Subsequent Weight Gain Research Articles

Prospective study of predictive factors determining borderline hypertensive individuals who develop sustained hypertension: Prognostic value of increased diastolic orthostatic blood pressure tilt-test response and subsequent weight gain

Repeat hemodynamic determinations in supine and tilting positions were performed in 23 young men with borderline hypertension (HBP). The mean duration of follow-up was 48 months. During the study 11 patients had no change in hemodynamic parameters (group II), while 12 patients exhibited significant increase in systolic ( p < 0.001) and mean ( p < 0.01) arterial pressures (BP) and in body weight ( p < 0.05) (group I). In this latter group, the initial hemodynamic pattern included supine elevations in cardiac output (CO) and heart rate (HR) and significant increase in diastolic orthostatic BP. After follow-up, the group I primary supine increases in CO and HR were followed by secondary supine increases in total peripheral resistance ( p < 0.01) and systolic ( p < 0.001) and mean ( p < 0.01) BP with lower CO ( p < 0.05) and HR ( p < 0.001). In addition, it was shown during long-term follow-up in group I patients that: (1) the increase in systolic BP per unit age was negatively correlated with initial age ( p < 0.001), (2) the increase in BP was positively correlated with weight gain ( p < 0.05), and (3) the diastolic orthostatic hypertension disappeared. This study provides evidence that, in patients with borderline HBP having supine elevations of CO and HR, the subsequent development of sustained HBP can be expected, with follow-up observation of lower supine HR and disappearance of diastolic orthostatic hypertension accompanied by rapid weight gain.

Effect of Sweating

To the Editor.— Regarding the article Losing Weight Through Exercise (1980;244:377), in the authors' disparagement of effortless reduction by methods that cause increased water loss, they make the often repeated misleading statement that may be temporarily reduced until rehydration occurs. This implies that there is no caloric consumption involved in the water loss. The same statement could be made for the loss incurred by a marathon runner during a race and his subsequent weight gain after rehydration. The fact overlooked by most people who attempt to debunk saunas and other devices that cause enhanced sweating is that the water does not just leak out of the body. Sweating is a part of the complex thermoregulatory process of the body involving substantial increases in heart rate, cardiac output, 1,2 and metabolic rate, 3-4 and consumes considerable energy. In a sauna, heat is absorbed by the subject from

Perfusion Technology in the Hypothyroid Patient

Cardiopulmonary bypass may, by necessity, have to be performed in patients who are frankly hypothyroid. In treating five such patients, all of whom required coronary revascularization, it was noted that fluid balance during perfusion was considerably different than that in the normal population. In order to attempt to evaluate this difference, ten consecutive euthyroid patients having revascularization and the five hypothyroid patients were compared to correlate all fluid absorbed and excreted with the duration of bypass, the serum sodium, and subsequent weight gain. Fluid intake, urine output, and retained fluid were significantly elevated in the hypothyroid as compared to the euthyroid group, while serum sodium following operation was not significantly different. While there are considerable data indicating that hypothyroidism is associated with abnormal salt and water excretion, there is no information concerning the alterations which occur during cardiopulmonary bypass. The present study indicates that hypothyroidism is associated with significant diuresis (without administration of exogenous diuretic agents during cardiopulmonary bypass). The proposed explanation for this diuresis rests with the assumption that with cardiopulmonary bypass and appropriate fluid administration, the contracted blood volume in hypothyroid patients expands acutely and a diuresis results.

Ventromedial hypothalamic lesions elevate basal and cephalic phase gastric acid output

With the use of a new technique for the measurement of gastric acid output in the rat, this study identifies ventromedial hypothalamic (VMH) lesion-induced changes in gastric acid secretion. Basal and cephalic phase gastric acid secretion were monitored in VMH- and sham-lesioned control rats on days 1, 5, 9, 13, and 17 postlesion as well as after the full development of obesity. VMH lesions resulted in increases of both phases of secretion. The magnitude of hypersecretion in lesioned rats developed with time and was fully developed by day 9 postlesion. The hypersecretion did not require a hyperphagia or weight gain, but its degree correlated with subsequent weight gain. These data, in conjunction with a review of VMH lesion effects on insulin secretion, suggest a widespread effect of VMH lesions on visceral secretory responses. The relevance of these data to the etiology of the VMH syndrome is discussed.

