Physical activity is associated with risk factors for chronic disease across adult women's life cycle

OBJECTIVE: The purpose of this study was to examine the association of age (young, midlife, and older) and activity level (active and sedentary), determined by a pedometer, with risk factors of chronic disease, including body composition, dietary intake, serum lipids, insulin, leptin, C-reactive protein (CRP), plasma glucose, and resting metabolic rate (RMR) in women across the adult life cycle. METHODS: Young (aged 20 to 30 years) (n=49), midlife (aged 40 to 50 years) (n=62), and older (aged 60 years and older) (n=47) women were recruited for this cross-sectional study. For 7 days, participants completed weighed food records and wore a pedometer. Based on the average number of steps per day, the women were further classified as active (>/=7,500 steps per day) or sedentary (<7,500 steps per day). Height, weight, and waist circumference were determined for each participant. Fasting blood samples were taken to assess serum lipid, CRP, insulin, leptin, thyroid stimulating hormone, and plasma glucose levels. RMR and body composition (via dual-energy x-ray absorptiometry) were assessed. RESULTS: Young and midlife women had lower concentrations compared to older women for serum cholesterol (P<0.01), low-density lipoprotein cholesterol (P<0.01), triglycerides (P<0.01), leptin (P<0.01), and plasma glucose (P<0.01); midlife women had lower serum insulin concentrations vs young and older groups (P=0.01); young women had smaller waist circumference compared to midlife and older groups (P<0.01); percent body fat (P<0.01) and percent fat-free mass (P<0.01) differed between all ages. Lower values were found in active vs sedentary women for serum insulin (P=0.02), serum leptin (P<0.01), waist circumference (P<0.01) and percent body fat (P<0.01). A higher percent fat-free mass (P<0.01) was also found in active compared to sedentary women. No differences were found between activity groups for serum cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, CRP, plasma glucose levels, or RMR. RMR was higher in young and midlife vs the older women (P<0.01). Significant inverse correlations were found between activity (steps per day) and body mass index, insulin level, CRP concentration, leptin level, waist circumference, and body fat. Significant positive correlations were found between age and body mass index, total serum cholesterol level, low-density lipoprotein cholesterol level, serum triglyceride level, leptin level, plasma glucose level, CRP concentration, waist circumference, and body fat. Young and midlife women reported consuming more relative energy (kilocalories per kilogram body weight) and protein (grams per kilogram body weight) than older women (P<0.01). The midlife women reported consuming more dietary cholesterol compared to the young and older women (P<0.01). Active women reported a higher relative energy (kilocalories per kilogram body weight) and protein (grams per kilogram body weight) intake vs the sedentary women (P<0.01). Active women also reported a higher intake of dietary carbohydrates (grams per day, P<0.01; percent of energy, P=0.04). CONCLUSIONS: Overall, these results indicate that younger age and greater physical activity, despite age, are associated with fewer risk factors for chronic disease, such as cardiovascular disease, type 2 diabetes, and obesity.     

Interdependence of associations of physical activity, smoking, and alcohol and coffee consumption with serum high-density lipoprotein and non-high-density lipoprotein cholesterol--a population study in eastern Finland

The interdependence of the associations of physical activity, smoking, and consumption of alcohol and coffee with serum high-density lipoprotein and non-high-density lipoprotein cholesterol concentrations was studied in 9,347 persons ages 25-64 years from east and southwest Finland. In covariance analyses with corrections for age, body mass index, saturated fat index, and fasting time, the mean adjusted serum high-density lipoprotein to non-high-density lipoprotein cholesterol ratio was high among physically active male non-smokers but not among smokers (P = 0.024 for two-way interaction). The cholesterol ratio was lower among both men (P = 0.010 for two-way interaction) and women (P = 0.030 for two-way interaction) reporting no or very little use of alcohol, and this association was stronger among smokers and women with high coffee consumption (P less than 0.001 for two-way interaction). Our data suggest that the elevating effect of regular physical exercise on serum high-density lipoprotein cholesterol may be absent in smokers, whereas that of alcohol is greater in smokers than nonsmokers. High coffee consumption associates with decreased serum high-density lipoprotein cholesterol levels in smokers but increased levels in non-smokers.     

