Pancreatic β-Cell Proliferation in Obesity

Because obesity rates have increased dramatically over the past 3 decades, type 2 diabetes has become increasingly prevalent as well. Type 2 diabetes is associated with decreased pancreatic β-cell mass and function, resulting in inadequate insulin production. Conversely, in nondiabetic obesity, an expansion in β-cell mass occurs to provide sufficient insulin and to prevent hyperglycemia. This expansion is at least in part due to β-cell proliferation. This review focuses on the mechanisms regulating obesity-induced β-cell proliferation in humans and mice. Many factors have potential roles in the regulation of obesity-driven β-cell proliferation, including nutrients, insulin, incretins, hepatocyte growth factor, and recently identified liver-derived secreted factors. Much is still unknown about the regulation of β-cell replication, especially in humans. The extracellular signals that activate proliferative pathways in obesity, the relative importance of each of these pathways, and the extent of cross-talk between these pathways are important areas of future study.     

Obesity in Inner‐city African Americans

Objective. Obesity, a risk factor for chronic diseases, has a high prevalence in African Americans and low‐income individuals. However, little is known about perceptions of overweight, attempts to lose weight, and strategies used to lose weight among African Americans in inner cities.

Design. A 1990 cross‐sectional telephone survey (n = 1445) of north St Louis and central Kansas City, USA.

Results. Obesity was common (44%) in this sample of inner‐city African Americans. The obese perceived themselves as overweight (70%) and were trying to lose weight (66%). The majority of the obese (68%) were both dieting and exercising to lose weight. Smoking prevalence was not higher among the obese or those trying to lose weight. Many of the obese had received medical advice recently on low‐fat diets (51%) and had been advised to lose weight (40%). Factors independently associated with perception, attempts to lose weight and medical advice differed, but included degree of obesity.

Conclusions. These results corroborate US national data that obesity is a public health problem in this population and that obese inner‐city African Americans perceive themselves as overweight and are trying to lose weight, especially as degree of obesity increases. It also appears that smoking is not being used as a weight loss strategy and that the obese, as a group, are receiving some medical advice on low‐fat diets. This information is critical for designing culturally sensitive weight‐control programmes.     

Obesity epidemic in India: intrauterine origins?

The epidemic of 'obesity' in India is not appreciated because BMI underestimates the adiposity of Indians. Specific adiposity measurements are necessary for recognition of the adiposity of 'thin' Indians. The origin of this adiposity is only beginning to be understood. In addition to a possible genetic predisposition, intrauterine 'programming' might be responsible, although in the 'thrifty phenotype' hypothesis the adiposity of the 'thin' fetus has not been appreciated. Dutch men who faced 'winter hunger' during the first trimester of their in utero life have become more obese as adults. Low birth weight predicts central obesity in some studies, including studies in urban children. It has also been shown that small and thin Indian newborns (weight 2.7 kg and ponderal index 2.4 kg/m3) have poor muscle and visceral mass but higher adiposity for a given weight compared with white Caucasian babies. This body composition is influenced by maternal adiposity before pregnancy and by aspects of maternal nutritional intake and circulating nutrient concentrations during pregnancy. There are no strong paternal determinants of adiposity at birth. Adiposity may be an integral part of the orchestrated adjustments made to support 'brain preservation' during intrauterine growth, because brain tissue is predominantly fat. Increased nutrition in the face of a genetic predisposition or multigenerational undernutrition increases maternal insulin resistance in late pregnancy and promotes fetal adiposity even in absence of marked hyperglycaemia. Further research is necessary to define the role of specific nutrients and metabolites in the intrauterine processes promoting adiposity before maternal interventions to curtail the epidemic of obesity and diabetes are planned.     

Does Obesity Increase Sexual Dysfunction in Women?

This study was conducted to determine the prevalence of sexual dysfunction among women with obesity who are otherwise healthy and applied to the diet center of a hospital located in Ankara, the capital city of Turkey. The sample included 203 volunteers. Data were collected using the personal data form developed by the authors and the female sexual dysfunction inventory (FSFI). The mean age of the participants was 41.17 ± 8.38 years old. Of the participants, 48.7 % were elementary school graduates, 60.6 % were housewives, 64.0 % had the body mass index (BMI) score between 30.00 and 34.99, and the mean BMI score of the participants was 34.73 ± 4.86. Of the participants, 44.3 % stated that being over-weight had adversely affected their sexual life at a score of 6 points or more. Twenty point two of the participants received information regarding sexuality. It is remarkable that health care professionals were found to be the least frequently referred (3 %) resource regarding sexuality. The mean FSFI score of the participants was 27.36 ± 4.80. Severe dysfunction were observed in 12.8 % of the participants. Moreover, all domains of sexual function were dysfunctional. Female sexual function in the present study was not found correlated with several variables, such as the level of education, work status, menopausal status, and knowledge of sexuality. In conclusion, in order to improve women with obesity’s health and well-being diet to lose weight as well as sexual counseling are to be recommended.     

