Search

The purpose of this study was to predict low, moderate, hard and very hard physical activity (PA) and walking/biking/jogging based PA. One-hundred and fifty-nine severe to morbid obese African-American adolescents participated. We predicted 8% of the variance in hard PA largely due to family support and 10% of the variance in very hard PA due to other support (e.g. counselor) and having home PA equipment. We also predicted 10% of the variance in walking/biking/jogging due to the walkability of the neighborhood. Our findings support the value of social support and environmental supports in helping obese African American adolescents increase PA.

The aim of the study was to examine changes in systolic blood pressure (SBP) and whether physical activity and obesity status predicted SBP change for African-American adolescents (n = 181) participating in a behavioral weight control trial.Data were collected at baseline, 7 months (end-of-treatment), and 9 months (2-month follow-up).Nearly half of adolescents achieved clinically significant SBP reductions at 7 and 9 months. Significantly, fewer adolescents had elevated SBP at 7 and 9 months compared with baseline (both p.001). Changes in percent overweight and moderate-to-vigorous activity predicted changes in SBP over time.Obesity reduction and increases in moderate-to-vigorous physical activity may predict short-term, clinically meaningful reductions in SBP for African American adolescents with obesity.

Nutrition plays an important role in maintaining body weight within a healthy range and in improving and maintaining the health and well-being of cancer survivors. Avoiding weight gain and maintaining a healthy body weight over time have been shown to be challenging in cancer survivors. Optimal nutrition strategies to avoid weight gain, achieve weight loss, and achieve healthy weight maintenance are important to promote the overall health of cancer survivors. Improvements in the understanding of the role of obesity and nutrition approaches to weight management in cancer survivorship have been made over the decade since we authored the original chapter. In this chapter, we provide an overview of the mechanisms involved in body weight regulation and dietary intervention strategies for weight loss and healthy weight maintenance.

Every institution that is involved in research with animals is expected to have in place policies and procedures for the management of allegations of noncompliance with the Animal Welfare Act and the U.S. Public Health Service Policy on the Humane Care and Use of Laboratory Animals. We present here a model set of recommendations for institutional animal care and use committees and institutional officials to ensure appropriate consideration of allegations of noncompliance with federal Animal Welfare Act regulations that carry a significant risk or specific threat to animal welfare. This guidance has 3 overarching aims: 1) protecting the welfare of research animals; 2) according fair treatment and due process to an individual accused of noncompliance; and 3) ensuring compliance with federal regulations. Through this guidance, the present work seeks to advance the cause of scientific integrity, animal welfare, and the public trust while recognizing and supporting the critical importance of animal research for the betterment of the health of both humans and animals.-Hansen, B. C., Gografe, S., Pritt, S., Jen, K.-L. C., McWhirter, C. A., Barman, S. M., Comuzzie, A., Greene, M., McNulty, J. A., Michele, D. E., Moaddab, N., Nelson, R. J., Norris, K., Uray, K. D., Banks, R., Westlund, K. N., Yates, B. J., Silverman, J., Hansen, K. D., Redman, B. Ensuring due process in the IACUC and animal welfare setting: considerations in developing noncompliance policies and procedures for institutional animal care and use committees and institutional officials.

Nonhuman primates (NHPs) share with humans many features of lipid metabolism and often develop all features of the metabolic syndrome, including hypertriglyceridemia and low high-density lipoprotein cholesterol, and have been used in many studies of potential therapeutics during the preclinical phase. Here we identify for the first time in middle-aged and older rhesus the natural occurrence of hypercholesterolemia, and this hypercholesterolemia develops despite maintenance on a low-cholesterol diet. The aims of this study were to (a) define normal and hypercholesterolemia in rhesus monkeys, (b) determine the factors associated with the development of hypercholesterolemia, (c) compare the lipoprotein profiles in adult rhesus monkeys fed a low-fat/low-cholesterol diet (LFLC) with the profiles of human subjects, and (d) determine the effect of a 16-week high-fat/high-cholesterol (HFHC) diet feeding on total cholesterol and lipoprotein profiles in middle-aged and older monkeys. In our colony, maintained on a constant diet with negligible cholesterol, the mean total cholesterol level in healthy nondiabetic monkeys was 3.7 ± 0.02 mmol/L, with hypercholesterolemia identified as the 95th percentile of the normal cholesterol distribution (≥5.2 mmol/L). Severe hypercholesterolemia developed in the HFHC-fed group; however, despite the high-fat diet composition, unexpectedly, no weight gain occurred in these NHPs. The diet-induced hypercholesterolemia differed significantly in lipoprotein pattern from that of the spontaneous hypercholesterolemia. In summary, despite ingesting only a LFLC, NHPs frequently develop hypercholesterolemia, reflecting lipoprotein patterns similar to human subjects; and this lipid profile of spontaneous hypercholesterolemia differs significantly from the hypercholesterolemia induced by an HFHC diet.