中老年人血清瘦素与脂联素水平及其相关危险因素研究

目的 探讨相对健康的中老年人血清瘦素与脂联素水平与心脑血管疾病危险因素的相关性.方法 从"广州生物库队列研究"中收集1515名相对健康的50岁及以上的中老年人个人资料及病史、体格检查并测定血清空腹血糖、血脂、瘦素和脂联素的水平.结果 (1)广州市1515名的血清瘦素水平(x-±s)男女性分别为(3.90±2.36)ng/ml和(12.17±2.01)ng/ml;脂联素水平男女性分别为(5.33±2.78)mg/L和(7.18±2.58)mg/L.(2)男女性血清瘦素和脂联素水平均随年龄增长而升高;在调整BMI后,男性瘦素水平仍随年龄增长而显著升高(趋势检验P＜0.001),而女性其脂联素水平也随年龄增长而显著升高(趋势检验P＜0.05).(3)在调整年龄后,男女性血清瘦素和脂联素水平均与吸烟状态无明显相关(P=0.09～0.76).(4)血清瘦素水平,男女性均随腰围、BMI、SBP、LDL-C和TG增加而显著升高(P=0.04,＜0.001),同时还随男性的DBP和空腹血糖升高及HDL-C降低而显著升高(P=0.03～0.02).(5)血清脂联素水平男女性均随腹围以及TG升高而下降(P=0.003,＜0.001),而男性血清脂联素水平还随BMI与空腹血糖升高及HDL-C水平下降而下降(P=0.05,＜0.001),女性则随SBP和TC上升而下降(P=0.05～0.006).结论 广州市相对健康的中老年人血清瘦素和脂联索水平男性比女性低;男性瘦素水平和女性脂联素水平同年龄增加呈显著相关.血清瘦素升高和脂联素下降与传统心脑血管危险因素上升有关.     

The effects of gender and age on associations between blood lipid levels and obesity in Danish men and women aged 35-65 years.

The purpose of the study was to assess the influence of gender and age on the associations between different measures of obesity, and blood lipid levels. Overall obesity (body fat, body fat percentage and body mass index) or abdominal obesity (waist/hip-ratio, waist/thigh-ratio and waist-circumference) and lipid levels [high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), total cholesterol and triglyceride level] were measured in 1987/88 in a random Danish population sample of men and women (N = 2987), aged 35, 45, 55 and 65 yr. All lipid levels were dependent on gender and age. The associations between most measures of obesity and HDL or LDL were independent of gender and age, whereas, with a few exceptions, associations between measures of obesity and total cholesterol, VLDL or triglycerides were dependent on gender and/or age. Compared to levels of HDL, LDL and total cholesterol, abdominal obesity specifically affected levels of VLDL or triglycerides, whereas overall obesity affected HDL, LDL, VLDL, total cholesterol and triglyceride levels more evenly. When men and women were compared, associations between the measures of obesity and blood lipids were stronger in men than in women of the same age, except for the associations between measures of abdominal obesity and VLDL or triglycerides in 45-year-old women. No age trend was found for associations between the measures of obesity and VLDL or triglycerides, whereas young age-groups showed stronger associations between obesity and total cholesterol than older age-groups. Failure to consider age/gender effects induces bias and may lead to misleading conclusions regarding the bivariate association between obesity and lipids, and further may make results from population studies incomparable.     

Lipids and lipoproteins in a young adult population. The Beaver County Lipid Study

