Correlates of weight loss and muscle-gaining behavior in 10- to 14-year-old males and females.

BACKGROUND: This study examined the influence of appearance and social acceptance esteem, awareness and internalization of media stereotypes, body size acceptance, and teasing on the weight loss and muscle-gaining behaviors of 10- to 14-year-old boys and girls. METHODS: Male (n = 670) and female (n = 788) students were drawn from one of four public senior middle schools (grades 6-8) in Southern Ontario as part of a longitudinal outcome-based study. Students' baseline self-report questionnaires, measuring the above variables, were analyzed for the purposes of this study. RESULTS: A higher percentage of girls reported engaging in weight loss behaviors, whereas a higher percentage of boys admitted to muscle gaining and the use of specific weight control methods such as laxative use and vomiting. Regression analyses revealed that internalization of media messages and body size acceptance were equally predictive of boys' weight loss and muscle-gaining behaviors, while teasing was found to also predict their muscle-gaining behavior. Among the girls, appearance esteem, internalization of media stereotypes, and body size acceptance were predictive of weight loss behaviors. None of the study variables were predictive of girls' muscle-gaining behavior. CONCLUSIONS: weight loss and muscle-gaining behaviors appear to have their onset in children as young as 10 years. The findings support the need for prevention programs that focus on media literacy and ways to decrease weight-based teasing in the school setting.

Weight-Loss practices and asthma: findings from the behavioral risk factor surveillance system.

OBJECTIVE: To describe weight-control practices and receipt of weight-loss advice among obese people with asthma. RESEARCH METHODS AND PROCEDURES: We analyzed data from the 2000 Behavioral Risk Factor Surveillance System. RESULTS: Among 13953 participants with current asthma, 27.3% had a body mass index of >or=30 kg/m2. Overall, 48.1% of participants with asthma reported trying to lose weight (64.1% among overweight or obese participants and 72.9% among obese participants). Among participants with asthma who were trying to lose or maintain weight, 74.7% reported trying to reduce their energy and/or fat intake, and 57.8% reported using physical activity. Approximately 29.7% were using the recommended combination of energy and/or fat intake reduction and physical activity of >or=150 min/wk. During the 12 months before the interview, 16.2% of overweight and 44.9% of obese participants with asthma reported receiving advice to lose weight. Among obese participants receiving weight-loss advice, 82.9% reported trying to lose weight compared to 63.8% of participants who did not receive such advice. DISCUSSION: Health professionals can play an important role in educating their patients with asthma about the importance of weight control and assisting their overweight and obese patients in setting appropriate weight goals and helping them achieve those goals.

The goal was a better understanding of the correlation between body mass and plantar peak pressure in patients with diabetic neuropathy. A further aim was to obtain insight into the practicability of simulated weight increase and weight release and to delineate more clearly the indications for reducing body weight in order to lower the risk of ulcerations. Simulated change of body weight: (1) +20 kg by a waistcoat and (2)-20 kg by a movable overhead suspension. While normal forces and thus mean normal pressures depend directly on body mass, this does not necessarily apply to peak normal pressures. As shown in a transversal study by Cavanagh with pressure measurements in the bare foot, there is only a poor correlation between body mass and peak pressure. Therefore, peak pressure in heavy persons cannot be expected to be higher than in lighter weight persons. However, from these results it cannot be concluded that peak pressure is likely to remain unchanged irrespective of a change in body weight in a specific subject. Ten subjects were investigated: five controls and five patients suffering from diabetes without neuropathy or preceding ulcerations. All subjects wore the same kind of ready made shoes with ready made standard fitting insoles of cork. Each subject was measured in three modes of weight simulation: normal weight,20 kg weight increase (waistcoat with weight pieces), and 20 kg weight release. Weight release was effected by a modified rescue harness attached to an overhead suspension rail with 6m free walking distance. Individual alignment of the waistcoat and the suspension was checked by a force platform. In-shoe pressure measurement was done with the PEDAR in-shoe system (by Novel, Munich,Germany). For data analysis with the PEDAR standard software only peak pressures were considered. The foot was divided into six regions, particularly metatarsal region and heel. No significant difference between diabetics and controls was found. In the regions at highest risk (metatarsals and heel),peak pressure increased and decreased with weight. In the combined group (n=10), a simulated weight loss of 20 kg decreased metatarsal peak pressure by 5.4+/-1.9 N/cm(2), a 20 kg weight gain increased it by 7.4+/-5.1 N/cm(2). Therefore, without a significant deviation from linearity, peak pressure was found to be a linear function of weight. The results of this study show that weight increase or weight loss in the individual patient has an effect on the plantar peak pressure. The effect is significant in the metatarsal and heel regions. The linearity allows for a simple method of predicting the effect of weight loss by inverting the effect of simulated weight gain.

