The role of motor and nutritional individuality in childhood obesity.

Nutritional and motor individuality vary significantly among human subjects, and their mutal relationship is decisive for a desirable energy balance and turnover with regard to body composition, physical fitness level and health. Early establishment of optimal individualities, with regard to genetic, epigenetic and other factors which influence the organism early in life is desirable for a positive life-long health prognosis and life expectancy. Approaches for the evaluation of both nutritional and motor individualities have been elaborated as an important starting point for their positive development and eventual modification. This should aim to achieve not only prevention of diseases, but also to improve health prevention and achieving the status of "positive health".

Long-term changes in prevalence of overweight and obesity in Czech 7-year-old children: evaluation of different cut-off criteria of childhood obesity.

The objective of this paper was an evaluation of change in prevalence of overweight and obesity in Czech children, and a comparison of cut-off points for body mass index references from the Czech Republic (CzR), International Obesity Task Force and WHO. The authors conducted a survey in 7-year-old children, and compared data from 1951, 1981, 1991, 2001 and 2008 (WHO cut-offs). 2008 data were evaluated according to different cut-offs. Results showed that since 1951 in boys, overweight prevalence increased from 13.0% in 1951 to 26.8% in 2001, in girls from 10.9% to 22.9%. Obesity increased in boys from 1.7% to 8.3%, in girls from 1.7% to 6.9%. From 2001 to 2008 obesity in boys increased; obesity in girls and overweight in both genders decreased. In 2008 cohort the following values were found: overweight and obesity: CzR criteria, percentage was lowest (14.8% boys and 11.1% girls); WHO criteria, highest prevalence (23.5% boys and 19.5% girls); obesity: lowest ratio International Obesity Task Force criteria (4.4% boys, 3.3% girls), highest ratio boys WHO criteria (10.0%), girls CzR criteria (5.0%). Overweight and obesity prevalence increased in 7-year-old Czech children since 1951; since 2001 prevalence is plateauing with exception of boys. Using different body mass index references resulted in marked differences in overweight and obesity prevalence.

Hormonal and psychobehavioral predictors of weight loss in response to a short-term weight reduction program in obese women.

Among the factors influencing weight loss and maintenance, psychobehavioral, nutritional, metabolic, hormonal and hereditary predictors play an important role. Psychobehavioral factors influence adherence to lifestyle changes and thus weight loss maintenance. The outcome of short-term weight reduction treatment is mainly affected by changes in energy and nutrient intake and physical activity and thus the impact of hormones can possibly be obscured. In order to reveal hormonal determinants of weight loss, a 4-week in-patient comprehensive weight reduction program was introduced in which food intake and physical activity were under the strict control. Women (n = 67, BMI: 32.4+/-4.4 kg; age: 48.7+/-12.2 years) who exhibited stable weight on a 7 MJ/day diet during the first week of weight management were given a hypocaloric diet yielding daily energy deficit 2.5 MJ over the subsequent 3-week period. This treatment resulted in a mean weight loss of 3.80+/-1.64 kg. Correlation analysis revealed that baseline concentrations of several hormones were significantly associated either with a higher (free triiodothyronine, C-peptide, growth hormone, pancreatic polypeptide) or with a lower (insulin-like growth factor-I, cortisol, adiponectin, neuropeptide Y) reduction of anthropometric parameters in response to weight management. In a backward stepwise regression model age, initial BMI together with baseline levels of growth hormone, peptide YY, neuropetide Y and C-reactive protein predicted 49.8 % of the variability in weight loss. Psychobehavioral factors (items of the Eating Inventory, Beck Depression score) did not contribute to weight change induced by a well-controlled short-term weight reduction program.

Calcium intake and the outcome of short-term weight management.

Experimental and epidemiological studies suggest that calcium intake is inversely related to weight gain. Calcium of dairy origin has been shown to be more effective in promoting weight loss. However, clinical studies yielded controversial results concerning the role of calcium intake in weight change. The aim of this study was to ascertain whether the addition of calcium can affect the outcome of 3-week weight management (WM) with a hypocaloric diet characterized by a decreased calcium intake. Overweight/ obese women (n=67; BMI 32.2+/-4.1 kg/m(2); age 49.1+/-12.1 years) underwent a 4-week comprehensive WM program. WM included a 7 MJ/day diet resulting in a stable weight during the first week and a 4.5 MJ/day diet with mean daily calcium intake 350 mg during the second to fourth week. Participants were divided into three age- and BMI-matched groups who received placebo or calcium (500 mg/day). Calcium was administered either as carbonate or calcium of dairy origin (Lactoval). There was no significant difference in weight loss in response to WM between the placebo-treated and calcium-treated groups. However, addition of calcium to the diet resulted in a lower hunger score in the Eating Inventory as well as a decrease in plasma resistin levels. Body composition measured by bioimpedance demonstrated that added calcium leads to preservation of fat-free mass. Nevertheless, a greater loss of fat-free mass in the placebo group might be partly due to a greater loss of water.