Population-Based Trends in Male Adolescent Obesity in Israel 1967–2003

Obesity increased monotonically from 1.2% to 3.8% of males age 17 (1967–2003). Low socioeconomic status had an independent positive effect on obesity. The likelihood of obesity had risen more steeply over time among the low socioeconomic status group than among other adolescents. Rise in obesity, standard of living, and income inequality (as measured by the Gini index) increased concomitantly.     

The 2011 Famine in Somalia: lessons learnt from a failed response?

Background

Famine early warning systems clearly identified the risk of famine in South Central Somalia in 2010–2011 but timely action to prevent the onset of famine was not taken. The result was large scale mortality, morbidity, and population displacement.

Discussion

The main factor that turned a drought-related food crisis into a famine was the war that afflicted southern Somalia and the tactics adopted by the various belligerents. These included non-state actors, regional, and international governments. In disasters and complex emergencies, such as this, we posit that five conditions need to be in place to enable humanitarian agencies to provide a timely response to early warnings of famine. These are: presence; access; adequate funding; operational capacity; and legal protection for humanitarian action. In the run up to the Somalia famine each of these presented severe challenges to humanitarian action. The design of the current coordination and funding system contributed to the problems of achieving a neutral, independent, and effective humanitarian response.

Summary

The 2011 famine in Somalia was predicted and could have been mitigated or prevented if the humanitarian response had been timely and more effective. To improve responsiveness to early warnings, action is required to better insulate the humanitarian system from political agendas. While overcoming constraints, such as lack of access, may sometimes be beyond the scope of humanitarian actors, more could be done to enhance the perceived neutrality of parts of the humanitarian system. This should include a reappraisal of the cluster coordination system and reforms to donor funding mechanisms.

     

Obesity: does it occur in African children in a rural community in South Africa?

BACKGROUND: Total body fatness and a centripetal fat patterning are recognized as risk indicators of cardiovascular disease in adulthood. In this study, the development of these risk factors in rural South African children during the preschool years and first years of formal schooling is explored. METHOD: The initial cross-sectional data from the Ellisras Longitudinal Investigations in Rural Community Children Project, ongoing since 1996, were used, involving 684 boys and 652 girls, aged 3-10 years, in the Ellisras rural community. Overweight was measured using the body mass index (BMI) (kg/m2). Overfatness was based on the sum of the triceps and subscapular skinfold thicknesses. A centripetal fat patterning was measured by the sum of trunk skinfolds relative to limb skinfolds and the ratio of the subscapular to triceps skinfold. Further, the ratio of the subscapular to supraspinale skinfold was used as an indicator of lower body fat patterning. The 85th percentiles of the NHANES III were used as cutoff values for overweight, overfatness and a centripetal fat patterning. RESULTS: At ages 7 and 8 years, mean BMI was statistically significantly higher in males compared to females (P < 0.05). The log transformed supraspinale skinfold thickness was larger in females compared to males at ages 4-7 years; the log transformed subscapular skinfold was larger in girls compared to boys aged 7-10 years. Less clear patterns were found for the extremity skinfolds and the skinfold ratios. Very few children (0-2.5% in males and 0-4.3% in females) had BMI values above the NHANES III 85th percentiles, indicating a very low prevalence of overweight children in the area. About 15% of the males showed overfatness at ages 3-4 years, while low prevalence was found at older ages. CONCLUSION: Few Ellisras rural children had above normal values for BMI, indicating a low prevalence of obesity in this population. In the 3- and 4-year-old group more subjects were found to have excessive fat, as indicated by the sum of the triceps and subscapular skinfold thicknesses.     

