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Nicotinic acid (NiAc) is a potent inhibitor of adipose tissue lipolysis. Acute administration results in a rapid reduction of plasma free fatty acid (FFA) concentrations. Sustained NiAc exposure is associated with tolerance development (drug resistance) and complete adaptation (FFA returning to pretreatment levels). We conducted a meta-analysis on a rich pre-clinical data set of the NiAc–FFA interaction to establish the acute and chronic exposure-response relations from a macro perspective. The data were analyzed using a nonlinear mixed-effects framework. We also developed a new turnover model that describes the adaptation seen in plasma FFA concentrations in lean Sprague–Dawley and obese Zucker rats following acute and chronic NiAc exposure. The adaptive mechanisms within the system were described using integral control systems and dynamic efficacies in the traditional \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$I_{\text{max}}$$\end{document}Imax model. Insulin was incorporated in parallel with NiAc as the main endogenous co-variate of FFA dynamics. The model captured profound insulin resistance and complete drug resistance in obese rats. The efficacy of NiAc as an inhibitor of FFA release went from 1 to approximately 0 during sustained exposure in obese rats. The potency of NiAc as an inhibitor of insulin and of FFA release was estimated to be 0.338 and 0.436 \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\upmu {\text{M}}}$$\end{document}μM, respectively, in obese rats. A range of dosing regimens was analyzed and predictions made for optimizing NiAc delivery to minimize FFA exposure. Given the exposure levels of the experiments, the importance of washout periods in-between NiAc infusions was illustrated. The washout periods should be \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\sim$$\end{document}∼2 h longer than the infusions in order to optimize 24 h lowering of FFA in rats. However, the predicted concentration-response relationships suggests that higher AUC reductions might be attained at lower NiAc exposures.

A positive relationship exists between functional health and religion. We present an empirical definition of religion and describe the key elements of religious behavior, building a model that can be used to explore the presumed relationship between religion and health. Semi-structured interactive interviews were conducted with 22 participants over a 6-month period. Head Start programs and churches located in the inner city of a large metropolitan area. Twenty-two African American women were aged from 21 to 45. We focus on social relationships and propose that prophet-created religions mimic kinship relationships and encourage kinship-like cooperation between members.

Close to 19 million US adults have severe mental illnesses (SMI), and they die, on average, 25years earlier than the general population, most often from cardiovascular disease (CVD). Many of the antipsychotic medications used to treat SMI contribute to CVD risk by increasing risk for obesity, type 2 diabetes, dyslipidemia, and hypertension. Based on compelling evidence, the American Diabetes Association and the American Psychiatric Association developed guidelines for metabolic screening and monitoring during use of these medications.In this manuscript, we have reviewed the evidence on diabetes and other CVD risk screening, prevalence, and management among populations with SMI. We also review differences in screening among subpopulations with SMI (e.g., racial/ethnic minorities, women, and children). We found that despite national guidelines for screening for diabetes and other cardiovascular risk factors, up to 70% of people taking antipsychotics remain unscreened and untreated. Based on estimates that 20% of the 19 million US adults with SMI have diabetes and 70% of them are not screened; it is likely that over 2 million Americans with SMI have unidentified diabetes. Given that undiagnosed diabetes costs over $4,000 per person, this failure to identify diabetes among people with SMI represents a missed opportunity to prevent morbidity and translates to over $8 billion in annual preventable costs to our healthcare system.Given the high burden of disease and significant evidence of suboptimal medical care received by people with SMI, we propose several clinical and policy recommendations to improve diabetes and other CVD risk screening and care for this highly vulnerable population. These recommendations include reducing antipsychotic medication dose or switching antipsychotic medications, enhancing smoking cessation efforts, sharing electronic health records between physical and mental health care systems, and promoting integration of care.

Purpose of Review The goals of this paper are to report current research practices in investigations of human appetite control and to assess their relationships with emerging theoretical principles. Appetite is often distinguished by the separation of homeostatic and hedonic processes. Recent Findings This report assesses the validity of a homeostatic toolkit to measure subjectively perceived hunger and its relationship to the developing processes of satiation (control of meal size) and satiety (control of the post-eating period). The capacity of a procedure to measure the influence of hedonic processes on food intake is also evaluated. A major issue is the relationship between the pattern of eating behaviour (influenced by the underlying drive to eat and the inhibition induced by the act of eating itself) and the parallel underlying profile of hormonal and other metabolic biomarkers. Summary Increasing recognition is being given to individual variability in the expression of appetite, and the fact that the use of the average (mean) response conceals important information about the nature of appetite control. There is a growing interest in the identification of satiety phenotypes that operate in parallel to metabolic phenotypes. Interestingly, energy expenditure (metabolic and behavioural) contributes to an energy balance framework for understanding energy intake (appetite).

Many countries tightly ration access to publicly funded fertility treatments such as in vitro fertilisation (IVF). One basis for excluding people from access to IVF is their body mass index. In this paper, I consider a number of potential justifications for such a policy, based on claims about effectiveness and cost-efficiency, and reject these as unsupported by available evidence. I consider an alternative justification: that those whose subfertility results from avoidable behaviours for which they are responsible are less deserving of treatment. I ultimately stop short of endorsing or rejecting such a justification, though highlight some reasons for thinking it is unlikely to be practicable.

