Normal-weight Men Research Articles

The Gender-specific Role of Body Weight for Health, Earnings and Life Satisfaction in Piecewise and Simultaneous Equations Models

AbstractBased on the German Socio-Economic Panel, the correlation between the body mass index, health, earnings and life satisfaction is analysed by gender. The previous literature has found no consistent results. This might have several reasons. The purpose of this paper is to analyse the gender-specific role of weight in single equation, piecewise and simultaneous equations models. We ask whether this distinction is important for the degree of association between health, earnings, satisfaction and body weight. In our context, piecewise modelling means a separate inspection of weight coefficients for under- and overweight people, allowing the detection of non-linear influences. As a benchmark, we begin our estimations under the assumption that the association between health, earnings, satisfaction, and weight is the same for under- and overweight people, and that there are no jointly dependent influences between our three outcome variables. The basic results are: health worsens, income declines and satisfaction is poorer with higher body mass index. If the association with weight is separately determined for over- and underweight people, the estimates show striking differences between overweight men and women. Underweight women earn more and overweight less than others. For normal-weight men the income is on average higher than for over- and underweight men but this difference is insignificant. When matching and instrumental variables procedures are applied, the health outcome for overweight people matches that of independent and unmatched estimates. Stronger positive effects on health are found for underweight women. No clear-cut advantages in income of overweight women can be found. Underweight women and especially underweight men tend to be less happy. For overweight men this influence is ambiguous but more speaks in favour of a lesser level of satisfaction. Overweight women seem to be happier.

Cardiovascular autonomic reflex tests and serum FGF21 levels in overweight and normal-weight men and women

Objective We evaluated cardiovascular autonomic reflexes and serum fibroblast growth factor 21 (FGF21), a surrogate marker of mitochondrial function, in a cohort of overweight and normal-weight adults (n = 42). Methods Indices of autonomic function were monitored during supine rest, autonomic reflex tests and submaximal clinical exercise test, with heart rate variables and blood pressure measured with an automatic system. Results Markers of sympathetic dominance were accentuated in overweight adults, including elevated resting low-frequency to the high-frequency ratio for heart rate variability (203 ± 227 vs. 96 ± 42; p = .01), and handgrip diastolic blood pressure (36 ± 15 mmHg vs. 25 ± 12 mmHg; p = .01). A weak non-significant trend has been found for a negative correlation between blood pressure responses to isometric handgrip test and FGF21 in the overweight group (r = −0.37; p = .09). Conclusions Excess body weight appears to trigger sympathetic overactivity in overweight adults, yet autonomic dysregulation might not be associated with notable changes in serum FGF21.

Circulating leptin is associated with serum uric acid level and its tubular reabsorption in a sample of adult middle-aged men.

Leptin is associated with cardiovascular risk factors (e.g. hypertension, insulin resistance, kidney disease and excess body weight). Experimental studies showed that leptin might affect serum uric acid, by modulation of the uric acid excretion. However, there are few observational data on the relationship between leptin and uric acid in the general population. Therefore, the aim of the present study was to evaluate the relationship between leptin and uric acid and its excretion in a large middle-aged male general population. A sample of 930 adult male individuals (mean age: 52years) without therapy for high uric acid was included in the analysis (the Olivetti Heart Study). Uric acid was significantly and positively associated with blood pressure, BMI, waist circumference, insulin resistance, C-reactive protein and leptin (p < 0.01), while inversely with renal function (p = 0.01). The multivariate analysis confirmed the association between leptin and uric acid after adjustment for potential confounders (p < 0.01). After division for adiposity, this trend was confirmed separately for normal weight and excess body weight participants. Moreover, leptin was inversely associated with excretion of uric acid (p < 0.01), also in multivariate analysis (p = 0.03). The results of this study indicate a positive association between circulating leptin levels and uric acid, independently of potential confounders, both in normal and excess body weight men. Furthermore, an inverse association between leptin and uric acid excretion was detected.

Association Between Waist Circumference and Dementia in Older Persons: A Nationwide Population-Based Study.