Insights in Public Health: The Childhood Obesity Prevention Task Force (ACT 269): Recommendations for Obesity Prevention in Hawai‘i

Obesity in both adults and children is a critical issue in Hawai‘i, as well as nationally and internationally. Today in Hawai‘i, 57 percent of adults are overweight or obese as are almost 1 in 3 children entering kindergarten. Each year, obesity costs Hawai‘i more than $470 million in medical expenditures alone.¹ These staggering human and economic costs underscore the serious need for Hawai‘i to address obesity now.Due to the urgent need to reverse the current trends in obesity Senate Bill 2778 was signed into law, on July 6, 2012, as Act 269 by Governor Neil Abercrombie, creating The Childhood Obesity Prevention Task Force. The task force was charged with developing policy recommendations and proposed legislation for the 2013 legislature. The task force ultimately identified eleven recommendations for the 2013 legislative session and one recommendation for the 2014 legislative session. When implemented together, these recommendations could profoundly reshape Hawai‘i''s school, work, community, and health care environments, making healthier lifestyles obtainable for all Hawai‘i residents.     

Prepregnancy Obesity Prevalence in the United States, 2004–2005

Objective To provide a current estimate of the prevalence of prepregnancy obesity in the United States. Methods We analyzed 2004–2005 data from 26 states and New York City (n = 75,403 women) participating in the Pregnancy Risk Assessment Monitoring System, an ongoing, population-based surveillance system that collects information on maternal behaviors associated with pregnancy. Information was obtained from questionnaires self-administered after delivery or from linked birth certificates; prepregnancy body mass index was based on self-reported weight and height. Data were weighted to provide representative estimates of all women delivering a live birth in each particular state. Results In this study, about one in five women who delivered were obese; in some state, race/ethnicity, and Medicaid status subgroups, the prevalence was as high as one-third. State-specific prevalence varied widely and ranged from 13.9 to 25.1%. Black women had an obesity prevalence about 70% higher than white and Hispanic women (black: 29.1%; white: 17.4%; Hispanic: 17.4%); however, these race-specific rates varied notably by location. Obesity prevalence was 50% higher among women whose delivery was paid for by Medicaid than by other means (e.g., private insurance, cash, HMO). Conclusion This prevalence makes maternal obesity and its resulting maternal morbidities (e.g., gestational diabetes mellitus) a common risk factor for a complicated pregnancy. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.     

The Emergence and Portrayal of Obesity in The Irish Times: Content Analysis of Obesity Coverage, 1997–2009

This narrative exposes a critical communication lesson through a true account. In describing empathy and sympathy, it ushers readers on a brief journey where one vital exchange goes awry. A lesson emerges for clinical staff and patients communicating in sensitive circumstances. Empathy and sympathy both express feelings but differ in how these interwoven emotions emerge. It is suggested that sympathy shares feeling whereas empathy shares understanding. The narrative includes a dilemma and the consequence that results from ineffective communication, and concludes with suggestions to successfully manage similar communication encounters.     

Obesity and undernutrition in a very-low-income population in the city of Maceió, northeastern Brazil

Obesity is the nutritional disorder which has shown the greatest increase in prevalence, even in those countries in which deficiency diseases represent a severe public health problem. The goal of the present study was to analyse the anthropometric profile of a community living in the outskirts of Maceió, capital of Alagoas (northeastern Brazil), and to investigate the hypothesis of a coexistence of undernutrition and obesity in a very low-income population. The survey was conducted on 315 families (1247 individuals). Among the children (aged < or =10 years), the prevalence of wasting, stunting and wasting plus stunting was 3.8, 8.3 and 8.7 % respectively. Wasting (10.2 %) was the most prevalent form of undernutrition among adolescents; nonetheless, a higher frequency of stunting (11 %) and overweight-obesity (5.5 %) was seen specifically in girls, in agreement with trends found in other studies. Adults exhibited a high prevalence of overweight-obesity (25 %), but stunting was also present (22 %). Of the stunted individuals, 30 % were overweight-obese and 16.3 % were underweight. There were eighty-six families with at least one parent who was underweight (27 %) and 104 families with at least one parent who was overweight (33 %). Underweight and overweight-obesity were both present in ninety-six households (30 %). These results may indicate that better living conditions in urban areas in a population 'adapted' to chronic famine might increase the susceptibility to obesity. Considering the harm caused by the cumulative effect of these two conditions (undernutrition in childhood and obesity in adult life) there is a clear need for new studies to uncover the determinant factors so that preventive measures can be implemented.     

Prevalence and Perception of Childhood Obesity in California’s Farmworker Communities

In California’s central valley, childhood obesity rates are above the national average. The majority of families living in the rural, agricultural communities of this region are immigrant of Mexican heritage, and face numerous social and environmental challenges. Demographic and anthropometric data were collected from a population of Mexican-heritage children 3–8 years (N?=?609) and families (N?=?466) living in two central valley communities. Overall, 45?% of children and 82?% of mothers were classified as overweight or obese. Multivariable analyses indicated that mother’s BMI and acculturation level were positively associated with child BMI z-score. Most children classified as overweight or obese (92?% and 53?%, respectively) were perceived as having ‘normal’ weight by their mothers. Childhood obesity remains a major public health issue in Mexican-heritage, central valley communities. Our model indicates that mother’s BMI is predictor of child obesity, and parents tend to underestimate their child’s weight status. These findings highlight a need for family-targeted and culturally-tailored approaches to address relevant perceptions of obesity and risk factors in these communities.     