High dietary intake of saturated fat and cholesterol, and elevated low-density lipoprotein cholesterol levels are some of the modifiable risk factors for cardiovascular disease. Alpha-cyclodextrin (a-CD) when given orally has been shown in rats to increase fecal saturated fat excretion and to reduce blood total cholesterol levels in obese hypertriglyceridemic subjects with type 2 diabetes mellitus. In this study, the effects of dietary a-CD on lipid metabolism in low-density lipoprotein receptor knockout mice were investigated. Low-density lipoprotein receptor knockout mice were fed a "Western diet" (21% milk fat) with or without 2.1% of a-CD (10% of dietary fat content) for 14 weeks. At sacrifice, there was no difference in body weight; but significant decreases were observed in plasma cholesterol (15.3%), free cholesterol (20%), cholesterol esters (14%), and phospholipid (17.5%) levels in mice treated with alpha-CD compared with control mice. The decrease in total cholesterol was primarily in the proatherogenic apolipoprotein B-containing lipoprotein fractions, with no significant change in the high-density lipoprotein fraction. Furthermore, alpha-CD improved the blood fatty acid profile, reducing the saturated fatty acids (4.5%) and trans-isomers (11%) while increasing (2.5%) unsaturated fatty acids. In summary, the addition of alpha-CD improved the lipid profile by lowering proatherogenic lipoproteins and trans-fatty acids and by decreasing the ratio of saturated and trans-fatty acids to polyunsaturated fatty acids (-5.8%), thus suggesting that it may be useful as a dietary supplement for reducing cardiovascular disease.

Introduction The successful recruitment and retention of participants is integral to the translation of research findings. We examined the recruitment and retention rates of racial/ethnic minority adolescents at a center involved in the National Institutes of Health Obesity Research for Behavioral Intervention Trials (ORBIT) initiative by the 3 recruitment strategies used: clinic, informatics, and community. Methods During the 9-month study, 186 family dyads, each composed of an obese African American adolescent and a caregiver, enrolled in a 6-month weight-loss intervention, a sequential multiple assignment randomized trial. We compared recruitment and retention rates by recruitment strategy and examined whether recruitment strategy was related to dyad baseline characteristics. Results Of the 186 enrolled families, 110 (59.1%) were recruited through clinics, 53 (28.5%) through informatics, and 23 (12.4%) through community. Of those recruited through community, 40.4% enrolled in the study, compared with 32.7% through clinics and 8.2% through informatics. Active refusal rate was 3%. Of the 1,036 families identified for the study, 402 passively refused to participate: 290 (45.1%) identified through informatics, 17 (29.8%) through community, and 95 (28.3%) through clinics. Recruitment strategy was not related to the age of the adolescent, adolescent comorbidities, body mass index of the adolescent or caregiver, income or education of the caregiver, or retention rates at 3 months, 7 months, or 9 months. Study retention rate was 87.8%. Conclusion Using multiple recruitment strategies is beneficial when working with racial/ethnic minority adolescents, and each strategy can yield good retention. Research affiliated with health care systems would benefit from the continued specification, refinement, and dissemination of these strategies.

The purpose of this study was to develop an adaptive behavioral treatment for African American adolescents with obesity. In a sequential multiple assignment randomized trial, 181 youth ages 12-16 years with primary obesity and their caregiver were first randomized to 3 months of home-based versus office-based delivery of motivational interviewing plus skills building. After 3 months, nonresponders to first phase treatment were rerandomized to continued home-based skills or contingency management. Primary outcome was percent overweight and hypothesized moderators were adolescent executive functioning and depression. There were no significant differences in primary outcome between home-based or office-based delivery or between continued home-based skills or contingency management for nonresponders to first-phase treatment. However, families receiving home-based treatment initially attended significantly more sessions in both phases of the trial, and families receiving contingency management attended more sessions in the second phase. Overall, participants demonstrated decreases in percent overweight over the course of the trial (3%), and adolescent executive functioning moderated this effect such that those with higher functioning lost more weight. More potent behavioral treatments to address the obesity epidemic are necessary, targeting new areas such as executive functioning. Delivering treatment in the home with contingency management may increase session attendance for this population.