This study examined whether a positive association exists between waist circumference (WC) and dementia among older persons. The study population comprised 872,082 participants aged 65 years and older who participated in a Korean national health screening examination between January 1, 2009, and December 31, 2009. Adjusted hazard ratios and 95% CIs for dementia during follow-up from 2009 to 2015 were calculated according to baseline BMI and WC categories. After a multivariate adjustment that included BMI, the hazard ratios for dementia showed a stepwise increase according to the increase in WC categories by 5 cm from 85 to 90 cm in men and from 80 to 85 cm in women until ≥ 110 cm (from 1.06 [95% CI: 1.03-1.09] to 1.64 [95% CI: 1.37-1.94] in men and from 1.04 [95% CI: 1.02-1.07] to 1.58 [95% CI: 1.36-1.84] in women). The influence of the current WC category for abdominal obesity on the risk of dementia was different according to BMI; especially, the normal weight men and women with abdominal obesity had a prominent increased risk of dementia compared with those without abdominal obesity. Abdominal obesity, as measured by WC, was associated with significantly increased risk of dementia after adjustment for general obesity.

The Relation of Birth Weight and Adiposity Across the Life Course to Semen Quality in Middle Age

Studies of body mass index and semen quality have reported mixed results, but almost all were cross-sectional and many were conducted in selected populations. Longitudinal studies in population-based cohorts are necessary to identify how timing and duration of excess adiposity may affect semen quality. In 193 members of the Child Health and Development Studies birth cohort, we examined associations of birth weight and adiposity at six time points spanning early childhood and adulthood with sperm concentration, motility, and morphology at mean age 44 years, as well as with corresponding 2010 World Health Organization (WHO) subfertility reference levels. Birth weight for gestational age percentile was positively associated with square-root sperm concentration (regression coefficient B [95% confidence interval] = 0.02 × 103 sperm/ml [0.004, 0.04]). Overweight/obesity in men's 20s was associated with lower percent progressive motility (B =-5.2 [-9.9, -0.63]), higher odds of low motility (odds ratio (OR) = 2.4 [1.3, 4.4]), and higher odds of poor morphology (OR = 1.9 [0.94, 3.8]). Those who were overweight/obese in their 20s were also more likely to meet two or three WHO subfertility criteria (OR = 3.9 [1.6, 9.4]) compared with normal-weight men. Each additional adult decade in which a participant was overweight/obese was associated with higher odds of low motility (OR = 1.3 [0.96, 1.6]) and higher odds of meeting two or three WHO subfertility criteria (OR = 1.5 [1.0, 2.2]). In our data, associations among adiposity and sperm concentration, motility, and morphology varied according to timing and duration of exposure, potentially reflecting different biological mechanisms that influence these semen parameters.

Sensitivity of plasma cholecystokinin and peptide YY in obese and normal weight men

Sensitivity of plasma cholecystokinin and peptide YY in obese and normal weight men

Influence of obesity, weight loss, and free fatty acids on skeletal muscle clock gene expression.

The molecular circadian clock plays a role in metabolic homeostasis. We tested the hypothesis obesity and systemic factors associated with insulin resistance affect skeletal muscle clock gene expression. We determined clock gene expression in skeletal muscle of obese women (n = 5) and men (n = 18) before and 6 mo after Roux-en-Y gastric bypass (RYGB) surgery and normal-weight controls (women n = 6, men n = 8). Skeletal muscle clock gene expression was affected by obesity and weight loss. CRY1 mRNA (P = 0.05) was increased and DBP mRNA (P < 0.05) was decreased in obese vs. normal weight women and restored to control levels after RYGB-induced weight loss. CLOCK, CRY1, CRY2, and DBP mRNA (P < 0.05) was decreased in obese men compared with normal weight men. Expression of all other clock genes was unaltered by obesity or weight loss in both cohorts. We correlated clock gene expression with clinical characteristics of the participants. Among the genes studied, DBP and PER3 expression was inversely correlated with plasma lipids in both cohorts. Circadian time-course studies revealed that core clock genes oscillate over time (P < 0.05), with BMAL1, CIART, CRY2, DBP, PER1, and PER3 expression profiles altered by palmitate treatment. In conclusion, skeletal muscle clock gene expression and function is altered by obesity, coincident with changes in plasma lipid levels. Palmitate exposure disrupts clock gene expression in myotubes, indicating that dyslipidemia directly alters the circadian program. Strategies to reduce lipid overload and prevent elevations in nonesterified fatty acid and cholesterol levels may sustain circadian clock signals in skeletal muscle.