[Relationships between the "eating inventory" factors, socioeconomic status, anthropometric body adiposity indexes and health risks in Czech population]. / Vztahy mezi faktory "dotazniku jidelnich zvyklostí", socioekonomickým stavem, antropometrickými ukazateli akumulace tuku a zdravotnimi riziky u ceské populace.

BACKGROUND: The aim of the study was to compare and evaluate psychological traits of eating behaviour assessed using the Eating Inventory (El) known also as the Three Factor Eating Questionnaire (TFEQ) and their relationship to body adiposity, health and social characteristic in a quota sample of Czech adults. METHODS AND RESULTS: The sample included 1624 women and 1429 men who were interviewed individually by instructed investigators. The sample was quota representative--for gender, age, size of residential location, region and socioeconomic status in Czech adults. Anthropometric data were obtained together with socioeconomic and lifestyle information. Subjects filled out the EI. Health status was evaluated according to the data reported by GPs. Our results show, that women had higher restraint but lower disinhibition and hunger scores than men. Hunger and disinhibition were always strongly associated, whereas restraint was negatively related to the other two factors in men, and to hunger in women. In both men and women an educational level positively correlated with dietary restraint and negatively with hunger. However, significant negative relationship between educational level and disinhibition was revealed only in men. In backward stepwise regression analysis both dietary restraint and disinhibition predicted BMI and waist circumference. BMI and waist circumference were negatively related to restraint, but positively to disinhibition. Restraint and disinhibition were associated with prevalence of comorbidities in men, while disinhibition and hunger were in women. Individuals with high scoring in disinhibition score (upper quartile) exhibited significantly higher prevalence of hypertension, cardiovascular diseases and hyperlipidaemia than those who scored low (lower quartile). These relationships were most marked in middle-aged subjects. CONCLUSIONS: Psychological traits of eating behaviour seem to have an important role in the development and clinical expression of body adiposity. Especially disinhibition is significantly associated with BMI and waist circumference and prevalence of several pathologies.

[Influence of early postnatal nutrition in preterm infants on their anthropometric and hormonal characteristics at the age of 10 years]. / Vliv casné postnatální výzivy u predcasne narozených detí na jejich antropometrické a hormonální charakteristiky ve veku 10 let.

BACKGROUND: [corrected] A protective effect of breast feeding on the development of obesity has been clearly demonstrated. Several studies associated higher protein intake in postnatal period with the earlier "adiposity rebound" and the higher BMI in later life. METHODS AND RESULTS: Twenty eight girls born at 34th week of pregnancy (weight: 2.22+/-0.31 kg, length: 45.2+/-2.5 cm, BMI: 11.0+/-1.5 kg/m(2)), were subdivided in two groups differing in protein intake during the first postnatal month due to either breast feeding or formula feeding (113.5+/-18.7 g/month vs. 174.00+/-14.3 g/month; p<0.0001). Groups did not differ in average body weight, height and BMI at birth. Anthropometric and hormonal characteristics, body composition, energy and macronutrient intakes were determined at the age of 10 years in girls together with parental BMI. Association between the early postnatal nutrition and anthropometric and hormonal indexes at 10 years was evaluated. No significant differences between the groups in anthropometric and hormonal characteristics were found at 10 years except for IGF-1 which was significantly higher in the group with increased postnatal protein intake. Protein intake during the first postnatal month was not related to fat mass and leptin levels at 10 years. Protein intake during the first postnatal month significantly correlated with IGF-l level, BMI and body circumferences at 10 years. Postnatal fat intake correlates with body circumferences and IGF-1 and also with sagital diameter and leptin at 10 years. CONCLUSIONS: Early postnatal nutrition could encode IGF-1 in later life and this way may be involved in body size programming. Factor analysis revealed IGF-1 as a link between the postnatal energy and macronutrient intake and anthropometric indices and leptin at the age of 10 years.

