Article

Lifestyle Factors and 5-Year Abdominal Fat Accumulation in a Minority Cohort: The IRAS Family Study

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  • Colorado School of Public Health
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Abstract

The objective of this study was to examine whether lifestyle factors were associated with 5-year change in abdominal fat measured by computed tomography (CT) in the Insulin Resistance and Atherosclerosis (IRAS) Family Study. We obtained abdominal CT scans at baseline and at 5 years, from African Americans (AA) (N = 339) and Hispanic Americans (N = 775), aged 18-81 years. Visceral (VAT) and subcutaneous (SAT) adipose tissue was measured at the L4/L5 vertebral level. Physical activity was documented by self-report of vigorous activity and a 1-year recall instrument. Dietary intake was assessed at follow-up using a semi-quantitative food frequency questionnaire referencing the previous year. Generalized linear models, accounting for family structure, were used to assess the associations between percent change in fat accumulation and smoking, physical activity, total calories, polyunsaturated, monounsaturated, protein, and saturated fat intake, percent of calories from sweets, and soluble and insoluble fiber. Soluble fiber intake and participation in vigorous activity were inversely related to change in VAT, independent of change in BMI. For each 10 g increase in soluble fiber, rate of VAT accumulation decreased by 3.7% (P = 0.01). Soluble fiber was not associated with change in SAT (0.2%, P = 0.82). Moderately active participants had a 7.4% decrease in rate of VAT accumulation and a 3.6% decrease in rate of SAT accumulation versus less active participants (P = 0.003 and P = 0.01, respectively). Total energy expenditure was also inversely associated with accumulation of VAT. Soluble fiber intake and increased physical activity were related to decreased VAT accumulation over 5 years.

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... There are contradictory findings regarding the association between different dietary patterns (DPs), LAP, and VAI. The 12,13 significant association between carbohydrate intake, 14 dietary fatty acids including saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids(PUFAs) with VAT has not been reported in all 8 investigations. However, it is important to note that foods and nutrients are consumed in combination, and complex combinations of nutrients are likely to be interactive or to 15 have a synergistic effect. ...
... But VAI was significantly associated with HBA1C and HDL-C. In contrast to our findings in a prospective study, no relation was detected , between SFAs, MUFAs, PUFAs, and 5-year percent change 14 in VAT however, one cross-sectional study revealed a positive association between fat intake and VAT in 14 overweight young adults aged 30 to 45 years diabetics. Our study findings are consistent with this study. ...
... But VAI was significantly associated with HBA1C and HDL-C. In contrast to our findings in a prospective study, no relation was detected , between SFAs, MUFAs, PUFAs, and 5-year percent change 14 in VAT however, one cross-sectional study revealed a positive association between fat intake and VAT in 14 overweight young adults aged 30 to 45 years diabetics. Our study findings are consistent with this study. ...
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I believe that by my this original article will be beneficial for the scientists who deal with the research work about T2DM patients. This article will be able to give guidelines regarding lipid profile, and visceral adiposity index parameters.
... In a longitudinal study in African-Americans and Hispanic-Americans, intake of SFA, MUFA, and PUFA was not associated with 5-year changes in VAT or SAT area ( Hairston et al. 2012). Consistent with these results, data from a Danish cohort followed for 5 years failed to show an association between the change in WC, a surrogate measure of VAT, and total intake of fat ( Halkjaer et al. 2006). ...
... In sum, there is little evidence to date that high protein intake is associated with reduced VAT accumulation, independent of exercise. In fact, results from six observational studies including 2393 individuals found no association between overall protein intake and VAT area measured by CT scan or MRI after adjustment for age, race, sex, baseline VAT and SAT, and energy intake ( StallmannJorgensen et al. 2007, Davis et al. 2009, Bailey et al. 2010, Lagou et al. 2011, Hairston et al. 2012, Kondoh et al. 2014). ...
... In U.S. Latino teenagers, VAT area was associated with insoluble fiber but not soluble fiber intake ( Davis et al. 2009). On the other hand, in overweight African-American and Latino adults, soluble fiber intake was negatively associated with VAT area, whereas insoluble fiber intake was not ( Hairston et al. 2012). The effects of high fiber/whole grain diet on body fat distribution do not seem to be mediated by reduced energy intake as the vast majority of the earlier mentioned studies adjusted for energy intake. ...
... There are contradictory findings regarding the association between different dietary patterns (DPs), LAP, and VAI. The 12,13 significant association between carbohydrate intake, 14 dietary fatty acids including saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids(PUFAs) with VAT has not been reported in all 8 investigations. However, it is important to note that foods and nutrients are consumed in combination, and complex combinations of nutrients are likely to be interactive or to 15 have a synergistic effect. ...
... But VAI was significantly associated with HBA1C and HDL-C. In contrast to our findings in a prospective study, no relation was detected , between SFAs, MUFAs, PUFAs, and 5-year percent change 14 in VAT however, one cross-sectional study revealed a positive association between fat intake and VAT in 14 overweight young adults aged 30 to 45 years diabetics. Our study findings are consistent with this study. ...
... But VAI was significantly associated with HBA1C and HDL-C. In contrast to our findings in a prospective study, no relation was detected , between SFAs, MUFAs, PUFAs, and 5-year percent change 14 in VAT however, one cross-sectional study revealed a positive association between fat intake and VAT in 14 overweight young adults aged 30 to 45 years diabetics. Our study findings are consistent with this study. ...
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Introduction:Excess visceral adipose tissue (VAT) is one of the most deleterious fat depots in the body, with strong links to 1,2cardiovascular disease and certain types of cancer. Lipid accumulation product (LAP) index, a recently developed biomarker of central fat accumulation, has been recommended as a precise indicator of the risk of insulin resistance, metabolic syndrome, type 2 diabetes, and 3-5cardiovascular disease. Higher LAPhas have been associated with abnormal glucose homeostasis and insulin resistance, as well as elevated alanine aminotransferase in healthy 6 individuals. A Chinese study showed that both LAPand visceral adiposity index (VAI) were effective markers for 7 stratifying adults for obesity phenotypes.In addition,Abstract Background: Diabetes Mellitus (DM) is a metabolic disorder characterized by chronic hyperglycemia resulting from deficiency of insulin secretion, action, or both. Globally, type 2 diabetes mellitus (T2DM) is considered one of the most common diseases. Dietary habits and sedentary lifestyles are the major factors for the rapidly rising incidence of DM among developing countries. Objective: This study was carried out with an objective to evaluate the association between visceral adiposity index(VAI) and dietary patterns regarding fast food-taking habits in T2 DM patients in Bangladesh.Methods:This case-control study was performed from 2015 to 2017 in BIRDEM with 700 study subjects aged 30 to 60 years. Out of which 350 were T2DM and 350 were healthy control. Cases were selected from the outpatient department of BIRDEM, and controls were selected from healthy workers and employees of BIRDEM & IMC. We evaluated waist & hip circumference, BMI, systolic and diastolic blood pressure, fast food taking the history, exercise history using a preset questionnaire. Serum fasting glucose, ABF, TAG, Total cholesterol, HDL-C, LDL-C, HbA1c, and Serum insulin were estimated according to a standardized method and by calculation method HOMAIR, HOMAB, Secretory-HOMA& VAI were estimated. Results: There were significant differences in mean age, BMI, waist circumferences, hip circumferences, waist & hip ratio, systolic and diastolic blood pressure in between case and control. The value of Systolic blood pressure was 126 ± 15.84 mmHg in diabetes and 117 ± 15.46 mmHg in the control group, whereas the diastolic blood pressure was 82 ± 8.12 mmHg and 79 ± 8.89 mmHg, respectively. There were significant differences found in the waist and hip circumference in T2DM & controls, which were in (94.68±8.64) cm, (103.23±7.75) cm & (87.75±10.67) cm, (97.52±9.34) cm respectively.There were significant increases in mean VAI in T2DM compared to control, where p <0.001 & it was 3.93±2.72 in the case and 2.60±2.22 in control respectively. LSD test within One-way ANOVAhad done to test the differences of fast food taking habit pattern per week with different glycemic, Lipidemic markers and had shown significant difference with fasting blood glucose, 2 hours after breakfast, HBA1c with fast food taking group where p values were 0.01, 0.004, 0.03 respectively and non -significantly associated with HOMA-IR, HOMAB%, VAI, TAG, Cholesterol & LDL-C level in the study population. Multiple linear regression of VAI with glycemic and Lipidemic parameters and significant (p<0.001) association was found for HBA1c and HDL-C in the study population. Correlation of VAI with anthropometric, glycemic and Lipidemic parameters shows a significant (p <0.001) positive correlation with FBS, ABF, HBA1C, TAG, Cholesterol, LDL-C, HOMAIR and negative correlation with HDLC in T2DM subjects. Conclusion: VAI was positive and significantly correlated with FBS, ABF, HBA1c, TAG, Cholesterol, LDL-C, HOMA-IR and negatively correlated with HDL-C. VAI was non-significantly associated with fast food taking habit in the study population. Keywords: Visceral adiposity index, Dietary patterns, Fast food taking habit, Type-2 Diabetes Mellitus, HBA1C, Fasting blood sugar,HOMA-IR..
... used a lifestyle questionnaire 52 ; not mutually exclusive, in 9 the qualitative aspects analyzed were nutrients inclusive of alcohol, 37 55 and 3 investigated participants who were overweight or moderately obese. 53,54,56 Concerning nutritional assessment, 2 studies assessed dietary intake using food records, 53,55 1 used 24-hour recalls, 54 and 1 used a food-frequency questionnaire 56 ; not mutually exclusive, in 3 the qualitative aspects analyzed were nutrients, 54-56 in 2 foods or food groups, 54,56 and in 1 dietary patterns. 53 With regard to AAT assessment, 2 studies assessed both VAT and SAAT 55,56 and 2 assessed VAT only 53,54 ; 3 used multivariable-adjusted analysis 54-56 and 1 used basicadjusted 53 analysis; 2 used single-slice CT 55,56 and 2 used single-slice MRI to assess VAT and/or SAAT. ...
... used a lifestyle questionnaire 52 ; not mutually exclusive, in 9 the qualitative aspects analyzed were nutrients inclusive of alcohol, 37 55 and 3 investigated participants who were overweight or moderately obese. 53,54,56 Concerning nutritional assessment, 2 studies assessed dietary intake using food records, 53,55 1 used 24-hour recalls, 54 and 1 used a food-frequency questionnaire 56 ; not mutually exclusive, in 3 the qualitative aspects analyzed were nutrients, 54-56 in 2 foods or food groups, 54,56 and in 1 dietary patterns. 53 With regard to AAT assessment, 2 studies assessed both VAT and SAAT 55,56 and 2 assessed VAT only 53,54 ; 3 used multivariable-adjusted analysis 54-56 and 1 used basicadjusted 53 analysis; 2 used single-slice CT 55,56 and 2 used single-slice MRI to assess VAT and/or SAAT. ...
... The scores for the overall study quality of both individual cross-sectional (1.5 36,39,43,52 to 1.7 37,44,46,49,50 ) and longitudinal (1.5 53 to 1.7 55,56 ) observational studies ranged from 1.5 to 1.7, with no study scoring below the threshold of 1.3 for inclusion in the synthesis of results. The following domain score ranges and means were recorded for the cross-sectional and longitudinal studies, respectively: quality of reporting, 1.6-1.9 ...
Article
Knowledge of the role that qualitative as opposed to energy aspects of diet play in the accumulation of visceral abdominal adipose tissue (VAT) and subcutaneous abdominal adipose tissue (SAAT) is limited and not conclusive. A systematic review was conducted to evaluate and summarize the existing literature investigating the relationships between qualitative aspects of diet, from single dietary components to overall dietary patterns, and VAT and SAAT. The PubMed, Web of Science, Embase, and Cochrane databases were searched. Observational and controlled intervention studies that assessed healthy adults or adolescents using magnetic resonance imaging, computed tomography, dual-energy X-ray absorptiometry, or ultrasound were eligible for inclusion. After quality assessment of all eligible studies, 20 observational and 23 controlled intervention studies were included. Considering study quality, including nutritional and abdominal adipose tissue assessment, about 30 caloric and noncaloric qualitative aspects of diet were found "to be associated with or affect" VAT and/or SAAT, most notably, medium-chain triacylglycerols, dietary fiber, calcium, phytochemicals, and dietary patterns; for fructose and alcohol, the relationships were less clear. Additional well-designed prospective studies are warranted to confirm current findings and to identify further qualitative aspects of diet that may influence VAT and SAAT accumulation. © The Author(s) 2015. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
... Some epidemiologic studies, including cross-sectional studies [10][11][12][13][14][15][16][17][18][19] and longitudinal studies [20][21][22][23][24], have investigated the association between nutritional components or foodstuff and VFA. These analyses indicated that only dietary fiber [17,21,23], carotenoid [15] and calcium [16,22] were negatively associated with VFA in terms of nutritional components. ...
... Some epidemiologic studies, including cross-sectional studies [10][11][12][13][14][15][16][17][18][19] and longitudinal studies [20][21][22][23][24], have investigated the association between nutritional components or foodstuff and VFA. These analyses indicated that only dietary fiber [17,21,23], carotenoid [15] and calcium [16,22] were negatively associated with VFA in terms of nutritional components. There are 2 analyses including over 1000 individuals; however, both studies targeted exclusively Westerners and patients [20,21]. ...
... These analyses indicated that only dietary fiber [17,21,23], carotenoid [15] and calcium [16,22] were negatively associated with VFA in terms of nutritional components. There are 2 analyses including over 1000 individuals; however, both studies targeted exclusively Westerners and patients [20,21]. We reported the association of visceral fat and nutrition in healthy Asians who eat mainly rice and tend to accumulate more visceral fat compared with Westerners [25] in a cross-sectional study [12,19]. ...
