Effects of obesity and body fat distribution on lipids and lipoproteins in nondiabetic American Indians: The Strong Heart Study

OBJECTIVES: To examine the relationship between obesity and lipoprotein profiles and compare the effects of total obesity and central adiposity on lipids/lipoproteins in American Indians. RESEARCH METHODS AND PROCEDURES: Participants were 773 nondiabetic American Indian women and 739 men aged 45 to 74 years participating in the Strong Heart Study. Total obesity was estimated using body mass index (BMI). Central obesity was measured as waist circumference. Lipoprotein measures included triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein AI (apoAI), and apolipoprotein B (apoB). Partial and canonical correlation analyses were used to examine the associations between obesity and lipids/ lipoproteins. RESULTS: Women were more obese than men in Arizona (median BMI 32.1 vs. 29.2 kg/m2) and South Dakota and North Dakota (28.3 vs. 28.0 kg/m2), but there was no sex difference in waist circumference. Men had higher apoB and lower apoAI levels than did women. In women, when adjusted for center, gender, and age, BMI was significantly related to HDL cholesterol (r = -0.24, p < 0.001). There was a significant but weak relation with apoAI (r = -0.14, p < 0.001). Waist circumference was positively related to triglycerides (r = 0.14, p < 0.001) and negatively related to HDL cholesterol (r = -0.23, p < 0.001) and apoAI (r = -0.13, p < 0.001). In men, BMI was positively correlated with triglycerides (r = 0.30, p < 0.001) and negatively correlated with HDL cholesterol (r = -0.35, p < 0.001) and apoAI (r = -0.23, p < 0.001). Triglycerides increased with waist circumference (r = 0.30, p < 0.001) and HDL cholesterol decreased with waist circumference (r = -0.36, p < 0.001). In both women and men there was an inverted U-shaped relationship between obesity and waist with LDL cholesterol and apoB. In canonical correlation analysis, waist circumference received a greater weight (0.86) than did BMI (0.17) in women. However, the canonical weights were similar for waist (0.46) and BMI (0.56) in men. Only HDL cholesterol (-1.02) carried greater weight in women, whereas in men, triglycerides (0.50), and HDL cholesterol (-0.64) carried a large amount of weight. All the correlation coefficients between BMI, waist circumference, and the first canonical variable of lipids/lipoproteins or between the individual lipid/lipoprotein variables and the first canonical variable of obesity were smaller in women than in men. Triglycerides and HDL cholesterol showed clinically meaningful changes with BMI and waist circumference in men. All lipid/lipoprotein changes in women in relation to BMI and waist circumference were minimal. DISCUSSION: The main lipoprotein abnormality related to obesity in American Indians was decreased HDL cholesterol, especially in men. Central adiposity was more associated with abnormal lipid/lipoprotein profiles than general obesity in women; both were equally important in men.     

The peroxisome proliferator-activated receptor alpha Leu162Val polymorphism influences the metabolic response to a dietary intervention altering fatty acid proportions in healthy men

BACKGROUND: Serum lipid responses to dietary modification are partly determined by genetic factors. OBJECTIVE: We tested whether plasma lipoprotein and lipid responsiveness to a modification in the dietary ratio of polyunsaturated to saturated fatty acids (P:S) is influenced by the peroxisome proliferator-activated receptor alpha (PPARalpha) Leu162Val polymorphism in healthy men. DESIGN: Ten carriers of the V162 allele and 10 L162 homozygotes were matched according to age and body mass index (BMI). During the protocol, all subjects followed the National Cholesterol Education Program Step I diet, but intake of saturated and polyunsaturated fatty acids was adjusted to obtain a P:S of 0.3 for the first 4-wk period (low-P:S diet) and a P:S of 1.0 for the next 4-wk period (high-P:S diet). RESULTS: At screening, the PPARalpha Leu162Val polymorphism was not associated with anthropometric indexes or plasma lipoprotein and lipid concentrations. After the high-P:S diet, a significant gene-by-diet interaction was observed for changes in plasma total cholesterol, apolipoprotein (apo) A-I, and cholesterol concentrations in small LDL particles (P 相似文献   