African-American women have disturbingly high rates of hypertension, exceeding those of African-American men and other ethnic groups. Reasons for these disparities are not understood. Depression, more common in women than men, has been linked to endothelial dysfunction, inflammation, metabolic and hematologic abnormalities, and increased sympathetic nervous system activity--all factors associated with cardiovascular disease. A descriptive correlational design was used to test the following hypotheses: 1) African-American women with higher levels of depression will have higher blood pressure (BP) levels, more cardiovascular risk factors, greater stress, and lower social support; and 2) depression will mediate the relationship between stress and BP. A convenience sample of 245 hypertensive African-American women (mean age, 61+/-12.7 years) was recruited through free BP screenings offered in the community. All data were collected during a structured interview and brief physical examination. Pearson r correlation coefficients, analysis of variance, and multiple regression analyses were used to analyze the hypotheses. Women with higher levels of depression had higher diastolic BP and were more likely to smoke, eat fewer fruits and vegetables, and have more stress and less social support. Depression mediated the relationship between stress and diastolic BP. The findings emphasize the importance of assessing both behavioral and psychosocial factors in urban African-American women with hypertension.

The prevalence of obesity and overweight persists in the preschool population, despite some prevention and treatment advances, particularly in minorities. Investigating the prevalence of dyslipidemia and the effect of family health may also guide the focus of intervention efforts.Anthropometric data were collected from urban minority preschool children (n=161; 42% female) enrolled in USDA Head Start. Blood was collected by finger prick and analyzed with the Cholestech LDX Analyzer (Cholestech Corporation, Hayward, CA). Caregivers provided a self-reported family health history for cardiovascular diseases (CVDs).By BMI percentile, 8% of the children were underweight (UW), 54% healthy weight (HW), 10% overweight (OW), and 28% obese (OB). One of every 5 children had borderline or high-risk levels for total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides based on the National Cholesterol Education Program categories. In OW/OB children only, BMI was positively correlated with TC (r(61)=0.428; p=0.001) and LDL (r(58)=0.395; p=0.005). Child BMI was also associated with family comorbid diseases (r(159)=0.177; p=0.025). UW/HW children with a family history of CVD had significantly higher LDL than UW/HW children without a family history of CVD (p=0.001). Step-wise regression analysis revealed that BMI (p=0.005) plus family history of heart attack (p=0.018) were significant predictors of blood TC levels.Continued efforts to treat and prevent elevated weight are urgently needed for minority preschoolers. Attention to CVD screening may be an important target in school, community, and healthcare arenas for minority populations regardless of weight status.

To explore the feasibility and short term outcomes of using an interactive kiosk integrated into office flow to deliver health information in a primary care clinic.Fifty-one adults with BMI ≥25 were randomly assigned to use a kiosk with attached devices to receive a six-week healthy eating/weight monitoring (intervention) or general health/BP monitoring (attention-control) program. Outcomes were measured at baseline, 8 weeks (post) and three month follow-up.Participants completed an average of 2.73 weekly sessions, with transportation and time given as limiting factors. They found the kiosk easy to use (97%), liked the touchscreen (94%), and would use the kiosk again (81%). Although there were no differences between groups, the 27 completing all assessments showed reduced weight (p=.02), and decreased systolic (p=.01) and diastolic BP (p.001) at follow-up. Although healthy eating behaviors increased, the change was not statistically significant.Using a kiosk within a clinic setting is a feasible method of providing health information and self-monitoring. Multi-session educational content can provide beneficial short-term outcomes in overweight adults.A kiosk with attached peripherals in a clinic setting is a viable adjunct to provider education, particularly in medically underserved areas.

n Abstract: Leptin is an adipocyte-derived hormone involved in regulation of satiety, and it also appears to have a role in breast cancer risk. Leptin therefore might be a useful indicator of the potential preventive effects of weight loss in breast cancer survivors. In this study we examined whether the change in leptin levels could be predicted by weight loss in obese breast cancer survivors. The subjects in this study were participating in a randomized trial of an individualized approach towards weight loss in Detroit, MI. Breast cancer survivors (body mass index of 30–44 kg ⁄m 2 ) were enrolled and fasting blood samples were obtained for leptin analysis over 1 year of study. Leptin levels were available from at least two time points for 36 women, and weight change ranged from a gain of 11% to a loss of 25% of baseline weight. Using a repeated-measures regression model, both baseline leptin level and concurrent percent body fat were found to synergistically predict leptin levels. Thus, for women with the same body fat, those with higher baseline leptin levels are predicted to exhibit smaller decreases in leptin with weight loss. Similar results were obtained for body weight and body weight change, but the associations with body fat were stronger. Breast cancer survivors with initially higher leptin levels may differ with regard to regulation of change in leptin during weight loss resulting in relatively smaller changes in leptin with equivalent amounts of weight loss. n