Association of body mass index with life expectancy with and without cardiovascular disease.

We estimated the average numbers of years lived with and without cardiovascular disease (CVD) in normal weight, overweight, and obese individuals, aged ≥30 years. A total of 7529 participants were recruited. The multi-state Markov model was used to obtain hazard ratios (HRs) for three transitions (CVD free to nonfatal CVD, CVD free to all-cause death, and nonfatal CVD to all-cause death) stratified by body mass index (BMI) categories at baseline and adjusted for confounders including sex, age, smoking, family history of premature CVD, education and physical activity. Life expectancies (LEs) were also estimated for each transition stratifying by BMI categories and sex. We found 986 incident cases of nonfatal CVD and 669 overall deaths (236 CVD deaths) after more than 18 years of follow-up. Overweight and obesity were associated with an increased risk of nonfatal CVD (HR, 1.42 (95% confidence interval (CI) 1.21-1.66) and (1.64, 1.37-1.96), respectively), compared with normal weight individuals. Overweight and obesity were also associated with lower risk of mortality without CVD (0.39, 0.20-0.77) and (0.35, 0.14-0.85), respectively. Among those with CVD, overweight compared with normal weight was associated with a lower risk of mortality (0.72, 0.56-0.94). Total LEs for both men and women with overweight and obesity were not significantly different from their normal weight counterparts. Compared with normal weight individuals, men and women with obesity lived 4.1 (CI: -6.3, -1.3) and 4.3 (-6.4, -2.0) fewer years free of CVD; however, they lived 3.9 (2.1, 6.0) and 3.7 (2.1, 5.6) longer years with CVD than their normal weight counterparts, respectively. We demonstrated that although total LE was not influenced by higher BMI; individuals with overweight and obesity could expect longer longevity after diagnosis of nonfatal CVD. These extra years of life impose financial burden on both patients and the health care system.

Cigarette Smoking Is Negatively Associated with the Prevalence of Type 2 Diabetes in Middle-Aged Men with Normal Weight but Positively Associated with Stroke in Men.

Background The prevalence of diabetes and potentially related complications, including stroke, is rapidly increasing in China. The long-term effects of lifestyle may affect glucose metabolism in the general population. Although some studies have shown an association between smoking and the risk of type 2 diabetes mellitus (T2DM), the relationship remains unclear. Furthermore, the relationship between smoking and stroke in patients with T2DM has not been fully elucidated. Objective We investigated the influence of cigarette smoking on T2DM and stroke in China. Detailed questionnaires about smoking status and anthropometric measurement were completed by participants, and oral glucose tolerance testing (OGTT), hemoglobin A1c (HbA1c), homeostasis model assessment of IR (HOMA-IR), and blood lipids were measured. Results In total, 8196 adults aged 40 years or older were included. We found a reduced risk of impaired glucose regulation (IGR) and T2DM in male smokers with normal weight (body mass index (BMI) < 25 kg/m2 or waist circumference (WC) < 90 cm) compared with nonsmokers after adjusting for age, alcohol intake, physical activity, educational level, family history of diabetes, SBP, DBP, TG, TC, HDL-C, and LDL-C. However, no significant association was detected in male current smokers with overweight/obesity or female smokers. In addition, compared with nonsmokers without T2DM, current smokers with T2DM had a significantly higher risk of stroke (odds ratio: 2.64, 95% confidence interval: 1.25–5.57; P = 0.011) after adjusting for confounders. Conclusions Smoking was negatively associated with T2DM in Chinese men of normal body weight, but no significant association was found for men with overweight/obesity or women. In addition, smoking was positively associated with nonfatal stroke, especially in patients with T2DM. Further prospective studies are needed to examine the association between smoking, diabetes, and stroke in different ethnic groups.