肥胖儿童的代谢特征和临床干预效果分析

目的 分析肥胖儿童糖脂代谢的临床特征并分析膳食纤维联合运动干预对患儿的临床效果,为进一步了解学龄期肥胖儿童体内糖脂代谢紊乱情况,及早给予干涉,降低成年及老年慢性疾病的风险。方法 选取2013年6月-2014年11月在青海省儿童医院园诊断为肥胖的110例儿童为肥胖组,同期通过自愿原则在当地筛选出90名体检正常的儿童为正常组,收集两组身高、体重、腰围、臀围数据,并计算体质指数(BMI),比较这些简单人体测量数据的差异。同时将肥胖组儿童随机分为两组:试验组(55例)和对照组(55例),试验组采用膳食纤维饮食联合运动干预,对照组不采取特殊的干预措施,比较两组患儿治疗5周前后反映糖代谢、脂代谢血液中生化指标、血压的变化情况。结果 与正常组比较,肥胖组的腰围、臀围、体重、BMI更大,差异有统计学意义(P＜0.05)。膳食纤维联合运动干预后,试验组较对照组儿童的体重、BMI、腰围明显下降,空腹血糖、餐后2 h血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、血压亦均明显下降(P＜0.05);而两组低密度脂蛋白胆固醇差异无统计学意义(P＞0.05)。结论 肥胖儿童在临床上有显著糖脂代谢紊乱的特征。膳食纤维联合运动干预后患儿糖代谢、脂质代谢紊乱得到较好调节,血压变化较对照组明显降低。     

基于降秩回归的血脂相关膳食模式与糖尿病的关系

目的 探寻血脂相关膳食模式与糖尿病的关联,为糖尿病的膳食干预提供科学依据。方法 选取4 759名来自伊犁州霍城县的农村居民作为研究对象,通过问卷调查、体格检查及实验室检测收集研究对象的相关资料。通过降秩回归法提取血脂相关膳食模式;利用Pearson相关分析评估血脂相关膳食模式评分及各食物组摄入量与血脂的相关性;并通过logistic回归分析模型探寻血脂相关膳食模式与糖尿病患病风险之间的关联。结果 血脂相关膳食模式主要以小麦、畜肉和油炸面食摄入较多,而杂粮、蔬菜和水果等摄入较少为特征。血脂相关膳食模式与TC (r=0.296,P<0.001)、LDL-C(r=0.225,P<0.001)及TG(r=0.332,P<0.001)呈正相关,而与HDL-C(r=-0.237,P<0.001)呈负相关。logistic回归分析模型分析结果显示,调整混杂因素后,血脂相关膳食模式评分Q4组比Q1组的糖尿病患病风险增加99%(OR=1.99; 95%CI:1.47～2.68;P<0.001),且随着膳食模式评分增高,糖尿病患病风险具有升高的线性趋势(P_趋势     

Effect of Dietary and Lifestyle Interventions on the Amelioration of NAFLD in Patients with Metabolic Syndrome: The FLIPAN Study

Background: Adults with fatty liver present unusual glycaemia and lipid metabolism; as a result, non-alcoholic fatty liver disease (NAFLD) is now considered as part of the metabolic syndrome (MetS). Objective: To assess the 6- and 12-month effects of customized hypocaloric dietary and enhanced physical activity intervention on intrahepatic fat contents and progression of NAFLD, in patients with MetS. Design: Cross-sectional study in 155 participants (40–60 years old) from Balearic Islands and Navarra (Spain) with a diagnosis of NAFLD and MetS, and BMI (body mass index) between 27 and 40 kg/m²; patients were randomized in a 1:1:1 ratio to either Conventional Diet, Mediterranean diet (MD)–high meal frequency, and MD–physical activity groups. Methods: Dietary intake was assessed using a validated food frequency questionnaire. Adherence to Mediterranean diet, anthropometrics, physical activity, and biochemical parameters (fasting glucose, glycated hemoglobin, bilirubin, aspartate aminotransferase, alanine aminotransferase—ALT–, gamma-glutamyl transferase, uric acid, urea, creatinine, albumin, total cholesterol, high-density lipoprotein cholesterol—HDL-cholesterol–, and triglycerides) were also assessed. Results: Subjects with NAFLD and MetS had reduced intrahepatic fat contents, and liver stiffness, despite the intervention the participants went through. All participants ameliorated BMI, insulin, Hb1Ac, diastolic blood pressure, HDL-cholesterol, and ALT, and improved consumption of total energy, fish, and legumes. Participants in the MD–HMF group improved waist circumference. Conclusions: Customized hypocaloric dietary and enhanced physical activity interventions may be useful to ameliorate NAFLD.     

