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Objective: The authors assessed the efficacy of sertraline in the treatment of night eating syndrome. Method: Thirty-four outpatients diagnosed with night eating syndrome were randomly assigned to receive either sertraline (N=17) or placebo (N=17) in an 8-week, double-blind, flexible-dose (50-200 mg/day) study. A mixed effects linear regression model was used to analyze change in the primary outcome measure, Clinical Global Impression (CGI) improvement rating. Secondary outcomes included changes in night eating symptoms, the number of nocturnal awakenings and ingestions, total daily caloric intake after the evening meal, CGI severity ratings, quality of life ratings, and weight. Results: Sertraline was associated with significantly greater improvement than placebo. Twelve subjects in the sertraline group (71%) were classified as having responded (CGI improvement rating [less than or equal to] 2, indicating much or very much improved) versus only three (18%) in the placebo group. There were also significant improvements in night eating symptoms, CGI severity ratings, quality of life ratings, frequency of nocturnal ingestions and awakenings, and caloric intake after the evening meal. Overweight and obese subjects in the sertraline group (N=14) lost a significant amount of weight by week 8 (mean=-2.9 kg, SD=3.8) compared with overweight and obese subjects receiving placebo (N=14) (mean=-0.3 kg, SD=2.7). Conclusions: In this 8-week trial, sertraline was effective in the treatment of night eating syndrome and was well tolerated.

Background: Total body potassium (TBK) is an index of fat-free mass. Data describing changes in TBK in African American, Asian, or Hispanic populations have not been reported. Objective: The aim was to investigate possible sex and racial differences in TBK in adults over an age range of 70 y. Design: The study used longitudinal and cross-sectional data collected in a body-composition unit from 973 men and 1368 women of African American, Asian, white, and Hispanic race-ethnicity. Random coefficient models in which baseline weight and height were taken into account were applied to estimate sex-specific changes in TBK among the 4 racial-ethnic groups. Results: The ages of 30 and 31 y were identified for women and men, respectively, as the cutoffs after which TBK began to decline. Both sexes had similar racial-ethnic patterns for expected mean TBK at the age cutoffs: African Americans had the highest value, followed by whites, Hispanics, and Asians. After the age cutoffs, the decline in TBK differed by race and sex. In women, African Americans showed the most rapid decline, whereas Asians had the lowest. In men, Hispanics had the most rapid decline in TBK, followed by African Americans, whites, and Asians. Conclusion: Significant sex and racial differences exist in the rate of change in TBK with age. Further studies are needed to explore the associations of declining TBK with health risks. KEY WORDS Total body potassium, race, sex, age, skeletal muscle mass, African Americans, Asians, whites, Hispanics

Background: Limited research has been done to explore differences between ethnic groups, including Hispanic Americans (HAs), in the association between percentage body fat (PBF) and body mass index (BMI; in kg/[m.sup.2]); the numbers of HAs are increasing in the US population. Objective: We investigated whether the relation between PBF and BMI in adult HAs differed from that of African Americans (AAs) and European Americans (EAs). Design: We used a multiple regression model in which PBF measured with dual energy X-ray absorptiometry was predicted by the reciprocal of BMI (1/BMI; in [m.sup.2]/kg) in a sample of 487 men ([n.sub.EA] = 192, [n.sub.AA] = 148, and [n.sub.HA] = 147) and 933 women ([n.sub.EA] = 448, [n.sub.AA] = 304, and [n.sub.HA] = 181). Results: For men, our results showed no significant differences between HAs and EAs, AAs and EAs, or HAs and AAs in the slope of the line relating 1/BMI to PBF. In women, there were significant differences in PBF as predicted by BMI between HAs and EAs (P < 0.002) and AAs and HAs (P = 0.020), but not between AAs and EAs. When PBF was estimated on the basis of predicting equations, the trend of the predicted PBF value in women differed according to ethnic group and BMI category. At a BMI < 30, HAs tended to have more body fat than did EAs and AAs, and at a BMI > 35, EAs tended to have more body fat than did the other groups. Conclusions: Our results show that the relation between PBF and BMI in HA women differs from that of EA and AA women. KEY WORDS Body composition, ethnicity, percentage body fat, body mass index, Hispanic Americans, Hispanics, dual-energy X-ray absorptiometry, DXA

Background: Waist circumference (WC) is strongly linked to obesity-associated risks. However, currently proposed WC risk thresholds are not based on associations with obesity-related risk factors but rather with body mass index (BMI; in kg/[m.sup.2]). Objective: The objective was to determine the relations of WC to obesity-associated risk factors in a representative sample of US whites and to derive comparable risk thresholds for WC and BMI. Design: Data on 9019 white participants of the third National Health and Nutrition Examination Survey were divided into 2 groups according to the presence of [greater than or equal to] 1 of 4 obesity-associated risk factors: low HDL cholesterol, high LDL cholesterol, high blood pressure, and high glucose. Odds ratio (OR) equations were derived from logistic regression models for WC and BMI with the use of the 25th percentile in the study population as the reference. Receiver operating characteristic curves for identifying risk factors were computed for WC and BMI. Results: At BMIs of 25 and 30, ORs were 1.19 (95% CI: 1.06, 1.35) and 2.37 (95% CI: 1.33, 4.22) for men and 1.56 (95% CI: 1.29, 1.91) and 3.16 (95% CI: 1.94, 5.28) for women, respectively. The corresponding ORs for WC were at 90 and 100 cm for men and at 83 and 93 cm for women. Minima on the receiver operating characteristic curves for men were at 96 cm for WC and at 26 for BMI and for women were at 86 cm for WC and 25 for BMI. Conclusion: WC is more closely linked to cardiovascular disease risk factors than is BMI. KEY WORDS Body mass index, BMI, cardiovascular disease risk factors, obesity, waist circumference, third National Health and Nutrition Examination Survey, NHANES III