Natural history of obesity in 6,946 women between 50 and 59 years of age.

A health survey of 6946 50-to-59 year-old women of TOPS, an organization for weight reduction, was used to study the natural history of obesity. Weight history was compared for four groups of women divided on the basis of their per cent above ideal body weight (IBW) in their 50s (less than 20%, 20-49%, 50-99% and 100+%). In each of the four groups, the majority of women were not obese by age 20. Sixteen per cent of the women who were 100+% overweight in their 50s were not obese at anytime during their first 30 years of life. Thirty-six per cent of the women who were 50-99% about IBW were not overweight at anytime prior to their 30th birthday. The history of obesity prior to age 30 was not associated with weight gain between the ages of 30 and 50. These data suggest: 1) than there is no critical time for the development of obesity, and 2) that previous weight history is not a dominant factor in determining subsequent weight gain.

Concentrations of glucose, albumin, inorganic phosphate and sodium in the blood of beef calves at 2 ½ months of age and their relationships with subsequent weight gain

SummaryBlood samples were taken at 9, 10 and 11 weeks of age from 230 male Hereford × Friesian calves, the progeny of 12 Hereford bulls. Concentrations of blood glucose, serum albumin, inorganic phosphate and sodium were measured and correlated with body weights and growth rates until slaughter at 19½ months of age.Correlations between growth rates and glucose concentrations (0·44) and between growth rates and albumin concentrations (0·38) were observed until 4 months of age. Similar correlations between body weights and blood glucose or albumin concentrations persisted until 6 months of age. By 10 months, however, the correlations had begun to decline, and by slaughter they had become insignificant.Correlations between growth rates and inorganic phosphate or sodium concentrations were smaller, and also decreased with age.The effect of hypoglycaemia on growth rate was compared with the effect of enzootic pneumonia. Although the 10% of calves with the lowest glucose concentrations were growing 24% more slowly than the other calves at the time of sampling, this growth depression was not related to pneumonia, and they subsequently made up for most of the early loss of growth.Three blood samples were also taken from 22 Hereford bulls. No significant correlations were observed between the blood composition of the bulls and the body weights or weight gains of their progeny.

Gastric Bypass in the Operative Revision of the Failed Jejunoileal Bypass

Fifty-five patients with failed jejunoileal bypasses underwent reanastomosis and gastric bypass at the same operation. One patient died of undetermined cause three months postoperatively. The 54 surviving patients were all relieved of their preoperative symptoms, and 40 patients achieved satisfactory weight control. Technical complications prevented weight loss in 13 patients: four were given pouches too large to be effective, and nine had late disruption of the staple line. Two patients gained weight despite the fact that their pouches were of appropriate size. Reanastomosis will reverse the side effects of jejunoileal bypass, and a properly performed gastric bypass at the same operation will afford protection against subsequent weight gain.

Influence of Initial Food Restriction on Subsequent Body Weight Gain and Body Fat Accumulation in Rats