2006年青岛市35岁以上人群腰围与糖耐量调查及3年后转归情况分析

[目的]了解35岁以上人群腰围与糖耐量情况,探讨影响糖耐量正常人群糖耐量转归的因素,为糖尿病预防提供科学依据。[方法]在青岛市城乡选取2006年糖耐量正常的684名35～74岁人群,测量其腰围值,3年后进行随访。[结果]2006年684名糖耐量正常者中,腹型肥胖罹患率为53.22%。3年后随访上述684人,IGR累积发病率为28.07%,其中腹型肥胖组为34.89%,腰围正常组为20.31%(P<0.01);DM累积发病率为3.51%,其中腹型肥胖者为4.67%,腰围正常组为2.19%(P>0.05)。684人中,2006年腰围为82.38±9.23cm,2009年腰围为85.29±9.45cm(P<0.01)。多因素非条件Logistic回归分析结果,影响糖耐量情况的因素有收缩压(SBP)、腰围(WC)、低密度脂蛋白胆固醇(LDL)、总胆固醇(TC)、尿酸(UA),OR值分别为1.011、1.047、0.643、1.584、1.003。[结论]腹型肥胖者较腰围正常者易发生IGR;收缩压高、腰围值高、低密度脂蛋白胆固醇含量低、总胆固醇含量高、尿酸高的人容易转归为IGR和/或DM。     

有氧及复合运动对单纯性肥胖青少年身体形态和生化指标影响

评价有氧运动及复合运动方式对改善单纯性肥胖青少年体脂和血液生化指标的影响,为指导肥胖学生科学有效地控制体重提供参考.方法 将43名参加2015年暑期江苏某减肥夏令营的肥胖或超重青少年随机分为有氧运动组(22名)和有氧运动结合核心力量训练的复合运动组(21名),进行为期6周的运动干预.分别在入营后和出营前进行体重、体脂率、体质量指数(BMI)、腰围、臀围、大腿围等形态指标和空腹血糖(GLU)、血清胰岛素(INS)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)和低密度脂蛋白(LDL)等血液生化指标测量.结果 经过6周2种运动干预,肥胖青少年的体成分和人体围度指标均下降,与运动前差异均有统计学意义(P值均<0.05).复合运动组BMI、体脂率、腰围、臀围、大腿围、皮褶厚度的改善幅度均比有氧运动组高.6周的运动干预后,血脂、血糖和血清胰岛素的指标均有变化,且两组TC,LDL变化差异均有统计学意义(有氧运动t值分别为2.736,2.091;复合运动t值分别为2.574,2.991,P值均<0.05);复合运动组的血清胰岛素改善幅度比有氧运动组更大,差异有统计学意义(P<0.05).结论 有氧运动、复合运动干预均能有效改善肥胖青少年体脂和代谢指标.     

利用面板数据模型研究血脂对血压的影响

目的 利用面板数据模型,探讨血脂四项指标对血压的影响。 方法 收集社区居民连续5年的血脂、血压及身高、体重、腰围等体检数据,建立以血压为因变量,以血脂四项指标为自变量,以BMI和腰围为控制变量的面板数据模型,分析血脂水平变化对血压的影响。 结果 单因素模型中,影响收缩压的有甘油三酯、低密度脂蛋白;影响舒张压的有总胆固醇、甘油三酯、低密度脂蛋白。多因素模型中,影响收缩压的有高密度脂蛋白与低密度脂蛋白,影响舒张压的是低密度脂蛋白与甘油三酯,总胆固醇未能进入两个方程。 结论 血脂四项中,总胆固醇不能影响血压,甘油三酯增高会导致舒张压上升,高密度脂蛋白增高会降低收缩压,低密度脂蛋白增高会导致收缩压与舒张压的上升。居民膳食指南中,对于胆固醇的摄入,作出不再受限制的简单的建议是不够的,应该综合当前的研究结果,对脂肪的摄入提出更精准的推荐。     

Associations of diet and lifestyle with hyperlipidemia for middle-aged and elderly persons among the Guangxi Bai Ku Yao and Han populations