Though atherosclerosis may have its origins in childhood, intervention studies on coronary heart disease risk factors have usually begun in older adults. Whether young adults exhibit similar relationships of lifestyle to coronary heart disease risk factors, and therefore might be suitable candidates for appropriate intervention, is poorly understood. The Beaver County Lipid Study is a 9-year follow-up study of a free-living young adult population (mean age 22 years) who were initially screened for hypercholesterolemia as seventh grade school children. This report focuses upon cross-sectional correlates of lipid and lipoprotein concentrations in 561 individuals (males n = 262; females n = 299) in 1981-1982. Body mass index was positively related to low density lipoprotein (LDL) cholesterol and triglycerides in men (r = 0.21; p less than 0.001 and r = 0.41; p less than 0.001) and women (r = 0.16; p less than 0.001 and r = 0.20; p less than 0.001). Cigarette smoking was inversely associated with high density lipoprotein (HDL) cholesterol in men (r = -0.11; p less than 0.001) and women (r = -0.20; p less than 0.001) but positively related to triglycerides in both sexes (r = 0.10; p = 0.05 for men and r = 0.19; p less than 0.01 for women). Alcohol consumption was positively related to HDL cholesterol and triglycerides only among men (r = 0.19; p less than 0.001 and r = 0.12; p less than 0.05, respectively). Educational achievement was also positively related to HDL cholesterol in men (p less than 0.01) and women (p less than 0.001). Multivariate analyses indicate that the sex difference in LDL cholesterol was largely eliminated by controlling for body mass index while significant sex differences in both HDL cholesterol and triglycerides remained after controlling for covariates. Results suggest that the known associations in older adults of body mass index and health-related behavior with lipoproteins are well established by young adulthood. Early intervention particularly for obesity may help ameliorate some of the male excess in cardiovascular disease risk.     

Serum leptin levels in patients with hyperlipidemias

Leptin is a protein hormone produced by adipocytes that reflects the body fat content. The aim of our study was to compare serum leptin levels in randomly selected untreated males and females with hypercholesterolemia and combined hyperlipidemia and in healthy control subjects matched for age and body mass index and to study the relations between leptin and serum lipids and lipoproteins. No statistically significant differences in serum leptin levels were found between the male control group (5.26 +/- 2.81 ng/mL(-1)) and the male group with hypercholesterolemia (8.16 +/- 3.85 ng/mL(-1)) or combined hyperlipidemia (7.51 +/- 4.83 ng/mL(-1)) and between the female control group (13.0 +/- 8.12 ng/mL(-1)) and the female group with hypercholesterolemia (15.36 +/- 8.89 ng/mL(-1)) or combined hyperlipidemia (18.63 +/- 10.15 ng/mL(-1)). Leptin concentration in male group with hypercholesterolemia did not differ significantly from the female control group; in the other male groups, leptin levels were significantly lower than those of the other female groups. Serum leptin levels in all studied groups except for the male group with hypercholesterolemia positively correlated with body mass index. Serum leptin levels correlated negatively with high-density lipoprotein cholesterol in the female group with hypercholesterolemia (r = -0.67, P < 0.01) and the male group with combined hyperlipidemia (r = -0.56, P < 0.01). A positive correlation between serum leptin and high-density lipoprotein cholesterol (r = 0.67, P < 0.01) and between leptin and lipoprotein (a) (r = 0.71, P < 005) was found in female group with combined hyperlipidemia. No other significant relationships between leptin and serum lipids or lipoproteins were found. We conclude that serum leptin levels in patients with hyperlipidemias do not significantly differ from those healthy control subjects matched by age and body mass index.     

1310例体检人群血清脂蛋白胆固醇与年龄、性别及血糖水平的相关性研究

目的探讨成人血清脂蛋白胆固醇与年龄、性别及空腹血糖水平的关系。方法选择1310名体检健康人作为研究对象,根据年龄分为6组,测定其血清脂蛋白胆固醇及空腹血糖,比较各年龄组及性别间脂蛋白胆固醇变化和差异,并行相关分析。结果极低密度脂蛋白胆固醇(VLDL-C)及低密度脂蛋白胆固醇(LDL-C)有随年龄增长而升高的趋势(r=0.19及0.25,均P=0.000),但60岁后男性VLDL-C有所下降。60岁前各年龄段男性VLDL-C结果均显著高于女性(P=0.000),60岁后男女间无差别(P>0.05)。50岁前男性LDL-C水平均高于女性(P<0.05),50岁以后男女间无差别(P>0.05)。高密度脂蛋白胆固醇(HDL-C)随年龄增长变化不明显(P>0.05),但女性各年龄段HDL-C结果均显著高于男性(P=0.000)。相关分析显示随空腹血糖水平升高VLDL-C升高趋势不明显(r=0.08,P=0.004),但LDL-C有所升高(r=0.13,P=0.000)且HDL-C明显降低(r=-0.18,P=0.000)。结论随年龄增长健康人群有发生脂蛋白代谢紊乱的倾向,且男性趋势更明显;空腹血糖增高和脂代谢紊乱有一定的相关性。     