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: High visceral fat area (VFA) is a stronger predictor of cardiovascular disease and overall mortality than body mass index or waist circumference. VFA may be decreased by proper dietary habits. Although previous epidemiologic studies demonstrated an association between nutritional components or foodstuffs and VFA, only the associations of a few nutrients, such as dietary fiber and calcium, are reported. We performed a comprehensive 2-year longitudinal study in more than 624 healthy people and analyzed 33 micronutrients to investigate nutrients that contribute to changes in visceral fat. Our analyses revealed that “macronutrients” and “micronutrients” were “mutual confounders”. Therefore, when evaluating the association between VFA and micronutrients, associations were adjusted by macronutrients. The ingestion of 7 nutrients: soluble dietary fiber, manganese, potassium, magnesium, vitamin K, folic acid, and pantothenic acid, which are abundant components in vegetable diets, was significantly inversely correlated with a change in VFA. Additionally, a change in the ingestion of one nutrient, monounsaturated fat, was significantly positively correlated with a change in VFA. These associations were independent of body mass index and waist circumference. Thus, a predominantly vegetable diet may decrease VFA. In addition, adjusting the intake of macronutrients might help to clarify the association of micronutrients with VFA.
... In addition to genetics, sex, and age, modifiable factors including physical activity and diet have been associated with VAT [4,5]. VAT and SAT seem to be differentially influenced by diet [5][6][7][8]. It has been suggested that diet can explain more of the variation in VAT compared to SAT [5], and lifestyle modification can reduce VAT more than it can reduce SAT [9]. ...
... 6 Additionally adjusted for SFAs and PUFAs (% of energy) instead of total fat. 7 Additionally adjusted for SFAs and MUFAs (% of energy) instead of total fat. 8 Additionally adjusted for plant protein (% of energy) instead of total protein. ...
... Among the limited observational studies available on the association between the dietary intake and visceral adiposity measured directly by MRI or CT scan, only two studies have so far investigated the association prospectively [7,19]. No significant association was reported between two-year changes in total protein intake and change in VAT in 85 overweight youths, aged 11-17 years [19]. ...
Article
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We aimed to investigate associations between dietary macronutrient proportions and prospective visceral adiposity index changes (DVAI). The study included 1254 adults (18–74 years), from the Tehran Lipid and Glucose Study (TLGS), who were followed for three years. Dietary intakes were assessed twice using food frequency questionnaires. Associations of dietary macronutrient with DVAI and risk of visceral adiposity dysfunction (VAD) after three years were investigated. The percentage of energy intake from protein in the total population, and from fat in women, were associated with higher increases in VAI. A 5% higher energy intake from protein substituted for carbohydrate, monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs) was associated with higher DVAI. Higher energy intake from animal protein substituted for PUFAs was positively associated with ΔVAI. Substituting protein and PUFAs with MUFAs were related to higher ΔVAI. The associations were similar in men and women, but reached significance mostly among women. Risk of VAD was increased when 1% of energy from protein was replaced with MUFAs. Substituting protein for carbohydrate and fat, and fat for carbohydrate, resulted in increased risk of VAD in women. Higher dietary proportions of protein and animal-derived MUFA may be positively associated with DVAI and risk of VAD.
... association between different dietary patterns (DPs), LAP, and VAI. Significant association between carbohydrate intake, [12,13] dietary fatty acids [14] including saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs) with VAT has not been reported in all investigations. [8] However, it is important to note that foods and nutrients are consumed in combination, and complex combinations of nutrients are likely to be interactive or to have a synergistic effect. ...
... In contrast to our findings, in a prospective study, no relation was detected between SFAs, MUFAs, PUFAs, and 5-year percent change in VAT [14] ; however, one cross-sectional study revealed a positive association between fat intake and VAT in overweight young adults aged 17 to 35 years. [14] An Iranian investigation reported that increasing MUFA by decreasing total protein or PUFA in isoenergetic diets was positively associated with visceral adiposity index changes. ...
... In contrast to our findings, in a prospective study, no relation was detected between SFAs, MUFAs, PUFAs, and 5-year percent change in VAT [14] ; however, one cross-sectional study revealed a positive association between fat intake and VAT in overweight young adults aged 17 to 35 years. [14] An Iranian investigation reported that increasing MUFA by decreasing total protein or PUFA in isoenergetic diets was positively associated with visceral adiposity index changes. [36,37] The hypothesis that MUFAs are healthy fatty acids comes from studies investigating the impacts of olive oil, whereas further studies suggest MUFA intakes from animal sources to have different effects. ...
Article
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In the present study, we aimed to examine the association between lipid accumulation product (LAP) and visceral adiposity index (VAI) with dietary pattern (DP) in the US adults. Participants of the National Health and Nutrition Examination Survey (NHANES) with data available on dietary intake from 2005 to 2010 were included. DPs were derived by principal component analysis. We applied analysis of covariance and multivariable-adjusted linear regressions accounting for the masked variance and utilizing the proposed weighting methodology. The analytical sample comprised 18,318 participants (mean age = 45.8 years), of whom 48.3% (n = 8607) were men with no age difference by gender (P = .126). The first DP was representative of a diet rich in carbohydrate and sugar, total fat and saturated fatty acid (SFA), high-caloric dieatry pattern; the second DP was highly loaded with vitamins, minerals and fiber (nutrient-dense dietary patten), and the third DP was mainly representative of high dietary polyunsaturated fatty acids (PUFAs) and monounsaturated fatty acids (MUFAs) (healthy fat DP). The adjusted (age, sex, race, physical activity, smoking, C-reactive protein) mean of LAP, VAI and glucose homeostasis indices increased across increasing quarters of the first DP score (all P < .001), while across increasing score of the second DP, the adjusted mean of LAP, VAI, glucose homeostasis indices decreased (all P < .001). Findings were similar in adjusted linear regressions models. Our findings support that affordable measurements, such as VAI and LAP, could be good alternative surrogate markers of visceral fat. They are also significantly related to DPs in same line as with glucose/insulin homeostasis and anthropometric indices.
... In this study each 10 g increase in fiber intake was associated with a lower WC BMI in women by 0.06 cm and in men by 0.01 cm. The Insulin Resistance and Atherosclerosis Family Study (339 African American adults and 775 Hispanic American adults; 5-years) observed that each 10 g increase in soluble fiber decreased the accumulation of visceral fat tissue by 3.7% (p = 0.01) [108]. An intervention trial of Malaysian housewives (255 women; reduced calorie diet to 1200-1500 kcal/day; 6 months) showed that each gram reduction of fiber/1000 kcal intake prevented body fat loss by 243 g/day (p = 0.035) [109]. ...
... Hispanic American adults; 5-years) observed that each 10 g increase in soluble fiber decreased the accumulation of visceral fat tissue by 3.7% (p = 0.01) [108]. An intervention trial of Malaysian housewives (255 women; reduced calorie diet to 1200-1500 kcal/day; 6 months) showed that each gram reduction of fiber/1000 kcal intake prevented body fat loss by 243 g/day (p = 0.035) [109]. ...
Article
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Less than 10% of most Western populations consume adequate levels of whole fruits and dietary fiber with typical intake being about half of the recommended levels. Evidence of the beneficial health effects of consuming adequate levels of whole fruits has been steadily growing, especially regarding their bioactive fiber prebiotic effects and role in improved weight control, wellness and healthy aging. The primary aim of this narrative review article is to examine the increasing number of health benefits which are associated with the adequate intake of whole fruits, especially fruit fiber, throughout the human lifecycle. These potential health benefits include: protecting colonic gastrointestinal health (e.g., constipation, irritable bowel syndrome, inflammatory bowel diseases, and diverticular disease); promoting long-term weight management; reducing risk of cardiovascular disease, type 2 diabetes and metabolic syndrome; defending against colorectal and lung cancers; improving odds of successful aging; reducing the severity of asthma and chronic obstructive pulmonary disease; enhancing psychological well-being and lowering the risk of depression; contributing to higher bone mineral density in children and adults; reducing risk of seborrheic dermatitis; and helping to attenuate autism spectrum disorder severity. Low whole fruit intake represents a potentially more serious global population health threat than previously recognized, especially in light of the emerging research on whole fruit and fruit fiber health benefits.
... Images obtained at the L4/L5 vertebral regions were used to determine SAT and VAT. Bowel fat was subtracted from the measurements of VAT (20,21). ...
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OBJECTIVES We aimed to identify factors that are independently associated with the metabolic clearance rate of insulin (MCRI) and to examine the association of MCRI with incident type 2 diabetes in nondiabetic Hispanics and African Americans.RESEARCH DESIGN AND METHODS We investigated 1,116 participants in the Insulin Resistance Atherosclerosis Study (IRAS) Family Study with baseline examinations from 2000 to 2002 and follow-up examinations from 2005 to 2006. Insulin sensitivity (S(I)), acute insulin response (AIR), and MCRI were determined at baseline from frequently sampled intravenous glucose tolerance tests. MCRI was calculated as the ratio of the insulin dose over the incremental area under the curve of insulin. Incident diabetes was defined as fasting glucose ≥126 mg/dL or antidiabetic medication use by self-report.RESULTSWe observed that S(I) and HDL cholesterol were independent positive correlates of MCRI, whereas fasting insulin, fasting glucose, subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and AIR were independent negative correlates (all P < 0.05) at baseline. After 5 years of follow-up, 71 (6.4%) participants developed type 2 diabetes. Lower MCRI was associated with a higher risk of incident diabetes after adjusting for demographics, lifestyle factors, HDL cholesterol, indexes of obesity and adiposity, and insulin secretion (odds ratio 2.01 [95% CI 1.30-3.10], P = 0.0064, per one-SD decrease in log(e)-transformed MCRI).CONCLUSIONS Our data showed that lower MCRI predicts the incidence of type 2 diabetes.
... 3 Higher levels of self-reported physical activity are associated with lower visceral adipose tissue (VAT) in both younger and older women 4 and with both VAT and subcutaneous adipose tissue (SAT) in men and women. 5,6 Importantly, randomized trials have demonstrated reductions in visceral fat with moderate amounts of aerobic exercise. 7,8 Many prior reports are limited by use of self-reported physical activity obtained by questionnaire, which can be hampered by recall bias as well as the inability to accurately quantify physical activity levels. ...
Article
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We examined the relation between objectively measured physical activity with accelerometry and subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in a community-based sample. We evaluated 1249 participants of the Framingham Third Generation and Omni II cohorts (mean age 51.7 years, 47% women) who underwent assessment of moderate-to-vigorous physical activity (MVPA) with accelerometry over 5 to 7 days, and multi-detector computed tomography for measurement of SAT and VAT volume; fat attenuation was estimated by SAT and VAT hounsfield units (HU). In women, higher levels of MVPA were associated with decreased SAT (P<0.0001) and VAT volume (P<0.0001). The average decrement in VAT per 30 minute/day increase in MVPA was -453 cm(3) (95% CI -574, -331). The association was attenuated but persisted upon adjustment for BMI (-122 cm(3), P=0.002). Higher levels of MVPA were associated with higher SAT HU (all P≤0.01), a marker of fat quality, even after adjustment for SAT volume. Similar findings were observed in men but the magnitude of the association was less. Sedentary time was not associated with SAT or VAT volume or quality in men or women. MVPA was associated with less VAT and SAT and better fat quality. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
... Both sweets and cakes were inversely associated with VAT and SAAT in the present study, with a stronger inverse association for intake of cakes with VAT in participants with a BMI < 26·7 kg/m 2 . Similarly, an observational study in overweight youths showed a negative association for intakes of sweets with the amount of SAAT but not with VAT (29) . Data from the EPIC-Potsdam study suggest a potential benefit of cake and cookie intake on VAT (30) . ...
Article
Excess accumulation of visceral adipose tissue (VAT) is a known risk factor for cardiometabolic diseases; further, subcutaneous abdominal adipose tissue (SAAT) and the ratio of both (VAT:SAAT ratio) have been discussed as potentially detrimental. Information about the association between diet and adipose tissue is scarce. This study aimed to identify food group intake associated with VAT and SAAT and the VAT:SAAT ratio in a Northern German population. A cross-sectional analysis was conducted in 344 men and 241 women who underwent an MRI to quantify total volumes of VAT and SAAT. Intake of fourteen food groups was assessed with a self-administered 112-item FFQ. Linear regression models adjusted for age, sex, energy intake, physical activity, intake of other food groups and mutual adjustment for VAT and SAAT were calculated to analyse the associations between standardised food group intake and VAT and SAAT, or the VAT:SAAT ratio. Intakes of potatoes (P=0·043) and cakes (P=0·003) were positively and inversely, respectively, associated with both VAT and SAAT. By contrast, intake of cereals was negatively associated with VAT (P=0·045) only, whereas intakes of eggs (P=0·006) and non-alcoholic beverages (P=0·042) were positively associated with SAAT only. The association between eggs and non-alcoholic beverages with SAAT remained significant after further consideration of VAT. Intake of non-alcoholic beverages was also inversely associated with the VAT:SAAT ratio (P=0·001). Our analysis adds to the evidence that intake of foods is independently associated with VAT or SAAT volumes.
... Increased visceral adiposity is connected with an increase in production of inflammatory cytokines by adipocytes, though reducing VAT may help to reduce systemic inflammation. Higher intake of dietary fibre has been linked to healthy behaviours (physical activity), higher nutritional value and high antioxidant status of the diet [15]. Recent studies provide additional support for the role of dietary fibre in obesity prevention, by consumption of unrefined, high-fibre carbohydrate-based foods. ...
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The intake of fibre in the diet of a child or an adult, through various foods (such as wholegrain foods, nuts, fruits and vegetables), plays an important role in reducing the risk and lowering the incidence of numerous diseases. The interest of researchers and consumers in the role of diet in the prevention or treatment of many illnesses, and maintaining the general and oral health, has been growing lately. The aim of our study was to underline the role of dietary fibre through its effects on many aspects of the human body and metabolism. Evidence has been found that dietary fibre from whole foods or supplements may reduce the risk of cardiovascular disease by improving serum lipids and reducing serum total and low-density lipoprotein (LDL) cholesterol concentrations in adults and children. Increased fibre content decreases the glycaemic index of foods, which leads to a significant improvement in glycaemic response. High fibre intake is associated with reduced risk of colorectal and breast cancer. In contemporary children, the reluctance to chew raw, hard plant foods may result in a risk of malocclusion and a lack of tooth wear, which cause the need for orthodontic intervention. Fibre consumption is associated with high nutritional value and antioxidant status of the diet, enhancing the effects on human health.