Nutritional status of COPD patients with acute exacerbation.

The prevalence and features of nutritional status in patients with chronic obstructive pulmonary disease (COPD) have been studied extensively in stable conditions, but are poorly defined in the presence of an acute exacerbation. The aim of this study is to evaluate the nutritional status of COPD patients with acute exacerbation and possible relationship between nutritional parameters and pulmonary functions. The study group consisted of 53 COPD patients acutely admitted to the hospital for standardized medical treatment. The nutritional status of patients was assessed by anthropometric measurements, biochemical analysis, and immunologic testing. The patients were divided into two groups as having severe (FEV1 < 50%) and mild to moderate (FEV1 ? 50%) COPD and weight loss greater than 5% for the comparison of the study parameters. Ideal body weight (IBW%) was found as 104.42 +/- 4.30 in severe COPD, where as it was 115.31 +/- 7.28 in mild to moderate COPD group (p= 0.07). There was no relationship demonstrated between IBW% and FEV1. IBW% was correlated with DLCO for the total study population (r= 0.353, p= 0.035). weight loss greater than 5% of body weight (BW) was observed in 54% of patients. Comparison of the patient's actual weight to their usual weight revealed statistically significant weight loss (p< 0.01). Mean values of serum albumin, transferrin were found in normal range. Delayed type hypersensitivity skin test revealed normal immune status. When the study parameters were compared, no any statistically significant differences in parameters related to nutritional status were detected, between severe and mild to moderate COPD groups. As a statistically significant weight loss was found between the actual and usual weights of the patients, monitoring of nutritional parameters and eventual dietetic treatment should also be included in the goals of the medical treatment of patients with COPD in acute exacerbation.

Pancreatin enhanced erosion of and macromolecule release from 2,2-bis(2-oxazoline)-linked poly(epsilon-caprolactone).

The degradation and erosion of solvent cast films and injection molded bars prepared from poly(epsilon-caprolactone) (PCL) and 2,2'-bis(2-oxazoline) linked poly(epsilon-caprolactone) (PCL-O) were evaluated in simulated gastric fluid (SGF) (pH 1.2, pepsin present) and in simulated intestinal fluid (SIF) (pH 7.5, pancreatin present). After incubation of the polymer films (10 mg) and bars (70 mg) in the medium, the resulting decrease in molecular weight (degradation) was determined by size exclusion chromatography and the weight loss of the preparations was measured. In addition, the effect of pancreatin on FITC-dextran (MW 4400) release from PCL and PCL-O microparticles, prepared by w/o/w double emulsion technique, was studied. No degradation or weight loss was observed for either PCL or PCL-O films in SGF (12 h incubation, 37 degrees C). When compared to PBS pH 7.4, pancreatin hardly enhanced the weight loss of PCL films and bars. In contrast, pancreatin enhanced substantially erosion of PCL-O films and bars. Unlike PCL preparations, the PCL-O preparations showed surface erosion in SIF. Pancreatin increased considerably FITC-dextran release from both PCL and PCL-O microparticles. In conclusion, the present results demonstrate the enzyme sensitivity of the novel PCL-O polymer. In addition, the results show that pancreatin present in intestinal fluid may substantially affect drug release from PCL based preparations.

Effects of short-term modest weight loss on fasting and post-prandial lipoprotein sub-fractions in type 2 diabetes mellitus patients.