Fasting unmasks differential fat and muscle transcriptional regulation of metabolic gene sets in low versus normal birth weight men.

BackgroundIndividuals born with low birth weight (LBW) have an increased risk of metabolic diseases when exposed to diets rich in calories and fat but may respond to fasting in a metabolically preferential manner. We hypothesized that impaired foetal growth is associated with differential regulation of gene expression and epigenetics in metabolic tissues in response to fasting in young adulthood.MethodsGenome-wide expression and DNA methylation were analysed in subcutaneous adipose tissue (SAT) and skeletal muscle from LBW and normal birth weight (NBW) men after 36 h fasting and after an isocaloric control study using microarrays.FindingsTranscriptome analyses revealed that expression of genes involved in oxidative phosphorylation (OXPHOS) and other key metabolic pathways were lower in SAT from LBW vs NBW men after the control study, but paradoxically higher in LBW vs NBW men after 36 h fasting. Thus, fasting was associated with downregulated OXPHOS and metabolic gene sets in NBW men only. Likewise, in skeletal muscle only NBW men downregulated OXPHOS genes with fasting. Few epigenetic changes were observed in SAT and muscle between the groups.InterpretationOur results provide insights into the molecular mechanisms in muscle and adipose tissue governing a differential metabolic response in subjects with impaired foetal growth when exposed to fasting in adulthood. The results support the concept of developmental programming of metabolic diseases including type 2 diabetes.FundThe Swedish Research Council, the Danish Council for Strategic Research, the Novo Nordisk foundation, the Swedish Foundation for Strategic Research, The European Foundation for the Study of Diabetes, The EU 6th Framework EXGENESIS grant and Rigshospitalet.

Dementia risk by combinations of metabolic diseases and body mass index: Japan Gerontological Evaluation Study Cohort Study.

Aims/IntroductionTo compare the dementia risk associated with pre‐existing diabetes, hypertension, dyslipidemia, obesity (body mass index [BMI] ≥25 kg/m2) and underweight (BMI <18.5 kg/m2) among older adults. We also explored the dementia risk associated with combinations of metabolic diseases and BMI.Materials and MethodsWe used data from the Japan Gerontological Evaluation Study. Participants completed a health checkup in 2010 and were followed for 5.8 years on average. Dementia was measured by municipal long‐term care insurance registration. Diabetes, hypertension, dyslipidemia, obesity and underweight were diagnosed by medication use or health examination results. We calculated the incidence of dementia and adjusted hazard ratios (HRs).ResultsAmong 3,696 participating older adults, 338 developed dementia. Adjusted HRs (95% confidence intervals) in men and women (reference: those without corresponding disease of normal weight) were as follows: 2.22 (1.26–3.90) and 2.00 (1.07–3.74) for diabetes; 0.56 (0.29–1.10) and 1.05 (0.64–1.71) for hypertension; 1.30 (0.87–1.94) and 0.73 (0.49–1.08) for dyslipidemia; 0.73 (0.42–1.28) and 0.82 (0.49–1.37) for BMI of 25–29.9 kg/m2; and 1.04 (0.51–2.10) and 1.72 (1.05–2.81) for underweight. Dementia risk was significantly higher in underweight men with dyslipidemia (HR 4.15, 95% CI 1.79–9.63) compared with normal‐weight men without dyslipidemia, and in underweight women with hypertension (HR 3.79, 1.55–9.28) compared with normal‐weight women without hypertension. Dementia incidence was highest among underweight older adults with hypertension followed by dyslipidemia.ConclusionsAmong Japanese older adults, underweight and prevalent diabetes are risk factors for developing dementia. Lower BMI is also associated with a higher incidence of dementia.