The Eating Inventory, body adiposity and prevalence of diseases in a quota sample of Czech adults.

OBJECTIVE: To study the relationships between the Eating Inventory (EI) factors (restraint, disinhibition and hunger), body adiposity and prevalence of selected diseases in a quota sample of Czech adults. SUBJECTS AND METHODS: The sample included 1429 men and 1624 women who were interviewed individually by trained investigators. The sample was quota representative--for gender, age, size of residential location, region and socioeconomic status in Czech adults. Anthropometric data, socioeconomic and lifestyle information were obtained. Subjects filled out the EI questionnaire. Physicians reported about subjects' morbidity. RESULTS: Backward stepwise regression analysis revealed that restraint and disinhibition were significant predictors of body mass index (BMI) along with gender, age, parental obesity, weight loss attempts, present dieting and educational level. The same factors plus income predicted the waist circumference. BMI and waist circumference were negatively related to restraint but positively to disinhibition. According to logistic regression analysis restraint and disinhibition were significantly associated with hypertension, cardiovascular diseases and hyperlipidaemia. Diabetes was significantly related to restraint and hunger scores. The observed association between EI factors and diseases remained significant even when BMI and age were taken into account. CONCLUSION: As shown in earlier studies, disinhibition was positively and restraint negatively associated with BMI and waist circumference. For the first time, factors of the EI were also identified as significant predictors of diseases characterizing the metabolic syndrome.

The influence of n-3 polyunsaturated fatty acids and very low calorie diet during a short-term weight reducing regimen on weight loss and serum fatty acid composition in severely obese women.

Polyunsaturated fatty acids of n-3 series (n-3 PUFA) were shown to increase basal fat oxidation in humans. The aim of the study was to compare the effect of n-3 PUFA added to a very low calorie diet (VLCD), with VLCD only during three-week inpatient weight reduction. Twenty severely obese women were randomly assigned to VLCD with n-3 PUFA or with placebo. Fatty acids in serum lipid fractions were quantified by gas chromatography. Differences between the groups were determined using ANOVA. Higher weight (7.55+/-1.77 vs. 6.07+/-2.16 kg, NS), BMI (2.82+/-0.62 vs. 2.22+/-0.74, p<0.05) and hip circumference losses (4.8+/-1.81 vs. 2.5+/-2.51 cm, p<0.05) were found in the n-3 group as compared to the control group. Significantly higher increase in beta-hydroxybutyrate was found in the n-3 group showing higher ketogenesis and possible higher fatty acid oxidation. The increase in beta-hydroxybutyrate significantly correlated with the increase in serum phospholipid arachidonic acid (20:4n-6; r = 0.91, p<0.001). In the n-3 group significantly higher increase was found in n-3 PUFA (eicosapentaenoic acid, 20:5n-3, docosahexaenoic acid, 22:6n-3) in triglycerides and phospholipids. The significant decrease of palmitoleic acid (16:1n-7) and vaccenic acid (18:1n-7) in triglycerides probably reflected lower lipogenesis. A significant negative correlation between BMI change and phospholipid docosahexaenoic acid change was found (r = -0.595, p<0.008). The results suggest that long chain n-3 PUFA enhance weight loss in obese females treated by VLCD. Docosahexaenoate (22:6n-3) seems to be the active component.

[Serum leptin levels in patients with heroin addiction, the effect of one year of methadone substitution]. / Sérové koncentrace leptinu u osob závislých na heroinu, vliv rocní substituce metadonem.

BACKGROUND AND AIM: The aim of the study was to explore the influence of heroin addiction and one year methadone maintenance treatment respectively on serum leptin levels. METHODS AND RESULTS: 14 heroin addicted subjects (9 men and 5 women) with average age 27.1 years (variation 22-38 years) and 17 control healthy subjects were included into the study. Mean duration of heroin addiction was 9 years. The subjects were treated for one year with mean daily dose of 90 mg of methadone. Serum leptin levels were measured by enzymoimmunoassay, the rest of the biochemical parameters was measured by standard laboratory methods. Body Mass Index (BMI) was calculated by conventional method (kg/m2). Statistical analysis was performed using t test and paired t test. Serum leptin levels in heroin addicts (7.08 +/- 2.80 ng/ml) did not significantly differ from those of control group (6.10 +/- 1.23 ng/ml). One year of methadone maintenance treatment significantly increased serum leptin levels to 12.10 +/- 3.17 ng/ml vs control group (< 0.05). The same was true for BMI which increased significantly from basal 21.47 +/- 2.54 to 24.61 +/- 2.82 (< 0.05). CONCLUSIONS: Long term addiction to heroin did not change serum leptin levels as compared with control group. One year of methadone maintenance treatment significantly increased serum leptin levels as well as BMI values. We suggest that the increase in serum leptin levels could be explained by the restoration of hypopituitary-hypothalamo-adrenal and/or hypopituitary-hypothalamo-gonadal axis by methadone maintenance treatment. Alternatively, the improvement of nutritional status with subsequent decrease in the infectious complications may be involved.