血清omentin-1与代谢性风险因素的关系

目的 探讨绝经后女性血清网膜素-1（omentin-1）浓度与代谢风险相关因素的关系,进一步了解脂肪组织对代谢性风险因素的影响. 方法 对336名41～81岁的绝经后女性进行横断面研究,测量受试者身高、体重、腰围,血压水平;葡萄糖氧化酶法测定空腹血糖浓度;运用酶联免疫吸附试验（ELISA）测定血清脂肪因子浓度;放射免疫法测定雌激素、胰岛素浓度;全自动生化仪测量血脂浓度;并运用双能X线骨扫描仪（DEXA）测定体脂、躯干体脂、瘦重;分析他们之间的关系. 结果 （1）血清网膜素水平与身高、年龄、绝经年龄、绝经年限、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、血糖、胰岛素抵抗指数、血压相关无显著性（P＞0.05）,其与BMI（r=-0.248）、体重（r=-0.220）、腰围（r=-0.176）、躯干体脂（r=-0.446）、体脂（r=-0.815）、体脂百分比（r=-0.599）负相关;（2）利用非参数检验分析不同代谢性风险因素数目组网膜素水平,发现含有1个及以上代谢性风险因素数目组的网膜素水平明显低于无代谢性风险因素组的水平（P＜0.05）. 结论 （1）绝经后女性血清omentin-1与体重、BMI、腰围、体脂、躯干体脂、体脂百分比负相关;（2）血清omentin-1随代谢性风险因素聚集程度的升高而下降,其可作为代谢性风险因素的预测因子.     

Racial differences in adipocyte size and relationship to the metabolic syndrome in obese women

OBJECTIVE: To determine whether racial differences exist in the relationship of the abnormalities defining the metabolic syndrome (MS) to regional adiposity and fat cell size (FCS) in obese postmenopausal women. RESEARCH METHODS AND PROCEDURES: We determined the relationship of metabolic variables associated with the MS to regional body composition and abdominal (ABD) and gluteal (GLT) FCS in 25 white (CAU) and 25 African-American (AF-AMER) older women matched for age (58 +/- 5 years; mean +/- SD) and BMI (35 +/- 4 kg/m2). RESULTS: MS was present in 36% of the AF-AMER and 57% of the CAU women. There were no differences in total body, trunk, gluteofemoral fat mass or regional FCS, but AF-AMER women had 22% lower visceral fat, 24% higher insulin, and 31% lower triglyceride levels than CAU women (p < 0.05). Multiple regression analysis with body fat, visceral ABD fat area, and FCS as independent variables showed that GLT FCS was independently correlated with 2-hour insulin (r = 0.56), triglyceride (r = 0.62), and high-density lipoprotein cholesterol (r = -0.72) levels in AF-AMER women but not in CAU women, where only systolic blood pressure correlated with subcutaneous ABD fat area (r = 0.57) (p < 0.05). DISCUSSION: The associations between GLT FCS and metabolic dysfunction in obese AF-AMER but not CAU women suggest that central obesity is a less valid predictor of the MS in obese postmenopausal AF-AMER women than in CAU women and that GLT FCS may be a more sensitive indicator of risk for the MS in AF-AMER women.     

Pecans lower low-density lipoprotein cholesterol in people with normal lipid levels

