Dietary Intake of Whole and Refined Grain Breakfast Cereals and Weight Gain in Men

Objective: Prospective studies have suggested that substituting whole grain for refined grain products may lower the risk of overweight and obesity. Breakfast cereal intake is a major source of whole and refined grains and has also been associated with having a lower BMI. The aim of this study was to prospectively assess the association between whole and refined grain breakfast cereal intakes and risk of overweight (BMI ≥ 25 kg/m²) and weight gain. Research Methods and Procedures: We examined 17, 881 U.S. male physicians 40 to 84 years of age in 1982 who were free of cardiovascular disease, diabetes mellitus, and cancer at baseline and reported measures of breakfast cereal intake, weight, and height. Results: Over 8 and 13 years of follow‐up, respectively, men who consumed breakfast cereal, regardless of type, consistently weighed less than those who consumed breakfast cereals less often (p value for trend = 0.01). Whole and refined grain breakfast cereal intake was inversely associated with body weight gain over 8 years, after adjustment for age, smoking, baseline BMI, alcohol intake, physical activity, hypertension, high cholesterol, and use of multivitamins. Compared with men who rarely or never consumed breakfast cereals, those who consumed ≥1 serving/d of breakfast cereals were 22% and 12% less likely to become overweight during follow‐up periods of 8 and 13 years (relative risk, 0.78 and 0.88; 95% confidence interval, 0.67 to 0.91 and 0.76 to 1.00, respectively). Discussion: BMI and weight gain were inversely associated with intake of breakfast cereals, independently of other risk factors.     

Changing Diet and Exercise Behaviors in Individuals at Risk for Weight Gain

To date, there have been very few studies on the primary prevention of obesity and/or weight gain. This paper identifies three time periods that might be appropriate for such efforts at weight gain prevention-the 25 to 35 year age window, the perimeno pausal period, and the year following successful weight loss. Research is encouraged that compares these three time periods and various intervention strategies. Several different approaches to primary prevention are identified, including group treatment pro grams with weekly meetings vs. less intensive, community- based interventions; focusing on those who are currently at ideal body weight vs. including those who are over weight as well; and targeting weight gain prevention per se vs. attempting to produce modest weight losses and/or modify cardiovascular risk factors. This paper suggests that primary prevention efforts should include exercise, changes in quality and quantity of food consumed, behavior modification, and some degree of therapist contact, but the manner in which these changes should be implemented to produce long-term habit change remains unclear.     

Beliefs About Weight Gain and Attitudes Toward Relapse in a Sample of Women and Men with Obesity

Objective : The purpose of this study was to examine beliefs regarding reasons for weight gain, likely responses to weight loss relapse, notions of reasonable weight loss, and correlations between beliefs and attitudes in a large nonclinical sample of men and women with obesity. Research Methods and Procedures : Participants were 3,394 white women (n= 1,674) and men (n = 1,720) with obesity who had responded to a survey about body image and eating behaviors conducted by Consumer Reports magazine. Results : Women and men indicated that the most important reasons for their weight gain were lack of exercise and enjoying eating; the least important reason was a need to avoid social or sexual situations. Both groups reported that their most likely response to relapse is to start watching food intake, whereas their least likely response is to ask a friend, spouse, or family member for help. Women rated depression, stress, low self-esteem, and need to avoid situations as more important reasons for their weight gain than did men, and women were more likely to feel terrible and regain as a response to relapse. There was no relationship between an individual's beliefs about weight gain, responses to relapse, or notions of reasonable weight loss. Discussion : Implications of these findings for the treatment of obesity are discussed.     

Association of Cholecystokinin 1 Receptor and β3‐Adrenergic Receptor Polymorphisms with Midlife Weight Gain