... Hairston et al. proposed that a sleep duration of 5 hours or less was associated with an increase in BMI as well as visceral and subcutaneous fat accumulation. 30 In the present study visceral fat did not show signifi cant difference either in boys or girls of ISDN or ASDN groups (Tables 1 and 2) Physical activity is an important determinant of BF% and visceral fat and it affects the sleep time as well. It has been proposed that less sleep increases BMI by decreasing physical activity as a consequence of fatigue and changes in hormones that regulate energy expenditure. ...
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p> Background: In this highly advanced era and competitive world everyday life offers less time for sleep and physical activity and the result is serious consequences on physical fitness and health of the society and particularly the young generation. Aims and Objectives: The present study was undertaken to find out the influence of sleep deprivation and physical activity on body composition parameters of college students. Materials and Methods: Total 98 students of MBBS 1<sup>st</sup> professional at Sri Aurobindo Medical College and Post Graduate Institute, Indore of both sexes were recruited for the study. Students were divided as Adequate sleep duration at night (ASDN ≥7 hours) and Inadequate sleep duration at night (ISDN <7 hours) groups Anthropometric measurements were done and information of sleep parameters and physical activity recorded. Body composition analysis was done by Bio-impedance analysis (BIA) . Results: Sleep duration was significantly associated with Body fat %(BF%) and Body mass index (BMI) in boys but not in girls. There was significant difference in obesity parameters like BF% and BMI between ASDN and ISDN in both sexes. Significant difference was also observed on comparing Physical activity with BF% and BMI of entire group. Conclusion: sleep length is inversely associated with obesity in boys but not in girls. It also affects physical activity which further aggravates obesity. Asian Journal of Medical Sciences Vol.7(5) 2016 56-60</p
... 64 Since the site of action of dietary fiber is the intestinal tract, fiber may predominantly reduce visceral adipose tissue, as reported in many studies including adolescents. [65][66][67] Notably, in line with other studies assessing the effect of ultra-processed foods on overall and abdominal obesity, 20,21,24,68 the strength of the associations did not change after further adjustment for some nutritional factors (fiber density, percent energy from added sugars, and percent energy from saturated fats), suggesting that (1) these nutritional factors did not act as mediators of the association, and (2) other mechanisms such as substance and cosmetic additive contents may partly explain the observed associations. Indeed, studies have shown that these additives are able to change the host's metabolism and physiology and promote 3587). ...
Article
Background Ultra-processed foods represent a considerable part of the diet of US children and adolescents, yet their association with total-, abdominal- and visceral overweight/obesity remains understudied. Objective To examine associations between dietary contribution of ultra-processed foods and total-, abdominal- and visceral overweight/obesity in a nationally representative sample of US adolescents. Design Cross-sectional analyses were performed on data collected from adolescents participating in the 2011-2016 NHANES. Participants/setting Participants included 3,587 adolescents aged 12–19 years, who had at least one valid day 24-hour dietary recall data. Main outcome measures Total overweight/obesity, abdominal overweight/obesity and visceral overweight/obesity data were collected. Statistical analyses performed All food items (g/day) recorded in the 24hour recalls were classified according to Nova. Multiple logistic regressions were used to evaluate associations between the dietary contribution of ultra-processed foods (expressed in percentage of total grams per day) and outcomes. Multivariable models were adjusted for socio-demographic covariates, physical activity, total energy intake, whether the individual was following a special diet for weight loss, and indicators of the nutritional quality of the diet. Results In multivariable analyses, the highest consumption of ultra-processed food was associated with 45%, 52%, and 63% higher odds of total-, abdominal-, and visceral overweight/obesity, respectively (OR 1.45, 95% CI 1.03 - 2.06, p for linear trend = 0.040; OR 1.52, 95% CI 1.06 - 2.18, p for linear trend = 0.026; OR 1.63, 95% CI 1.19 - 2.24, p for linear trend = 0.005, respectively), compared with the lowest consumption. A 10% increment in the proportion of ultra-processed foods in the diet was associated with an increased risk of both abdominal overweight/obesity (OR 1.07; 95% CI 1.01 - 1.13) and visceral overweight/obesity (OR 1.07; 95% CI 1.02-1.13). Conclusions Study findings support the growing evidence of cross-sectional and prospective associations between ultra-processed foods and increased adiposity and also with metabolically unhealthy phenotypes of obesity in adolescence. Timely action to reduce the consumption of ultra-processed foods among adolescents is needed.
... Images obtained at the L4/L5 vertebral regions were used to determine the area of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT). Bowel fat was subtracted from the measurements of VAT (25,26). ...
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Objectives We aimed to compare the associations of directly measured plasma free 25-hydroxyvitamin D [25(OH)D] and total 25(OH)D concentrations with insulin sensitivity and beta-cell function in non-diabetic Hispanics and African-Americans. We hypothesized that directly measured free 25(OH)D would be more strongly associated with these measures of glucose homeostasis and that associations would differ by race. Methods We studied 1,189 non-diabetic participants in the Insulin Resistance Atherosclerosis Study (IRAS) Family Study, using data from baseline examinations in 2000–2002. Insulin sensitivity (SI), acute insulin response (AIR) and disposition index (DI) were determined from frequently sampled intravenous glucose tolerance tests. Plasma free and total 25(OH)D concentrations were measured by ELISA and radioimmunoassay, respectively. Results The median concentrations of plasma free 25(OH)D were 3.46 pg/ml for Hispanics and 2.17 pg/ml for African Americans (p<0.0001), while the median concentrations of plasma total 25(OH)D were 16 ng/ml for Hispanics and 10 ng/ml for African Americans (p<0.0001). Plasma free and total 25(OH)D were both positively associated with SI and DI in generalized estimating equations adjusted for demographic and lifestyle factors. After further adjustment with BMI, the associations were no longer statistically significant, except for a significant association between plasma free 25(OH)D and SI. There was no effect modification by ethnicity on any of the exposure-outcome associations. Conclusions Our data showed that plasma free 25(OH)D had a slightly stronger association with SI compared to plasma total 25(OH)D, although the difference was modest and there were no marked differences in the associations between Hispanics and African Americans.
... This is in agreement with a study by Goodpaster et al 28 in the study of effects of weight loss on regional fat distribution and insulin sensitivity in obesity in 32 obese sedentary women and men over a 4month weight loss program. Further, Hairston et al, 29,30 in a study of Hispanic and African Americans over a five year period, reported that lifestyle interventions such as physical activities and high consumption of fiber were associated with a decrease in abdominal visceral fat. The study, though spanning a five year period, (compared to our study of three months) does highlight the importance of physical activities and consumption of healthy diet in mitigating the effects of insulin resistance due to abdominal visceral and consequently improving insulin sensitivity. ...
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We evaluated the changes in apolipoproteins, glycemic status, and body composition after 3 months using a culturally sensitive diabetes education program, En Balance, in diabetic Hispanics. Thirty-four (9 males, 25 females) Hispanic diabetics participated in the En Balance program over three months. Body composition was determined by dual energy X-ray absorptiometry (DXA), fasting plasma glucose (FPG), A1c, and apolipoproteins (Apo) measured after 3 months participation. Differences were analyzed using paired t testing and relationships between changes in Apo, A1c, total cholesterol, body mass index and body composition by Spearman correlations. Completion of En Balance resulted in a significant reduction in weight (80.31 +/- 1.97 kg vs 81.25 +/- 17.97 kg, P = .015), FPG (143.21 +/- 57.8 mg/dL vs 166.41 +/- 65.9 mg/dL P = .003), and A1c (7.08 +/- 1.6% vs 7.87 +/- 2.0%, P = < .001). DXA demonstrated reduction in total fat (29.54 +/- 10.0 kg vs 30.24 +/- 11.80 kg, P = < .001) and trunk fat (15.09 +/- 5.6 kg vs 16.87 +/- 5.4 kg, P = .001). High density lipoprotein significantly increased (48.85 +/- 11.4 vs 44.65 +/- 8.8, P = .002) and total serum cholesterol/high density lipoprotein ratio decreased (3.87 +/- .98 vs 4.35 +/- 1.0, P = .001). There were significant correlations at three months between changes in Apo A1 and A2 (r = .559, P < .001), Apo E and total cholesterol (r = .746, P < .001), between A1c and FPG (r = .563, P = .001) and BMI and body weight (r = .732, P < .001). The En Balance program improved body composition, A1c, FPG, total cholesterol/HDL ratio and HDL. If these trends can be sustained, En Balance may serve as a unique educational paradigm for improving type 2 diabetes in Hispanics.
... Following Suder et al. [40], low physical activity was a major risk factor of abdominal obesity prevalence in boys [OR 1.91; 95% CI (1.06-3.43)]. A decline in adipose, visceral and subcutaneous tissues was observed on the basis of IRAS Family Study (Insulin Resistance Atherosclerosis Study)research in subjects practising exercises compared to those who practised rarely or not at all [44]. Factors such as age and inadequate physical activity levels and increased screen time were associated with higher odds of total and central obesity in Greek children from the National Action for Children's Health (EYZHN) program [45]. ...
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Inadequate eating habits, as well as a low level of physical activity, influence adipose tissue deposition. The aim of the study was to assess the prevalence of central obesity in upper-secondary students and to determine the factors related to its occurrence. The survey included 309 participants, aged 16 to 18 years from Krakow (Poland). Anthropometric measurements were taken during the periodic assessment of students’ health status. An anonymous questionnaire was used to assess the nutritional and non-nutritional risk factors of participants. According to different methods of measurement, abdominal obesity (AO) was observed in 15.5% (WC—waist circumference), 10.7% (WHtR—waist to height ratio) or 21.7% (WHR—waist to hip ratio) participants. Abdominal obesity (WC) was significantly associated with family history of excess body weight and higher economic status of the family. The risk of AO (WC) was significantly lower among adolescents who declared higher physical activity. Boys who eat first breakfasts have lower AO risk according to WHtR interpretation. Abdominal obesity in gender group was related to the self-esteem of one’s own appearance according to WHtR and WC. Abdominal obesity was associated with the family environment and modifiable lifestyle factors and was dependent on gender.
... Konsumsi serat dihubungkan dengan penurunan jumlah lemak viseral. Peningkatan konsumsi serat larut sebanyak 10 gram per hari menurunkan resiko meningkatnya lemak viseral sebanyak 3,7% 40 . Serat larut seperti betaglucan di dalam lambung membentuk sebuah substansi dengan tekstur seperti gel yang berfungsi untuk menghambat pengosongan lambung dan meningkatkan rasa kenyang 41 . ...
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p>Beras coklat memiliki kandungan magnesium, serat lebih tinggi dan indeks glikemik lebih rendah dari beras putih, diduga dapat mencegah kenaikan glukosa darah dan menurunkan lemak tubuh. Tujuan penelitian ini untuk mengetahui hubungan antara kepatuhan diet berbasis beras coklat dengan kadar glukosa darah puasa dan komposisi lemak tubuh pada pasien Diabetes Mellitus (DM) Tipe 2. Penelitian ini merupakan penelitian quasi experimental dengan rancangan one group pre test and post test design pada 18 pasien DM Tipe 2 yang memenuhi kriteria inklusi. Responden penelitian diberikan intervensi selama 3 bulan berturut. Pemeriksaan glukosa darah puasa dan komposisi lemak tubuh dilakukan sebelum dan setelah intervensi diberikan. Selama pemberian intervensi diet, 94.4% responden patuh diet. Setelah intervensi diberikan terjadi penurunan kontrol glukosa darah dari kategori buruk sebesar 27.7%, persentase lemak tubuh kategori tinggi sebesar 22.2% dan indeks lemak viseral kategori tinggi sebesar 22.2%, namun tidak terdapat hubungan antara kepatuhan diet dengan glukosa darah puasa, total lemak tubuh dan lemak visceral (p=0.339, p= 0.496, p=0.551, spearman). Kesimpulan dari penelitian ini bahwa pemberian diet berbasis beras coklat pada pasien DM Tipe 2 dapat menurunkan kadar glukosa darah puasa dan komposisi lemak tubuh namun tidak terdapat hubungan antara kepatuhan diet dengan ketiga parameter tersebut.</p
... There are, however, contradictory findings regarding the association between different dietary intakes, LAP, and visceral adiposity index (VAI). No significant relationship has been reported between consumption of carbohydrates [21,22], dietary fatty acids [23], including saturated fatty acids, monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs), and VAT [24]. However, it is important to note that food and nutrients are consumed in combination, and complex compositions of nutrients likely have interactionist or synergistic impact [25]. ...
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In the present study, we sought to examine the association between dietary patterns (DPs) and visceral adiposity, lipid accumulation product (LAP), and triglyceride-glucose index. This cross-sectional study was conducted on adults aged between 18-45 years old who lived in Tehran, Iran, between February 2017 and December 2018 (n = 270). DPs were derived using principal component analysis. We used analysis of variance to examine differences in continues variables across tertiles of major DPs. Subsequently, for the modeling of these relationships, and also considering the possible effect of the confounding factors, multivariate regression was used. Three DPs were identified: healthy pattern, mixed pattern, and western pattern, respectively. Compared with individuals in the lowest category of mixed pattern, those in the highest category had lower fasting blood sugar (96.26 ± 11.57 vs. 101 ± 28.66, p = 0.01). A significant association was found between healthy pattern, after adjustment for potential confounders, and odds of LAP; such that individuals in the top category of healthy pattern score were 71% less likely to have a high LAP compared with those in the lowest category (odds ratio, 0.29; 95% confidence interval, 0.10-0.81). We found that adherence to a healthy DP was associated with decreased LAP. To confirm the veracity of these findings, more studies should be conducted.