OBJECTIVE: To compare serum lipid profiles and dietary intakes of people with normal lipid levels who consumed pecans and those who did not consume nuts. DESIGN: Eight-week, randomized, controlled study of pecan treatment group vs control group. SUBJECT: Nineteen people with normal lipid levels completed the study; 10 had been randomly assigned to the pecan treatment group (7 women, 3 men, mean age = 45 +/- 10 years) and 9 to the control group (8 women, 1 man, mean age = 37 +/- 12 years). INTERVENTION: The pecan treatment group consumed 68 g pecans per day for 8 weeks plus self-selected diets. The pecans contributed 459 kcal and 44 g fat daily. The control group avoided nuts and consumed self-selected diets. MAIN OUTCOME MEASURES: Total serum cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and total triglyceride levels were measured at the time of entrance to the study (baseline), week 4, and week 8. Computer analyses were done on five 3-day food records. STATISTICAL ANALYSIS: Comparisons were made using analysis of variance or paired t test. RESULTS: LDL-C was lowered in the pecan treatment group from 2.61 +/- 0.49 mmol/L at baseline to 2.35 +/- 0.49 at week 4 (P < .05) and to 2.46 +/- 0.59 at week 8 (P < .05). At week 8, total cholesterol and HDL-C in the pecan treatment group were significantly lower (P < .05) than in the control group (total cholesterol: 4.22 +/- 0.83 vs 5.02 +/- 0.54 mmol/L; HDL-C: 1.37 +/- 0.23 vs 1.47 +/- 0.34 mmol/L). Dietary fat, monounsaturated fat, polyunsaturated fat, insoluble fiber, magnesium, and energy were significantly higher in the pecan treatment group than in the control group. Body mass indexes and body weights were unchanged in both groups. APPLICATIONS: Pecans can be included in a healthful diet when energy intake and potential weight gain are addressed.     

Sex differences in the coronary heart disease risk profile: a possible role for insulin. The Beaver County Study

The mortality rate from coronary heart disease is much higher among men than women except in diabetes mellitus, which appears to reduce this sex difference. It is hypothesized that the female advantage is due, at least partly, to the more efficient insulin mediated glucose homeostasis in females, an advantage lost in the diabetic state. The authors studied 170 young adult men and women aged 20-24 years from a population-based survey in Beaver County, Pennsylvania, in 1981-1982, in an attempt to further elucidate the sex-specific relationships between fasting serum insulin concentrations and several risk factors. Women who used oral contraceptives and subjects whose fasting serum glucose exceeded 110 mg/dl were excluded. Insulin was related to body mass index in both sexes (r = 0.31; p less than 0.01 for men; r = 0.26, p less than 0.01 for women) and to systolic blood pressure (r = 0.27, p less than 0.01 for men; r = 0.36, p less than 0.001 for women). Insulin was related to diastolic blood pressure in men only (r = 0.31, p less than 0.05). Multivariate analysis revealed fasting serum insulin to be an independent predictor of systolic blood pressure in both sexes and of diastolic blood pressure in men only. Insulin was inversely related to high density lipoprotein cholesterol only among men and this relationship appeared to be largely independent of body mass index and triglycerides. Results indicate that insulin concentration is associated with an adverse coronary heart disease risk factor profile especially among men, consistent with their excess risk of cardiovascular disease.     

Combined effects of saturated fat and cholesterol intakes on serum lipids: Tehran Lipid and Glucose Study

ObjectiveThis study investigated the combined effect of saturated fat and cholesterol intake on serum lipids among Tehranian adults.MethodsIn 443 subjects ≥18 y, dietary intake was assessed. Height and weight were measured and body mass index was calculated. Serum cholesterol, triacylglycerol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol levels were calculated. Cholesterol intakes ≥300 mg/d and saturated fat intakes ≥7% of total energy were defined as high intakes. Individuals were categorized into four groups based on cholesterol and saturated fat intakes.ResultsSubjects' mean age was 40.1 ± 14.6 y; those in whom cholesterol and saturated fat intake was normal had significantly less energy and fat intake than those with high cholesterol and saturated fat intakes (P < 0.01). Saturated fat intake had a significant effect on serum total and HDL-C levels. Subjects with a normal saturated fat intake had significantly less serum total and HDL-C than those who had high saturated fat intake (P < 0.01 and P < 0.05, respectively). Adjusting for age, sex, and body mass index, the main effect of cholesterol intake on HDL-C was significant (P = 0.05). Mean serum HDL-C was lower in subjects who had normal cholesterol intake than in those with high cholesterol intake.ConclusionThese results show that cholesterol and saturated fat intakes have no combined effect on serum low-density lipoprotein cholesterol level, whereas cholesterol intake per se affects serum HDL-C level.     