BACKGROUND: There are fifty-six ethnic groups in China. Han is the largest group and Bai Ku Yao is the isolated subgroup of the Yao minority. Little is known about the difference in the prevalence of hyperlipidemia between the Han and other minority groups in the rural areas. OBJECTIVE: The aim of this study was to compare the associations of diet and lifestyle factors with hyperlipidemia for middle-aged and elderly persons between the Guangxi Bai Ku Yao and Han populations. DESIGN: This is a cross-sectional study. A total of 485 subjects of Bai Ku Yao and 501 subjects of Han Chinese ethnicity aged 40 years and older were surveyed by a stratified cluster random sampling technique. METHODS: Information on demography, dietary intake, and lifestyle factors was collected by standard questionnaires. Blood pressure, height, weight, waist circumference, and serum lipid levels were measured, and body mass index (BMI) was calculated as weight (kg) divided by height (m) squared. RESULTS: The prevalence rates of hypercholesterolemia, hypertriglyceridemia, and hyperlipidemia in Bai Ku Yao and Han were 19.59% vs 36.13% (P<0.001), 13.81% vs 16.97% (P>0.05), and 28.45% vs 43.11% (P<0.001), respectively. Hyperlipidemia was positively correlated with BMI; waist circumference; total energy, total fat, and saturated fatty acids intakes; and negatively associated with sex (women were higher), physical activity, and total dietary fiber intake in Bai Ku Yao (P<0.05 to 0.001), whereas hyperlipidemia was positively associated with BMI; waist circumference; total energy, total fat, and saturated fatty acids intakes; and negatively associated with physical activity and total dietary fiber intake in Han (P<0.05 to 0.001). CONCLUSIONS: The prevalence of hyperlipidemia was significantly lower among ethnic Bai Ku Yao than among ethic Han individuals, which might mainly be attributed to the more favorable dietary patterns, lifestyle choices, and physical activity levels in the former ethnic group.     

Dietary phylloquinone intake as a potential marker for a heart-healthy dietary pattern in the Framingham Offspring cohort

Abstract Associations were evaluated among self-reported dietary intakes of phylloquinone (vitamin K-1), lifestyle characteristics, and intermediary markers of cardiovascular disease risk in a population-based cohort of men and women. Dietary phylloquinone intakes were assessed by food frequency questionnaire in 1,338 men and 1,603 women (mean age, 54 years) participating in the Framingham Heart Study. Cross-sectional associations with lifestyle characteristics and lipid profiles, including total cholesterol, low-density lipoprotein and high-density lipoprotein cholesterol, and triglyceride concentrations, were estimated across increasing quintile categories of phylloquinone intakes. Participants in the highest quintile category of phylloquinone intake consumed more fruit, vegetables, fish, dietary fiber, and dietary supplements ( P <.001), and consumed less meat and less saturated fat ( P <.001). Higher phylloquinone intakes were also associated with lower triglyceride concentrations ( P <.001). In conclusion, a high phylloquinone intake may be a marker for an overall heart-healthy dietary pattern.     

Different types of soluble fermentable dietary fibre decrease food intake,body weight gain and adiposity in young adult male rats

Diet is an important component of type 2 diabetes therapy. Low adherence to current therapeutic diets points out to the need for alternative dietary approaches. This study evaluated the effect of a different dietary approach, the macrobiotic Ma-Pi 2 diet, and compared it with standard diets recommended for patients with type 2 diabetes. A randomized, controlled, open-label, 21-day trial was undertaken in patients with type 2 diabetes comparing the Ma-Pi 2 diet with standard (control) diet recommended by professional societies for treatment of type 2 diabetes. Changes in fasting blood glucose (FBG) and post-prandial blood glucose (PPBG) were primary outcomes. HbA1c, insulin resistance (IR), lipid panel and anthropometrics were secondary outcomes. After correcting for age, gender, BMI at baseline, and physical activity, there was a significantly greater reduction in the primary outcomes FBG (95% CI: 1.79; 13.46) and PPBG (95% CI: 5.39; 31.44) in those patients receiving the Ma-Pi 2 diet compared with those receiving the control diet. Statistically significantly greater reductions in the secondary outcomes, HbA1c (95% CI: 1.28; 5.46), insulin resistance, total cholesterol, LDL cholesterol and LDL/HDL ratio, BMI, body weight, waist and hip circumference were also found in the Ma-Pi 2 diet group compared with the control diet group. The latter group had a significantly greater reduction of triglycerides compared with the Ma-Pi 2 diet group. Intervention with a short-term Ma-Pi 2 diet resulted in significantly greater improvements in metabolic control in patients with type 2 diabetes compared with intervention with standard diets recommended for these patients. Current Controlled Trials ISRCTN10467793 .     