... The associations between VFA and breath gases (hydrogen and methane) were assessed by multiple regression analysis with a stepwise variable selection method using VFA as an objective variable, and breath gases (hydrogen and methane) and covariates as explanatory variables. Visceral fat is affected by a variety of environmental factors, such as age [33], sex [33], BMI [21], WC [21], smoking [34], alcohol consumption [35], exercise [36], and dietary habits [37], including total dietary fiber intake [38,39]. Furthermore, the human gut microbial composition is affected by a variety of environmental factors, including age [40], dietary habits [41,42], and habitual medicine use [43]. ...
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High visceral fat area (VFA) is a stronger predictor of cardiovascular disease and overall mortality, compared with body mass index (BMI) and waist circumference (WC). Recent reports demonstrate that obesity is related to breath gas, which is produced by the intestinal microflora. However, these studies define obesity using BMI, not VFA. In this population-based cross-sectional study, we investigated the relationship between breath gases (methane and hydrogen) and both VFA and BMI. A total of 1033 participants (62% women; age [mean ± standard deviation] 54.4 ± 14.9 years) in the 2015 Iwaki Health Promotion Project in Japan were enrolled in the study. Breath samples were collected using a breath bag and analyzed by gas chromatography. VFA was measured using a visceral fat meter. The proportion of methanogenic bacteria to total intestinal microbiota was measured by polymerase chain reaction and 16S rRNA gene sequencing analysis. Our analysis revealed a significant association between high VFA and low breath methane, even after adjusting for confounding factors (B=-0.024 and P=0.004). To identify the association between breath methane and VFA in participants with methane-producing bacteria in their intestinal microflora, participants were divided into two groups based on the presence or absence of methanogenic bacteria in their stool. The Methanogen+ group was further divided into two subgroups with breath methane higher (Methane-UP) or lower (Methane-LO) than the median breath methane concentration. VFA was significantly higher in the Methane-UP group than in the Methane-LO group. In participants with methanogenic bacteria, breath methane concentration might be an independent biomarker of visceral fat accumulation.
... Interestingly, an overfeeding study of saturated and polyunsaturated fat showed distinct effects on visceral and liver fat (11). Most previous studies have assessed the role of nutrients in fat deposition (14)(15)(16)(17)(18), although higher energy intake during childhood has been suggested to be associated with greater nonalcoholic fatty liver disease risk irrespective of the macronutrients consumed (19). However, it is increasingly being recognized that studying foods and food groups rather than single nutrients may be important in relation to health outcomes, as foods are not merely the sum of their nutrients (20)(21)(22)(23). ...
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Background Visceral adipose tissue (VAT) and hepatic triglyceride content (HTGC) are major risk factors for cardiometabolic diseases. Objective We aimed to investigate the association of dietary intake of the main food groups with VAT and HTGC in middle-aged men and women. Methods We used data from the Netherlands Epidemiology of Obesity study, a population-based study including 6671 participants aged 45–65 y at baseline. In this cross-sectional analysis, VAT and HTGC were assessed by magnetic resonance imaging and spectroscopy, respectively, as the primary outcomes. Habitual intake of main food groups (dairy, meat, fish, fruits and vegetables, sweet snacks, and fats and oils) was estimated through the use of a food-frequency questionnaire. We examined associations of intake of different food groups with VAT and HTGC by linear regression analysis stratified by sex and adjusted for age, smoking, education, ethnicity, physical activity, basal metabolic rate, energy-restricted diet, menopausal state, and total energy intake. Results In women, a 100-g/d higher intake of dairy was associated with 2.0 cm² less VAT (95% CI: −3.4, −0.7 cm²) and a 0.95-fold lower HTGC (95% CI: 0.90-, 0.99-fold). Moreover, a 100-g/d higher intake of fruit and vegetables was associated with 1.6 cm² less VAT (95% CI: −2.9, −0.2 cm²) in women. Fruit and vegetables were negatively associated (0.95; 95% CI: 0.91, 1.00) with HTGC, and sweet snacks were positively associated (1.29; 95% CI: 1.03, 1.63). Patterns were weaker but similar in men. Fish intake was not associated with VAT or HTGC and plant-based fat and oil intake were only associated with VAT after adjustment for total body fat. Conclusions Despite some variation in the strength of the associations between men and women, dietary intake of sweet snacks was positively associated with HTGC, and fruit and vegetable intake were negatively associated with visceral and liver fat content. Prospective studies are needed to confirm these results. The Netherlands Epidemiology of Obesity study is registered at clinicaltrials.gov with identifier NCT03410316.
... Fibre supplements like glucomannan can also help. 7,8,9 It is available as a supplement, in drink mixes and is also added to food products, such as pasta and flour. It is also the main ingredient in shirataki noodles. ...
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These are ten simple steps to help those people who want to have a healthy diet and lose weight, but don't know where to get simple information. These are only basic first steps to gaining knowledge in attaining a regular healthy diet and trying to lose some excess weight. Not all foods suit everyone. So, your healthy diet should be tailored to each individual. This is particularly important if you have health problems such as diabetes mellitus, high cholesterol, obesity etc. The best way to effectively implement a long-lasting healthy diet is try it gradually, evolve your diet. Some foods may not agree with you, so try and test. Ask your friends about different foods and how they prepare and cook it. So, they are enjoyable and delicious to eat. Hope the ten steps help you in achieving a regular lasting healthy diet, and getting some pounds off.
Article
To assess adolescent and young adult determinants of visceral adipose tissue (VAT) at ages 26-28 years. Prospective study (ages 9-28 years) of cardiometabolic measures, menarche age, menses irregularities, metabolic syndrome, impaired fasting glucose-type 2 diabetes mellitus, and VAT in 400 girls (248 black, 152 white). Adolescent (age 14-19) independent variables for greater VAT at ages 26-28 included larger mean waist circumference (partial R(2) = 30.8%), earlier age at menarche (0.9%), and white race (1.8%). Young adult (ages 20-28 years) independent variables for greater VAT included larger mean waist circumference (partial R(2) = 61.7%), greater triglyceride levels (3.3%), lower high-density lipoprotein cholesterol (1.0%), and greater insulin resistance (homeostasis model assessment-estimated insulin resistance; 0.4%). Independent variables for greater VAT when both adolescent and young adult variables were used included waist (tertile rank change from adolescence to young adulthood, partial R(2) = 58.3%), greater young adult triglyceride levels (4.4%), white race (1.8%), greater young adult homeostasis model assessment-estimated insulin resistance (age 20-28, 2.4%), and earlier menarche age (0.7%). Menses irregularities were not independently associated with young adult VAT. Adolescent girls with early menarche and larger waist circumference should be targets for primary prevention of accretion of VAT. In young adulthood, VAT is associated with dysregulated cardiometabolic profiles, which is greater for those with waist circumference increases from adolescence to adulthood. Waist circumference during young adulthood, and to a lesser degree during adolescence, is an inexpensive surrogate for VAT at ages 26-28 years. Copyright © 2015 Elsevier Inc. All rights reserved.
Article
Visceral (VAT) and subcutaneous abdominal (SAAT) and trunk (STRAT) adipose tissue (AT) have been suggested to be differentially influenced by diet. We investigated whether and to what extent usual patterns of nutrient intake are associated with VAT, SAAT, and STRAT compared with nondietary predictors in northern German adults (n = 583). AT volumes were quantified by magnetic resonance imaging. Nutrient intake was estimated by a 112-item food-frequency questionnaire linked to the German Food Code and Nutrient Database. Exploratory nutrient patterns were derived by principal components analysis (PCA) and partial least-squares regression (PLS) of 87 nutrients. Cross-sectional associations between nutrient patterns, single nutrients, or total energy intake and AT compartments were analyzed by multiple linear regression. Next to sex and age, respectively, which were important nondietary predictors and accounted for more of the variation in VAT (∼13% and ∼4%) than in SAAT or STRAT (both 4-7% and <1%), variation in VAT (16.8% or 17.6%) was explained to a greater extent by 9 or 2 nutrient patterns derived by principal components analysis or partial least-squares regression, respectively, than was variation in SAAT (10.6% or 8.2%) or STRAT (11.5% or 8.6%). Whereas VAT (16.6%) was primarily explained by nutrient quality, SAAT (6.9%) and STRAT (7.4%) were mainly explained by total energy intake. VAT was positively associated with nutrients characteristic of animal (except for dairy) products, including arachidonic acid (standardized β: 0.25; 95% CI: 0.15, 0.34; P < 0.0001), but negatively with dietary fiber, including polypentoses (standardized β: -0.17; 95% CI: -0.24, -0.09; P < 0.0001), and nutrients found in milk. The direction and strength of many associations, however, depended strongly on sex and adjustment for BMI. VAT may be particularly associated with sex-specific interplays of nutrients found in animal products and fiber, whereas SAAT and STRAT are associated with total energy intake. © 2015 American Society for Nutrition.
Chapter
The human gastrointestinal and energy metabolism regulatory systems evolved with pre-agricultural high fiber diets (>50 g fiber/day). Prospective cohort studies and randomized controlled trials (RCTs) show that high adherence to healthy fiber-rich dietary patterns such as the Mediterranean (MedDiet), Dietary Approaches to Stop Hypertension (DASH), New Nordic, and vegetarian diets may at a minimum help to prevent weight gain and can support weight loss and lower waist circumference compared to low-fat or Western diets in overweight or obese individuals. Mechanisms associated with healthy fiber-rich dietary pattern effects on managing body weight and central obesity include: (1) reducing dietary energy density directly or displacing higher energy foods associated with the Western diet pattern; (2) lowering available metabolizable energy; and (3) increasing postprandial satiety by affecting both the upper digestive tract and colonic microbiota. Fiber intake is inversely associated with obesity risk and populations with higher fiber diets tend to be leaner than those with low fiber diets. Prospective cohort studies suggest that increased total fiber intake by ≥12 g/day to a total daily fiber intake of >25 g, especially as a replacement for refined low fiber food, can prevent weight gain by 3.5–5.5 kg each decade. RCTs show that adequate fiber intake ≥28 g fiber/day from fiber-rich diets can reduce body weight and waist circumference compared to low fiber Western diets (≤ 20 g fiber/day). Fiber-rich diets are generally more effective at promoting weight loss than fiber supplements.
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Purpose: to study and determine the anthropometric and hemodynamic parameters of the examined patients with alimentary adiposity of the I-II degree, to evaluate the effectiveness of the complex physical therapy program developed by us on the basis of studying the dynamics of the parameters of the functional state of the cardiovascular system, the anthropometric parameters of women, patients with alimentary adiposity of I-II degree during rehabilitation process. Material and methods: the study was based on a clinical and laboratory examination of 50 women, patients with alimentary obesity I-II degree, the main (25 women) and control (25 women) group. The average age of women in the main group was 24,49±0,71 years, the control age was 24,06±0,57 years. In the main group, a comprehensive physical therapy program was developed for women, patients with mild obesity of I-II degree, which includes a hypocaloric diet; massage according to the method of P.B. Efimenko (2013) physiotherapeutic treatment in the form of influence of sinusoidal modulated current with sympatho-mimetics on the region of local fatty deposits (according to the method of I. Tereshchenko, 1997) and thermal hydroprocedures in the form of contrast baths; therapeutic gymnastics; morning hygienic gymnastics; dosed walking. Result: application of the program of physical therapy made it possible to reveal positive changes in the anthropometric and hemodynamic parameters of young women with obesity. Conclusions: physical exercises contribute to the improvement and normalization of metabolism; reduce the excess weight of the body restore the body's adaptation to physical stress; normalize the function of the cardiovascular system, motor activity and psychoemotional state.
Chapter
The prevalence of prediabetes and diabetes has increased globally in parallel with the rising levels of obesity in adults and children, a phenomenon sometimes called diabesity. If this global trend continues, by 2030 an estimated one billion people are expected to have prediabetes and diabetes.
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Etiology. Type 2 diabetes (diabetes) is a disease that is preventable through the practice of a healthy lifestyle, including the consumption of a healthy, fiber-rich dietary pattern, weight loss/management, and physical activity (Textbook of natural medicine, Elsevier, Philadelphia, 2013, pp. 1320–48; Br J Clin Nutr 92:7–19, 2004; N Engl J Med 345(11):790–797, 2001; Lancet 383:1999–2007, 2014; Lancet 379(9833): 2279–90, 2012; J Hum Nutr Diet 27:251–60, 2014). Only about 5 % of the US and many other westernized populations routinely follow a diabetes preventive lifestyle or consume adequate levels of dietary fiber (fiber) (Advisory guidelines advisory report to the Secretary of Health and Human Services and the Secretary of Agriculture, Figure D1.2:131, 2015; Dietary reference intakes: energy, carbohydrates, fiber, fat, fatty acids, cholesterol, protein and amino acids, National Academies Press, Washington, DC, 2005, pp 339–421; EFSA J 8(3):1462, 2010; J Am Diet Assoc 108:1716–31, 2008; Nutr J 13:34, 2014; Am J Med 126(12):1059–67, 2013; Am J Epidemiol 180(6):565–73, 2014; Fiber intake of the US population. What we eat in American, NHANES 2009-2010. Food Surveys Research Group, Dietary Surveys Research Group No. 12; 2014).
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Data on age-related differences in fat mass and distribution in men are scarce. We performed a cross-sectional analysis of age-related differences in fat distribution in men. In a cohort of 1133 men aged 20-87 yr, body composition was assessed using a Hologic Discovery A device. We assessed fat mass (FM) and FM indices adjusted for height. Interindividual variability was calculated as standard deviation, interquartile range, and difference between the 95th and 5th percentiles in 5-yr age groups. After adjustment for lifestyle factors, the FM and FM index of appendicular, gynoid, central, android, and subcutaneous abdominal compartments increased with age. Their variability did not vary with age. Visceral FM was 181% higher in men aged >80 yr compared to men aged 20-30 yr, and the variability increased with age. FM in the central, android, subcutaneous abdominal, and visceral compartments correlated with age significantly more strongly before the age of 70 than after this age. The relative differences between the elderly and younger men were greater for visceral FM than for subcutaneous (abdominal and appendicular) fat. The interindividual variability in visceral FM is higher in elderly men. The association between visceral FM and age is stronger before the age of 70.