Modulation of brain activity by hormonal factors in the context of ingestive behaviour

IntroductionMetabolic and hormonal signals have been shown to be associated with brain activity in the context of ingestive behaviour. However, this has mostly been seen in studies using external administration of hormones or glucose. We therefore studied endocrine-brain interaction in a physiological setting with hormone levels determined by metabolic conditions such as normal food intake vs. prolonged fasting. Methods24 healthy, normal weight men participated in two sessions, one involving a 38-hour fasting period and one a non-fasting control condition with standardized meals. Functional magnetic resonance imaging was performed at the end of the experiment with participants being required to rate pictures of food. Brain activation was compared between conditions in predefined regions of interest (ROIs). Multiple blood samples were taken to determine levels of insulin, C-peptide, cortisol, ACTH, glucose and adiponectin. These were used as a predictor variable in a regression analysis on brain activations in the different ROIs. ResultsFood pictures were rated as more desirable in the fasting condition. Univariate analysis of ROI activations revealed mainly effects of food rating and no significant effects of the metabolic state. Multiple regression analysis revealed associations between orbitofrontal cortex activation and blood glucose in the non-fasting condition. In the fasting condition adiponectin was associated with the signal from the caudate nucleus and insulin and C-peptide were associated with functional activity of orbitofrontal regions. DiscussionAssociations of endocrine signals and functional neural regions could be demonstrated in a realistic setting without external administration of hormones. As the current approach was correlational, further studies need to address the causal role of hormonal signals.

The effects of aerobic exercise combined with resistance training on cardiovascular risk factors in obese adolescent males

Objective To explore the effect of 12 weeks of aerobic exercise combined with resistance training on the cardiovascular risk factors of obese adolescent men. Methods Thirty-six obese male adolescents (the obese group) and 36 age-matched normal-weight adolescent men (the control group) were recruited. Those in both groups maintained their routine eating habits. The obese group participated in a 12-week combined aerobic exercise and resistance training program. Markers of inflammation, blood lipids, insulin sensitivity, vascular endothelium function and body composition were measured before and after the intervention. Results Some in the obese group lost visceral fat mass (VFM) and some gained it. Before the intervention the average levels of serum interleukin-1 receptor antagonist (IL-1Ra), tumor necrosis factor-α, leptin, insulin, insulin resistance index (HOMA-IRI), high-sensitivity C-reactive protein, triglycerides, adiponectin and high-density lipoprotein cholesterol of the obese group were all significantly higher than those of the control group. After the intervention there had been significant decreases in the average levels of IL-1Ra, IFN-γ-inducible protein 10, insulin and HOMA-IRI, but no significant change in average body weight in the obese group as a whole. The group which lost VFM, however, showed greater improvement in triglycerides and insulin resistance than those who gained. Conclusions Twelve weeks of aerobic exercise combined with resistance training can reduce the inflammatory response and insulin resistance of obese adolescent men. The participants who lost more VFM after exercise improved their lipid profile and insulin sensitivity the most. Key words: Exercise; Obesity; Adolescents; Cardiovascular risk factors; Visceral fat

977-P: Validation of the Noninvasive Blood Glucose Monitoring Device Nirlus

Background: Since the prevalence of diabetes mellitus has dramatically increased over the last decades, reliable non-invasive techniques for blood glucose monitoring are required to overcome problems and obstacles for regularly home-based blood glucose assessment. The aim of this study was the validation of the newly developed non-invasive blood glucose system NIRLUS® (Near Infra Red Light Ultra Sound, NIRLUS Engineering AG, Lübeck, Germany) under well standardized conditions. Methods: 17 healthy normal weight men (BMI: 22.4 ± 1.4 kg/m2) aged 18 to 45 years were enrolled in this study. During an intravenous glucose tolerance test (ivGTT), blood glucose profiles were measured simultaneously by two researchers with the NIRLUS® system (blinded for measured values) and a gold-standard laboratory reference system (reference, EKF-Diagnostics Biosen C-line, Barleben, Germany), respectively. During the course of ivGTT, blood glucose levels ranged from hyper- to mild hypoglycemia. Results:Correlation analysis revealed a strong association between NIRLUS and reference values (r=0.934; p&amp;lt;0.00). Subsequent Bland Altman analysis showeda symmetric distribution without blood glucose level depending deviation (r=0.047; p=0.395) and 95.5% of the NIRLUS/reference pairs were within the difference (d) of d±2SD. Error grid analysis revealed that 93.6% of NIRLUS/reference pairs are located in the area A, and 6.4% in the area B, respectively. No data were allocated in the areas C to E. Conclusion: This proof-of-concept study clearly demonstrates accuracy of blood glucose measures obtained by NIRLUS®as compared to a gold-standard laboratory reference system. Precise non-invasive glucose monitoring by NIRLUS®is feasible and might lower the burden of glucose control in patients with diabetes. Disclosure S. Meyhoefer: Research Support; Spouse/Partner; NIRLUS Engineering AG. B. Wilms: Research Support; Spouse/Partner; NIRLUS Engineering AG. F. Ihling: Research Support; Spouse/Partner; NIRLUS Engineering AG. A. Windjäger: Research Support; Spouse/Partner; NIRLUS Engineering AG. V. Herrmann: Research Support; Self; NIRLUS Engineering AG. A. Augustinov: Research Support; Self; NIRLUS Engineering AG. S.M. Schmid: Research Support; Self; NIRLUS AG. Funding NIRLUS Engineering AG