Low-density lipoprotein subclass distribution pattern and adiposity-associated dyslipidemia in postmenopausal women

OBJECTIVE: A predominance of small, dense low-density lipoprotein (LDL) particles (subclass pattern B) is associated with increased risk for coronary heart disease and is characterized by elevated triglycerides and depressed high-density lipoprotein (HDL) cholesterol concentrations. The present analysis was undertaken to assess the impact of LDL subclass distribution pattern and adiposity on serum lipids in postmenopausal women. METHODS: Anthropometric measurements and fasting lipid data were obtained from 254 postmenopausal women 70 years of age or younger, not receiving sex hormone replacement, who were participating in a clinical trial designed to assess the influence of hormone replacement regimens on coronary heart disease risk markers. RESULTS: The prevalence of LDL subclass pattern B was 32%. Triglyceride levels were higher and HDL cholesterol lower (both p<0.001) in women with pattern B vs. pattern A, but total and LDL cholesterol levels did not differ. LDL subclass pattern contributed independently to the variance in HDL cholesterol (p<0.001) and log(e) triglyceride (p<0.001) concentrations explained by anthropometric variables (waist circumference or body mass index). Compared to women with LDL subclass pattern A and waist circumference below the median value of 83.0 centimeters, those with pattern B and waist > or =83.0 centimeters had markedly lower HDL cholesterol levels [44.0 (41.6-47.4) vs. 57.2 (54.1-60.3) mg/dL, mean (95% CI)] and increased triglyceride concentrations [geometric mean 147.8 (131.6-165.7) vs. 95.4 (88.2-102.5) mg/dL]. CONCLUSIONS: These data suggest that adiposity and LDL subclass distribution pattern are independent determinants of plasma triglyceride and HDL cholesterol concentrations in postmenopausal women.     

北京市城区9～10岁儿童肥胖相关指标与血脂水平关系的探讨

目的分析北京市城区儿童体重指数（BMI）、体脂百分含量及腰围与血脂谱的关系。方法采用随机整群抽样法抽取852名北京市城区9～10岁学生，血脂使用自动生化分析仪进行测定。Fisher确切概率法，有序资料的趋势性检验及中位数回归等统计学方法，分析了其中847份有效样本。结果随BMI、体脂百分含量和腰围的增加，总三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）有升高的趋势，高密度脂蛋白胆固醇（HDL—C）有降低的趋势，组间差异均有统计学意义（P〈0．01）。TG主要受腰围（t=686）、性别（t=3．96）、体脂百分含量（t=1．85）影响；TC受体脂百分含量（t=5．31）影响；LDL—C受腰围（t=4．65）、身高（t=-2．79）、体脂百分含量（t=2．77）影响；HDL-C主要受腰围（t=-12．24）、性别（t=-5.83）影响。结论随着肥胖程度的增加，儿童血脂水平上升，且腰围对血脂水平的预测能力最强。     

Associations between Dietary Animal and Plant Protein Intake and Cardiometabolic Risk Factors—A Cross-Sectional Study in China Health and Nutrition Survey

Available data investigating the associations between dietary animal and plant protein intakes and cardiometabolic risk factors (CMRFs) among populations with habitual plant-based diets are heterogenous and limited in scope. The current study was to assess the associations between dietary animal and plant protein intakes and CMRFs, including lipid and lipoprotein profiles, glucose homeostasis biomarkers, low-grade chronic inflammatory biomarker and uric acid in Chinese adults. Data of 7886 apparently healthy adults were extracted from the China Health and Nutrition Survey 2009. Dietary protein (total, animal and plant) intakes were assessed with three consecutive 24 h dietary recalls, and CMRFs were measured with standard laboratory methods. Substituting 5% of energy intake from animal protein for carbohydrates was positively associated with total cholesterol, low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C) and uric acid (all p < 0.05). Substituting 5% of energy intake from plant protein for carbohydrates was inversely associated with non-HDL-C and LDL-C:HDL-C ratio, and positively associated with HDL-C and glycated hemoglobin (all p < 0.05). Some of these associations varied in subgroup analyses by BMI, sex, age or region. There were no significant associations between animal or plant protein intakes and high-sensitivity C-reactive protein. The public health implication of these findings requires further investigation.     