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Background/objectives: Higher visceral fat mass (VFM) is associated with an increased risk for developing cardio-metabolic diseases. The mechanisms by which an unhealthy diet pattern may influence VF development has yet to be examined through cutting-edge multi-omic methods. Therefore, our objective was to examine the dietary influences on VFM and identify gut microbiome and metabolite profiles that link food intakes to VFM. Subjects/methods: In 2218 twins with VFM, food intake and metabolomics data available we identified food intakes most strongly associated with VFM in 50% of the sample, then constructed and tested the 'VFM diet score' in the remainder of the sample. Using linear regression (adjusted for covariates, including BMI and total fat mass) we investigated associations between the VFM diet score, the blood metabolomics profile and the faecal microbiome (n=889), and confirmed these associations with VFM. We replicated top findings in monozygotic (MZ) twins discordant (⩾1 s.d. apart) for VFM, matched for age, sex and the baseline genetic sequence. Results: Four metabolites were associated with the VFM diet score and VFM: hippurate, alpha-hydroxyisovalerate, bilirubin (Z,Z) and butyrylcarnitine. We replicated associations between VFM and the diet score (Beta[s.e.]: 0.281[0.091]; P=0.002), butyrylcarnitine (0.199[0.087]; P=0.023) and hippurate (-0.297[0.095]; P=0.002) in VFM-discordant MZ twins. We identified a single species, Eubacterium dolichum to be associated with the VFM diet score (0.042[0.011], P=8.47 × 10(-5)), VFM (0.057[0.019], P=2.73 × 10(-3)) and hippurate (-0.075[0.032], P=0.021). Moreover, higher blood hippurate was associated with elevated adipose tissue expression neuroglobin, with roles in cellular oxygen homeostasis (0.016[0.004], P=9.82 × 10(-6)). Conclusion: We linked a dietary VFM score and VFM to Eubacterium dolichum and four metabolites in the blood. In particular, the relationship between hippurate, a metabolite derived from microbial metabolism of dietary polyphenols, and reduced VFM, the microbiome and increased adipose tissue expression of neuroglobin provides potential mechanistic insight into the influence of diet on VFM.International Journal of Obesity accepted article preview online, 15 March 2017. doi:10.1038/ijo.2017.70.
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The prevalence of obesity has doubled over the past 25 years in the United States, particularly in North Carolina. Obesity is influenced by biological, social, and environmental factors; its prevalence has been found to be higher among African American women and other racial ethnic minorities. Guided by the social ecological model, the purpose of this cross sectional study was to examine the relationship of the psycho-social, psycho-behavioral factors, and body mass index levels (BMI) in African American women living in North Carolina versus their Hispanic American and European American counterparts. A logistic regression model using secondary data from the Behavioral Risk Factor Surveillance System revealed a significant association in income levels, house hold size, dietary intake, physical activity, and increased BMI levels in African American women. African American women were significantly more likely to be obese (r = 0.93 p > 0.05) compared to European American and Hispanic American women. The association of each variable to BMI assessed for African American women was as follows: income (r = 0.46, p = 0.001), dietary intake (r = 0.-17, p = 0.04), household size (r = 0.57, p = 0.001), physical activity (r = -0.16, p = 0.05), depression (r = 0.37, p = 0.001), and alcohol consumption (r = 0.39, p = 0.001). A culturally sensitive weight loss model addressing the psycho-behavioral and psychosocial risk factors that negatively influence BMI and subsequently, obesity is warranted for African American women living in North Carolina to promote social change and decrease the incidence of obesity in this ethnic group.ence of obesity has doubled over the past 25 years in the United States,
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This review focuses on racial differences in systemic levels of lipid peroxidation markers F2-isoprostanes as metabolic characteristics predisposing to obesity and type 2 diabetes. Elevated levels F2-isoprostanes were found in obesity, type 2 diabetes and their comorbidities. It was hypothesized that increased F2-isoprostane levels reflect the obesity-induced oxidative stress that promotes the development of type 2 diabetes. However, African Americans have lower levels of systemic F2-isoprostane levels despite their predisposition to obesity and type 2 diabetes. The review summarizes new findings from epidemiological studies and a novel interpretation of metabolic determinants of systemic F2-isoprostane levels as a favorable phenotype. Multiple observations indicate that systemic F2-isoprostane levels reflect intensity of oxidative metabolism, a major endogenous source of reactive oxygen species, and specifically, the intensity of fat utilization. Evidence from multiple human studies proposes that targeting fat metabolism can be a productive race-specific strategy to address the existing racial health disparities. Urinary F2-isoprostanes may provide the basis for targeted interventions to prevent obesity and type 2 diabetes among populations of African descent.
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The Nam–Powers–Boyd Occupational Status Scale for the year 2000 is introduced here. It is the sixth in a decennial series of such scales that were initiated at the Census Bureau a half century earlier. The bureau's examination of occupational status actually goes back to the end of the 19th century and its thread continues today. The historical background of the 2000 scale, the methodology for constructing the scores, some comparisons with other occupational scales, the 2000 scores themselves, and applications of the 2000 scores are presented.
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To study 5-year change in computed tomography (CT)-derived visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) associated with sleep duration in 2 minority groups. Longitudinal epidemiologic study. Three US communities. African Americans (N = 332) and Hispanic Americans (N = 775), aged 18-81 years, participating in the IRAS Family Study. none Abdominal CT scans and BMI obtained at a 5-year interval. Sleep duration was assessed by questionnaire at baseline and categorized as < or = 5 h, 6-7 h, and > or = 8 h. Generalized estimating equations assessed the association between sleep duration and 5-year fat accumulation with adjustment for age, race, gender, study site, baseline fat measure, physical activity, total calories, smoking status, and education. Age interacted with sleep duration to predict change in fat measures (P < 0.01). In those younger than 40 years, < or = 5 h of sleep was related to a greater accumulation of BMI (1.8 kg/m2, P < 0.001), SAT (42 cm2, P < 0.0001), and VAT (13 cm2, P > 0.01), compared to sleep duration between 6 and 7 h. Eight hours or more of sleep was also significantly related to a greater accumulation of BMI (0.8 kg/m2, P < 0.001), SAT (20 cm2, P < 0.01) and VAT (6 cm2, P < 0.05) compared to sleep duration between 6 and 7 h. No significant relationship existed between sleep duration and fat depot change in participants older than 40 years old. In this minority cohort, extremes of sleep duration are related to increases in BMI, SAT, and VAT in persons younger than 40 years old.
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There is increasing interest in understanding racial differences in adiposity in specific body depots as a way to explain differential health risks associated with obesity. Our aim was to examine the differences in abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) between white and African American adults. The sample included 1967 adults aged 18-84 y, including 790 white women, 435 African American women, 606 white men, and 136 African American men. Total body fat was measured by using dual-energy X-ray absorptiometry, whereas abdominal VAT and SAT cross-sectional areas (L4-L5 level) were measured by using computed tomography. Sex-specific differences in SAT and VAT between racial groups were analyzed by the use of general linear models, which controlled for age and total body fat. Additional models tested for racial differences in VAT and SAT and controlled for age, total body fat, smoking, and menopausal status. Statistical significance was accepted at P < 0.05. Abdominal VAT was significantly higher in white than in African American men and women, even after adjustment for covariates. White women had significantly lower SAT than did African American women, both before and after adjustment for covariates. White men had significantly higher SAT than did African American men, but after adjustment for covariates, their SAT was lower than that of African American men. Abdominal visceral adiposity is significantly greater in white men and women. After adjustment for covariates, white men and women had significantly lower SAT than did African American men and women. The results of this study highlight the heterogeneity of human body fat distribution across racial groups.This trial was registered at clinicaltrials.gov as NCT00959270.
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Background Overweight adults are at an increased risk of developing numerous chronic diseases. Methods Ten-year follow-up (1986-1996) of middle-aged women in the Nurses' Health Study and men in the Health Professionals Follow-up Study to assess the health risks associated with overweight. Results The risk of developing diabetes, gallstones, hypertension, heart disease, and stroke increased with severity of overweight among both women and men. Compared with their same-sex peers with a body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) between 18.5 and 24.9, those with BMI of 35.0 or more were approximately 20 times more likely to develop diabetes (relative risk [RR], 17.0; 95% confidence interval [CI], 14.2-20.5 for women; RR, 23.4; 95% CI, 19.4-33.2 for men). Women who were overweight but not obese (ie, BMI between 25.0 and 29.9) were also significantly more likely than their leaner peers to develop gallstones (RR, 1.9), hypertension (RR, 1.7), high cholesterol level (RR, 1.1), and heart disease (RR, 1.4). The results were similar in men. Conclusions During 10 years of follow-up, the incidence of diabetes, gallstones, hypertension, heart disease, colon cancer, and stroke (men only) increased with degree of overweight in both men and women. Adults who were overweight but not obese (ie, 25.0≤BMI≤29.9) were at significantly increased risk of developing numerous health conditions. Moreover, the dose-response relationship between BMI and the risk of developing chronic diseases was evident even among adults in the upper half of the healthy weight range (ie, BMI of 22.0-24.9), suggesting that adults should try to maintain a BMI between 18.5 and 21.9 to minimize their risk of disease.
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To date, no studies have assessed the longitudinal changes of dietary intake on metabolic risk factors in Latino youth. We assessed the relation between changes in dietary intake, specifically sugar and fiber intakes, with changes in adiposity and risk factors for type 2 diabetes in a longitudinal analysis of overweight Latino youth. Overweight Latino youth (n = 85; aged 11-17 y) underwent the following measures over 2 y [mean (+/-SD) time difference was 1.5 +/- 0.5 y]: dietary intake by 2-d diet recalls, body composition by dual-energy X-ray absorptiometry and magnetic resonance imaging, and glucose and insulin indexes by oral- and intravenous-glucose-tolerance tests. Partial correlations and repeated-measures analysis of covariance assessed the relation between changes in dietary intake with changes in adiposity and glucose and insulin indexes, independent of the following a priori covariates: sex, Tanner stage, time between visits, and baseline dietary and metabolic variables of interest. Increases in total dietary fiber (g/1000 kcal) and insoluble fiber (g/1000 kcal) were associated with decreases in visceral adipose tissue (VAT) (r = -0.29, P = 0.02, and r = -0.27, P = 0.03, for total dietary and insoluble fiber, respectively), independent of baseline covariates and change in subcutaneous abdominal adipose tissue. Participants who had decreased total dietary fiber (mean decrease of 3 g . 1000 kcal(-1) x d(-1)) had significant increases in VAT compared with participants who had increased total dietary fiber (21% compared with -4%; P = 0.02). No other changes in dietary variables were related to changes in adiposity or metabolic variables. Small reductions in dietary fiber intake over 1-2 y can have profound effects on increasing visceral adiposity in a high-risk Latino youth population.
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OBJECTIVE To describe the 5-year change in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas. RESEARCH DESIGN AND METHODS Absolute change in VAT and SAT measured by abdominal computed tomography scans has been obtained at a 5-year interval from African Americans (n = 389) and Hispanic Americans (n = 844), aged 20–69 years, in 10-year age-groups. RESULTS Mean 5-year increases in VAT areas in women were 18, 7, 4, 0.4, and −3 cm2 for African Americans and 13, 7, 3, 1, and −15 cm2 for Hispanics, across the 5 age decades (trend not significant). Mean 5-year increases in SAT areas in women were 88, 46, 19, 17, and 14 cm2 for African Americans and 53, 20, 17, 12, and 1 cm2 for Hispanics, across the 5 age decades (P < 0.05 for both). Similar trends have been observed in men. CONCLUSIONS Accumulation of abdominal fat is greatest in young adulthood. These data may be useful in identifying subgroups at risk of type 2 diabetes.
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Exercise intensity may affect the selective loss of abdominal adipose tissue. This study showed whether aerobic exercise intensity affects the loss of abdominal fat and improvement in cardiovascular disease risk factors under conditions of equal energy deficit in women with abdominal obesity. This was a randomized trial in 112 overweight and obese [body mass index (in kg/m(2)): 25-40; waist circumference >88 cm], postmenopausal women assigned to one of three 20-wk interventions of equal energy deficit: calorie restriction (CR only), CR plus moderate-intensity aerobic exercise (CR + moderate-intensity), or CR plus vigorous-intensity exercise (CR + vigorous-intensity). The diet was a controlled program of underfeeding during which meals were provided at individual calorie levels (approximately 400 kcal/d). Exercise (3 d/wk) involved treadmill walking at an intensity of 45-50% (moderate-intensity) or 70-75% (vigorous-intensity) of heart rate reserve. The primary outcome was abdominal visceral fat volume. Average weight loss for the 95 women who completed the study was 12.1 kg (+/-4.5 kg) and was not significantly different across groups. Maximal oxygen uptake ( O(2)max) increased more in the CR + vigorous-intensity group than in either of the other groups (P < 0.05). The CR-only group lost relatively more lean mass than did either exercise group (P < 0.05). All groups showed similar decreases in abdominal visceral fat (approximately 25%; P < 0.001 for all). However, changes in visceral fat were inversely related to increases in O(2)max (P < 0.01). Changes in lipids, fasting glucose or insulin, and 2-h glucose and insulin areas during the oral-glucose-tolerance test were similar across treatment groups. With a similar amount of total weight loss, lean mass is preserved, but there is not a preferential loss of abdominal fat when either moderate- or vigorous-intensity aerobic exercise is performed during caloric restriction. This trial was registered at (ClinicalTrials.gov) as: NCT00664729.