Impact of Hunger, Satiety, and Oral Glucose on the Association Between Insulin and Resting-State Human Brain Activity.

To study the interplay of metabolic state (hungry vs. satiated) and glucose administration (including hormonal modulation) on brain function, resting-state functional magnetic resonance imaging (rs-fMRI) and blood samples were obtained in 24 healthy normal-weight men in a repeated measurement design. Participants were measured twice: once after a 36 h fast (except water) and once under satiation (three meals/day for 36 h). During each session, rs-fMRI and hormone concentrations were recorded before and after a 75 g oral dose of glucose. We calculated the amplitude map from blood-oxygen-level-dependent (BOLD) signals by using the fractional amplitude of low-frequency fluctuation (fALFF) approach for each volunteer per condition. Using multiple linear regression analysis (MLRA) the interdependence of brain activity, plasma insulin and blood glucose was investigated. We observed a modulatory impact of fasting state on intrinsic brain activity in the posterior cingulate cortex (PCC). Strikingly, differences in plasma insulin levels between hunger and satiety states after glucose administration at the time of the scan were negatively related to brain activity in the posterior insula and superior frontal gyrus (SFG), while plasma glucose levels were positively associated with activity changes in the fusiform gyrus. Furthermore, we could show that changes in plasma insulin enhanced the connectivity between the posterior insula and SFG. Our results indicate that hormonal signals like insulin alleviate an acute hemostatic energy deficit by modifying the homeostatic and frontal circuitry of the human brain.

Low serum vitamin D is independently associated with unexplained elevated ALT only among non-obese men in the general population

Introduction and ObjectivesThere are inconsistent findings on the association between human non-alcoholic fatty liver disease (NAFLD) and vitamin D, perhaps due to insufficient specificity for gender and obesity status. We aimed to assess whether serum levels of 25-hydroxyvitamin D are associated with unexplained elevated alanine aminotransferase (ALT) in general population across gender and body mass index (BMI) levels. Materials and methodsA cross-sectional analysis of a population-based cohort with a nationwide-distribution using electronic medical database. The population consisted of individuals aged 20–60 years who underwent blood tests for ALT and vitamin D. ResultsA total of 82,553 subjects were included (32.5% men, mean age 43.91±10.15 years). The prevalence of elevated ALT was higher among men and women with vitamin D insufficiency or deficiency, but in multivariate analysis, adjusting for: age, BMI, serum levels of glucose, total cholesterol, triglycerides, statin use and season, only the association among men remained significant for the vitamin D deficiency category (OR=1.16, 95%CI 1.04–1.29, P=0.010). Stratification by BMI revealed that only among normal weight and overweight men vitamin D deficiency was associated with elevated ALT (OR=1.27, 95%CI 1.01–1.59, P=0.041 and OR=1.27, 95%CI 1.08–1.50, P=0.003, respectively). No independent association was shown among women at all BMI categories. ConclusionsIn a “real-life” general population, the association between vitamin D deficiency and unexplained elevated ALT is specific for non-obese men. The clinical significance of vitamin D for human NAFLD should be further elucidated with attention for a modifying effect of gender and adiposity.