Women and Men with Hypercholesterolemia Respond Similarly to an American Heart Association Step 1 Diet

Objective To compare serum lipid level responses of women and men with hypercholesterolemia to an American Heart Association (AHA) step 1 diet.Design Sixty-three women and 99 men with varying degrees of hypercholesterolemia were instructed on an AHA step 1 diet. Subjects were followed up on a biweekly basis with individual visits and group classes for 8 weeks.Setting Outpatient clinic facility of the Metabolic Research Group, University of Kentucky, Lexington.Subjects/samples Through community cholesterol screenings, we recruited 76 women and 108 men aged 30 to 70 years who were within 80% to 130% of their ideal body weight. Serum cholesterol levels were between 5.17 mmol/L and 8.99 mmol/L and serum triglyceride levels when subjects were fasting were less than 5.08 mmol/L. Sixty-three women and 99 men completed the study.Intervention Subjects followed an AHA step 1 diet (30% of energy from fat, 50 to 60% of energy from carbohydrate, 10 to 20% of energy from protein, and less than 300 mg cholesterol per day) for 8 weeks.Main outcome measures Serum lipid levels, nutrient intake, and body weight.Statistical analyses performed Subjects were divided into three groups according to initial serum cholesterol levels (mild=5.17 to 6.17 mmol/L; MODERATE=6.20 to 6.95 mmol/L; SEVERE = 6.98 mmol/L). Within-individual changes in nutrient intakes, body weights, and serum lipid levels were analyzed using dependent t tests. Between-group comparisons were made using analysis of variance (ANOVA). When significant differences were found using ANOVA, differences between groups were evaluated with the Tukey test.Results All subjects tolerated the diet well and average dietary adherence was good, as assessed by a food frequency questionnaire and analysis of 3-day diet records. Serum total cholesterol levels decreased 9.2% overall for women (P<.001) and 7.2% for men (P<.001); serum low-density lipoprotein cholesterol levels decreased 9.2% for women and 9.8% for men; and serum high-density lipoprotein cholesterol levels decreased 3.6% for women and 2.8% for men. Mean serum triglyceride levels decreased significantly for women but not for men. No significant differences were found in the responses of women and men in the corresponding groups. Women and men with higher initial serum cholesterol values showed significantly greater hypocholesterolemic responses to diet than those with lower initial serum cholesterol values.Applications/conclusions The findings of this study confirm the beneficial role of dietary intervention for reducing atherogenic serum lipid levels in women and men. J Am Diet Assoc. 1995; 95:436–441.     

Lack of an association between coffee consumption and lipoprotein lipids and apolipoproteins in young adults: The beaver county study

The relationship between coffee consumption and lipoprotein lipids and apolipoproteins was examined in 472 white men and women (20-24 years of age) in Beaver County, Pennsylvania, during 1981-1982. Coffee intake, expressed as nondrinker, one to two cups per day, and three or more cups per day, was unrelated to total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, or apoproteins AI, AII, or B. After covariate adjustment for cigarette smoking, alcohol intake, body mass index, and adherence to a diet low in cholesterol and saturated fat, the results remained essentially unchanged. The only statistically significant finding was that women who consumed three or more cups of coffee per day had significantly lower triglyceride concentrations compared with coffee nondrinkers (P less than 0.05). Thus, these findings fail to substantiate a significant association of low to moderate coffee intake with an increased lipid and apoprotein risk profile in these young adults.     

Body composition in HIV-infected women

Although loss of lean body mass is a common complication of human immunodeficiency virus (HIV) infection that can occur across the disease trajectory, few studies have characterized the body composition of HIV-infected women. We used bioelectrical impedance analysis to characterize the body composition of HIV-infected (n = 56) and uninfected (n = 12) women who were matched on percentage of ideal body weight. The HIV-infected women did not differ from the uninfected women by height-adjusted fat mass or body cell mass. Intergroup comparisons among the HIV-infected women showed that underweight women had significantly less fat mass than did normal-weight women but did not significantly differ with respect to body cell mass. Among all HIV-infected women, CD4(+) lymphocyte count was positively correlated with fat mass (r = 0.32, P = 0.01) but not with body cell mass. No significant correlations were found between any body-composition parameter and plasma viral load. Our findings suggest that, unlike men, HIV-infected underweight women show a preferential loss of fat mass and a relative preservation of body cell mass. This altered pattern of weight loss may relate to higher premorbid fat stores in women and/or hormonal differences.     