Adiponectin and its role in the obesity-induced insulin resistance and related complications.

It is now generally accepted that adipose tissue acts as an endocrine organ producing a number of substances with an important role in the regulation of food intake, energy expenditure and a series of metabolic processes. Adiponectin is a recently discovered protein produced exclusively by adipocytes. A number of studies have shown that obesity, insulin resistance and atherosclerosis are accompanied by decreased adiponectin levels and that adiponectin replacement under experimental settings is able to diminish both insulin resistance and atherosclerosis. The aim of this review is to summarize the current knowledge about the physiology and pathophysiology of adiponectin and to discuss its potential in the treatment of insulin resistance and atherosclerosis.

[Leptin levels in female patients with restrictive and purgative types of anorexia nervosa]. / Hladiny leptinu u pacientek s restriktivní a purgativní formou mentální anorexie.

BACKGROUND: Anorexia nervosa is an eating disorder with typically chronic course. Two subtypes of anorexia nervosa have been described based on the pattern of eating behavior. Restrictive form of anorexia nervosa is characterized by chronically decreased food intake, while the purgative subtype typically consists of alternating episodes of fasting and overnutrition with factitious vomiting. METHODS AND RESULTS: The aim of this study was to compare anthropometric parameters, serum levels of fat-derived hormone leptin, cholesterol, triacylglycerols and serum leptin/body mass index ratio in patients with restrictive and purgative subtypes of anorexia nervosa respectively. Significantly lower body weight (37.79 +/- 3.93 vs. 49.63 +/- 9.84 kg, p < 0.05), body mass index (13.51 +/- 1.43 vs. 17.75 +/- 2.64 kg/m2, p < 0.05),), body fat percentage (13.28 +/- 2.83 vs. 18.9 +/- 5.65%, p < 0.05), serum leptin (1.117 +/- 0.95 vs. 5.88 +/- 4.7 ng/ml, p < 0.05) and cholesterol levels (4.14 +/- 1.78 vs. 6.31 +/- 1.27 mmol/l, p < 0.05) were found in patient with restrictive relative to purgative subtype of anorexia nervosa. In contrast, no difference in triglyceride levels between both groups was found. Serum leptin levels positively correlated with body mass index and body fat percentage only in patients with purgative subtype of anorexia nervosa (body mass index r = 0.95, p < 0.001, body fat percentage r = 0.64, p < 0.05) but not in those with restrictive subtype. CONCLUSIONS: In conclusion, we demonstrated that serum leptin levels were significantly lower in restrictive relative to purgative subtype of anorexia nervosa. We suggest that this difference is primarily due to distinctions in body fat content.

Soluble leptin receptor levels in patients with chronic renal failure.

Soluble leptin receptor (SLR) is the extracellular part of the leptin receptor. This protein is released into circulation and constitutes the main circulating leptin-binding protein. The aim of our study was to measure SLR concentrations in patients with chronic renal failure (CRF) and healthy subjects and to explore the relationship of SLR to other hormones and cytokines. The patients with CRF had significantly higher serum leptin, TNF-alpha and insulin levels than healthy subjects (25.1+/-23.5 vs. 9.4+/-7.6 ng.ml(-1) (S.D.); 14.2+/-4.2 vs. 4.55+/-2.5 ng.ml(-1); 39.8+/-36.1 vs. 20.3+/-11.1 mU.l(-1)). Serum soluble leptin receptor levels did not differ between these groups (19.1+/-11.3 vs. 19.6+/-6.1 U.ml(-1)). An inverse relationship between serum SLR and leptin levels was found in both groups. In patients with CRF the inverse relationship between SLR and insulin, body fat content and total protein levels were also found, while in healthy subjects only inverse relationship of SLR with insulin and albumin concentrations were detected. We conclude that soluble leptin receptor levels in patients with chronic renal failure do not differ from those of healthy subjects despite higher serum leptin levels in CRF patients. The physiological consequences of this finding require further investigation.