The association between body mass index and anal canal human papillomavirus prevalence and persistence: the HIM study

ABSTRACT Background: While receptive anal sex is an established risk factor for anal human papillomavirus (HPV) infection and squamous cell carcinoma of the anus (SCCA), people with anal HPV infection and SCCA commonly report no lifetime receptive anal sex suggesting other factors may also increase risk for anal HPV infection and persistence. Given potential associations between obesity and conditions that may cause perianal or anal canal lesions, we hypothesized that body mass index (BMI) was associated with HPV infection. Methods: Genotyping for 36 HPV types was conducted on anal canal specimens from men, ages 18–70, from Brazil, Mexico, and the USA. Eligibility included no history of genital warts or HIV. Evaluable specimens were collected from 328 men having sex with men (MSM) and 1348 men having sex with women (MSW) who reported no lifetime receptive anal sex. Prevalence of anal HPV infection and six-month persistence by BMI were estimated in addition to adjusted prevalence ratios for the association between BMI and HPV infection. Results: Among MSW, obese men had a higher prevalence of HPV-16 in the anal canal (3.1%), compared to normal weight men (1.3%) although 95% CI overlapped. Among MSM, prevalence of HPV decreased with increasing BMI. A similar pattern was observed for persistence. After adjustment for confounders, obese MSW had 2.4 times higher odds of HPV-16 compared to normal weight men. Conclusions: BMI may be positively associated with anal HPV (especially HPV-16) among MSW and negatively associated with anal HPV among MSM which supports continued universal HPV vaccination programs.

Decreasing the Consumption of Foods with Sugar Increases Their Reinforcing Value: A Potential Barrier for Dietary Behavior Change

BackgroundThe Dietary Guidelines for Americans (DGA) have recommended reducing added sugar intake since its inception in 1980. Nearly 40 years later, added sugar consumption still exceeds 2015-2020 DGA recommendations among most of the population. The reinforcing value of food influences eating behaviors, and foods high in added sugars are highly reinforcing. Restricting intake of foods high in added sugars as part of a low-sugar diet may increase their reinforcing value such that reducing consumption may be difficult to maintain. If so, this would present a mechanistic barrier to making the necessary dietary changes to meet 2015-2020 DGA recommendations. PurposeTo determine whether the relative reinforcing value of foods high in added sugars is altered when reducing intake of all foods high in sugars. MethodsObese (n=19) and normal weight (n=23) men and woman who habitually consumed over 10% of their calories from added sugars completed the study. Reinforcing value of foods high in added sugars was measured via progressive ratio schedules of reinforcement before and on day 7 of a weeklong controlled feeding intervention where added sugars comprised 2.5% to 4.0% of daily calories and total sugars 7.3% to 8.6% of daily calories. ResultsThe reinforcing value of foods high in added sugars increased (P<0.01) after consuming a diet low in total added sugars for 1 week in both obese and normal weight participants. ConclusionAdhering to a low-sugar diet for 1 week increases the reinforcing value of foods high in added sugars. Future studies should examine whether consuming a diet low in added sugars, but not other sugar, increases reinforcing value of foods high in added sugars and whether high–added sugar food reinforcement returns to baseline after longer-term reductions in added sugars.