We investigated the relationship of polymorphisms in the cholecystokinin 1 receptor [CCK1R; G to T (n‐128), A to G (n‐81)] and the β₃‐adrenergic receptor (β₃‐AR; Trp64Arg) with midlife weight gain. The participants were 1012 Japanese men and women (40 to 59 years of age). Their weight at 18 years old was obtained from a questionnaire. Weight change was defined as the current weight minus the weight at 18 years old. Subjects were grouped into four categories by these genotypes: W/W = noncarriers, W/H = Arg⁶⁴ carriers of the β₃‐AR, H/W = T (n‐128) or G (n‐81) carriers of the CCK1R, H/H = T (n‐128) or G (n‐81) and Arg⁶⁴ carriers. In men, the interaction between the CCK1R and β₃‐AR polymorphisms was significant (two‐way ANOVA, p < 0.05), but neither the CCK1R nor the β₃‐AR was individually associated with weight gain. The H/H group showed a higher possibility of weight gain of 10 kg or more compared with the W/W group in men. The odds ratio for weight gain (≥10 kg) of H/H was 2.54 (95% confidence interval: 1.50 to 4.30) compared with W/W. In women, neither main effect nor interaction was significant. These results suggest that the combination of CCK1R and the β₃‐AR polymorphisms is a contributing factor for midlife weight gain in men.     

Inflammation Markers Predict Increased Weight Gain in Smoking Quitters

Objective: Undesirable weight gain often follows smoking cessation. We investigated whether weight gain after smoking cessation is greater in those with higher levels of inflammatory markers. Research Methods and Procedures: We studied weight gain and risk of a large gain (≥90th percentile) over 3 years in a cohort study of 11, 687 U.S. men and women, 45 to 64 years old, with focus on the 2664 who continued and the 493 who quit smoking. Results: Among new quitters, adjusted weight gain for those in the highest (vs. lowest) quartile of leukocytes was 0.56 kg/yr more (95% confidence interval, 0.17 to 0.95); for those in the highest (vs. lowest) quartile of fibrinogen, 0.60 kg/yr more (95% confidence interval, 0.27 to 0.92; p = 0.02 and 0.001 for adjusted smoking status by leukocyte and smoking status by fibrinogen interaction terms, respectively). In adjusted analyses, the odds ratio for a large gain associated with quitting (vs. continuing) was 6.2 for those in the highest quartile of leukocytes vs. 2.2 for those in the lowest leukocyte quartile (p = 0.03 for smoking status by inflammatory marker interaction). Similarly, the odds ratio for a large gain associated with quitting was 4.5 in the highest fibrinogen quartile vs. 2.5 in the lowest (p = 0. 09 for the interaction term). Discussion: Weight gain after smoking cessation is increased in those with higher baseline levels of leukocytes and fibrinogen. These findings suggest a close relationship between inflammatory mediators and regulators of energy balance that may have important clinical implications.     

A Low Sympathoadrenal Activity is Associated with Body Weight Gain and Development of Central Adiposity in Pima Indian Men

TATARANNI P ANTONIO JAMES B YOUNG, CLIFTON BOGARDUS, ERIC RAVUSSIN. A low sympathoadrenal activity is associated with body weight gain and development of central adiposity in Pima Indian men. To investigate the possible role of impaired sympathetic nervous system and/or adrenal medullary function in the etiology of human obesity, we studied 64 Pima Indian men (28 ± 6 years, 101 ± 25 kg, 34 ± 9% body fat, mean ± SD) in whom sympathoadrenal function was estimated at baseline by measurements of 24-hour urinary norepinephrine (NE) and epinephrine (Epi) excretion rates under weight-maintenance conditions. Body weight, body composition (hydrodensitometry), and body fat distribution (waist-to-thigh circumference ratio, W/T) were measured at baseline and follow-up. Follow-up data were available on 44 subjects who gained on average 8.4 ± 9.5 kg over 3.3 ± 2.1 years. In these subjects, baseline NE excretion rate, adjusted for its determinants (i.e., fat free mass, fat mass, and W/T), correlated negatively with bodyweight gain (r=?0.38; p=0.009). Baseline Epi excretion rate correlated negatively with changes in W/T (r=?0.44; p=0.003). In conclusion, our data show for the first time that a low sympathetic nervous system activity is associated with body weight gain in humans. Also, a low activity of the adrenal medulla is associated with the development of central adiposity.     