The responses of serum and adipose Fatty acids to a one-year weight reduction regimen in female obese monozygotic twins.

We have reported strong intrapair resemblances (IPRs) in serum phosphatidylcholine (PC) fatty acid composition within adult monozygotic twins living apart. This study assessed the contribution of genetic factors to changes in serum and adipose tissue fatty acids resulting from weight loss and followed by a subsequent year of weight maintenance. Eleven pairs of female obese monozygotic twins (age: 38.9 +/- 1.8; BMI: 32.5 +/- 0.9) were recruited for the study. Fasting serum and adipose tissue were obtained after 1 week of inpatient stabilization, after 1 month of inpatient very-low-calorie diet (VLCD), and again after 1 year of outpatient weight maintenance. Fatty acids in serum lipid fractions and adipose tissue were quantitated by gas chromatography. Using multiple regression adjusted for age and initial value, IPRs were determined for the changes induced by VLCD and by the year of weight maintenance. There were few IPRs in nonessential fatty acids. By contrast, there were numerous IPRs for essential fatty acids (EFA), especially in the n-3 family across the VLCD. Following the maintenance year, however, frequent IPRs for nonessential fatty acids were seen, particularly in serum PC, and strong IPRs were seen for 18:3 n-3 and 20:5 n-3 across multiple fractions. These results infer the existence of strong genetic factors determining both the nonessential and EFA compositions of tissue lipids in humans independent of diet. Of particular note were the consistent IPRs for n-3 fatty acids despite dietary stress, indicating that the conservation and distribution of this EFA family are subject to considerable genetic variance in humans.

Serum cortisol and sex hormone binding globulin (SHBG) levels, body fat distribution and the role of genetic factors in obese females.

Fasting plasma levels of both cortisol and sex hormone binding globulin (SHBG) in obese women were significantly inversely related to anthropometric characteristics of body fat distribution. It means that a central accumulation of body fat might be partly mediated by cortisol and SHBG levels. Significant within-pair resemblance observed in plasma cortisol level in obese female monozygotic twins suggests an important role of genetic factors in determination of cortisol secretion. However, no within-pair similarities revealed in plasma SHBG concentrations favour a major role of environmental factors in the regulation of plasma SHBG level. On the other hand the twin study supported the role of genetic determinants in changes of both cortisol and SHBG levels in response to energy deficit induced by very low calorie diet (VLCD). The mechanisms controlling baseline levels of cortisol and SHBG apparently differ from those controlling their responses to energy restriction.

Adipose tissue distribution in obese females. Relationship to androgens, cortisol, growth hormone and leptin.

Adipose tissue distribution predicts development of obesity complications better than total adipose tissue content. The aim of the study was to evaluate the role of the hormonal factors contributing to the adipose tissue distribution in obese females. The cohort examined consisted of 94 women in the range of overweight to obesity, aged 44.2 +/- 11.2 years (21-67), weight 100.1 +/- 17.5 kg (65.8-148), BMI 37.13 +/- 5.72 kg/m2 (26.4-50.7). Adipose tissue (AT) distribution was examined by CT at level L4/5 and intraabdominal adipose tissue and the subcutaneous abdominal adipose tissue area (IAAT and SAAT, respectively) were determined. Growth hormone (GH), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS), cortisol, testosterone, androstene-dione, SHBG, total thyroxine, total triiodothyronine (T3), TSH and leptin were assessed by routine methods by RIA and CLIA. GH, DHEA and DHEA-S correlated significantly negatively with IAAT (r = -0.24, p < 0.05, r = -0.30, p < 0.01, r = -0.34, p < 0.005, respectively). A borderline significant negative correlation of T3 with IAAT was shown (r = -0.20, p = 0.054). A significant positive correlation of SAAT with total testosterone and serum leptin was found (r = 0.27, p < 0.01, r = 0.64, p < 0.001, respectively). When comparing the difference of individual hormone levels between the 1st and 5th quintile of IAAT, no significant difference between the groups was found after adjustment for weight and age. In contrast, when comparing the 1st and 5th quintile according to the SAAT a significantly lower total testosterone and leptin in the 1st quintile of SAAT was found. Only in leptin the difference remained significant after adjustment for adipose tissue content. In conclusion, the results suggest that the relationship of individual hormones examined in this study to the central adipose tissue distribution are mostly mediated by age and adipose tissue content; they do not seem to be in a causal connection with the intraabdominal adipose tissue content. The only exception concerns leptin, which is significantly related to the subcutaneous abdominal adipose tissue area.