Body fat distribution in the Finnish population: environmental determinants and predictive power for cardiovascular risk factor levels.

STUDY OBJECTIVE--The aim was to examine (1) whether health habits are associated with body fat distribution, as measured by the waist/hip girth ratio, and (2) to what extent environmental factors, including anthropometric characteristics, explain the variability in levels of cardiovascular risk factors. DESIGN--The study was a population based cross sectional survey, conducted in the spring of 1987 as a part of an international research project on cardiovascular epidemiology. SETTING--The survey was conducted in three geographical areas of eastern and south western Finland. SUBJECTS--2526 men and 2756 women aged 25-64 years took part in the study, corresponding to a survey participation rate of 82%. MEASUREMENTS AND MAIN RESULTS--In men, waist/hip ratio showed stronger associations with exercise (Pearson's r = -0.24), resting heart rate (r = 0.10), alcohol consumption (r = 0.07), smoking (r = 0.05), and education (r = -0.23) than did body mass index. Jointly, exercise, resting heart rate, alcohol consumption, education, and age explained 18% of variance in male waist/hip ratio, but only 9% of variance in male body mass index. In women, environmental factors were more predictive for body mass index than for waist/hip ratio, with age and education being the strongest determinants. Waist/hip ratio and body mass index were approximately equally strong predictors of cardiovascular risk factor levels. The additional predictive power of waist/hip ratio over and above body mass index was tested in a hierarchical, stepwise regression. In this conservative type of analysis the increase in explained variance uniquely attributable to waist/hip ratio was 2-3% for female and 1-2% for male lipoprotein levels, and less than 0.5% for female and 0-2% for male blood pressure values. CONCLUSIONS--The distribution of abdominal obesity in Finland is significantly influenced by health habits and sociodemographic factors in both men and women. This in turn is obviously one reason for the relatively small "independent" effect of body fat distribution on cardiovascular risk factor levels.     

Anthropometric assessment of 10-y changes in body composition in the elderly

BACKGROUND: An increased central distribution of fat with advancing age is associated with chronic metabolic and cardiovascular abnormalities. Little is known about the magnitude or pattern of fat distribution and its association with healthy aging. OBJECTIVE: This study describes approximately 10-y changes in body composition at 11 anthropometric sites in elderly persons and the metabolic and physical activity factors associated with these changes. DESIGN: Skinfold thicknesses, girths, body fat by hydrodensitometry, physical activity by questionnaire, and metabolic variables were examined twice, 9.4 +/- 1.4 y apart, in 54 men and 75 women aged 60.4 +/- 7.8 y at baseline. RESULTS: Subcutaneous fat declined (-17.2%; P < 0.001), whereas total fat mass increased (7.2%; P < 0.05). Waist and hip circumference changes were the best anthropometric predictors of total fat mass change (r(2) = 0.40-0.65, P < 0.0001). Thigh girth change was more strongly associated with fat-free mass change (r(2) = 0.22, P < 0.01) than with fat mass change (r(2) = 0.07, P < 0.05) in women. An increase in physical activity was associated with an attenuation of thigh girth decline in men and women (F ratio = 5.13, P < 0.007). Traditional metabolic markers of visceral adiposity (triacylglycerol, glucose, and total cholesterol) were not significantly related to the change in waist circumference. CONCLUSIONS: Skinfold thicknesses cannot be used to assess changes in body fat mass because of age-related fat redistribution. Higher levels of physical activity can attenuate the decline in appendicular lean tissue expected over 10 y. Waist and thigh girths, rather than skinfold thicknesses, should be considered for use in longitudinal studies in the elderly because the changes in these girths capture increased abdominal adiposity and sarcopenia, respectively.     