Traditional Dietary Pattern Is Associated with Elevated Cholesterol among the Inuit of Nunavik

Our cross-sectional study assessed the associations between dietary patterns and cardiovascular disease (CVD) risk factors among Nunavik Inuit. This study was conducted as part of the 2004 Nunavik Inuit Health Survey, which included the collection of clinical measurements, plasma samples, and diet information from a food frequency questionnaire. A sample of 666 Inuit aged 18 years and older was included in our analyses. Dietary patterns were generated by principal component analysis. Multivariate general linear models adjusting for sex, age, waist circumference, and other potential confounders were used to examine associations between dietary patterns and CVD risk factors. Four distinct patterns were identified, namely the traditional, Western, nutrient-poor food, and healthy patterns. The traditional pattern showed positive associations with plasma total cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein B100, LDL peak particle diameter, and oxidized LDL (all P values for trend≤0.04), but showed no association with the total cholesterol:high-density lipoprotein cholesterol ratio or with inflammatory biomarkers (all P values for trend ≥0.19). The nutrient-poor food pattern was positively associated with oxidized LDL (P=0.04), but inversely associated with high-sensitivity C-reactive protein (P<0.0001). The Western and healthy patterns showed no association with any CVD risk factor. Our data show that high adherence to a traditional pattern among Nunavik Inuit is not associated with important changes in CVD risk factors, with the exception of a slight elevation in cholesterol concentrations, most likely attributable to increased n-3 fatty acid intake. Dietary patterns reflecting the recent introduction of market foods in the Inuit diet appear to exert a trivial influence on CVD risk factors.     

Major dietary patterns and their associations with cardiovascular risk factors among women in West Bengal, India

Few studies have examined dietary patterns in relation to cardiovascular risk factors in Asian populations, particularly in India. The present study was undertaken to explore dietary patterns in a general urban Bengalee population of women in West Bengal, India, and their association with cardiovascular risk factors. We performed a cross-sectional study of 701 women (aged 35 years and above) selected by cluster sampling from twelve different wards of the Kolkata Municipal Corporation (Kolkata, India). The following three major dietary patterns were identified: the 'vegetable, fruits and pulses' pattern (characterised by higher intakes of dark-yellow and green leafy vegetables, sweets, fruits, pulses, nuts, poultry and eggs, and lower intake of mustard oil); the 'hydrogenated and saturated fat and vegetable oil' pattern (characterised by higher intakes of butter, hydrogenated oil, ghee, vegetable oil, mustard oil, condiments, sweets, fish, high-fat dairy and refined grain); the 'red meat and high-fat dairy' pattern (characterised by higher intakes of red meat, high-fat dairy products, whole grain, high-energy drinks and condiments, and lower intakes of fish, refined grain and low-fat dairy products). The vegetable, fruits and pulses pattern was inversely associated with serum total cholesterol (TC), LDL-cholesterol and non-HDL-cholesterol (HDL-C) concentrations (P < 0·05 for all). The hydrogenated and saturated fat and vegetable oil pattern was positively associated with BMI, waist circumference (WC) and HDL-C concentration (P < 0·05 for all). In this Bengalee population, these three major dietary patterns were observed, and the dietary patterns were independently associated with BMI, WC and serum TC concentrations in women.     

Association of body fat distribution with plasma lipids, lipoproteins, apolipoproteins AI and B in postmenopausal women

Associations between the distribution of body fat, measured by the waist/hip circumference ratio (WHR), and plasma lipid fractions were examined in 84 postmenopausal women. WHR was correlated r = 0.39 with body mass index (BMI). After adjustment for BMI and other covariates, WHR was positively and significantly associated with concentrations of triglycerides, apolipoprotein B, low-density lipoprotein cholesterol, and the total cholesterol/high density lipoprotein cholesterol ratio. WHR was negatively and significantly associated with concentrations of high density lipoprotein cholesterol and apolipoprotein AI. These results indicate that in postmenopausal women abdominal fat preponderance is associated with an atherogenic plasma lipid profile, independent of its association with BMI.     