Birth Weight,Adulthood BMI,and Subsequent Weight Gain in Relation to Leptin Levels in Swedish Women

LISSNER, LAUREN, CECILIA KARLSSON, ANNA KARIN LINDROOS, LARS SJOSTROM, BJORN CARLSSON, LENA CARLSSON, AND CALLE BENGTSSON. Birth weight, adulthood BMI, and subsequent weight gain in relation to leptin levels in Swedish women. Obes Res. Objective Leptin seems to be involved in the regulation of energy balance, although little is known about the epidemiology of leptin with respect to prediction of weight gain and incidence of obesity-related diseases. The dual aim of this study is to document characteristics of leptin after long-term storage, and to describe its relation to body weight, from birth to old age, in an ongoing prospective study. Research Methods and Procedures A population-based sample of Swedish women was first examined at the ages of 38 to 60 and re-examined 24 years later. This study used 1358 frozen serum samples that had been stored 29 years for analysis of leptin concentrations and their relation to body weight history. Results Leptin values obtained from stored samples showed the same correlation with relative weight as that seen in a contemporary sample with similar demographic characteristics. Lower self-reported birth weight was associated with higher leptin levels in adulthood (p = 0.01), controlling for age and adult BMI. Prospective analyses revealed that high leptin in 38 to 46-year-olds predicted subsequent long-term weight gain (p = 0.003), although no significant associations were seen in women initially aged 50 or older. Discussion: It is feasible to use frozen serum for studying leptin in relation to obesity and related developments many years later. High leptin level was a risk factor for subsequent weight gain in 38- and 46-year-old women. Retrospective analyses involving birth weight suggest that leptin resistance in adulthood might have fetal origins.     

Predictors of Weight Change in Middle‐aged and Old Men

Objective: Studies on weight change and mortality have yielded inconclusive results. This 10‐year prospective study was undertaken to improve understanding of factors affecting weight change. Research Methods and Procedures: The subjects were 1143 men, aged 36 to 88 years (mean, 53.3 years) at entry. A questionnaire was filled in at entry and at the end of the follow‐up with queries on weight, height, weight at the age of 20, physician‐diagnosed diseases, smoking, alcohol use, dietary habits, leisure physical activity, occupation, present occupational activity, living conditions (living alone or cohabiting), and former athletic status. Further information on morbidity was obtained from selected national registers. Factors predicting weight change during the study were identified by stepwise linear multiple regression analysis. Results: The mean 10‐year weight change was 0.8 (range, ?29 to +24) kg. Age at entry (β‐coefficient, ?0.17, SE 0.02), weight at entry (β, ?0.03, SE 0.01), diabetes at entry (β, ?3.55, SE 1.02), diabetes diagnosed after entry (β, ?3.94, SE 0.96), malignant cancer (β, ?1.60, SE 0.70), being a smoker (β, ?1.59, SE 0.48), and increased physical activity (β, ?1.27, SE 0.54) were significantly (p < 0.05) associated with weight loss in the final model. The model explained 13% of the variance of weight change. Discussion: The results emphasize the complexity of weight change. Some factors associated with weight change are apparently negatively, and some positively, associated with health. This could explain the equivocal findings on weight change and mortality in the literature.     

Weight Change and Risk of Developing Type 2 Diabetes

Objective: To examine the association between weight change and risk of type 2 diabetes and whether initial weight modifies the association. Research Methods and Procedures: This is a prospective cohort study of 20, 187 alumni from Harvard University and the University of Pennsylvania. At baseline in 1962 or 1966, men (mean age, 45.9 years) reported their weight, height, and other risk factors. They also had had their weight and height measured at university entry (mean age, 18.5 years). Participants were followed from baseline to 1998 for type 2 diabetes. Results: During follow‐up, 1223 men developed type 2 diabetes. Weight gain significantly increased the risk of this disease. The multivariate relative risks associated with BMI change from university entry to baseline of <?0.5, ±0.5, >0.5 to 1.0, >1.0 to 1.5, >1.5 to 2.0, >2.0 to 3.0, and >3.0 kg/m² per decade were 0.88, 1.00 (referent), 1.29, 2.09, 2.69, 4.67, and 7.02, respectively (p for trend < 0.0001). Even among men with a low initial BMI < 21 kg/m², weight gain significantly increased risk; the corresponding relative risks were (no cases), 1.00 (referent), 1.00, 1.93, 2.47, 4.82, and 7.68, respectively (p for trend < 0.0001). Discussion: A low initial BMI does not ameliorate the increase in risk of type 2 diabetes with weight gain. Avoidance of weight gain, even among lean individuals, is important to reduce the risk of this disease.     