Serum leptin concentrations in patients with short-bowel syndrome

BACKGROUND: Short-bowel syndrome is a state of severe malabsorption resulting from absence or removal of the small bowel for several causes. A number of short-bowel patients develop hyperphagia. Leptin, a protein secreted from adipose tissue, signals the amount of energy stores to the brain. OBJECTIVE: To study body composition and leptin regulation in short-bowel patients and to determine whether or not leptin concentrations are linked with hyperphagia. DESIGN: We studied 25 short-bowel patients (remnant bowel less than 150 cm) and 31 controls and 10 oral nutrition. Fifteen patients received total parenteral nutrition and 10 oral nutrition. Anthropometric measurements, body composition (by bioelectrical impedance), and cholesterol, triacylglycerol and leptin concentrations were studied in all subjects. RESULTS: There were no differences between short-bowel patients and controls in anthropometric variables, body composition, or leptin concentrations. Leptin concentrations were higher in short-bowel women than men (9.21+/-8.54 vs. 3.22+/-1.86 ng/ml, P=0.01). Leptin concentrations correlated positively with age (r=0.4, P=0.045), body mass index (r=0.52, P=0.007), fat mass (r=0.67, P=0.001) and body fat (r=0.68, P=0.0001); there were no correlations with other body composition parameters. We found no correlations between parenteral or oral nutrition and body composition parameters, or between leptin concentrations and the presence of hyperphagia. Logistic regression analysis showed that body fat correctly identified leptin concentrations in 60% of patients. CONCLUSIONS: Body composition, leptin concentrations and leptin regulation in patients with short-bowel syndrome are similar to those of controls. Leptin concentrations do not correlate with hyperphagia in short bowel-patients.     

Fat distribution and gamma-glutamyl transferase in relation to serum lipids and blood pressure in 38-year old Dutch males

In this study we describe the associations between indicators of fatness, fat distribution, and alcohol consumption (gamma-glutamyl transferase) with serum lipids and blood pressure in a random selected group (n = 69) of 38-year old men. Waist circumference, subscapular skinfold and body mass index all had similar positive associations with total cholesterol, triglycerides and diastolic blood pressure. Gamma-glutamyl transferase levels were associated with indicators of fatness and fat distribution (waist circumference, waist/hip ratio, body mass index, and subscapular skinfold) and serum lipids (total cholesterol, LDL-cholesterol, triglycerides). Gamma-glutamyl transferase and body mass index both made independent contributions to the explanation of the waist/hip ratio. In multiple regression analysis, gamma-glutamyl transferase levels were (after adjustment for waist/hip ratio and body mass index) associated with serum lipids (total cholesterol, LDL-cholesterol, and triglycerides), but not with HDL-cholesterol and blood pressure. Body mass index only showed an independent relation to triglyceride levels, whereas the waist/hip ratio was only associated with diastolic blood pressure in multiple regression. It is concluded that gamma-glutamyl transferase levels are a potentially important indicator of abdominal fat distribution and unfavourable lipoprotein profiles.     

Correlates of high-density lipoprotein cholesterol in a sample of healthy workers

METHODS. Correlates of high-density lipoprotein cholesterol are analyzed in a sample of 797 male workers in southern Italy participating in the Olivetti Heart Study. At the univariate level high-density lipoprotein cholesterol concentrations are positively related to alcohol consumption (r = 0.127; P less than or equal to 0.001) and sport activity (r = 0.074; P less than or equal to 0.05) and inversely related to body mass index (r = -0.160; P less than or equal to 0.001), serum triglycerides (r = -0.349; P less than or equal to 0.001), cigarette smoking (r = -0.227; P less than or equal to 0.001), and coffee consumption (r = -0.153; P less than or equal to 0.001). RESULTS. In the group as a whole, body mass index, alcohol consumption, cigarette smoking, and serum triglycerides remain significantly related to high-density lipoprotein cholesterol in the multivariate model, while the association with coffee intake and sport activity loses statistical significance. A significant negative interaction is reported between physical activity and cigarette smoking, and a positive significant linear trend between high-density lipoprotein cholesterol and sport activity is observed only in nonsmokers. CONCLUSION. These findings suggest that body mass index, alcohol consumption, cigarette smoking, serum triglycerides, and sport activity are important correlates of high-density lipoprotein cholesterol but that the positive significant association between sport activity and high-density lipoprotein cholesterol is absent in smokers.