OBJECTIVE: We assessed the efficacy of a modest weight loss (1.5 +/- 0.3 kg) and simultaneous rapid improvement in glycemic control on fasting an post-prandial lipoprotein sub-fractions in nine overweight (BMI=28 +/- 1.7 kg/m(2)) well controlled Type 2 diabetic patients (HbA(1c)=7.3 +/- 0.1%). MATERIAL AND METHODS: They followed a non-drastical hypocaloric balanced diet (1 561 +/- 39 kcal/day) over ten days in hospital. The fat content of the diet was significantly lowered from 96 +/- 12 g/day to 62 +/- 4 g/day (p<0.03). Plasma lipid and lipoprotein levels were measured in fasting and four hours after standard breakfast and four hours after standard lunch twice before and after ten days of hospitalization. The sub-fractions of very low density and low density lipoprotein were obtained by cumulative flotation ultracentrifugation. RESULTS: This weight loss reduced two well known independent cardiovascular risk factors such as the post-prandial glycemic excursions (p<0.05) and the post-prandial lipemia (p<0.05). Multiple linear regression analyses identified weight loss as an independent variable accounting for the ability to predict post-prandial capillary triglyceride clearance (p<0.05). Improvements in post-prandial glycemic excursions which was also entered as a parameter did not appear as a variable being able to predict these changes (p=0.4). In addition to the 23% improvement in post-prandial capillary triglyceride clearance (p<0.02), a decrement in post-prandial VLDL-2 triglyceride enrichment was found (p<0.05). Finally, fasting and post-prandial LDL-3 cholesterol levels were diminished (p<0.05) and the LDL-2/LDL-3 mass ratio post-prandial kinetics were improved (p<0.05). CONCLUSIONS: Even a modest weight loss in overweight, average controlled type 2 diabetic patients can achieve a significant improvement in two cardiovascular risk factors, namely post-prandial triglyceride excursions and the LDL-2/LDL-3 mass ratio kinetics independently from glycemic control improvements.

The Swedish Obese Subjects (SOS) study--rationale and results.

OBJECTIVE: obesity is associated with increased morbidity and mortality. Several observational epidemiological studies have indicated that weight gain and weight loss, even in the obese, is also related to an increased mortality. The Swedish Obese Subjects (SOS) study was initiated in 1987 as an attempt to elucidate this paradox. DESIGN: Two thousand matched patient pairs will be followed for 10 y each. One pair member is surgically treated, while the other receives conventional obesity treatment. By February 2000, 1879 patient pairs have been recruited. RESULTS: The two-y weight reduction was 28+/-15 kg among the operated patients and 0.5+/-8.9 kg among the obese controls. After eight years the weight loss was 20+/-16 kg in the surgical group, while the controls had gained 0.7+/-12 kg. Weight reductions achieved in the surgical group reduced the two-y incidence of diabetes 32 times as compared to the controls. After eight years there was still a 5-fold reduction in diabetes incidence. The two-y incidence of hypertension was similarly reduced 2.6 times in the surgical group. After eight years the incidence of hypertension was almost equal in the two study groups. CONCLUSION: Compared to weight stability, large intentional weight loss results in substantial reductions in the two-y incidence of several cardiovascular risk factors. After eight years there is still a reduced risk of developing diabetes in the surgical group, while the incidence of hypertension is equal in the two treatment groups. Whether intentional weight loss will reduce mortality is still too early to tell.

Is bortezomib, a proteasome inhibitor, effective in treating cancer-associated weight loss? Preliminary results from the North Central Cancer Treatment Group.

BACKGROUND: weight loss predicts a poor prognosis for cancer patients, and previous studies have implicated the ubiquitin-proteasome pathway as a major mediator of cancer-associated weight loss. The recent emergence of bortezomib, a proteasome inhibitor, now allows testing on whether proteasome inhibition is effective therapy for cancer-associated weight loss. METHODS: This study represents a subanalysis from two prior antineoplastic trials in patients with adenocarcinoma of the pancreas. The first included 46 patients with metastatic pancreatic cancer who were treated with single-agent bortezomib (intravenous doses of 1.5 or 1.3 mg/m(2) on days 1, 4, 8, and 11 of a 21-day cycle). The second included 42 patients with pancreatic cancer treated with single-agent octreotide (200 or 500 mug subcutaneously three times a day). The FACT-C questionnaire provided appetite and related data for bortezomib-treated patients. Serial weight data were available from both trials. Such data from the octreotide trial were utilized for comparative purposes because the latter holds no track record in treating cancer-associated weight loss. RESULTS: Bortezomib- and octreotide-treated patients were roughly comparable at baseline, and neither agent demonstrated notable antineoplastic effects. FACT-C data suggested stable appetite, but high patient dropout rates invite caution in interpretation. For example, in response to "I have a good appetite," mean scores for bortezomib-treated patients were 45 at baseline (n=42), 45 at the end of cycle 1 (n=26), and 44 at the end of cycle 2 (n=9). In contrast, weight data appeared more straightforward to interpret: direct comparisons of mean change in weight from baseline between bortezomib- and octreotide-treated patients showed no significant differences between groups. CONCLUSIONS: These preliminary results suggest that bortezomib shows negligible favorable effects on cancer-associated weight loss in patients with metastatic pancreatic cancer. We conclude that further study of bortezomib specifically in this setting and for this indication is not warranted.