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The purpose of this study was to assess the relationship between lifestyle factors and abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in a community-based setting. Cross-sectional associations between lifestyle factors (dietary quality, physical activity, smoking, and alcohol consumption) and SAT and VAT volumes were examined in 2,926 Framingham Heart Study participants (48.6% women, aged 50 +/- 10 years). Diets consistent with the 2005 Dietary Guidelines Adherence Index and greater physical activity were inversely associated with SAT and VAT (P < 0.0001-0.002). In men, former smoking was associated with higher SAT (2,743 +/- 56 cm(3)) compared with current smokers (2,629 +/- 88 cm(3)) or those who never smoked (2,538 +/- 44 cm(3); P = 0.02). Both former and current smoking was associated with higher VAT (P = 0.03 [women]; P = 0.005 [men]). Women with high amounts of alcohol intake (>7 drinks/week) had lower SAT (2,869 +/- 106 cm(3)) than those who consumed less alcohol (3,184 +/- 44 cm(3), P = 0.006); significant differences in VAT were not observed (P = 0.18). In men, high amounts of alcohol intake (>14 drinks/week) were associated with higher VAT (2,272 +/- 59 cm(3)) compared with intake of <or=14 drinks/week (2,139 +/- 25 cm(3), P = 0.04), whereas SAT did not differ (P = 0.91). An increasing number of healthy lifestyle factors were associated with lower SAT and VAT volumes (all P < 0.003). Adherence to recommended dietary guidelines and physical activity are associated with lower SAT and VAT volumes. However, both smoking and high alcohol intake are differentially associated with VAT volumes. Further research to uncover the putative mechanisms is warranted.
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The effect of a high-fiber (4.7 g/MJ) and an isoenergetic low-fiber (1.7 g/MJ) meal on 6-h postprandial thermogenesis, substrate metabolism, hormones, and satiety was investigated in 10 healthy, normal-weight male subjects. Diet-induced thermogenesis (DIT) was significantly reduced after the high-fiber meal (416.4 +/- 28.6 kJ/6 h) compared with the low-fiber meal (498.5 +/- 23.1 kJ/6 h; ANOVA: P < 0.0001), as was postprandial fat oxidation (P < 0.0001). The difference in DIT was correlated with the different palatability of the test meal (r = 0.89, P < 0.01). No differences were observed in plasma concentrations of glucose, insulin, norepinephrine, epinephrine, or gastrointestinal hormones, but C-peptide increased less (P < 0.05) and nonesterified fatty acids decreased more (P < 0.05) after the high-fiber meal. Finally, fullness was increased and desire to eat decreased after the high-fiber meal (P < 0.0001). In conclusion, a high-fiber meal decreased DIT and fat oxidation but increased fullness compared with a low-fiber meal.
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To evaluate the merit of body mass index (BMI), % body fat, waist circumference and waist-to-hip ratio as predictors of abdominal visceral fat (AVF) level. Cross-sectional measurements obtained from 458 female and 331 male subjects of French Canadian descent with an age range from 18-72 y. AVF level was assessed by computed tomography. BMI was calculated as weight (in kg) divided by stature2 (in m), body density was derived from underwater weighing and % body fat was computed from the estimate of body density with the Siri equation. Waist-to-hip ratio was calculated as waist circumference divided by hip circumference. Receiver operating characteristic (ROC) curves were used to identify the optimal cut-off points. In younger women (< 40 y, n = 258), waist-to-hip ratio was the poorest predictor of AVF level with areas under the ROC curves (Az) ranging from 0.684-0.716, sensitivity (Sen) from 63.3-68.8% and specificity (Spe) from 64.0-67.5%, whereas the Az, Sen and Spe for other predictors ranged from 0.924-0.983, 87.0-96.8, and 83.4-92.7, respectively. The same trend was observed in older (> or = 40 y, n = 200) women, although differences between waist-to-hip ratio and other predictors were less pronounced. In older men, waist circumference was the best overall predictor (Az from 0.88-0.92), whereas BMI showed the lowest Az values (0.831-0.875, P < or = 0.001 vs waist circumference). In younger men, BMI had the smallest Az (P < 0.007 vs others) with the lowest AVF cut-off point (100 cm2). However, with higher AVF cut-offs the differences were not significant. Waist circumference is the best overall predictor of abdominal visceral obesity, whereas in women waist-to-hip ratio is a poor indicator of AVF and its use as a surrogate measure of visceral fat should be avoided.
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Overweight and obesity are increasing dramatically in the United States and most likely contribute substantially to the burden of chronic health conditions. To describe the relationship between weight status and prevalence of health conditions by severity of overweight and obesity in the US population. Nationally representative cross-sectional survey using data from the Third National Health and Nutrition Examination Survey (NHANES III), which was conducted in 2 phases from 1988 to 1994. A total of 16884 adults, 25 years and older, classified as overweight and obese (body mass index [BMI] > or =25 kg/m2) based on National Institutes of Health recommended guidelines. Prevalence of type 2 diabetes mellitus, gallbladder disease, coronary heart disease, high blood cholesterol level, high blood pressure, or osteoarthritis. Sixty-three percent of men and 55% of women had a body mass index of 25 kg/m2 or greater. A graded increase in the prevalence ratio (PR) was observed with increasing severity of overweight and obesity for all of the health outcomes except for coronary heart disease in men and high blood cholesterol level in both men and women. With normal-weight individuals as the reference, for individuals with BMIs of at least 40 kg/m2 and who were younger than 55 years, PRs were highest for type 2 diabetes for men (PR, 18.1; 95% confidence interval [CI], 6.7-46.8) and women (PR, 12.9; 95% CI, 5.7-28.1) and gallbladder disease for men (PR, 21.1; 95% CI, 4.1-84.2) and women (PR, 5.2; 95% CI, 2.9-8.9). Prevalence ratios generally were greater in younger than in older adults. The prevalence of having 2 or more health conditions increased with weight status category across all racial and ethnic subgroups. Based on these results, more than half of all US adults are considered overweight or obese. The prevalence of obesity-related comorbidities emphasizes the need for concerted efforts to prevent and treat obesity rather than just its associated comorbidities.
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We conducted a prospective study among Japanese Americans of diabetes incidence in relation to visceral and regional adiposity, fasting insulin and C-peptide, and a measure of insulin secretion, because little prospective data exist on these associations. Baseline variables included plasma glucose, C-peptide, and insulin measured after an overnight fast and 30 and 120 min after a 75-g oral glucose tolerance test; abdominal, thoracic, and thigh fat areas by computed tomography (CT); BMI (kg/m2); and insulin secretion (incremental insulin response [IIR]). Study subjects included 290 second-generation (nisei) and 230 third-generation (sansei) Japanese Americans without diabetes, of whom 65 and 13, respectively, developed diabetes. Among nisei, significant predictors of diabetes risk for a 1 SD increase in continuous variables included intra-abdominal fat area (IAFA) (odds ratio, 95% CI) (1.6, 1.1-2.3), fasting plasma C-peptide (1.4, 1.1-1.8), and the IIR (0.5, 0.3-0.9) after adjusting for age, sex, impaired glucose tolerance, family diabetes history, and CT-measured fat areas other than intra-abdominal. Intra-abdominal fat area remained a significant predictor of diabetes incidence even after adjustment for BMI, total body fat area, and subcutaneous fat area, although no measure of regional or total adiposity was related to development of diabetes. Among sansei, all adiposity measures were related to diabetes incidence, but, in adjusted models, only IAFA remained significantly associated with higher risk (2.7, 1.4-5.4, BMI-adjusted). Greater visceral adiposity precedes the development of type 2 diabetes in Japanese Americans and demonstrates an effect independent of fasting insulin, insulin secretion, glycemia, total and regional adiposity, and family history of diabetes.
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This review was undertaken to determine whether exercise-induced weight loss was associated with corresponding reductions in total, abdominal, and visceral fat in a dose-response manner. A literature search (MEDLINE, 1966--2000) was performed using appropriate keywords to identify studies that consider the influence of exercise-induced weight loss on total and/or abdominal fat. The reference lists of those studies identified were cross-referenced for additional studies. Total fat. Review of available evidence suggested that studies evaluating the utility of physical activity as a means of obesity reduction could be subdivided into two categories based on study duration. Short-term studies (< or = 16 wk, N = 20) were characterized by exercise programs that increased energy expenditure by values double (2200 vs 1100 kcal.wk-1) that of long-term studies (> or = 26 wk, N = 11). Accordingly, short-term studies report reductions in body weight (-0.18 vs -0.06 kg x wk(-1)) and total fat (-0.21 vs -0.06 kg x wk(-1)) that are threefold higher than those reported in long-term studies. Moreover, with respect to dose-response issues, the evidence from short-term studies suggest that exercise-induced weight loss is positively related to reductions in total fat in a dose-response manner. No such relationship was observed when the results from long-term studies were examined. Abdominal fat. Limited evidence suggests that exercise-induced weight loss is associated with reductions in abdominal obesity as measured by waist circumference or imaging methods; however, at present there is insufficient evidence to determine a dose-response relationship between physical activity, and abdominal or visceral fat. In response to well-controlled, short-term trials, increasing physical activity expressed as energy expended per week is positively related to reductions in total adiposity in a dose-response manner. Although physical activity is associated with reduction in abdominal and visceral fat, there is insufficient evidence to determine a dose-response relationship.
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Menopause is a time of increased risk of obesity in women. The effect of menopause in African American women, in whom obesity is already highly prevalent, is unknown. We compared dietary intakes and energy expenditure (EE) between middle-aged, premenopausal African American and white women participating in a longitudinal study of the menopausal transition. Dietary intakes by food record, EE by triaxial accelerometer, physical activity by self-report, and body composition by dual-energy X-ray absorptiometry were compared in 97 white and 52 African American women. Twenty-four-hour and sleeping EE were measured by whole-room indirect calorimetry in 56 women. Sleeping EE (adjusted for lean and fat mass) was lower in African American than in white women (5749 +/- 155 compared with 6176 +/- 75 kJ/d; P = 0.02); however, there was no significant difference in 24-h EE between groups. Reported leisure activity over the course of a week was less in African American than in white women (556 +/- 155 compared with 1079 +/- 100 kJ/d; P = 0.02), as were the daily hours spent standing and climbing stairs. Dietary intakes of protein, fiber, calcium, magnesium, and several fatty acids were significantly less in African Americans, whereas there were no observed ethnic differences in intakes of fat or carbohydrate. Body fat within the whole group was positively correlated with total, saturated, and monounsaturated fat intakes and inversely associated with fiber and calcium intakes. Fiber was the strongest single predictor of fatness. Ethnic differences in EE and the intake of certain nutrients may influence the effect of menopausal transition on obesity in African American women.
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It is unknown whether the ability of waist circumference (WC) to predict health risk beyond that predicted by body mass index (BMI) alone is explained in part by the ability of WC to identify those with elevated concentrations of total or abdominal fat. We sought to determine whether BMI and WC independently contribute to the prediction of non-abdominal (total fat - abdominal fat), abdominal subcutaneous, and visceral fat. Fat distribution was measured by magnetic resonance imaging in 341 white men and women. Multiple regression analysis was performed to measure whether the combination of BMI and WC explained a greater variance in non-abdominal, abdominal subcutaneous, and visceral fat than did BMI or WC alone. These fat depots were also compared after a subdivision of the cohort into 3 BMI (normal, overweight, and class I obese) and 3 WC (low, intermediate, and high) categories according to the classification system used to identify associations between BMI, WC, and health risk. Independent of age and sex, the combination of BMI and WC explained a greater variance in non-abdominal, abdominal subcutaneous, and visceral fat than did either BMI or WC alone (P < 0.05). For non-abdominal and abdominal subcutaneous fat, BMI was the strongest correlate; thus, by adding BMI to WC, the variance accrued was greater than when WC was added to BMI. However, when WC was added to BMI, the added variance explained for visceral fat was greater than when BMI was added to WC. Furthermore, within each of the 3 BMI categories studied, an increase in the WC category was associated with an increase in visceral fat (P < 0.05). BMI and WC independently contribute to the prediction of non-abdominal, abdominal subcutaneous, and visceral fat in white men and women. These observations reinforce the importance of using both BMI and WC in clinical practice.
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Unlabelled: The relationship between excess abdominal adipose tissue, metabolic and cardiovascular health risk has stimulated interest in the efficacy of physical activity in specifically perturbing this adipose depot. The evolution of imaging techniques has enabled more direct measurement of changes in abdominal and visceral fat. The purpose of this summary was to systematically review the relationship between physical activity and abdominal fat. Methods: Database searches were performed on MEDLINE, CINAHL, SPORT DISCUS and PUBMED, from 1985 to 2005 with keywords "exercise", "abdominal fat" and "visceral fat". Results: Nineteen randomized controlled trials (RCTs) and eight non-randomized controlled trials were selected. In RCTs using imaging techniques to measure change in abdominal fat in overweight or obese subjects, seven out of 10 studies (including three trials with type 2 diabetics) reported significant reductions compared with controls. Reductions in visceral and total abdominal fat may occur in the absence of changes in body mass and waist circumference. Waist-to-hip ratio is not a sensitive measure of change in regional adiposity in exercise studies. No studies fulfil the Consolidated Standards of Reporting Trials (CONSORT) statement's criteria for the highest quality of randomized trial; however, many studies were in progress or published before the opportunity to comply with these recommendations. Therefore, limited evidence from a number of studies suggests a beneficial influence of physical activity on reduction in abdominal and visceral fat in overweight and obese subjects when imaging techniques are used to quantify changes in abdominal adiposity. More rigorous studies are needed to confirm these observations.