To determine the effect of initial food restriction on sub sequent body weight gain and body fat accumulation, rats were restricted to 75, 50, or 25% of the intake of control rats for 1 week and were subse quently pair-fed on a food intake basis to the control rats. As expected, restricted rats gained weight at a slower rate and had less body fat at the end of the restriction period than control rats. Upon refeeding the same amount of food as consumed by the control rats, these rats gained more body fat than control rats. This compensatory fat gain occurred regardless of whether the rats were force-fed twice daily, meal-fed once daily, or allowed to consume the food throughout the day. Both a high-carbohydrate and a high-fat diet produced compensatory fat gain. Compensation was apparent as early as the first week of refeeding and was greater in rats which had been restricted to 50 or 25% of ad libitum intake than in rats less severely restricted. Restricted rats were also refed on a body weight basis. They gained as much weight and fat as the ad libitum fed controls, indicating that the restricted rats were more efficient in converting dietary energy to body fat when refed than rats fed ad libitum continuously. These results suggest that the initial food restriction inherent in many studies involving meal frequency may cause the subsequent increased food ef ficiency and greater accumulation of body fat often attributed to an altera tion in meal pattern. Our studies indicate that meal pattern has a minimal influence on body fat content provided the control animals are pair-fed throughout the entire experiment. J. Nutr. 108: 1724-1732, 1978. INDEXING

Effects of estradiol-17β on cholesterol metabolism in the rat: A study using a deuterium label and mass spectrometry

The effect of estradiol-17β (E 2) on several important aspects of cholesterol metabolism were examined in the rat. Ovariectomized rats were implanted subcutaneously with 1 or 4 cm. of silastic tubing packed with E 2, and were also given 2% D 2O in their drinking water. The E 2 diffused slowly out of the implants and the two different lengths of tubing resulted in constant E 2 blood concentrations of either high (4.0 cm) or physiological (1.0 cm) levels. By measuring the rate of incorporation of deuterium into plasma cholesterol by mass spectrometry over a period of 42 days, we determined the rate constant of cholesterol synthesis and cholesterol turnover time and rate under two E 2 dosage conditions. E 2 treatment did not affect the rate constant of cholesterol synthesis or the cholesterol turn-over time. However, cholesterol turnover rate (mg synthesized/day) showed a dose dependent reduction with increasing doses of E 2. This may be secondarily caused by E 2's suppression of both food Intake and subsequent weight gain; E 2 treated animals are smaller and, therefore, synthesize less cholesterol per day. Additionally, E 2 treated animals showed a rise in plasma cholesterol levels and in the fraction of labeled cholesterol appearing in the plasma.

A comparison of the use of conventional and semipurified diets of high and low linoleate content on the responses of laying hens to dietary linoleic acid

AbstractPullets given a semi‐purified, low‐linoleate (SPLL) diet from 15–40 weeks of age produced significantly larger eggs but had significantly smaller body weights at 40 weeks than birds fed conventional diets to this age. When semi‐purified diets were fed from 40 weeks subsequent body weight gain was significantly greater in birds previously fed the semi‐purified diet. The minimum increase in mean egg weight between 40–68 weeks was observed in pullets fed from 15 weeks on the SPLL diet and given restricted amounts of food from 40 weeks. This poor egg weight increase was offset by ad libitum feeding, by feeding a conventional diet between 15–40 weeks or by feeding a semi‐purified, high‐linoleate, maize oil‐supplemented diet at similar ME intakes from 40–68 weeks. However, the actual mean egg weights at 68 weeks of restricted or ad libitum fed birds given the SPLL diet from 15 weeks were little different to those of birds on equivalent feeding regimens and consuming greater amounts of linoleic acid.

Transpyloric feeding in small preterm infants.

Wolfsdorf, J., Makarawa, S., Fernandes, C., Fenner, A. (1975). Archives of Disease in Childhood, 50, 723. Transpyloric feeding in small preterm infants. In 20 preterm infants, birthweight ranging from 775 to 1540 g, transpyloric feeding was carried out using expressed human milk as the sole nutrient (study group). 10 further infants, birthweight range 910-1500 g, were also fed with human milk via nasogastric tube (control group). The group fed transpylorically had higher fluid intakes during the early days of life. Body weight loss after birth was similar in both groups, but subsequent weight gain was more rapid in the study group. Thus transpyloric feeding is considered to offer the following advantages in comparison with nasogastric feeding. (1) No danger of aspiration after vomiting. (2) More rapid weight gain.

