and height equation but not in the lean samples. When measured fat is regressed on estimated fat, correlations are low, and standard errors are high, suggesting that the Mellits and Cheek equation predicts poorly the body fat percentage of individual females. In summary, the Mellits and Cheek equation is moderately useful for the prediction of group means for body composition on samples with normal ranges of height and weight. It does not produce acceptable results on groups selected for extreme leanness or obesity. It is not recommended for fat prediction of individuals.

Prolactin responses, menstrual cycles, and body composition of women runners.

Fourteen young women with normal menses participated in an endurance running program to investigate the effects of physical training on menstrual function, plasma PRL, and body composition. Body composition, measured by hydrostatic weighing, and PRL (basal and TRH-stimulated ) were determined initially and after each subject had increased her weekly mileage by 30 miles (delta 30) and 50 miles (delta 50). Mean (+/- SEM) total body weight did not change, but the subjects became significantly leaner (relative fat, 25.5 +/- 1.3% at baseline vs. 22.4 +/- 0.9% at delta 50; P less than 0.02). Thirteen women developed menstrual changes (mainly oligomenorrhea), but not amenorrhea. Mean (+/- SEM) unstimulated PRL levels were 16.8 +/- 3.1%, 16.9 +/- 2.4, and 11.5 +/- 2.1 ng/ml at baseline, delta 30, and delta 50, respectively (P less than 0.03 at delta 50 compared to baseline and delta 30). Mean ( +/- SEM) integrated TRH-stimulated PRL responses increased from 5002 +/- 462 ng/ml.min at baseline to 5748 +/- 609 mg/ml.min at delta 30 and 6535 +/- 552 ng/ml.min at delta 50, and were significantly different from one another (F = 4.01; P less than 0.04). Endurance training, without total body weight loss or extreme leanness, results in frequent menstrual dysfunction. Other authors have shown that young female athletes have an increased PRL response to acute exercise compared to nonathletes. One mechanism responsible for menstrual dysfunction in endurance-trained women may be frequent and exaggerated PRL responses to exercise and other stimuli.