The within-pair resemblance in serum levels of androgens, sex-hormone binding globulin and cortisol in female obese identical twins - effect of negative energy balance induced by very low-calorie diet.

The first aim of the present study was to evaluate the changes in serum levels of cortisol, testosterone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEA-S) and sex hormone-binding globulin (SHBG) in response to weight loss induced by one month of treatment with a very low-calorie diet (VLCD) in twelve pairs of female obese monozygotic twins. The second aim of the study was to investigate any within-pair resemblance in serum levels of steroids and SHBG before and after a negative balance protocol, as well as the resemblance in changes in response to therapeutic weight loss. VLCD-induced weight loss of 8.7+2.9 kg was associated with significant increases in serum testosterone (p<0.05) and SHBG (p<0.001) levels, whereas no significant changes in serum levels of cortisol, DHEA and DHEA-S were observed. Significant within-pair resemblances for both pre-treatment and post-treatment concentrations were revealed for DHEA-S (pre-treatment ICC = 0.795, p < 0.01, post-treatment ICC = 0.712, p < 0.01) and for testosterone (pre-treatment ICC = 0.594, p <0.05, post-treatment ICC = 0.735, p < 0.01). The baseline within-twin-pair resemblance in serum cortisol level at 7 a.m. (ICC=0.747, p < 0.05) was lost with VLCD treatment, while its concentration at 9 p.m. developed a within-pair similarity with weight loss (ICC = 0.824, p < 0.001). Similarly, VLCD treatment led to a significant within-pair resemblance in post-treatment level of DHEA (ICC = 0.755, p < 0.01), while no within-twin-pair resemblance was shown for either pre-treatment or post-treatment SHBG levels. None of the hormones measured exhibited any within-pair resemblance in response to VLCD-induced energy deficit, except for serum cortisol levels. A significant within-twin-pair resemblance in the changes in serum cortisol levels at 7 a. m. (ICC = 0.789, F = 8.5, p < 0.001), at 1 p.m. (ICC = 0.660, F = 4.9, p <0.01) and at 9 p.m. (ICC = 0.795, F = 8.8, p <0.001) were demonstrated even after adjustment for fat mass loss. An absence of any within-pair similarity was observed in both pretreatment and post-treatment levels of SHBG, while a significant within-pair resemblance in SHBG response to VLCD treatment (ICC = 0.658, p < 0.05) was recorded. We conclude that the significant within-twin-pair resemblance demonstrated for androgens and cortisol might suggest an important role for genetic factors in the regulation of their serum levels. Our results also suggest that the mechanisms controlling baseline levels of cortisol and SHBG differ from those influencing their responses to energy deficit induced by VLCD.

A twin study of weight loss and metabolic efficiency.

OBJECTIVE: To assess the genetic contribution to determinants of therapeutic weight loss in obese female identical twins. DESIGN: Subjects were studied for 40 days on an inpatient unit in three phases: 7 baseline days; 28 days of weight reduction by a very low calorie diet (1.6 MJ per day); and 5 days after weight reduction. SUBJECTS: Fourteen pairs of premenopausal obese female identical twins (age: 39.0+/-1.7 y; body weight (BW): 93.9+/-21.2 kg; body mass index (BMI): 34.2+/-7.8 kg/m2). MEASUREMENTS: : Body composition by hydrodensitometry and resting metabolic rate by indirect calorimetry were assessed before and after weight loss. RESULTS: : There was great variability among pairs in loss of weight (5.9-12.4 kg) and body fat (3.1-12.4 kg). By contrast, the intraclass correlation (ICC) within twin pairs was 0.85, P<0.001 for weight and 0.88, P<0.001 for body fat. A measure of metabolic efficiency, calculated as the difference between 'estimated' and 'measured' energy deficit showed high intrapair correlation (ICC=0.77; P<0.001). CONCLUSIONS: The high correlation in metabolic efficiency within twin pairs in response to therapeutic weight loss suggests a strong genetic contribution.

Respiratory quotient in obesity: its association with an ability to retain weight loss and with parental obesity.

