Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991

Kuczmarski, Robert J.; Flegal, Katherine M.; Campbell, Stephen; Johnson, Clifford L.

doi:10.1001/jama.272.3.205

Cited by 1,498 publications

(927 citation statements)

References 36 publications

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“…The prevalence of overweight (body mass index (BMI) > 25 kg=m 2 ) and obesity (BMI > 30 kg=m 2 ) are estimated to be 63 and 55% among American middle-aged men and women, respectively (Must et al, 1999), and the increase in prevalence of obesity in the last two decades is 8% (Kuczmarski et al, 1994).…”

Section: The Glycemic Index In Obesitymentioning

confidence: 99%

Glycemic index in chronic disease: a review

et al. 2002

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Aim: The intent of this review is to critically analyze the scientific evidence on the role of the glycemic index in chronic Western disease and to discuss the utility of the glycemic index in the prevention and management of these disease states. Background: The glycemic index ranks foods based on their postprandial blood glucose response. Hyperinsulinemia and insulin resistance, as well as their determinants (eg high energy intake, obesity, lack of physical activity) have been implicated in the etiology of diabetes, coronary heart disease and cancer. Recently, among dietary factors, carbohydrates have attracted much attention as a significant culprit, however, different types of carbohydrate produce varying glycemic and insulinemic responses. Low glycemic index foods, characterized by slowly absorbed carbohydrates, have been shown in some studies to produce beneficial effects on glucose control, hyperinsulinemia, insulin resistance, blood lipids and satiety. Method: Studies on the short and long-term metabolic effects of diets with different glycemic indices will be presented and discussed. The review will focus primarily on clinical and epidemiological data, and will briefly discuss in vitro and animal studies related to possible mechanisms by which the glycemic index may influence chronic disease.

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Section: The Glycemic Index In Obesitymentioning

confidence: 99%

Glycemic index in chronic disease: a review

et al. 2002

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“…Whereas low fat diets for calorie reduction can undoubtedly be effective for many people, we feel that they cannot be taken as an established standard; to our knowledge, there has never been a long term study where a low fat diet was instituted in the absence of confounding features such as cessation of smoking and exercise. Also, fat restriction per se does not enhance long-term (one year or longer) weight loss or prevent regain of weight [19] and the record of compliance is modest at best [20]. Most important, the fact that, in the obesity and diabetes epidemic, fat consumption went down (for men, the absolute amount) and carbohydrate consumption went up [21,22], means that other approaches should be considered.…”

Section: Introductionmentioning

confidence: 99%

Carbohydrate restriction improves the features of Metabolic Syndrome. Metabolic Syndrome may be defined by the response to carbohydrate restriction

2005

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Metabolic Syndrome (MetS) represents a constellation of markers that indicates a predisposition to diabetes, cardiovascular disease and other pathologic states. The definition and treatment are a matter of current debate and there is not general agreement on a precise definition or, to some extent, whether the designation provides more information than the individual components. We consider here five indicators that are central to most definitions and we provide evidence from the literature that these are precisely the symptoms that respond to reduction in dietary carbohydrate (CHO). Carbohydrate restriction is one of several strategies for reducing body mass but even in the absence of weight loss or in comparison with low fat alternatives, CHO restriction is effective at ameliorating high fasting glucose and insulin, high plasma triglycerides (TAG), low HDL and high blood pressure. In addition, low fat, high CHO diets have long been known to raise TAG, lower HDL and, in the absence of weight loss, may worsen glycemic control. Thus, whereas there are numerous strategies for weight loss, a patient with high BMI and high TAG is likely to benefit most from a regimen that reduces CHO intake. Reviewing the literature, benefits of CHO restriction are seen in normal or overweight individuals, in normal patients who meet the criteria for MetS or in patients with frank diabetes. Moreover, in low fat studies that ameliorate LDL and total cholesterol, controls may do better on the symptoms of MetS. On this basis, we feel that MetS is a meaningful, useful phenomenon and may, in fact, be operationally defined as the set of markers that responds to CHO restriction. Insofar as this is an accurate characterization it is likely the result of the effect of dietary CHO on insulin metabolism. Glucose is the major insulin secretagogue and insulin resistance has been tied to the hyperinsulinemic state or the effect of such a state on lipid metabolism. The conclusion is probably not surprising but has not been explicitly stated before. The known effects of CHO-induced hypertriglyceridemia, the HDL-lowering effect of low fat, high CHO interventions and the obvious improvement in glucose and insulin from CHO restriction should have made this evident. In addition, recent studies suggest that a subset of MetS, the ratio of TAG/HDL, is a good marker for insulin resistance and risk of CVD, and this indicator is reliably reduced by CHO restriction and exacerbated by high CHO intake. Inability to make this connection in the past has probably been due to the fact that individual responses have been studied in isolation as well as to the emphasis of traditional therapeutic approaches on low fat rather than low CHO.We emphasize that MetS is not a disease but a collection of markers. Individual physicians must decide whether high LDL, or other risk factors are more important than the features of MetS in any individual case but if MetS is to be considered it should be recognized that reducing CHO will bring improvement. Response of symptoms to CHO ...

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“…[1][2][3] Although life-style treatments should be considered first, most patients do not achieve and maintain sufficient weight loss with diet and exercise alone. 4 One possible therapeutic approach is a combination of diet and exercise with antiobesity medications.…”

Section: Introductionmentioning

confidence: 99%

Influence of Sibutramine on blood pressure: evidence from placebo-controlled trials

et al. 2005

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OBJECTIVE: Sibutramine, a serotonin and norepinephrine transporter inhibitor, is widely used as an adjunctive obesity treatment. There have been concerns that norepinephrine reuptake inhibition with sibutramine could exacerbate arterial hypertension. DESIGN: Combined analysis of two placebo-controlled trials. SUBJECTS: The combined data set consisted of 1336 patients. Of these patients, 966 were randomized to sibutramine and 370 were randomized to placebo. MEASUREMENTS: Body weight, blood pressure, heart rate (HR). RESULTS: Sibutramine reduced body weight regardless of basal blood pressure. In the complete set of patients, systolic blood pressure did not change with either intervention over the 48-week period (À0.1715.5 mmHg with sibutramine, À0.2715.2 mmHg with placebo, P ¼ 0.9). The change in diastolic blood pressure over the 48 week period was 0.379.5 mmHg with sibutramine and À0.879.2 mmHg with placebo (P ¼ 0.049). The blood pressure response was not exacerbated in patients with grade 1 or 2 hypertension or in patients with isolated systolic hypertension. Sibutramine treatment caused a slight increase in supine HR that was sustained throughout the studies. CONCLUSIONS: Sibutramine treatment is unlikely to elicit a critical increase in blood pressure even in hypertensive patients. However, blood pressure and HR should be monitored closely. In patients who experience a clinically significant and sustained increase in blood pressure, the drug should probably be discontinued.

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Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991

Cited by 1,498 publications

References 36 publications

Glycemic index in chronic disease: a review

Glycemic index in chronic disease: a review

Carbohydrate restriction improves the features of Metabolic Syndrome. Metabolic Syndrome may be defined by the response to carbohydrate restriction

Influence of Sibutramine on blood pressure: evidence from placebo-controlled trials

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