The impact of resistance training has not been thoroughly examined in overweight older adults undergoing weight loss. Subjects (n = 27) were overweight and obese (BMI 31.7 +/- 3.6 kg/m(2)) older (age 67 +/- 4 years) adults and were randomized into either a 10-week Dietary Approaches to Stop Hypertension for weight loss diet (DASH, n = 12) or DASH plus moderate intensity resistance training (DASH-RT, n = 15). Outcomes included weight loss, total body and mid-thigh composition, muscle and physical function. There were no significant weight loss differences between the DASH-RT and DASH groups (-3.6 +/- 0.8 vs. -2.0 +/- 0.9%, p = 0.137). The DASH-RT group had a greater reduction in body fat than the DASH group (-4.1 +/- 0.9 vs. -0.2 +/- 1.0 kg, p = 0.005). The DASH-RT group had greater changes in lean mass (+0.8 +/- 0.4 vs. -1.4 +/- 0.4 kg, p = 0.002) and strength (+60 +/- 18 vs. -5 +/- 9 N, p = 0.008) than the DASH group. There were favorable changes in mid-thigh composition variables in the DASH-RT group that were different than the lack of changes observed in the DASH group, except for intermuscular adipose tissue. Both groups experienced decreases in 400-m walk times showed (DASH -36 +/- 11 s, DASH-RT -40 +/- 7 s) with no differences between groups. Moderate intensity resistance training during weight loss appears to improve fat mass and thigh composition, but weight loss only does not. However, global measures of physical functioning may improve with a weight loss-only program.

Young adults have and are at risk of developing MetS. Identification of MetS early in life is critical and screening young adults will aid in targeted intervention development to decrease CHD risk.

Because of high rates of overweight/obesity and MbS, college-age adults are at risk for developing chronic diseases including diabetes mellitus and cardiovascular disease.

More than one-half of young adults aged 18-24 y have at least 1 coronary heart disease (CHD) risk factor and nearly one-quarter have advanced atherosclerotic lesions. The extent of atherosclerosis is directly correlated with the number of risk factors. Unhealthy dietary choices made by this age group contribute to weight gain and dyslipidemia. Risk factor profiles in young adulthood strongly predict long-term CHD risk. Early detection is critical to identify individuals at risk and to promote lifestyle changes before disease progression occurs. Despite the presence of risk factors and pathological changes, risk assessment and disease prevention efforts are lacking in this age group. Most young adults are not screened and are unaware of their risk. This review provides pathological evidence along with current risk factor prevalence data to demonstrate the need for early detection. Eighty percent of heart disease is preventable through diet and lifestyle, and young adults are ideal targets for prevention efforts because they are in the process of establishing lifestyle habits, which track forward into adulthood. This review aims to establish the need for increased screening, risk assessment, education, and management in young adults. These essential screening efforts should include the assessment of all CHD risk factors and lifestyle habits (diet, exercise, and smoking), blood pressure, glucose, and body mass index in addition to the traditional lipid panel for effective long-term risk reduction.

The ATP binding cassette G5 (ABCG5) polymorphisms have been postulated to play a role in the response to dietary cholesterol. The objective of this study was to examine the contribution of the ABCG5 polymorphism on the plasma response to consumption of cholesterol and carotenoids from eggs. For this purpose, genotyping was conducted for 40 men and 51 premenopausal women who were randomly assigned to consume an egg (EGG, 640 mg/d additional dietary cholesterol and 600 microg lutein+ zeaxanthin) or placebo (SUB, 0 mg/d cholesterol, 0 microg lutein + zeaxanthin) diet for 30 d. The two arms of the dietary intervention were separated by a 3-wk washout period. Plasma concentrations of total cholesterol, LDL cholesterol (LDL-C), and HDL cholesterol were determined. Because eggs are an excellent source of lutein and zeaxanthin, the plasma levels of these carotenoids were also measured in a subset of subjects to determine whether the response to carotenoid intake was similar to that seen for dietary cholesterol and to evaluate the contribution of ABCG5 polymorphism to both responses. Individuals possessing the C/C genotype experienced a greater increase in both LDL-C (P < 0.05) and a trend for lutein (P = 0.08) during the EGG period compared with those individuals with the C/G (heterozygote) or G/G genotypes (homozygotes). These results, although obtained from a small number of subjects, suggest that the ABCG5 polymorphism may play a role in the plasma response to dietary cholesterol and carotenoids.

Waist circumference (WC) has been postulated to have stronger associations with biomarkers of coronary heart disease (CHD) than BMI. In this study, we measured the level of activity by determining steps walked per day and select biomarkers for CHD risk in 80 overweight or obese (BMI = 25-37 kg/m(2)) premenopausal women to evaluate whether these biomarkers are associated with WC or BMI. The plasma biomarkers measured, using samples from women who had fasted for 12 h, were lipids, apolipoproteins (apo), LDL peak diameter, LDL susceptibility to oxidation, glucose, leptin, and insulin. We identified subjects with the metabolic syndrome (11%) and insulin resistance (30%) to further distinguish subjects at increased risk for CHD. Both BMI and WC were positively correlated with insulin (r = 0.376 and 0.384, respectively, P < 0.05) and leptin (r = 0.614 and 0.512, respectively, P < 0.01) and negatively correlated with the number of steps taken per day (r = -0.245 and -0.354, respectively, P < 0.05). In addition, WC had positive correlations with diastolic blood pressure (r = 0.250, P < 0.05), plasma triglycerides (TG) (r = 0.270, P < 0.05), and apo C-III (r = 0.240, P < 0.05). Women with BMI > or = 30 kg/m(2) or WC > 88 cm had significantly higher leptin concentrations than women having a BMI < 30 kg/m(2) or a WC < or = 88 cm; women with WC > 88 cm also had higher diastolic pressure (P < 0.05), and higher plasma TG (P < 0.05) and apo C-III (P < 0.05) concentrations than those with WC < or = 88. In addition, subjects with the higher WC walked an average of 1000 fewer steps per day (P < 0.01). These results suggest that WC is a stronger predictor of CHD risk than BMI and is more closely associated with the level of exercise in premenopausal women.

The addition of TC to diet education is more effective than diet education alone at improving diet quality and emerging CHD risk factors, such as LDL particle size, in obese older women.

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