Package Unit Size and Amount of Food: Do Both Influence Intake?

Objective: Large portions increase intake and are hypothesized to contribute to the obesity epidemic. However, it is unclear if portion size affects intake through changes in the unit size of available food or the overall amount of food available for consumption. Thus, this study examined the independent effects of package unit size and amount of food on intake. It was hypothesized that both variables would influence intake. Research Methods and Procedures: Non‐obese (BMI <30 kg/m²), non‐smoking, unrestrained, college‐aged men (n = 12) and women (n = 16) who regularly consumed (≥3 times/wk) snack foods were randomly assigned to one of four groups crossing package unit size (small vs. large) and amount of food (small vs. large). Participants were given a box with 4 snack foods (potato chips, cheese crackers, cookies, and candy) packaged according to their assigned group to take home and eat over 3 days. Dependent variables were energy and gram intake of provided snack foods. Results: An effect of amount of food was found (p < 0.01). A 100% increase in the amount of food provided produced an 81% increase in energy consumed from the snack foods [small amount, 21,037.6 ± 10,852 kJ (5028 ± 2596 kcal) vs. large amount, 11,640.7 ± 4914.1 kJ (2782 ± 1174 kcal)]. No effect of package unit size was found. Discussion: These results suggest that the amount of food available to eat strongly influences intake.     

Eating behavior and obesity at Chinese buffets

Objective: The aim of this study was to investigate whether the eating behaviors of people at all‐you‐can‐eat Chinese buffets differs depending upon their body mass. The resulting findings could confirm or disconfirm previous laboratory research that has been criticized for being artificial. Methods and Procedures: Trained observers recorded the height, weight, sex, age, and behavior of 213 patrons at Chinese all‐you‐can‐eat restaurants. Various seating, serving, and eating behaviors were then compared across BMI levels. Results: Patrons with higher levels of BMI were more likely to be associated with using larger plates vs. smaller plates (OR 1.16, P < 0.01) and facing the buffet vs. side or back (OR 1.10, P < 0.001). Patrons with higher levels of BMI were less likely to be associated with using chopsticks vs. forks (OR 0.90,P < 0.05), browsing the buffet before eating vs. serving themselves immediately (OR 0.92, P < 0.001), and having a napkin on their lap vs. not having a napkin on their lap (OR 0.92, P < 0.01). Patrons with lower BMIs left more food on their plates (10.6% vs. 6.0%, P < 0.05) and chewed more per bite of food (14.8 vs. 11.9, P < 0.001). Discussion: These observational findings of real‐world behavior provide support for laboratory studies that have otherwise been dismissed as artificial.     

Relationship of Attitudes Toward Fast Food and Frequency of Fast‐food Intake in Adults

The purpose of the study was to examine the association between attitudes toward fast food and the frequency of fast‐food intake in adults. This study is a cross‐sectional evaluation of random digit‐dial telephone surveys to identify patterns of eating away from home and attitudes toward it. Participants included 530 adults (94% white, 65% women, 70% married, 42% with college educated). Attitudes toward fast food was measured using an 11‐item, 4‐dimensional scale: perceived convenience of fast food (α = 0.56); fast food is fun and social (α = 0.55); fast food perceived as unhealthful (α = 0.45); and dislike toward cooking (α = 0.52). Frequency of fast‐food intake was found to be significantly associated with age (odds ratios (OR) = 0.981, P = 0.001), gender (men > women), and marital status of the participants (single > married/partnered and divorced/separated/widowed). Additionally, frequency of fast‐food intake was also found to be significantly associated with perceived convenience of fast food (OR = 1.162, P < 0.001) and dislike toward cooking (OR = 1.119, P < 0.001) but not with perceived unhealthfulness of fast food (OR = 0.692, P = 0.207). These findings suggest public education regarding the unhealthfulness of fast food may not influence fast food consumption. Interventions targeting the issue of convenience and quick or efficient preparation of nutritious alternatives to fast food could be more promising.     

The Effects of Consuming Frequent,Higher Protein Meals on Appetite and Satiety During Weight Loss in Overweight/Obese Men

