Dietary fish oil does not protect rats exposed to restraint or sleep deprivation stress.

It has been suggested that fish oil (FO) prevents weight loss caused by physiological stress such as cancer, injury, or cardiovascular disorders. Previously, we observed that a high-fat diet containing corn and coconut oil exaggerated weight loss caused by the mixed physiological and psychological stress of repeated restraint (RR). This experiment tested the effects of a high-fat diet containing FO as the predominant lipid source in rats exposed to the mixed physiological and psychological stress of either RR or sleep deprivation (SD). FO did not prevent stress-induced hypophagia or weight loss in RR or SD rats but exaggerated the negative effects of stress on body weight in SD rats by promoting loss of lean body mass. RR caused a reduction in body fat content irrespective of dietary treatment. In SD rats, both stress and FO independently reduced body fat mass. FO did not have any effect on adrenal and thymus weights during RR or SD and did not influence corticosterone levels after 1 h of RR or after 48 or 96 h of SD. In conclusion, our results suggest that high levels of dietary FO do not improve the response to stress in rats exposed to mixed stressors.

The effect of body weight and weight loss on thyroid volume and function in obese women.

OBJECTIVE: Thyroid volume and thyroid function may vary in obese and nonobese women. It is not known whether weight loss could affect thyroid volume and function in obese subjects. PATIENTS AND METHODS: The study population consisted of 98 premenopausal euthyroid obese [body mass index (BMI) = 30 kg/m2] women (mean age 40.5 +/- 11.4 years) and 31 nonobese (BMI < 25 kg/m2) women (mean age 38.6 +/- 12.9 years). Weight, height, BMI, waist circumference, body fat percentage and fat weight of all subjects were measured. Thyroid function and thyroid ultrasonography were performed at baseline and after 6 months of obesity treatment. Subgroup analysis was done according to weight loss. RESULTS: Thyroid volume (P = 0.021) and TSH concentration (P = 0.047) were higher; free T3 (P < 0.001) and free T4 concentrations (P = 0.045) were lower in obese women; however, all were still in the normal range. There was a positive correlation between thyroid volume and body weight (r = 0.319, P = 0.002), BMI (r = 0.504, P < 0.001), body fat percentage (r = 0.375, P = 0.001), body fat weight (r = 0.309, P = 0.01) and waist circumference (r = 0.386, P = 0.004). There was a positive correlation between TSH concentration and body weight (r = 0.227, P = 0.042) and body fat weight (r = 0.268, P = 0.038). After 6 months of obesity treatment, thyroid volume (P = 0.008) and TSH concentration (P = 0.006) decreased only in obese women who lost > 10% body weight. There was a positive correlation between the changes of thyroid volume and the change of body weight (r = 0.341, P = 0.009) and the change of body fat weight (r = 0.406, P = 0.013). CONCLUSIONS: Our study suggests that thyroid volume and function may vary in obese women in association with body weight and fat mass; > 10% weight loss may affect thyroid volume and function, which however, is clinically insignificant.

The early identification of poor treatment outcome in a women's weight loss program.

Research examining factors associated with program attrition or failure to lose weight during active treatment has yielded mixed findings. The goal of the current investigation was to confirm and extend prior research on the predictors and correlates of attrition and failure to lose weight during treatment. This investigation examined whether baseline characteristics, early weight loss, attendance, weight-related quality of life, confidence and difficulties with eating and exercise, and diet-related thoughts and feelings during the final week of treatment were associated with percentage change in body weight. Forty-four, obese, sedentary, postmenopausal women were recruited to participate in a 24-session weight loss intervention. Poor treatment outcome (i.e., percentage change in body weight) was significantly associated with several baseline characteristics including higher body mass index (BMI), greater fat and lower carbohydrate consumption, poor body image, and greater expectations for program success. Poor treatment outcome was also significantly associated with poor program attendance, unsatisfactory early weight loss, unsatisfactory improvements in weight-related quality of life, and lower self-control and self-confidence. By the end of active treatment, women with poor treatment outcome evidenced significantly higher levels of guilt and feelings of failure. The need for early identification and intervention with participants at risk for treatment failure is discussed.