A high fasting respiratory quotient (RQ) was observed during the treatment by very low calorie diet (VLCD) in obese patients who regained weight at two-year follow-up (weight regainers) or in those who exhibited repeated cycles of weight loss with a subsequent weight regain (weight cyclers). In contrast obese patients who succeeded to retain the weight loss achieved initially by the VLCD at 2-yr follow-up (weight losers) or those who did not exhibit weight fluctuations (weight noncyclers) were characterized by a significantly lower RQ. Therefore a high fasting RQ during the VLCD treatment should be considered predictive of body weight gain. Resting metabolic rate (RMR) expressed per kg fat free mass (FFM) did not influence body weight changes. A high RQ revealed in obese subjects reporting parental obesity and a low fasting RQ observed in those obese without family history of obesity suggest a role of hereditary factors in the ability to oxidize fat in severely obese subjects. In contrast, parental history of obesity did not affect RMR in severely obese individuals.

Intrapair resemblance in very low calorie diet-induced weight loss in female obese identical twins.

OBJECTIVE: To assess intrapair resemblance in changes of body weight, total body fat, fat distribution, resting metabolic rate, fasting respiratory quotient and cardiovascular disease risk factors in response to therapeutic weight loss in female obese identical twins. DESIGN: Patients stayed for 40 days on an inpatient metabolic unit under careful supervision. The stay was divided into three parts: an initial period of 7 days for adjustment to the hospital environment and for baseline measurements, 28 days of the weight reduction regimen when negative energy balance was achieved mainly by a very low calorie diet (1.6 MJ per day) and 5 days of testing after weight reduction. SUBJECTS: Fourteen pairs of premenopausal female obese identical twins (age: 39.0+/-1.7 y; body weight (BW): 93.9+/-21.2 kg; body mass index (BMI): 34.2+/-7.8 kg/m2) participated in the study. MEASUREMENTS: Before and after weight loss, the following measurements were made: body composition by anthropometry and hydrodensitometry, intra-abdominal fat by ultrasonography, resting metabolic rate by indirect calorimetry. Total cholesterol, high-density lipoprotein-cholesterol, triglycerides and uric acid were determined by standard laboratory procedures. Blood pressure was measured in the morning in the recumbent position. RESULTS: Subjects lost 8.8+/-1.9 kg of weight, from 93.9+/-21.2 to 85.1+/-10.9 kg (P<0.0001) and 6.5+/-2.3 kg of body fat (P<0.001). Weight losses varied widely among subjects, with a high correlation between losses of members of twin pairs for body weight (r=0.85; P<0.001) and for body fat (r=0.88; P<0.0001). Changes in uric acid resulting from weight loss were also correlated among members of twin pairs whereas changes in blood pressure, cholesterol and triglycerides were not. CONCLUSION: The great intrapair resemblance observed in very low calorie diet-induced weight and fat losses in female obese identical twins suggests an important role of genetic factors in response to the weight reduction regimen.

Dietary habits and nutritional status in adolescents in Central and Eastern Europe.

The overall situation as regards dietary intake and nutritional status in the countries of Central and Eastern Europe has varied considerably during previous decades; however, after the political, social and economic changes during the nineties these differences have increased further, especially in the areas with low GDP and war, and in the regions affected by radionuclides etc. No systematic surveillance systems in representative samples of adolescents were in effect at the beginning of the nineties in Central and Eastern Europe. There exists relatively more data on nutritional status characterized by body mass index (BMI) and skinfold thickness measurements. Food intake has mainly been followed in smaller samples of adolescents, and or in special groups (athletes, obese, vegetarians, allergies, Romanies, pupils of special schools etc.). In the countries and/or areas with sufficient GDP and income the food intake has most often been too abundant when considering the real needs of the growing organism, especially from the point of view of energy output. The composition of the diet is not adequate, i.e. too much protein, fats, sugar etc. This situation is similar to that in Western countries, USA etc. On the other hand, adolescents in Central and Eastern Europe consume too few vegetables, fruit and milk products in their diet (i.e. low intakes of Ca, fibre and vitamin C), which is less apparent in Western countries. This is mainly due to bad eating habits and nutritional traditions in the families, but also due to the changes of the prices of the mentioned foodstuffs after political and economic changes in this part of the world. Certain nutritional deficiencies were also shown as factors increasing the health risks from the Chernobyl disaster, mainly in the Ukraine, Belorussia and certain parts of Poland.