Weight gain prevention among women

Objective: Women 25 to 45 years old are at risk for weight gain and future obesity. This trial was designed to evaluate the efficacy of two interventions relative to a control group in preventing weight gain among normal or overweight women and to identify demographic, behavioral, and psychosocial factors related to weight gain prevention. Research Methods and Procedures: Healthy women (N = 284), ages 25 to 44, with BMI < 30 were randomized to one of three intervention conditions: a clinic‐based group, a correspondence course, or an information‐only control. Intervention was provided over 2 years, with a follow‐up at Year 3. BMI and factors related to eating and weight were assessed yearly. Results: Over the 3‐year study period, 40% (n = 114) of the women remained at or below baseline body weight (±2 lbs), and 60% gained weight (>2 lbs). Intervention had no effect on weight over time. Independently of intervention, women who were older, not actively dieting to lose weight, and who reported less perceived hunger at baseline were more likely to be successful at weight maintenance. Weight maintenance also was associated with increasing dietary restraint (conscious thoughts and purposeful behaviors to control calorie intake) and decreasing dietary disinhibition (the tendency to lose control over eating) over time. Discussion: This study raises concern about the feasibility and efficacy of weight gain prevention interventions because most women were interested in weight loss, rather than weight gain prevention, and the interventions had no effect on weight stability. Novel approaches to the prevention of weight gain are needed.     

猪乳中一组高分子量蛋白的多态性与乳生长因子、窝增重的关系

利用十二烷基硫酸钠-聚丙烯酰胺凝胶不连续垂直板电泳(SDS-PAGE),对162头二花脸母猪乳中一组高分子量蛋白质(HMWP)进行了检测和分型,并运用线型模型统计分析方法分析了该基因座的不同基因型与母猪的乳生长因子(IGF-1、EGF和胰岛素)、哺乳仔猪生长(20日龄窝增重)的关系.结果表明,在三种HMWP基因型中,不同基因型母猪的乳中IGF-1浓度存在显著差异,HMWP基因型为BB型和BD型的母猪,其乳IGF-1浓度均高于DD型,其中BB型显著高于DD型(P＜0.05).乳中胰岛素浓度也存在差异的趋势,但未达到显著水平(P＞0.05),BB型和BD型母猪的乳中胰岛素浓度高于DD型.HMWP基因座不同基因型的乳EGF浓度无显著差异(P＞0.05).在三种HMWP基因型中,不同基因型母猪的20日龄窝增重存在显著差异,HMWP基因座为BB型和BD型的母猪,其20日龄窝增重均高于DD型,其中BD型显著高于DD型(P＜0.05).实验结果提示,HMWP多态性可能作为一个潜在的遗传标记应用于猪的遗传育种.     

Alcohol Intake and 8‐Year Weight Gain in Women: A Prospective Study

Objective: To examine prospectively the relationship between alcohol and 8‐year weight gain in women. Research Methods and Procedures: A prospective study of 49, 324 women 27 to 44 years old who did not have a history of cardiovascular disease, cancer, or diabetes, who were not pregnant during the study period, and who reported weights in 1991 and 1999. Results: In cross‐sectional analyses, there was a significant inverse relationship between alcohol and BMI even after adjustment for dietary factors and a wide range of confounders. In multivariate prospective analyses, a nonlinear relationship was seen between alcohol and weight gain (≥5 kg) in all women. Compared with nondrinkers, the adjusted relative odds [95% confidence interval (CI)] of weight gain according to grams per day were 0.94 (0.89, 0.99) for those consuming 0.1 to 4.9 g/d, 0.92 (0.85, 0.99) for 5 to 14.9 g/d, 0.86 (0.76, 0.78) for 15 to 29.9 g/d, and 1.07 (0.89, 1.28) for those consuming 30+ g/d (p < 0.0001 for quadratic trend). Women who continued to drink heavily and those who became heavy drinkers showed similar increased odds of weight gain. The increased odds of weight gain associated with heavy drinking (30+ g/d) were most marked in the younger women (<35 years) (odds ratio 1.64; 5% CI 1.03 to 2.61). In African‐American women, light drinking was associated with increased odds of weight gain compared with nondrinkers (odds ratio = 2.43; 95% CI 1.22 to 4.82) Discussion: Our data suggest that light to moderate drinking (up to 30 g/d) is not associated with weight gain in women except possibly in African‐American women. Heavier drinking may promote weight gain in women.     