The role of palliative radiotherapy in locally advanced non-small cell lung cancer.

The aim of this study was to evaluate retrospectively the treatment results of non-small cell lung cancer (NSCLC) patients treated with palliative intent in Dokuz Eylul University Hospital, Radiation Oncology Department. One hundred and fifteen inoperable, non-metastatic and symptomatic NSCLC patients were treated with palliative radiotherapy (PRT) between July 1991 and May 2000. PRT was used in patients with low performance status, weight loss more than 10% within last 6 months, secondary malignancies, co-morbid diseases and socio-economic problems. Parallelly opposed isocentric antero-posterior fields including both the parenchymal and mediastinal masses were used. 10-55 Gy total doses were delivered in 1-23 fractions with a median of 30 Gy. Nineteen patients received systemic chemotherapy before PRT. Survival analysis was made from the treatment beginning date, and subjective palliation rates were assessed according to clinical improvements in symptomatology evaluated 1-6 weeks after PRT. The median follow-up time was 28 weeks (1-234 weeks). Totally, 245 disease-related symptoms were detected in 115 patients. Overall "improvement" in symptomatology was found to be 90% (221/245) with a "near-total response" rate of 46% (113/245). Hemoptysis was the best palliated symptom. Median survival time was 30 weeks. Karnofsky performance status (KPS) (p=0.015), weight loss (p=0.0015), histologic tumor type (p=0.0024) and tumor size (p=0.02) were found to effect overall survival rates significantly in uni-variant analysis. Multi-variant analysis revealed statistically significant effect with histological tumor type and weight loss status. Only 16% of patients (3/19) showed partial and 5% (1/19) complete response to systemic treatment. Median survival time was 46 weeks in this group. In conclusion, this retrospective study of patients with poor prognostic factors confirms that PRT is an effective treatment modality in symptomatic locally advanced NSCLC patients resulting in 90% symptomatic improvement rate and a median survival of 30 weeks.

Time-course changes in macronutrient metabolism induced by a nutritionally balanced low-calorie diet in obese women.

The use of low-calorie diets is a common strategy for body-weight reduction purposes, but the time-course of the metabolic changes induced by moderately energy-restricted, otherwise balanced, diets is still poorly known. The aim of this nutritional intervention design was to study in obese women the effect of a balanced low-calorie diet on the metabolic rate, and metabolic fuel utilization changes during the weight loss process through the application of breath tests with stable isotope-labeled tracers. Seven obese (body mass index >30 kg/m(2)) women were assigned to a 10-week dietary hypoenergetic intervention regime supplying 55% of energy as carbohydrate, 30% as fat and 15% as protein. Metabolic rate and substrate utilization were evaluated for 6 h in separate occasions during the weight loss program by indirect calorimetry and after 13C-labeled glucose, triolein and leucine administration. Body weight loss after 10 weeks was 4.2+/-1.1 kg, while the percent body fat decrease was about 5%. Slimming was accompanied by a marked decrease in fasting leptin (about 25%). Postprandial carbohydrate utilization after the administration of a test meal with the same macronutrient distribution as the experimental low-energy diet was decreased (24.1%, P<0.05) as a consequence of the dietary restriction, which was associated with lower insulin plasma levels (P<0.05). Although protein and lipid oxidation were not significantly different after weight reduction (day 1 versus day 70), the metabolic utilization of these substrates tended to increase. Moreover, marginally significant indications obtained on days 15 and 45 suggest that the weight and body composition changes are attributable to a shift in endogenous and exogenous glucose utilization in favor of lipid burning. The breath tests determinations, which were performed on different occasions along the experimental trial, confirmed that the cumulative 13C output decreased for labeled tracers with time, being only statistically significant for the glucose utilization between days 15 and 45. In summary, the weight and fat mass losses were associated with a lower carbohydrate oxidation, which were probably compensated by an increase in lipid oxidation without major changes in protein mobilization.

