Guidelines for Healthy Weight

Department of Nutrition , Harvard University, Cambridge, Massachusetts, United States
New England Journal of Medicine (Impact Factor: 55.87). 09/1999; 341(6):427-34. DOI: 10.1056/NEJM199908053410607
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Available from: Graham A Colditz, Dec 31, 2013

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Article: Guidelines for Healthy Weight

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    • "A relative limitation of the study is the lack of information on weight changes before the study, that makes it impossible to exclude the 'reverse causation' possibility, which is inherently existing in any study of mortality (Willett et al., 1999) because the weight changes before the baseline examination could be a consequence of underlying diseases before enrolment rather than a cause of deaths. However, after excluding the deaths arisen within the first 5-year follow-up, the results were not changed substantially. "

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    • "However, the extent to which metabolic diseases are mitigated and the mechanisms that underlie the metabolic effects of bariatric surgery are poorly understood , particularly in nonmorbidly obese individuals, that is, those with a body mass index (BMI) of o35 kg/m 2 ; and despite the metabolic benefits, the existing national and international recommendations suggest avoiding metabolic and bariatric surgery in patients whose BMI is o35 kg/m 2 [1]. Patients who have higher BMIs are at greater risk for developing diabetes [1] [2]; therefore, it is difficult to determine whether improvements in type 2 diabetes mellitus 1550-7289/ r 2015 "
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    ABSTRACT: Our objective was to investigate the predictive preoperative factors and surgical components for type 2 diabetes mellitus (T2DM) improvement in patients with body mass index (BMI)<35 kg/m(2). All patients undergoing curative surgical resection for gastric cancer involving Billroth I gastroduodenal anastomosis, Billroth II gastrojejunal anastomosis (B-I, B-II), or Roux-en-Y total gastrectomy (RYTG), from 2008-2011, were retrospectively reviewed. Of these, 90 patients with T2DM were analyzed. The study population was divided into the "improved" and "not improved" groups. The preoperative and postoperative data were assessed using multiple logistic regression analysis. To assess the necessary surgical elements, the gastrointestinal reconstruction methods were categorized according to the presence of the fundus and gastrointestinal bypass. Fifty-four patients (60%) experienced improvements in their T2DM 2 years after surgery. Lower preoperative glycated hemoglobin (HbA1 c) (odds ratio [OR]: .502; 95% confidence interval [CI]: .313-.804; P = .004), not using multiple oral antidiabetic medications (OR: .341; 95% CI: .120-.969; P = .043), and high BMI before surgery (OR: 1.294; 95% CI: 1.074-1.559; P = .007) were identified as independent predictors of T2DM improvements. RYTG was more effective at improving T2DM than B-I (OR: .160; 95% CI: .032-.794; P = .025). Statistical analysis according to the surgical elements showed that the bypass procedure was associated with T2DM improvements (OR: 3.023; 95% CI: .989-9·240; P = .052). Gastrointestinal bypass significantly contributes to T2DM improvements in patients with BMI<35 kg/m(2). Low HbA1 c, high BMI, and not using multiple antidiabetic medications were important predictors of T2DM improvement. Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
    Surgery for Obesity and Related Diseases 12/2014; DOI:10.1016/j.soard.2014.12.008 · 4.07 Impact Factor
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    • "Obesity is a well-established risk factor for cholesterol gallstone and subsequent cholecystectomy [1-4]. This is because of the increased cholesterol synthesis or secretion associated with glucose intolerance and insulin resistance [2,5]. Gallbladder (GB) hypomotility secondary to obesity or autonomic neuropathy has also been proposed as one of the mechanisms [6,7]. "
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    ABSTRACT: Background The aim of this study was to evaluate the association between obesity and infected bile or bacteremia in patients with acute calculous cholecystitis. Methods Authors analyzed the medical records of 139 patients who had undergone cholecystectomy for the treatment of acute calculous cholecystitis from January 2007 to June 2013 in a single teaching hospital. Association of body mass index (BMI) with bactibilia and bacteremia was assessed using univariate and multivariate analysis. Clinical findings and biliary infection related data were recorded for the following variables: gender, age, alcohol and smoking history, the results of blood and bile cultures, cholesterolosis, diabetes, hypertension, and duration of the hospital stay. Results The microbial culture rate of bactibilia and bacteremia were 50.4% and 21.6%, respectively. In the univariate analysis, bacteremia was associated with bactibilia (OR: 4.33, p = 0.002). In the multivariate analysis for the risk factors of bactibilia, BMI and bacteremia were related with bactibilia (OR: 0.59, 95% CI: 0.42-0.84, p = 0.003) (OR: 3.32, 95% CI: 1.22-9, p = 0.02). In the multivariate analysis for the risk factors of bacteremia, BMI, bactibilia and age were related with bacteremia (OR: 0.76, 95% CI: 0.59-0.99, p = 0.04) (OR: 3.46, 95% CI: 1.27-9.45, p = 0.02) (OR: 1.05, 95% CI: 1.01-1.09, p = 0.02). Conclusion In this retrospective study, BMI was inversely correlated with bacteremia or bactibilia, which means obese or overweight patients are less likely to be associated with bacteremia or bactibilia in patients with acute calculous cholecystitis.
    BMC Gastroenterology 06/2014; 14(1):104. DOI:10.1186/1471-230X-14-104 · 2.37 Impact Factor
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