Reducing diabetes risk in American Indian women

BACKGROUND: American Indians experience high rates of type 2 diabetes. The impact of low-intensity interventions on diabetes risk among young American Indian women is unknown. DESIGN: Randomized controlled trial. SETTING/PARTICIPANTS: Community-based; participants were 200 young urban American Indian women who were block-randomized on fasting blood glucose (FBG) into intervention and control groups. Inclusion criteria included self-reported identity, aged 18-40 years, not pregnant, willingness to stay in urban area for 2 years, and not having type 2 diabetes. Measures were taken at baseline, 6, 12, and 18 months. Data were gathered in 2002-2006 and analyzed in 2006-2007. INTERVENTION: Five discussion group sessions (one meeting per month for 5 months) were held focusing on healthful eating, physical activity, goal-setting, and social support. MAIN OUTCOME MEASURES: Primary outcomes included dietary fat and vegetable consumption and self-reported physical activity. Secondary outcomes included cardiorespiratory fitness, insulin sensitivity, blood pressure, lipid profiles, percent body fat, BMI, intake of fruit, total sugar and sweetened beverages, FBG, and television viewing. RESULTS: Mean vegetable and fruit intake increased significantly more in the intervention group than in the control group over time (group by visit interaction, p=0.02 and p=0.002, respectively). Both groups had significant increases in percent body fat and decreases in waist circumference, insulin sensitivity, blood cholesterol, LDL, television viewing, and total intakes of energy, saturated fat, sugar, and sweetened beverages. CONCLUSIONS: A culturally influenced, low-intensity lifestyle intervention can improve self-reported intakes of vegetables and fruit over 18 months in young, urban American Indian women.     

Thigh Circumference and Diabetes: Obesity as a Potential Effect Modifier

Background

Thigh circumference is associated with diabetes risk; however, the role of obesity as a potential effect modifier has not been well studied.

Methods

We examined the association between thigh circumference and diabetes in a cross-sectional study of 384 612 Koreans aged 30 to 79 years. The association between diabetes and thigh circumference in relation to body mass index (BMI) was analyzed among 315 628 participants, using multivariate logistic regression. Thigh circumference was categorized into 9 percentile categories—namely, the 2.5th, 5th, 10th, 25th, 50th, 75th, 90th, 95th, and 97.5th percentiles—and the 50th percentile was used as the reference value for thigh circumference. Separate analyses were performed for men and women.

Results

The association of thigh circumference with diabetes showed contradictory patterns before and after adjustment for BMI and waist circumference. Small thigh circumference was associated with greater risk of diabetes among men and women. This relationship was stronger among participants younger than 50 years, although age was not a significant effect modifier. BMI was a significant effect modifier among men with a BMI of less than 25 kg/m². Among women, diabetes risk increased with smaller thigh circumference.

Conclusions

Small thigh circumference was associated with diabetes, and this association was stronger among participants with a BMI of less than 25 kg/m². Thigh circumference might be a useful diabetes marker in lean populations.Key words: thigh circumference, diabetes, effect modifier, obesity     

Association of Dietary Patterns with Weight Status and Metabolic Risk Factors among Children and Adolescents

Unhealthy dietary patterns are associated with obesity in children and adolescents. However, few studies have investigated the relationships between dietary patterns and obesity-related metabolic disorders among Asians. We identified dietary patterns in children and adolescents and examined the associations between these patterns and obesity, insulin resistance, and metabolic syndrome in South Korea. This study is a cross-sectional design. We used baseline data from an intervention study of 435 Korean children and adolescents aged 6–17 years. Insulin resistance was assessed as HOMA-IR ≥ 2.6. Metabolic syndrome was diagnosed by cardiovascular disease risk factor clustering. Dietary intakes were estimated using 3-day food records. Factor analysis was used to obtain dietary patterns, and we examined the associations between dietary patterns and obesity-related markers adjusted for potential covariates. Three dietary patterns were identified as fast food and soda (FFS), white rice and kimchi (WRK), and oil and seasoned vegetable (OSV) patterns. Compared with participants in the lower intake of FFS pattern, those in the top intake were associated with a higher waist circumference (WC) (β = 1.55), insulin level (β = 1.25), and body mass index (BMI) (β = 0.53) and it was positively associated with HOMA-IR ≥ 2.6 (OR = 2.11; 95% CI: 1.227–3.638) (p < 0.05). WRK pattern was associated with lower weight and higher HDL cholesterol, and the OSV pattern was associated with a lower weight, WC, and insulin level (p < 0.05). The FFS pattern showed a positive relation with WC, serum insulin, and BMI, and the other two dietary patterns indicated a preventive effect of those parameters. The FFS pattern was associated with significantly elevated insulin resistance among children and adolescents.