Impact of Metabolically Healthy Obesity in Patients with Andrological Problems

BackgroundAlthough the pathogenic role of metabolically complicated obesity (MCO) in erectile dysfunction (ED), major adverse cardiovascular events (MACE), and male infertility has been widely studied, that of metabolically healthy obesity (MHO) has been poorly investigated. AimTo assess the role of MHO in the pathogenesis of ED, prediction of MACE, and male reproductive health. MethodsA consecutive series of 4,945 men (mean age, 50.5 ± 13.5 years) with sexual dysfunction (SD) (cohort 1) and 231 male partners of infertile couples (mean age, 37.9 ± 9.1 years; cohort 2) were studied. A subset of men with SD (n = 1,687) was longitudinally investigated to evaluate MACE. All patients underwent clinical, biochemical, erectile function, and flaccid penile color Doppler ultrasound (PCDU) assessment. Infertile men also underwent scrotal and transrectal ultrasound; semen analysis, including interleukin (IL-) 8; and prostatitis-like symptom assessment. MHO was defined as body mass index >30 kg/m2 with high-density lipoprotein cholesterol level >40 mg/dL and absence of diabetes or hypertension. The rest of the obesity sample was defined as MCO. MHO or MCO were compared with the rest of the sample, defined as normal weight (NW) individuals. OutcomesClinical, biochemical, erectile, and PCDU assessment in MHO, MCO and NW men in both cohorts; longitudinal MACE incidence assessment in cohort 1. ResultsIn cohort 1, 816 men (16.5%) were obese, 181 (3.7%) were MHO, and 635 (12.8%) were MCO. In cohort 2, 68 men (28.4%) were obese, 19 (8.2%) were MHO, and 49 (21.2%) were MCO. After adjusting for confounders, in both samples, the men with MHO and MCO had lower total testosterone levels and worse PCDU parameters compared with the NW men. However, only MCO men had worse erectile function compared with NW men. In the longitudinal study, both MHO and MCO men independently had a higher incidence of MACE compared with NW men (P < .05 for both). In cohort 2, MHO and MCO men had a larger prostate volume, and MCO men also had higher ultrasound and biochemical (IL-8) features of prostatic inflammation compared with NW men, but no differences in prostatitis-like symptoms or seminal parameters. Clinical implicationsMHO men should be considered at high cardiovascular risk like MCO men and followed-up for erectile dysfunction and prostate abnormalities overtime. Strengths & LimitationsThe study simultaneously examined several endpoints with validated instruments within 2 different male populations, 1 with SD and 1 with infertility. As for limitations, there is no consensus in the scientific community regarding the definition of MHO, and the results are derived from patients with SD or infertility, which could have different characteristics than the general male population. ConclusionMHO is associated with subclinical ED, increased cardiovascular risk, and prostate enlargement.Lotti F, Rastrelli G, Maseroli E, et al. Impact of Metabolically Healthy Obesity in Patients with Andrological Problems. J Sex Med 2019:16;821–832.

Tart cherry consumption with or without prior exercise increases antioxidant capacity and decreases triglyceride levels following a high-fat meal.

Exercise and high-phytonutrient foods may lower oxidative stress and increase antioxidant levels, which could combat the negative effects associated with a high-fat (HF) meal. The objective of this study is to test the effects of Montmorency tart cherry (Prunus cerasus L.) consumption, with or without aerobic exercise, on antioxidant responses to an HF meal. Twelve normal-weight men (aged 22 ± 3 years), participated in a randomized crossover design comprising 4 trials: (i) HF meal with Montmorency tart cherry consumption (MC), (ii) HF meal with placebo (P), (iii) exercise prior to HF meal with MC (E+MC), and (iv) exercise prior to HF meal with P (E+P). The HF meal contained 60 g of fat and was consumed with MC or P. For exercise trials, a 30-min bout of submaximal treadmill exercise was performed the afternoon prior to HF meal consumption. Antioxidant capacity and triglycerides (TG) levels were measured at baseline and at 1, 2, and 3 h postprandially. Postprandial antioxidant capacity as assessed by oxygen radical absorbance capacity was significantly higher after MC and E+MC compared with E+P (incremental area under the curve (iAUC): 2.95 ± 2.19 and 4.87 ± 1.45 vs. -1.02 ± 1.72 mmol Trolox equivalents/L for MC and E+MC vs. E+P, respectively; p < 0.01). Postprandial TG levels were significantly lower after E+MC compared with P (iAUC: 58.99 ± 19.46 vs. 107.46 ± 22.66 mmol Trolox equivalents/L for E+MC vs. P, respectively; p < 0.05). These results indicate that MC consumption alone, and in combination with prior exercise, leads to greater antioxidant capacity following an HF meal compared with prior exercise with placebo. Further, MC consumption with prior exercise led to more favorable postprandial TG levels compared with placebo.