A Prospective Study of the Effect of Childbearing on Weight Gain in African‐American Women

Objective: To prospectively assess the influence of bearing a first, second, or later child on weight gain among African‐American women in the context of other risk factors. Research Methods and Procedures: Data were obtained in a prospective follow‐up study of African‐American women from across the U.S. who are participants in the Black Women's Health Study. Postal questionnaires were used to collect baseline data in 1995 and follow‐up data in 1997 and 1999. Parous and nulliparous women (11, 196) (21 to 39 years old at baseline), of whom 1230 had a singleton birth during follow‐up, are the subjects of the present analyses. We assessed change in BMI (kilograms per meter squared) in relation to childbearing during 4 years of follow‐up, with use of multivariable linear regression to control for important risk factors. Results: During 4 years of follow‐up, the BMI of participants increased by an average of 1.6 kg/m², equivalent to a weight gain of ～4.4 kg. Women who had a child during follow‐up gained more weight than women who remained nulliparous, and those who had a first child gained more than those who had a second or later child. The weight gain associated with childbearing increased with increasing baseline BMI and was appreciable among heavier women. For example, among women with a baseline index of 36, the increase in BMI for women who bore a first child was 1.1 kg/m² more than that of nulliparous women, equivalent to a difference in weight gain of ～3.0 kg. Discussion: Childbearing is an important contributor to weight gain among African‐American women.     

Genetic Variation in the Leptin Receptor Gene,Leptin, and Weight Gain in Young Dutch Adults

Objective: To investigate the association between leptin levels, polymorphisms in the leptin receptor (LEPR) gene, and weight gain. Research Methods and Procedures: From two large prospective cohorts in The Netherlands (n = 17, 500), we compared the baseline leptin of 259 subjects who had gained an average of 12.6 kg (range 5.5 to 33 kg) with 277 subjects who kept stable weight (range ?2.6 to 3.1 kg) after a mean follow‐up of 6.8 years. Three polymorphisms in the LEPR gene (Lys109Arg, Gln223Arg, and Lys656Asn) were determined. Results: Weight gainers had significantly higher baseline leptin levels than those who kept stable weight (odds ratio = 1.27, 95% confidence interval 1.1 to 1.5, per SD increase in log_e‐transformed leptin). Weight gainers with the Arg109 or the Arg223 alleles had higher leptin levels compared with the noncarriers of these alleles. Only among men, the association between leptin and weight gain tended to be stronger among those with an Arg223 allele compared with those without this mutation. Discussion: Relatively high leptin levels predict weight gain, suggesting that leptin resistance plays a role in the development of obesity in the general population. Higher leptin levels for those with a Lys109Arg or Gln223Arg mutation (or a linked other marker) may imply that these subjects have a modified functional leptin receptor. However, the role of these mutations on weight gain is limited.     

The Relationship of Rapid Weight Gain in Infancy to Obesity and Skeletal Maturity in Childhood

Objective: Children with birth weight appropriate for gestational age (AGA) who also demonstrate rapid weight gain in infancy have a greater risk of being overweight or obese during childhood. A concurrent advancement in skeletal maturity would account for their greater size and would, therefore, not necessarily pose a threat of greater risk during adolescence and early adulthood. This study aims to determine whether children with rapid weight gain during infancy have advanced skeletal maturity during childhood. Research Methods and Procedures: One hundred and ninety‐three African children (boys = 108; girls = 85) of normal birth weight and gestational age were assessed from birth to 9 years. Body composition was assessed at 9 years of age by whole‐body DXA, and skeletal maturity was assessed using the Tanner‐Whitehouse II technique. Rapid weight gain in infancy was defined as a +0.67 change in weight‐for‐age Z‐score between birth and 2 years. Results: Rapid weight gain was experienced by over 20% of the sample. Children with rapid weight gain were significantly lighter at birth and significantly taller, heavier, and fatter throughout childhood. Chronological age and Tanner‐Whitehouse II technique skeletal ages at 9 years were not significantly different between groups or between sexes within groups. Discussion: Because AGA children with rapid weight gain have a greater risk of overweight and obesity but are not advanced in skeletal maturity, later adolescent adjustments toward average weight and fatness values are unlikely. The identification and monitoring of such children is of importance in reducing their risk of morbidity.     