Perfusion of rabbit kidneys with cryoprotective agents

Rabbit kidneys were perfused at 5 or 37 °C for 2 hr with 2 m solutions of ethylene glycol, glycerol, or dimethylsulfoxide. It was found that each cryoprotectant caused an initial decrease in vascular resistance which was greater at 5 than at 37 °C but that dimethylsulfoxide caused a subsequent increase in resistance which was due to endothelial damage. In each experiment at 5 °C there was an initial weight loss by the kidney followed by a steady weight gain not significantly different from that observed in control experiments. At 37 °C however, only glycerol produced an initial weight loss, and all three cryoprotectants, but especially glycerol, produced severe subsequent weight gain. It is suggested that this effect is due to the cryoprotectants increasing the permeability of capillary membranes. The implications of these findings for long-term organ storage are discussed, and it is argued that glycerol and ethylene glycol merit further study.

Elevated Blood Pressure Levels in Adolescents, Evans County, Georgia

Hypertension in adolescents is still a debatable subject in regard to prognosis. Conclusions on the significance of prehypertension have been divided and no long-term follow-up has been reported in a representative population. In a group of 435 adolescents of the Evans County Epidemiologic Study, 11% had hypertension (≥140 and/ or ≥90 mm Hg) in 1961. After seven years, 30 of this group were reevaluated. Two deaths from cerebral hemorrhage occurred. One patient has hypertensive heart disease; sustained hypertension with cardiovascular and cerebrovascular symptoms developed in three more. Five were found to have asymptomatic sustained hypertension. Seven more had hypertension not reaching levels of sustained hypertension (≥160 and/or ≥95 mm Hg). Twelve have become normotensive. The most impressive associated finding was overweight and subsequent weight gain in eventual sustained hypertensives.

EFFECT OF FASTING ON GLUCOSE AND INSULIN METABOLISM OF OBESE PATIENTS

An oral glucose-tolerance test with measurement of plasma-insulin levels was performed in thirteen patients previously treated by prolonged starvation (17-99 days) for obesity. All patients showed improvement in glucose tolerance, with abolition of previous mildly diabetic curves in five patients, irrespective of subsequent weight gain. The mean plasma-insulin response was reduced after starvation and the degree of reduction in insulin secretion was inversely correlated with subsequent weight gain after the starvation period. The weight increase after fasting correlated highly significantly with time, but long-term improvement in carbohydrate metabolism suggests that starvation may have therapeutic importance in obesity unrelated to actual weight change.

Fibrinolysis and obesity: the effect of weight reduction.

SUMMARYIn eight obese subjects the initially low level of fibrinolytic activity increased after significant weight reduction. Reduction to a normal weight resulted in normal fibrinolytic activity, which was maintained when an isocaloric diet was resumed. Subsequent weight gain in two subjects caused a return of fibrinolytic activity to its initially low level. Overall, the ultimate level of fibrinolysis achieved was closely related to the degree of obesity.The changes in fibrinolysis appeared to be unrelated to changes in plasma levels of fibrinogen, triglyceride, cholesterol, free fatty acids and glucose.

The influence of the level of feeding of suckled pigs on subsequent performance during fattening

SUMMARYFour litters each containing six female pigs were used to compare the influence of the level of feeding of suckled pigs on subsequent weight gain and efficiency of feed conversion, and on carcass quality and ham composition.The high level pigs always remained on their dam until weaning at 56 days of age and had free access to a starter ration from the beginning of the 4th week of age. From 7 days of age until weaning the low plane pigs were removed from their dam for 12 hours per day and had no access to starter ration during this time. After weaning the pigs were fed ad libitum on dry feed.It was found that live-weight gain and feed conversion efficiency during fattening were increased by lowering the feed intake of pigs in the first weeks of life. There were no statistically significant differences between the different butcher's joints of the two groups. Although the differences were statistically non-significant, the ham of the low level pigs had a higher protein content (P = 0·06), a higher water content (P = 0·10), a lower fat content (P = 0·07) and a lower energy content (P = 0·12).