Overweight and obesity are epidemic in the United States, particularly among minority populations. This epidemic contributes to the development of chronic conditions that occur later in life such as type 2 diabetes and hypertension. Therefore, it is important to identify factors associated with the development of obesity during young adulthood. We conducted a cross-sectional survey among students graduating from a Historically Black College or University (HBCU) in the Mid-Atlantic region. Participants were 392 predominantly African American seniors graduating in the spring of 2003. Data were collected using a self-administered paper and pencil questionnaire which focused on weight, weight management activities, individual and familial weight history, and health status indicators. Participants were on average 24 +/- 5 years of age and 69% female; over 90% identified as African American or Black. According to NIH guidelines, about 30% of males and 28% of females were considered overweight, 12% of males and 7% of females were considered obese, and 7% of males and females were considered extremely obese. Significant correlates of being more overweight were being married, having children, lower socio-economic status, weight-loss attempts, personal and family history of overweight, and poorer health status. These data suggest that among this sample, the prevalence of overweight and obesity is similar to other populations of young African American adults. Familial factors such as socio-economic status and family weight history were important correlates of overweight. Overweight is a significant problem in this population, and these data should be useful for developing weight loss interventions aimed at young adults.

Attempts to define the genetic basis of obesity in the present century probably began with the study of Davenport reported in 1923. A number of papers were published on the topic based on weight for height data prior to the 1970s. Bray (1981) has summarized a good number of these studies which quite consistently demonstrated that obese children had frequently obese parents. Thus, in about 30% of the cases both parents of obese children were obese, with a range in frequency of 6% to 43%. Of course, one can readily observe that the fit between the obese state of the children and that of the parents is variable and not very tight. Following this period, the field of genetic epidemiology began to contribute new methods and research strategies in the efforts to define the genetic basis of quantitative multifactorial phenotypes. For the past 15 years or so, a good number of reports have been published regarding the heritability level and the segregation pattern of body mass for stature, and other indicators of obesity. Unfortunately, much less has been reported on the determinants and intermediate phenotypes of obesity or fat topography phenotypes.

The hypothesis that where adipose tissue is located on the body is an important predictor of health has been the subject of intense research over the past 10 to 15 years. The concept of an “apple shaped” body being associated with higher risk than a “pear shaped” body has appeared in the lay literature, and as a result, questions concerning fat distribution are being directed to physicians and other health care professionals. The purpose of this paper is to summarize the history and major findings in the area of fat distribution, and to point out current controversies and future directions of research.

This paper deals with other effects of obesity drugs than weight loss itself and weight loss related effects. The review does not pretend completeness. Rather will the effects — good and bad — be dealt with from examples putting the stress on experience from human studies of clinical relevance.

One of the major challenges in biology and medicine is the unravelling of the fundamental abnormality imparting vulnerability to the development of obesity. The experimental approaches adopted to date have simply not provided the solution. It is pertinent, particularly in the context of this meeting, that obesity frequently triggers or aggravates non-insulin-dependent diabetes. Thus, prevention or effective treatment of obesity would also have a prophylactic or ameliorative effect on type II diabetes. This paper will review and provide new data about the proposed functions of heparin-binding (fibroblast) growth factors in relation to adipose cell dynamics and processes opposing adipose differentiation.

The so-called diet-heart hypothesis has dominated research on relations between dietary components and coronary heart disease during the last 30 years. This hypothesis states that saturated fats elevate serum cholesterol levels and persons with elevated serum cholesterol levels are at high risk for coronary heart disease (Keys, 1952). The evidence available for the diet-heart hypothesis will be reviewed in this paper. Other areas of current interest are the relations between energy intake, dietary fiber, obesity, and coronary heart disease and relations between dietary minerals, blood pressure, and coronary heart disease. These relations will also be reviewed and recommendations for future research will be made.

Obesity, which refers to an excess of subcutaneous fat (Craddock, 1978; Craig, 1969), represents one of the most prevalent and refractory health problems occurring today (Brownell & Stunkard, 1978). In the professional area, new books on obesity are appearing with increasing regularity. Journals devoted specifically to this topic, for example, International Journal of Obesity, Journal of Obesity and Weight Regulation) along with numerous convention papers and workshops also add to the burgeoning professional literature. In the public area, a literal deluge of material awaits the interested individual in the form of popular trade books, over-the-counter drugs, weight loss clinics, health spas, and physical fitness centers. However, in spite of the continued focus by professionals and lay persons on the issues of overweight and obesity, as late as 1977 at a conference, “Obesity and the American Public,” investigators were professing their ignorance about the etiology and appropriate treatment of obesity (Kolaka, 1977). This ignorance is even more apparent in the field of developmental disabilities (DD), where a paucity of relevant is available. The purpose of this chapter is to present what is known about obesity in DD individuals as well as pertinent data obtained for non-DD persons. Also, where appropriate, suggestions will be made about what we yet need to learn about this complicated area.

We produce spontaneously diabetic rats from normal rats by repeating the selective breeding using glucose intolerance as the selection index. The rats are called GK rats and now we have the 37th generation. In this paper, characteristic features, insulin secretion and the effect of obesity will be presented.

The paper will follow the approach used by the first part of the Expert Committee published conjointly by the Food and Agricultural Organisation and the World Health Organisation (FAO/WHO, 1978) in 1978 on the Role of Dietary Fats in Human Nutrition. The first section dealt specifically with the role of dietary fats in early development. The report made the important point that there was a need to reduce the intake of saturated fats in countries at high risk to cardio-vascular disease, obesity and maturity onset diabetes but was unique in that it also referred to the need for additional fat in developing countries.