Pregnancy Weight Retention in Morbid Obesity

HUNT, STEVEN C, MARIA M DAINES, TED D ADAMS, EDWARD M HEATH AND ROGER R WILLIAMS. Pregnancy weight retention in morbid obesity. Obes Res. 1995;3:121–130. Recent hypotheses suggest that for women who develop morbid obesity, increases in weight associated with pregnancy may represent a significant contribution to their obesity status. The effects of multiple pregnancies on weight gain were studied in 96 morbidly obese women (<13.6 kg over ideal weight at ages 20–24 or before an earlier first pregnancy and currently >44.5 kg over ideal weight) and 115 random control women from the Utah population. Self-reported weights for each pregnancy included: prepregnancy, greatest during pregnancy, and 6 weeks following delivery, which were validated against available hospital records. Mean number of pregnancies in each group were similar (4.2 and 4.3), ranging from 1 to 9. Mean current age was 46 and mean weight gain since ages 20–24 was 46.0 kg in the morbidly obese and 14.1 kg in controls. Regression of current weight on total number of pregnancies, adjusting for weight at ages 20–24, showed a 1.3 kg/pregnancy increase in current weight (p=0.03) with no difference between groups (p=0.6). Weight gain subsequent to the last pregnancy was not related to the number of pregnancies (p=0.2). Morbidly obese women gained more weight during pregnancy than controls only for the first pregnancy. Gains were similar for all other pregnancies. Morbidly obese women had smaller weight losses after delivery than the controls, but these differences were not significant. For the first pregnancy, morbidly obese women had a net weight retention that was 4.0 kg greater than the controls at 6 weeks post-partum and an average of 1.6 kg/pregnancy greater retention for the remaining pregnancies. Pregnancy weight gains for each pregnancy subsequent to the first pregnancy were constant. These findings suggest: 1) women who develop morbid obesity have slightly less weight loss after delivery and greater between-pregnancy weight gains than controls; 2) the number of pregnancies does not affect the amount of weight gained after the last pregnancy; and 3) while multiparity may augment weight gain in morbidly obese women, it is probably not a primary factor in the later development of morbid obesity.     

Weight adjustment equation for hair sheep raised in warm conditions

To estimate the nutritional requirements of hair sheep, knowledge about the animal’s weight and its relationships with growth performances is essential. A study was carried with the objective to establish the relationships between BW, fasting BW (FBW), empty BW (EBW), average daily gain (ADG) and empty BW gain (EBWG) for hair sheep in growing and finishing phases in Brazilian conditions. Databases were obtained from 32 studies, for a total of 1145 observations; there were 3 sex classes (non-castrated male, castrated male and female) and 2 feeding systems (pasture and feedlot). The most representative breeds in the database were Santa Ines (n = 473), Morada Nova (n = 70) and Brazilian Somali (n = 47). The other animals in the database were crossbreeds (n = 555). The FBW (kg), EBW and EBWG (kg/day) were estimated according to linear regression. A random coefficient model was adopted, considering the study as a random effect and including the possibility of covariance between the slope and the intercept. The coefficients obtained from the linear regression of the FBW against the BW, EBW against the FBW and EBWG against the ADG did not differ between sex class (P > 0.05) and genotype (P > 0.05). The equations generated to estimate FBW from the BW, EBW from the FBW and EBWG from the ADG are as follows: FBW = −0.5470 (±0.2025) + 0.9313(±0.019) × BW, EBW = −1.4944 (±0.3639) + 0.8816 (±0.018) × FBW and EBWG = 0.906 (±0.019) × ADG, respectively. The low mean squared error values found in the cross-validation confirmed the reliability of these equations. Considering a sheep with a BW of 30 kg and a 100 g ADG, the estimated FBW, EBW and EBWG calculated using the generated equations are 27, 22.65 and 0.090 kg, respectively. In conclusion, the generated equations can be used in growing hair sheep. The validation procedure applied to the generated equations showed that its use for hair sheep seems to be appropriate.     