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The International Physical Activity Questionnaire (IPAQ) was developed to measure health-related physical activity (PA) in populations. The short version of the IPAQ has been tested extensively and is now used in many international studies. The present study aimed to explore the validity characteristics of the long-version IPAQ. Forty-six voluntary healthy male and female subjects (age, mean +/- standard deviation: 40.7 +/- 10.3 years) participated in the study. PA indicators derived from the long, self-administered IPAQ were compared with data from an activity monitor and a PA log book for concurrent validity, and with aerobic fitness, body mass index (BMI) and percentage body fat for construct validity. Strong positive relationships were observed between the activity monitor data and the IPAQ data for total PA (rho = 0.55, P < 0.001) and vigorous PA (rho = 0.71, P < 0.001), but a weaker relationship for moderate PA (rho = 0.21, P = 0.051). Calculated MET-h day(-1) from the PA log book was significantly correlated with MET-h day(-1) from the IPAQ (rho = 0.67, P < 0.001). A weak correlation was observed between IPAQ data for total PA and both aerobic fitness (rho = 0.21, P = 0.051) and BMI (rho = 0.25, P = 0.009). No significant correlation was observed between percentage body fat and IPAQ variables. Bland-Altman analysis suggested that the inability of activity monitors to detect certain types of activities might introduce a source of error in criterion validation studies. The long, self-administered IPAQ questionnaire has acceptable validity when assessing levels and patterns of PA in healthy adults.
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The researchers conducted this study to test the hypothesis that risk of type 2 diabetes is less following reductions in body size and central adiposity. The Diabetes Prevention Program (DPP) recruited and randomized individuals with impaired glucose tolerance to treatment with placebo, metformin, or lifestyle modification. Height, weight, waist circumference, and subcutaneous and visceral fat at L2-L3 and L4-L5 by computed tomography were measured at baseline and at 1 year. Cox proportional hazards models assessed by sex the effect of change in these variables over the 1st year of intervention upon development of diabetes over subsequent follow-up in a subset of 758 participants. Lifestyle reduced visceral fat at L2-L3 (men -24.3%, women -18.2%) and at L4-L5 (men -22.4%, women -17.8%), subcutaneous fat at L2-L3 (men -15.7%, women -11.4%) and at L4-L5 (men -16.7%, women -11.9%), weight (men -8.2%, women -7.8%), BMI (men -8.2%, women -7.8%), and waist circumference (men -7.5%, women -6.1%). Metformin reduced weight (-2.9%) and BMI (-2.9%) in men and subcutaneous fat (-3.6% at L2-L3 and -4.7% at L4-L5), weight (-3.3%), BMI (-3.3%), and waist circumference (-2.8%) in women. Decreased diabetes risk by lifestyle intervention was associated with reductions of body weight, BMI, and central body fat distribution after adjustment for age and self-reported ethnicity. Reduced diabetes risk with lifestyle intervention may have been through effects upon both overall body fat and central body fat but with metformin appeared to be independent of body fat.
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The purpose of the present study was to determine the dietary predictors of visceral adipose tissue (VAT) area in overweight young adults. A total of 109 young adults (fifty males and fifty-nine females) ate ad libitum in a university cafeteria for 14 d. All food and beverages consumed in the cafeteria were measured using observer-recorded weighed plate waste. Food consumption outside the cafeteria (i.e. snacks) was assessed by multiple-pass 24 h recall procedures. VAT was determined using computed tomography. Stepwise regression demonstrated that the best predictor of visceral adiposity in women was total dietary fat (P <or= 0.05). In men, the model for predicting visceral adiposity included Ca and total dietary fat. We concluded that total dietary fat is the best predictor of VAT area in both men and women. While this relationship was independent in women, in men there was a synergistic relationship between dietary fat consumption and Ca consumption in predicting VAT.
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Rising obesity rates around the world have had a profound impact on female reproductive health. Childhood obesity is associated with early onset of puberty, menstrual irregularities during adolescence and polycystic ovary syndrome. Women of reproductive age with high BMIs have a higher risk of ovulatory problems and tend to respond poorly to fertility treatment. Strategies for fertility control can also be complex since the efficacy and safety of hormonal contraceptives can be compromised by increased body weight. Obesity can aggravate symptoms of pelvic organ prolapse, stress urinary incontinence and increase the risk of endometrial polyps and symptomatic fibroids. Weight reduction enhances reproductive outcomes, diminishes symptoms of urinary incontinence and reduces morbidity following gynecological surgery. Sustained and substantial weight loss is difficult to achieve with the lifestyle and dietary measures that are currently available. A number of pharmacological treatment options are available, and there are emerging data on reproductive outcomes following surgical treatment for obesity.
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Nonalcoholic fatty liver disease (NAFLD) is associated with obesity and insulin resistance. The condition disproportionately affects Hispanic Americans. The aims of this study were to examine the risk factors and heritability of NAFLD in 795 Hispanic American and 347 African-American adults participating in the Insulin Resistance Atherosclerosis Study (IRAS) Family Study. Computed tomography (CT) scans of the abdomen were evaluated centrally for measures of liver-spleen (LS) density ratio and abdominal fat distribution. Other measures included insulin sensitivity (SI) calculated from a frequently sampled intravenous glucose tolerance test and various laboratory measures. Statistical models which adjust for familial relationships were estimated separately for the two ethnic groups. Heritability was calculated using a variance components approach. The mean age of the cohort was 49 years (range 22-84); 66% were female. NAFLD (LS ratio<1) was more common in Hispanic Americans (24%) than African Americans (10%). NAFLD was independently associated with SI and visceral adipose tissue (VAT) area in both ethnic groups, although the proportion of explained variance was considerably higher in the Hispanic models. Adiponectin contributed significantly in the African-American models whereas triglycerides (TGs) and plasminogen activator inhibitor 1 (PAI-1) contributed only in the Hispanic models. Liver density was modestly heritable in both ethnic groups (h2 approximately 0.35). In summary, the prevalence of NAFLD was twofold greater in Hispanic than African Americans. Certain correlates of NAFLD were similar between the ethnic groups, whereas others were distinct. NAFLD was modestly heritable. These findings suggest that NAFLD may have a differing environmental and/or genetic basis in these ethnic groups.
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We investigated among sexes the associations of visceral adipose tissue area (VAT) and body fat mass with smoking status, atherogenic dyslipidemia, inflammatory markers, insulin resistance, and blood pressure (BP). A random sample of the Turkish adult population consisting of 157 middle-aged men and women was evaluated cross-sectionally and partly prospectively. Although men were not influenced significantly, smoking vs never-smoking women had 4 years later a lower VAT (by 31 cm(2), P = .005). Fat mass was significantly correlated with homeostasis model, C-reactive protein, and BP in both sexes, although not with atherogenic dyslipidemia as was VAT. Compared with men, women had lower VAT (P < .01) and, because of interaction of sex and smoking (P = .06), tended to be less susceptible to accumulation of VAT per kilogram body fat mass. In linear regression models comprising 7 variables, VAT was associated in men with systolic BP, apolipoprotein B, and C-reactive protein (each P = .04) and was associated in women with age, smoking status, and high-density lipoprotein cholesterol (each P <or= .01). Significant positive correlations of VAT were obtained with future systolic BP in either sex (P < .03). Body fat mass and visceral fat accumulation are inhibited by cigarette smoking in women. Markers of insulin resistance and inflammation are independently associated with visceral fat marginally in women but significantly in men. Visceral fat is better associated than fat mass with atherogenic dyslipidemia and, in men, with apolipoprotein B. Thus, sex interacts with the dynamics of cardiometabolic risk.
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Unlabelled: Nonalcoholic fatty liver disease is a burgeoning problem. We have previously shown that Hispanics were at greater risk for nonalcoholic fatty liver disease than were African-Americans despite a similar prevalence of risk factors between these groups. We have performed the largest, population-based study to date (n = 2170) utilizing proton magnetic resonance (MR) spectroscopy, dual-energy x-ray absorptiometry, and multislice abdominal MR imaging to determine the contribution of body fat distribution to the differing prevalence of hepatic steatosis in the three major U.S. ethnic groups (African-American, Hispanic, Caucasian). Despite controlling for age and total adiposity, African-Americans had less intraperitoneal (IP) fat and more lower extremity fat than their Hispanic and Caucasian counterparts. The differences in hepatic triglyceride content (HTGC) between these groups remained after controlling for total, abdominal subcutaneous, and lower extremity adiposity; however, controlling for IP fat nearly abolished the differences in HTGC, indicating a close association between IP and liver fat regardless of ethnicity. Despite the lower levels of IP and liver fat in African-Americans, their prevalence of insulin resistance was similar to Hispanics, who had the highest levels of IP and liver fat. Furthermore, insulin levels and homeostasis model assessment values were highest and serum triglyceride levels were lowest among African-Americans after controlling for IP fat. Conclusion: IP fat is linked to HTGC, irrespective of ethnicity. The differing prevalence of hepatic steatosis between these groups was associated with similar differences in visceral adiposity. The metabolic response to obesity and insulin resistance differs in African-Americans when compared to either Hispanics or Caucasians: African-Americans appear to be more resistant to both the accretion of triglyceride in the abdominal visceral compartment (adipose tissue and liver) and hypertriglyceridemia associated with insulin resistance.
Article
Visceral adiposity is an essential component of metabolic syndrome. Reduction of excessive visceral fat prevents metabolic syndrome and improves atherosclerotic diseases. This study aimed to identify dietary patterns and physical exercise during the training-education period that predict visceral adiposity regain during the follow-up period. One hundred one moderately obese Japanese women, 23 to 67 years of age, participated in 0- to 4-month training-education and 12-month follow-up periods. Dietary patterns of food groups during training-education were analyzed by principal components analysis, and 3 major dietary patterns were derived. The change in visceral fat over the follow-up, adjusted for 4-month visceral fat area (VFA) and 4- to 16-month body mass index change, was analyzed using stepwise multiple linear regression. VFA and body weight decreased during training-education (P<0.001) and were maintained during follow-up. One major dietary pattern (of 3) (P=0.030) and standard deviations of daily exercise duration (P=0.012) during training-education predicted VFA regain during follow-up. This regain correlated negatively with combinations of bread, milk and dairy products, fruits, seeds and nuts, and mushrooms, but positively with combinations of rice, pickles, miso, alcohol, and meat. The large standard deviation of daily exercise duration during training-education showed greater VFA regain during follow-up than did the smaller standard deviation (P=0.023), but body mass index did not show a similar trend. Our results revealed that daily exercise fluctuations and dietary patterns were useful predictors of visceral fat regain.
Article
The metabolic syndrome is a complex clustering of metabolic defects associated with physical inactivity, abdominal adiposity, and aging. To examine the effects of exercise training intensity on abdominal visceral fat (AVF) and body composition in obese women with the metabolic syndrome. Twenty-seven middle-aged obese women (mean +/- SD; age = 51 +/- 9 yr and body mass index = 34 +/- 6 kg x m(-2)) with the metabolic syndrome completed one of three 16-wk aerobic exercise interventions: (i) no-exercise training (Control): seven participants maintained their existing levels of physical activity; (ii) low-intensity exercise training (LIET): 11 participants exercised 5 d x wk(-1) at an intensity < or = lactate threshold (LT); and (iii) high-intensity exercise training (HIET): nine participants exercised 3 d x wk(-1) at an intensity > LT and 2 d x wk(-1) < or = LT. Exercise time was adjusted to maintain caloric expenditure (400 kcal per session). Single-slice computed tomography scans obtained at the L4-L5 disc space and midthigh were used to determine abdominal fat and thigh muscle cross-sectional areas. Percent body fat was assessed by air displacement plethysmography. HIET significantly reduced total abdominal fat (P < 0.001), abdominal subcutaneous fat (P = 0.034), and AVF (P = 0.010). There were no significant changes observed in any of these parameters within the Control or the LIET conditions. The present data indicate that body composition changes are affected by the intensity of exercise training with HIET more effectively for reducing total abdominal fat, subcutaneous abdominal fat, and AVF in obese women with the metabolic syndrome.
Article
The relations of regional adipose tissue (AT) distribution measured by computed tomography (CT) to plasma insulin-glucose homeostasis and lipoprotein-lipid levels were studied in 58 obese and 29 lean control men. In the group of obese men, the visceral AT area measured by CT was positively correlated with fasting plasma triglyceride and insulin levels and with glucose and insulin areas under the curves measured during a 75-g oral glucose tolerance test. Visceral AT area was also negatively associated with plasma high-density lipoprotein (HDL) and HDL2 cholesterol levels. The relative accumulation of abdominal fat, estimated by the ratio of abdominal to femoral AT areas obtained by CT, was also a significant correlate of indices of carbohydrate metabolism and was the best univariate correlate of plasma lipoprotein levels. No significant associations were observed between the visceral AT area, the ratio of abdominal to femoral AT areas, and indices of carbohydrate and lipoprotein metabolism in the group of lean men. On the other hand, the subcutaneous abdominal AT area was a significant correlate of the glucose area under the curve in both groups of men, but this association was not independent from the percentage of total body fat. No relationship was observed between the femoral AT area and indices of carbohydrate metabolism in either lean or obese groups. In obese men, however, the femoral AT area was negatively correlated with plasma triglyceride concentration and positively correlated with plasma HDL and HDL2 cholesterol levels.(ABSTRACT TRUNCATED AT 250 WORDS)
Article
Physical activity was assessed by questionnaire among 4,956 young blacks and whites aged 18-30 years at the baseline examination (1985-1986) of the Coronary Artery Risk Development in Young Adults (CARDIA) study, a longitudinal study of cardiovascular risk factors. The Physical Activity Recall questionnaire categorized all activity during the previous week, while the Physical Activity History questionnaire quantified participation in 13 specific activities during the previous year. This report compares the two questionnaires with regard to their characterization of the activity levels of the sociodemographic subgroups of the study population and their associations with known physiologic correlates of physical activity. Both questionnaires resulted in the same physical activity patterns for sex (men greater than women) and age (younger greater than older) strata. However, the mean Physical Activity History score was higher in white women than in black women, while the Physical Activity Recall scores were nearly equal. The Physical Activity History score was directly related to educational status, and the Physical Activity Recall score was inversely related to educational status. The Physical Activity History score was generally more strongly associated with physiologic variables known to be related to physical activity (e.g., treadmill test duration). Based upon these findings, which may only be appropriate in this age group, it was concluded that the Physical Activity History score was the more valid measure of habitual physical activity in this study group of young adults.
