Extreme obesity: sociodemographic, familial and behavioural correlates in The Netherlands.

STUDY OBJECTIVE: To investigate the relationship between sociodemographic, behavioural, and family characteristics and the body mass index (BMI) (weight (kg)/height (m2)) of extremely obese people. DESIGN: Self reported sociodemographic, behavioural, and familial characteristics and weight and height were obtained by postal questionnaire. PARTICIPANTS AND SETTING: Adult, obese Dutch people who, on their own initiative, contacted our hospital for information on obesity treatment were sent a questionnaire. A total of 244 of 690 subjects had returned the questionnaire within the stated period of 80 days. Due to missing data 19 subjects could not be included in this analysis, leaving 191 women and 34 men. MAIN RESULTS: In women the BMI seemed to be significantly inversely associated with the level of education of the partner, the number of cups of coffee consumed, and number of cigarettes smoked a day. In addition, the BMI of women was positively related to BMI of their mothers. Together these variables explained 18.0% of the total variation in BMI. In men none of the selected variables was associated with their BMI. CONCLUSION: As the selected variables explained almost one fifth of the total variation in BMI, the impact of sociodemographic, familial, and behavioural factors should have more recognition in strategies aimed at reducing obesity.

Ileal pH and apparent absorption of magnesium in rats fed on diets containing either lactose or lactulose.

The hypothesis was tested that dietary lactose v. glucose stimulates Mg absorption in rats because lactose lowers pH of the ileal lumen, which improves Mg solubility which in turn enhances Mg availability for transport across the ileal epithelium. For comparison, the effects of lactulose were studied because it shares with lactose the characteristic of being poorly digestible. Replacement of glucose by lactose (100 g/kg) significantly stimulated apparent absorption of Mg. Apart from Mg absorption, lactulose also significantly enhanced absorption of Ca and phosphate. Lactose v. glucose lowered the pH of the ileal lumen from 7.5 to 7.2, whereas lactulose significantly reduced it to 7.0. In in vitro incubations a decrease in pH within the range of fluctuation in vivo was found to cause an improved solubility of Mg, and to a lesser extent also of Ca and phosphate. The smaller fall of ileal pH induced by feeding lactose instead of lactulose may explain why lactose improved Mg absorption only. For all individual rats combined there were negative relationships between ileal pH and apparent absorption of minerals, the relationship being strongest for Mg. Neither lactose nor lactulose was found to raise ileal solubility of minerals, which could relate to the possibility that the time of sampling was not appropriate. It is suggested that lactose-induced stimulation of Mg absorption in rats is caused by a lowering of ileal pH.

[Relationship between the use of postgraduate educational material on human immunodeficiency virus and the number of HIV consultations in family practice]. / Samenhang tussen het gebruik van nascholingsmateriaal over het humaan immunodeficiëntievirus en het aantal HIV-consulten in huisartspraktijken.

An enquiry using a structured questionnaire was conducted among all 6300 GPs in the Netherlands in order to assess the distribution of HIV-related problems over general practices in the Netherlands and the influence on it of the use of the 'HIV-wijzer voor de huisarts', a loose-leaf handbook on HIV, distributed since 1988 among all Dutch general practitioners. The enquiry was conducted one year after its publication. The 2156 respondents (34%) appeared to be reasonably representative of all GPs. The results show minor imperfections because a small proportion of the questionnaires was filled out incompletely. Almost 90% of respondents mentioned HIV-related consultations, 24% had HIV-seropositive patients and 18% had AIDS patients. These numbers were correlated mainly with municipality size, less with region. The use of the 'HIV-wijzer' was related to occurrence of HIV-related consultations and AIDS patients in a practice. GPs who do not encounter these problems are little motivated to read the 'HIV-wijzer'. For them, other means of education have to be developed or HIV has to be included in existing education programmes on other subjects.