Fetuin inhibits insulin-induced insulin receptor (IR) autophosphorylation and tyrosine kinase activity in vitro, in intact cells, and in vivo. The fetuin gene (AHSG) is located on human chromosome 3q27, recently identified as a susceptibility locus for type 2 diabetes and the metabolic syndrome. Here, we explore insulin signaling, glucose homeostasis, and the effect of a high-fat diet on weight gain, body fat composition, and glucose disposal in mice carrying two null alleles for the gene encoding fetuin, Ahsg (B6, 129-Ahsgtm1Mbl). Fetuin knockout (KO) mice demonstrate increased basal and insulin-stimulated phosphorylation of IR and the downstream signaling molecules mitogen-activated protein kinase (MAPK) and Akt in liver and skeletal muscle. Glucose and insulin tolerance tests in fetuin KO mice indicate significantly enhanced glucose clearance and insulin sensitivity. Fetuin KO mice subjected to euglycemic-hyperinsulinemic clamp show augmented sensitivity to insulin, evidenced by increased glucose infusion rate (P = 0.077) and significantly increased skeletal muscle glycogen content (P < 0.05). When fed a high-fat diet, fetuin KO mice are resistant to weight gain, demonstrate significantly decreased body fat, and remain insulin sensitive. These data suggest that fetuin may play a significant role in regulating postprandial glucose disposal, insulin sensitivity, weight gain, and fat accumulation and may be a novel therapeutic target in the treatment of type 2 diabetes, obesity, and other insulin-resistant conditions.

Oscillations in basal plasma levels of the pancreatic hormones; insulin, glucagon and pancreatic polypeptide have been reported previously. We now report on oscillations in circulating motilin-like immunoreactivity (MLI) in fasted and fed man. Six healthy subjects were studied during two 36-hour test periods, one while fasting and another with the regular ingestion of equicaloric meals at 0800, 1200 and 1800 hours. Blood was sampled every 30 min. from 0800 to 2400 and every 60 min. from 2400 to 0800 the next morning. In the fasting state the mean ±S.E. concentrations in plasma for the 6 subjects were: MLI, 180 ±19.4 pg/ml, insulin 4.4 ±1.1 μ/U/ml, pancreatic polypeptide (hpp), 119 ±25.0 pg/ml, and glucose 82 ±6.4 mg/dl. Large oscillations in plasma MLI were detected with 1/2 amplitude of 23.2 ±4.7% of mean, and a period of 159 min. which varied according to each subject. Plasma hpp levels fluctuated similarly, and a good correlation was found between MLI and hPP indicating a rhythmic secretion of these peptides by the gut and pancreas. MLI fluctuations were independent of insulin which revealed a significant oscillation with a period of 320 min. The ingestion of meals caused the expected increase in circulating levels of insulin, hPP, and glucose. In contrast a decrease in the concentration of MLI was observed. An inverse correlation was found between MLI and glucose and between MLI and insulin. Thus, fasting is associated with large oscillations of motilin, the gut motility hormone, which are suppressed by feeding. The increase in glucose and/or insulin may be important in suppressing motilin secretion during feeding.

Feeding patterns have been studied in 10 adult male rhesus monkeys (Macaca mulatta) adapted to primate restraint chairs for physiological studies. Using an automated computer-monitored liquid diet feeding system, feeding behavior was studied under 8 hour and 24 hour feeding schedules. Calorie/kg intake was significantly reduced with the 8 hour schedule ( p p >0.10). Meal size was negatively correlated with meal frequency across monkeys, but not within monkeys. Although monkeys ingested 78% of their voluntary intake during the light hours, there was no difference in meal size, meal duration, or rate of feeding between light and dark periods. With feeding restricted to 8 hours during the light period, meal size was positively correlated with the length of the interval preceding the meal in 4 of 6 monkeys, and meal size was also positively correlated with length of the postmeal interval in 3 of 6 monkeys. In contrast, 24 hour ad lib fed monkeys showed no relationship between premeal interval and subsequent meal size, but a positive correlation between meal size and postmeal interval in 3 of 4 monkeys. We conclude that feeding schedule or deprivation state may alter the relative roles of “hunger” and “satiety” signals in regulating food intake amounts and patterns.