Article
Computed tomography (CT) was used to study the association between adipose tissue localization and glucose tolerance in a sample of 52 premenopausal obese women aged 35.7 +/- 5.5 yr (mean +/- SD) and with a body fat of 45.9 +/- 5.5%. Body-fat mass and the body mass index (BMI) were significantly correlated with plasma glucose, insulin, and connecting peptide (C-peptide) areas after glucose (75 g) ingestion (.40 less than or equal to r less than or equal to .51, P less than .01). Trunk-fat accumulation and the size of fat cells in the abdomen displayed highly significant correlations with postglucose insulin levels. The C-peptide area was also positively correlated with abdominal fat cell size (r = .76, P less than .01) and was more closely associated with the sum of trunk skin folds (r = .59, P less than .001) than with the extremity skin folds (r = .29, P less than .05). Subcutaneous and deep-abdominal-fat areas measured by CT displayed comparable associations with the plasma insulin area (r = .44 and .49, respectively; P less than .001) but marked differences in the associations with glucose tolerance. Indeed, subcutaneous abdominal fat was not significantly correlated with the glucose area, whereas deep abdominal fat showed a significant correlation (r = .57, P less than .001) with the glucose area. Midthigh fat deposition measured by CT was not, however, correlated with plasma glucose, insulin, or C-peptide areas.(ABSTRACT TRUNCATED AT 250 WORDS)
Article
Sixty slightly overweight women were treated with a weight-reducing diet for 12 weeks in a randomized, double-blind, placebo-controlled study. In addition to the diet 30 women received dietary fibre tablets, whereas the remaining 30 women received identical-looking placebo tablets. During the trial both groups experienced a significant reduction in body weight (P less than 0.01). The mean weight loss 8.5 kg (7.5-9.5 kg) in the fibre group was significantly higher than that of the placebo group 6.7 kg (4.8-8.0 kg) (P less than 0.01). Both serum triglyceride and serum cholesterol concentrations were significantly lowered (P less than or equal to 0.02) after treatment in both groups. No significant differences were detected between the groups. Both systolic and diastolic blood pressure were significantly reduced (P less than 0.01) in the fibre group. No significant reduction in blood pressure was found in the placebo group. Side-effects, which were gastrointestinal in nature, were of low frequency. We conclude that supplementation with dietary fibre of the form used in this study is useful in the treatment of overweight women.
Article
A majority of people attempting to lose weight will use methods that do not involve medical expertise or professional organizations. Consumer organizations continually have problems with so-called slimming products which claim results that are scientifically unfounded and impossible. In this study four methods commonly used in Sweden were studied with emphasis on long-term effects. One-hundred and twenty moderately overweight women were allocated to one of five groups and repeatedly interviewed and monitored over a 2-year period. The long-term results with a protein powder preparation and a kelp-lecithin-vitamin capsule were poor. However, results were also poor with the nutritionally adequate recommendations issued by the Stockholm Home Economics consultation service but lacking programme support or follow-up. The weight losing programme of a 'slim club' was found to result in the greatest overall sustained weight loss (2.8 +/- 4.7 kg, mean +/- s.d.). An attempt to define 'compliance' with each programme was made, which showed that the majority of overweight women were not able to adhere to these given programmes for a 2-year period, probably because of unsatisfactory results. We consider it essential to document the long-term outcome of these methods in order to facilitate understanding of the situation of these overweight subjects and to assist consumer organizations in their efforts to prevent the spread of scientifically unsound weight reduction methods.
Article
To determine the level of a single transverse scan of intra-abdominal fat between L1 and L5 vertebrae that best predicts intra-abdominal fat volumes. Sixteen male and seven female patients with non-insulin-dependent diabetes mellitus, aged 44-74 y. Volumes and areas from single scans of intra-abdominal fat measured by magnetic resonance imaging with a 1.5 Tesla magnetic field strength. Intra-abdominal fat volumes and were calculated from fat areas from eight cross-sectional transverse single scans (nine scans in eight men) of 20 mm thickness. Men and women, respectively, had mean body mass index (BMI) of 27.9 (s.d. 3.0) and 31.6 (s.d. 4.7) kg/m2, and intra-abdominal fat of 2.3 (s.d. 0.5) and 2.5 (s.d. 0.6) kg. Intra-abdominal fat area of the fourth scan (in the direction of L1 to L5) gave the highest prediction of total intra-abdominal fat both in men (r = 0.959, P < 0.001) and in women (r = 0.973, P < 0.001). The intra-abdominal fat area of the third scan gave almost as good a prediction. These third and fourth scans corresponded to L2 and L3 vertebrae. The intra-abdominal fat areas from the sixth and seventh scans, corresponded to the frequently used L4-L5 and had lower correlations with intra-abdominal fat. There were no gender differences in the prediction of volumes from areas of intra-abdominal fat. Intra-abdominal fat areas of the fourth scan explained 93% of variance (SEE = 0.14 kg) of total of intra-abdominal fat for both genders: intra-abdominal fat (kg) = 0.0108 x intra-abdominal fat area of the fourth scan (cm2) + 0.244. In large studies of intra-abdominal fat, using magnetic resonance imaging (MRI) or computerised tomography scanning, a single intra-abdominal fat area at the intervertebral disc between L-2 and L-3 vertebrae offers a cheaper, faster and safer method, with high prediction of total intra-abdominal fat volumes and masses.
Article
Errors in self-reported dietary intake threaten inferences from studies relying on instruments such as food-frequency questionnaires (FFQs), food records, and food recalls. The objective was to quantify the magnitude, direction, and predictors of errors associated with energy intakes estimated from the Women's Health Initiative FFQ. Postmenopausal women (n = 102) provided data on sociodemographic and psychosocial characteristics that relate to errors in self-reported energy intake. Energy intake was objectively estimated as total energy expenditure, physical activity expenditure, and the thermic effect of food (10% addition to other components of total energy expenditure). Participants underreported energy intake on the FFQ by 20.8%; this error trended upward with younger age (P = 0.07) and social desirability (P = 0.09) but was not associated with body mass index (P = 0.95). The correlation coefficient between reported energy intake and total energy expenditure was 0.24; correlations were higher among women with less education, higher body mass index, and greater fat-free mass, social desirability, and dissatisfaction with perceived body size (all P < 0.10). Energy intake is generally underreported, and both the magnitude of the error and the association of the self-reporting with objectively estimated intake appear to vary by participant characteristics. Studies relying on self-reported intake should include objective measures of energy expenditure in a subset of participants to identify person-specific bias within the study population for the dietary self-reporting tool; these data should be used to calibrate the self-reported data as an integral aspect of diet and disease association studies.
Article
The resurgence of social epidemiology has yet to induce corresponding research into basic measurement issues. This paper aims to motivate investigators to refocus attention on the measurement of socioeconomic status (SES). With a primarily American focus, we document striking paucity of basic research in SES, review the history of SES measurement, highlight the central limitations of current measurement approaches, sketch a new theoretical perspective, present new pilot results, and outline areas for future research. We argue (1) that lack of conceptual clarity and the bypassing of standard psychometric techniques have retarded SES measurement. And (2) social epidemiologists should revisit the measurement of SES and consider whether a richer, psychometrically induced, approach would be more useful. Our pilot study suggests a great deal of uniformity between existing SES measures and that a new approach may be worthy of pursuit.
Article
We investigated the effect of fruit intake on body weight change. Hypercholesterolemic, overweight (body mass index > 25 kg/m2), and non-smoking women, 30 to 50 y of age, were randomized to receive, free of charge, one of three dietary supplements: apples, pears, or oat cookies. Women were instructed to eat one supplement three times a day in a total of six meals a day. Participants (411 women) were recruited at a primary care center of the State University of Rio de Janeiro, Brazil. Fifty-one women had fasting blood cholesterol levels greater than 6.2 mM/L (240 mg/dL) and 49 were randomized. Subjects were instructed by a dietitian to eat a diet (55% of energy from carbohydrate, 15% from protein, and 30% from fat) to encourage weight reduction at the rate of 1 kg/mo. After 12 wk of follow-up, the fruit group lost 1.22 kg (95% confidence interval = 0.44-1.85), whereas the oat group had a non-significant weight loss of 0.88 kg (0.37-2.13). The difference between the two groups was statistically significant (P = 0.004). To explore further the body weight loss associated with fruit intake, we measured the ratio of glucose to insulin. A significantly greater decrease of blood glucose was observed among those who had eaten fruits compared with those who had eaten oat cookies, but the glucose:insulin ratio was not statistically different from baseline to follow-up. Adherence to the diet was high, as indicated by changes in serum triacylglycerols, total cholesterol, and reported fruit intake. Fruit intake in the oat group throughout treatment was minimal. Intake of fruits may contribute to weight loss.
Article
Insulin resistance and visceral adiposity are associated with increased risk of type 2 diabetes. In this report, we describe the methods of the IRAS Family Study, which was designed to identify the genetic and environmental risk factors for insulin resistance and visceral adiposity. Families from two ethnic groups (African American and Hispanic) have been recruited from three clinical sites. Blood samples for DNA as well as other standard measures were collected. A CT scan (visceral adiposity) and a frequently sampled glucose tolerance test (insulin resistance) were performed. Preliminary estimates of heritability for indirect measures related to insulin resistance and visceral adiposity were obtained using a variance components approach in the first 93 families (approximately 1000 individuals). Estimates of heritability ranged from low (0.08) for fasting insulin and HOMA, to moderate (0.28) for fasting glucose, to high (0.54) for BMI. After adjustment for age, gender and ethnicity, all heritability estimates were significantly greater than zero (p < 0.05). These results are consistent with the expectation that intermediate measures of insulin resistance and visceral adiposity are heritable, and that the IRAS Family Study has statistical power to detect these intermediate phenotypes of type 2 diabetes and atherosclerosis.
Article
Abdominal fat accumulation is a risk factor for type 2 diabetes and cardiovascular disease. Identifying the demographic and lifestyle correlates of abdominal adiposity is an important step to target at-risk populations in prevention programs. There are few data of this kind in France. Anthropometric indicators of overall (body mass index, BMI) and abdominal (waist hip ratio, WHR; waist circumference, WC) adiposity, educational level, smoking status, and physical activity were assessed in 6,705 middle-aged men and women participating in the SU.VI.MAX study. The likelihood of being obese was increased more than twice in physically inactive subjects of both genders after adjustment for age, smoking status and educational level (OR=2.22, CI95%: 1.74-2.83 in men; OR=2.38, CI95%: 1.84-3.09 in women). Having a high WHR (>=0.95 in men, >=0.80 in women) was more likely in subjects >=50 y, in current smokers, and less likely in men with higher education. The likelihood of having a high WHR was also increased in physically inactive subjects of both genders after adjustment for age, BMI, smoking status and educational level (OR=1.33, CI95%: 1.10-1.60 in men; OR=1.46, CI95%: 1.22-1.74 in women). Having a high WC (>=102 cm in men, >=88 cm in women) was positively associated with age and also with physical inactivity (OR=1.63, CI95%: 1.20-2.22 in women). These cross-sectional data suggest significant positive associations of physical inactivity with both the WHR and WC, independently of overall adiposity as assessed by the BMI.
Article
This review provides an update of recent studies of dietary fiber and weight and includes a discussion of potential mechanisms of how dietary fiber can aid weight loss and weight maintenance. Human studies published on dietary fiber and body weight were reviewed and summarized. Dietary fiber content of popular low-carbohydrate diets were calculated and are presented. Epidemiologic support that dietary fiber intake prevents obesity is strong. Fiber intake is inversely associated with body weight and body fat. In addition, fiber intake is inversely associated with body mass index at all levels of fat intake after adjusting for confounding factors. Results from intervention studies are more mixed, although the addition of dietary fiber generally decreases food intake and, hence, body weight. Many mechanisms have been suggested for how dietary fiber aids in weight management, including promoting satiation, decreasing absorption of macronutrients, and altering secretion of gut hormones. The average fiber intake of adults in the United States is less than half recommended levels and is lower still among those who follow currently popular low-carbohydrate diets, such as Atkins and South Beach. Increasing consumption of dietary fiber with fruits, vegetables, whole grains, and legumes across the life cycle is a critical step in stemming the epidemic of obesity found in developed countries. The addition of functional fiber to weight-loss diets should also be considered as a tool to improve success.
Article
Epidemiological and clinical studies on the lifestyle-related obesity have identified smoking, physical activity and alcohol intake as risk factors for obesity. However, no consensus has yet been reached on the effect of smoking on visceral adiposity. This study was designed to assess whether smoking is associated with the accumulation of visceral fat, glucose and lipid metabolism. The subjects were 450 males aged from 24 to 68 years old, who were examined at the health control center in the regular health check conducted by their company. A self-administered questionnaire was used to ascertain smoking status, daily physical activity and alcohol drinking. The number of Brinkman index as an index for smoking status was positively related to being visceral fat area (VFA). In smokers whose Brinkman index was higher, the percent of subjects with abnormal body mass index, VFA, triglyceride, high density lipoprotein-cholesterol, atherosclerotic index, plasma glucose, immunoreactive insulin, or homeostasis model assessment of insulin resistance (HOMA-IR) was higher than that in non-smokers. When evaluated in terms of age-adjusted odds ratios for incidence of a VFA of 100 cm(2) or greater, alcohol drinking was associated with the highest odds ratio. Smoking, physical inactivity and excessive alcohol drinking were associated with visceral adiposity, and smoking affected glucose and lipid metabolism. In conclusions, these findings suggest that smoking is a risk factor for visceral fat accumulation and deterioration of glucose and lipid metabolism.
Visceral obesity in men. Associations with glucose tolerance, plasma insulin, and lipoprotein levels
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