Serum Leptin Concentrations and Weight Gain in Postobese,Postmenopausal Women

Objective : This study was designed to determine if serum leptin concentrations (adjusted for fat mass) after weight loss on a low-calorie diet predict subsequent weight gain. Research Methods and Procedures : Body composition and serum leptin concentrations were determined on 14 moderately obese, postmenopausal, nondiabetic women with a familial predisposition to obesity. Assessments were obtained under tightly controlled metabolic ward conditions of macronutrient intake and weight maintenance both before (obese state) and after a mean weight loss of 12.0 kg to normal body weight (postobese state). Four years later, without intervention, body weight and body composition were reassessed. Results : Weight loss resulted in significant decreases in fat mass (29.7 ± 5.4 vs. 20.3 ± 4.7; kg), body mass index (27.7 ± 1.6 vs. 23.0 ± 1.5; kg/m2), percent body fat (40.7 ± 4.3 vs. 33.1 ± 5.0), and serum leptin concentrations (31.8 ± 16.0 vs. 11.5 ± 5.4; ng/mL). Serum leptin concentrations were positively correlated (p<<0.05) with fat mass in both the obese and postobese states (r = 0.67 and r = 0.56, respectively). However, residual serum leptin concentrations (adjusted for fat mass) in the obese and postobese states were not related to changes in body weight (p<= 0.61 and 0.52), fat mass (p = 0.72 and 0.42), body mass index (p = 0.59 and 0.33), or percent body fat (p = 0.84 and 0.46) over the follow-up period. Discussion : These finding do not support the hypothesis that relatively low concentrations of leptin predict weight regain after weight loss. However, because the number of subjects in this study was limited, further studies are warranted.     

Weight Change in Adult Life and Health Outcomes

Objective: To investigate the relationship between weight change in adult life and subsequent mortality and cancer incidence in women. Research Methods and Procedures: In 1994 to 1995, all women (age range, 42 to 81) still under general practitioner observation in the United Kingdom's Royal College of General Practitioners Oral Contraception Study (n = 12 303) were sent a health survey asking about health and lifestyle issues, including current weight and weight at age 30. The main outcome measures were 6‐year all‐cause mortality and cancer incidence among different weight change deciles. Cox regression was used to calculate hazard ratios that were adjusted for: social class at recruitment, BMI at age 30, and age group, parity, smoking status, and hormone replacement therapy status in 1995. Results: Women who had been obese at age 30 were more likely to die and significantly more likely to develop cancer in the 6 years after the health survey than non‐obese respondents. Women reporting weight gains between age 30 and 1995 were significantly less likely to die during the 6 years after the health survey than those with a stable weight, whereas those with weight loss did not fare any better than those in the stable‐weight group. Discussion: Although obesity at young age was associated with subsequent mortality and cancer incidence, weight gain over a time period of 12 to 51 years appeared to be beneficial when compared with women with stable weight over the same time period. Further research is needed to confirm or refute our findings and to allow detailed examination of potential explanations for them.     

Weight loss strategies for obese adults: personalized weight management program vs. standard care

Objective: The objective of this study was to evaluate the effect of a 32‐week personalized Polar weight management program (PWMP) compared with standard care (SC) on body weight, body composition, waist circumference, and cardiorespiratory fitness in overweight or obese adults. Research Methods and Procedures: Overweight or obese (29 ± 2 kg/m²) men and women (n = 74) 38 ± 5 years of age were randomly assigned into either PWMP (men = 20, women = 21) or SC (men = 15, women = 18). Both groups managed their own diet and exercise program after receiving the same standardized nutrition and physical activity advice. PWMP also received a weight management system with literature to enable the design of a personalized diet and exercise weight loss program. Body weight and body composition, waist circumference, and cardiorespiratory fitness were measured at weeks 0, 16, and 32. Results: Eighty percent of participants completed the 32‐week intervention, with a greater proportion of the dropouts being women (PWMP: 2 men vs. 7 women; SC: 2 men vs. 4 women). At 32 weeks, PWMP completers had significantly (p < 0.001) greater losses in body weight [6.2 ± 3.4 vs. 2.6 ± 3.6 (standard deviation) kg], fat mass (5.9 ± 3.4 vs. 2.2 ± 3.6 kg), and waist circumference (4.4 ± 4.5 vs. 1.0 ± 3.6 cm). Weight loss and fat loss were explained by the exercise energy expenditure completed and not by weekly exercise duration. Discussion: More effective weight loss was achieved after treatment with the PWMP compared with SC. The results suggest that the PWMP enables effective weight loss through tools that support self‐monitoring without the requirement of more costly approaches to program supervision.