Snoring and Sleep Apnea in Obese Adolescents: Effect of Long-term weight loss-Rehabilitation.

Objective: To test the effect of a long-term weight loss rehabilitation program in extremely obese adolescents on breathing parameters during sleep. Methods: Thirty-eight extremely obese [mean body mass index (BMI) 45.3 +/- 7.9kg/m(2)] adolescents participated during a three- to nine-month period in an inpatient weight loss rehabilitation in a specialized long-term rehabilitation center. Breathing parameters were registered via a seven-channel portable screening device. Body weight and arterial blood pressure were measured before and after the long-term treatment. Results: Mean BMI decreased from 45.3 to 35.8 (p < 0.001), mean diastolic blood pressure decreased from 89 mmHg to 81 mmHg (p = 0,002). Nine patients had a RDI of >/=5 and 30 patients a RDI of <5; the mean RDI decreased from 4.08 to 3.27 (n.s.). Within the group, the RDI was >/=5 and the mean RDI decreased from 10.3/h to 5.2/h (p = 0.02). The mean SaO2 increased from 93.65 to 95.35% (p = 0.003), lowest SaO2 increased from 72.14 to 73.19% (n.s.) and snoring frequency decreased from 37.56% of total sleep time (TST) to 32.86% of TST (n.s.). Conclusion: A long-term inpatient weight loss program has a positive effect on breathing parameters during sleep in extremely obese adolescents. However, the effect on apneic events and snoring is relatively minor compared to the effect on arterial oxygen saturation. The role of obesity in the origin of respiratory events and snoring in adolescents might be overestimated.

Polymer erosion in PLGA microparticles produced by phase separation method.

This article deals with polymer erosion in biodegradable microparticles produced using the phase separation method. Poly(lactic-co-glycolic acid) copolymers with different compositions and molecular weights were employed. The microparticles were stored in phosphate buffer for 6 months. The molecular weight of the polymers was determined by size exclusion chromatography, and the weight loss was monitored gravimetrically. No weight loss was measured in the first weeks, although the molecular weight decreased significantly already from the start. After a certain storage period which was found to be specific for the type of polymer, the weight of the microparticles decreased rapidly. The start of this weight loss occurred when the molecular weight of the polymer in the degrading microparticles reached a threshold of approximately 15,000. This critical molecular weight was found to be identical for all investigated polymers, i.e. it was independent of the initial molecular weight of the polymer and of the lactic-glycolic ratio.

Results of biliopancreatic diversion after five years.

BACKGROUND: Gastric restrictive procedures, currently the most popular surgical operations for morbid obesity, have proved to be effective in initiating weight loss, but questions regarding their long-term efficacy in weight maintenance have arisen. Biliopancreatic diversion (BPD) is a mixed and complex technique that has shown good long-term results. There are no series with long-term follow-up of BPD in Spain. We present >5 year results (average 67.9 +/- 15 SD mons, range 48-96), evaluating weight loss, morbidity and mortality after BPD. METHODS: 74 patients who underwent BPD and completed 5 or more years of follow-up were studied. The results have been analyzed in terms of weight loss (classification of Reinhold), improvement in morbidity, and improvement in quality of life (BAROS). RESULTS: 78.6% were women. Mean age was 38 +/- 11 years (18-61). Mean preoperative body mass index (BMI) was 54 +/- 8 kg/m(2). Progression of BMI: 1 year 34 +/- 6, 2 years 31 +/- 6, 5 years 33 +/- 7 and 7 years 31 +/- 3 kg/m(2). Excess weight loss at 1 year follow-up was 67%, at 2 years 75%, at 5 years 70% and at 7 years 71%. There were significant differences between morbidly obese (BMI <50 kg/m(2)) and super-obese (BMI >50 kg/m(2) ), with better results in the morbidly obese group. CONCLUSION: BPD shows long-term effectiveness in weight loss, co-morbidity improvement and quality of life. Protein, vitamin and oligoelement deficits may appear in the long-term, so that strict follow-up and supplementation of deficiencies are necessary.