Vitamin D and Visceral Obesity in Humans: What Should Clinicians Know?

The extraskeletal effect of vitamin D on adipose tissue biology and modulation in human obesity is of great interest and has been extensively investigated. Current evidence from preclinical and clinical studies in human adipose tissue suggests that the anti-inflammatory effects of vitamin D are evident and consistent, whereas the effects of vitamin D on adipocyte differentiation, adipogenesis, and energy metabolism and the effects of vitamin D supplementation on adipokine levels are inconclusive. Interventional studies related to medical and surgical weight loss in humans have shown small or no improvement in vitamin D status. Additionally, the benefit of vitamin D supplementation for the reduction in visceral adipose tissue has only been demonstrated in a few studies. Overall, the findings on the relationship between vitamin D and visceral adipose tissue in humans are still inconclusive. Further studies are required to confirm the beneficial effects of vitamin D on ameliorating adipose tissue dysfunction.     

What Role Does the Endocannabinoid System Play in the Pathogenesis of Obesity?

The endocannabinoid system (ECS) is an endogenous signaling system formed by specific receptors (cannabinoid type 1 and type 2 (CB₁ and CB₂)), their endogenous ligands (endocannabinoids), and enzymes involved in their synthesis and degradation. The ECS, centrally and peripherally, is involved in various physiological processes, including regulation of energy balance, promotion of metabolic process, food intake, weight gain, promotion of fat accumulation in adipocytes, and regulation of body homeostasis; thus, its overactivity may be related to obesity. In this review, we try to explain the role of the ECS and the impact of genetic factors on endocannabinoid system modulation in the pathogenesis of obesity, which is a global and civilizational problem affecting the entire world population regardless of age. We also emphasize that the search for potential new targets for health assessment, treatment, and the development of possible therapies in obesity is of great importance.     

Maternal Pre-Pregnancy Obesity and Diagnosis of Asthma in Offspring at Age 3 Years

Objective The objective of this study was to examine the relationship between maternal pre-pregnancy obesity and a diagnosis of asthma in offspring at age 3 years. Methods A population-based sample of children born in large U.S. cities in 1998–2000 was followed since birth (N = 1971). The main outcome measure was whether the mother reported at 3 years that the child had ever been diagnosed with asthma. Multilevel logistic regression models were used to estimate the association between maternal pre-pregnancy obesity and child asthma diagnosis, as well as the extent to which the association can be explained by sociodemographic, medical, obstetric, and behavioral factors associated with both conditions. Results Children with obese mothers had 52% higher odds of having an asthma diagnosis by age 3 (OR = 1.52; 95% CI: 1.18–1.93). Sociodemographic, medical, obstetric, and behavioral factors explained some, but not all, of the association. Conclusions Maternal pre-pregnancy obesity is associated with diagnosis of asthma in offspring at age 3 years. The results from this study are preliminary and need to be replicated and further explored, but are suggestive of a complex intergenerational linkage between obesity and asthma.     

Obesity in the news: do photographic images of obese persons influence antifat attitudes?

News coverage of obesity has increased dramatically in recent years, and research shows that media content may contribute to negative public attitudes toward obese people. However, no work has assessed whether photographic portrayals of obese people that accompany news stories affect attitudes. In the present study, the authors used a randomized experimental design to test whether viewing photographic portrayals of an obese person in a stereotypical or unflattering way (versus a nonstereotypical or flattering portrayal) could increase negative attitudes about obesity, even when the content of an accompanying news story is neutral. The authors randomly assigned 188 adult participants to read a neutral news story about the prevalence of obesity that was paired with 1 of 4 photographic portrayals of an obese adult (or no photograph). The authors subsequently assessed attitudes toward obese people using the Fat Phobia Scale. Participants in all conditions expressed a moderate level of fat phobia (M = 3.83, SD = 0.58). Results indicated that participants who viewed the negative photographs expressed more negative attitudes toward obese people than did those who viewed the positive photographs. Implications of these findings for the media are discussed, with emphasis on increasing awareness of weight bias in health communication and journalistic news reporting.