In order to investigate the effects of the induction and remission of obesity on feeding behavior, male rhesus monkeys were made obese by sustained intragastric (IG) feeding of a complete liquid diet. Intragastric diet infusion levels of 100, 125, 145, and 165% of the baseline oral intake of each monkey were successively administered. During the initial overfeeding period (100% of the baseline oral intake), at least one week was required to reduce voluntary oral intake to less than 25% of the baseline levels and complete suppression of oral intake did not occur. This increased total caloric intake (IG infusion plus oral intake) resulted in a rapid rate of weight gain of at least 5 times the baseline rate. With successive increases in caloric infusion level, oral intake was eventually suppressed, and rapid weight gain was sustained. When the IG infusion was abruptly terminated after 50 to 130 days, 3 monkeys refused all food for 14 to 35 days. The monkeys' oral intakes stabilized three to ten weeks after the end of the overfeeding period. The length of this period prior to the resumption of normal oral intake was not related to length of overfeeding nor to the amount of weight gained. The monkeys' body weights dropped rapidly in the initial post-overfeeding period and then stabilized, sometimes at levels higher than their baseline body weights. In 2 monkeys, at the end of overfeeding the amounts infused were gradually reduced in order to determine the calories required to maintain their body weights at peak levels. Significantly fewer kcal/kg were required to maintain peak body weights than were ingested during the baseline periods. Following partial remission and subsequent stabilization of post overfeeding body weights, all monkeys ingested fewer kcal/kg than they had prior to the induction of obesity.

The literature indicates that the effects of developmental undernutrition on the rat nervous system are disproportionally found in the cerebellum, an organ involved in motor coordination and control. In this experiment, rats who had been developmentally undernourished did not show increased variability of forces placed on a bar by the paw in an operant learning paradigm, indicating normal motor control function. However, deficits were obtained when reinforcement was made contingent on bar press force regulation. Experimental rats shifted bar pressing forces to meet criterion more slowly than controls and received fewer reinforcements over training trials. The data are discussed in terms of recent suggestions that the cerebellum is directly involved in motor learning processes.

Differential effects of maternal nutrition and litter size variation were examined in a 2 x 2 factorial design in which undernourished or lib fed mothers nursed litters of 4 or 12. Litter size accounted for a greater proportion of pup body weight a weaning than did maternal nutrition. When the mother was fed ad lib, birth weight of individual pups and later body weight were correlated regardless of litter size. When the mother was undernourished, these correlations were not found. Enlargement of littersize increased the pup weight coefficient of variability only when the mother was fed ad lib. Size of the litter did not influence the maternal variables under study: open field behavior, adrenal weight, and body weight.

Female rats who had been made obese on a protein-supplemented high fat diet were mated. Impaired estrous cycling prevented conception in nearly half the experimental females. The young who were born to the remaining experimental mothers were lighter in birth weight. Most were cannibalized within the first week postpartum. Observation of mother-young interactions revealed a high level of pup licking. The disruptions in reproductive behaviors are similar to those reported in females whose obesity is a consequence of hypothalamic lesion.

Ability to regulate level of energy intake was studied in adult rhesus monkeys ( Macaca mulatta ) using calorically diluted diets. Twenty-four hour access to a complete liquid diet was provided via leakproof gravity feeders. The addition of water provided 4 caloric concentrations over the range of 0.5 to 1.35 kcal/ml. Average caloric intake per kg body weight was 84 ± 0.7 kcal/kg (mean ± SE). Seven of the eight monkeys maintained a constant caloric intake by adjusting oral intake in response to randomly ordered but sustained changes in caloric density. One monkey ingested a significantly higher caloric load while receiving the highest density diet. Rates of compensation for dilution following each diet change varied widely, occurring over periods of 3 days to 2 weeks. It was concluded that individual monkeys vary significantly in the rat of adjustment to caloric dilution, and thus long term studies must be used in studying controls of feeding in monkeys.

Physiological and behavioral development of rats was affected by prenatal nutrition and postnatal litter size. Prenatal nutrition was manipulated by combining differences in maternal nutrition with variation of prenatal litter size produced by pre-mating isolation of 1 uterine horn. The pups were reared in postnatal litters of either 4 or 12. During the 1st postnatal week, development and free behavior were affected only by the prenatal treatments. During the 2nd postnatal week, both prenatal and postnatal effects were observed. Development and behavior during the 3rd postnatal week reflected only postnatal litter size. Brain weight at weaning was influenced by both the prenatal and postnatal treatment.