The purpose of this study was to determine the effects of dietary protein and eating frequency on perceived appetite and satiety during weight loss. A total of 27 overweight/obese men (age 47 ± 3 years; BMI 31.5 ± 0.7 kg/m²) were randomized to groups that consumed an energy‐restriction diet (i.e., 750 kcal/day below daily energy need) as either higher protein (HP, 25% of energy as protein, n = 14) or normal protein (NP, 14% of energy as protein, n = 13) for 12 weeks. Beginning on week 7, the participants consumed their respective diets as either 3 eating occasions/day (3‐EO; every 5 h) or 6 eating occasions/day (6‐EO; every 2 h), in randomized order, for 3 consecutive days. Indexes of appetite and satiety were assessed every waking hour on the third day of each pattern. Daily hunger, desire to eat, and preoccupation with thoughts of food were not different between groups. The HP group experienced greater fullness throughout the day vs. NP (511 ± 56 vs. 243 ± 54 mm · 15 h; P < 0.005). When compared to NP, the HP group experienced lower late‐night desire to eat (13 ± 4 vs. 27 ± 4 mm, P < 0.01) and preoccupation with thoughts of food (8 ± 4 vs. 21 ± 4 mm; P < 0.01). Within groups, the 3 vs. 6‐EO patterns did not influence daily hunger, fullness, desire to eat, or preoccupation with thoughts of food. The 3‐EO pattern led to greater evening and late‐night fullness vs. 6‐EO but only within the HP group (P < 0.005). Collectively, these data support the consumption of HP intake, but not greater eating frequency, for improved appetite control and satiety in overweight/obese men during energy restriction‐induced weight loss.     

Increasing healthy eating vs. reducing high energy-dense foods to treat pediatric obesity

Objective: The objective was to compare targeting increased eating of healthy foods vs. reducing intake of high energy‐dense foods within the context of a family‐based behavioral weight control program. Methods and Procedures: Forty‐one 8–12 year‐old children >85th BMI percentile were randomly assigned to a 24‐month family‐based behavioral treatment that targeted increasing fruits and vegetables and low‐fat dairy vs. reducing intake of high energy‐dense foods. Results: Children in the increase healthy food group showed greater reduction in zBMI compared to children in the reduce high energy‐dense food group at 12‐ (?0.30 zBMI units vs. ?0.15 zBMI units, P = 0.01) and 24‐ (?0.36 zBMI units vs ?0.13 zBMI units, P = 0.04) month follow‐up. Parents in the increase healthy food group showed greater reductions in concern about child weight (P = 0.007), and these changes were associated with child zBMI change (P = 0.008). Children in the reduce high energy‐dense group showed larger sustained reductions in high energy‐dense foods (P < 0.05). Baseline levels of high energy‐dense foods (P < 0.05), parent food restraint (P = 0.01), parent concern over parent weight (P = 0.01) and parent acceptance of the child (P < 0.05) moderated child zBMI change, with greater sustained reductions in zBMI for children in the increase healthy food group for each measure. Parent zBMI change followed the same pattern as child changes, and parent and child zBMI changes were correlated (P < 0.001). Discussion: Focusing on healthy food choices within an energy restricted diet may be useful in family‐based weight control programs.     

Association of eating frequency with body fatness in pre- and postmenopausal women

Objective: To examine associations between eating frequency (EF) and body fatness in pre‐ and postmenopausal women, after excluding potential low‐energy reporters. Research Methods and Procedures: In this cross‐sectional study of 220 free‐living women, 64 pre‐ and 50 postmenopausal non‐low‐energy‐reporting women were further analyzed (age, 24 to 74 years; BMI, 18.5 to 38.6 kg/m²). Anthropometric and body composition measurements (DXA) were performed in all study participants. EF, energy, and macronutrient intake were assessed by 3‐day food record. Physical activity level and energy expenditure were assessed by self‐reported questionnaire. Results: No association between EF and adiposity indices was detected in premenopausal women. In contrast, EF was positively correlated with percentage body fat in postmenopausal women (r = 0.30, p = 0.03). EF was positively correlated with total energy intake in both groups and with total energy expenditure in premenopausal women only (r = 0.34, p = 0.02). Multivariate analysis revealed that, in postmenopausal women, EF was a significant predictor of body fatness (standardized β = 0.41, p = 0.01). Discussion: Frequent eating was not found to be related to adiposity in premenopausal women, but it was associated with increased body fat in postmenopausal women. Possible explanations could be that the frequent eating is not associated with a physically active lifestyle in postmenopausal women or that frequent eating predisposes women after menopause to a higher energy intake by increasing food stimuli and rendering it more difficult for them to control energy balance.     

Maternal feeding strategies, child eating behaviors, and child BMI in low-income African-American preschoolers

Objective: To test the hypothesis that low‐income African‐American preschool children would have a higher BMI if their mothers reported greater “restriction” and “control” in feeding and if mothers reported that children showed greater “food responsiveness” and “desire to drink.” In addition, to test whether higher maternal “pressure to eat” would be associated with lower child BMI. Research Methods and Procedures: A questionnaire was completed by 296 low‐income African‐American mothers of preschool children. It assessed three constructs on maternal feeding strategies (“restriction,” “pressure to eat,” and “control”) and two on child eating behaviors (“food responsiveness” and “desire to drink”). Children's BMI was measured, and mothers’ BMI was self‐reported. Results: The mean (standard deviation) BMI z‐score of the children was 0.34 (1.5), and 44% of the mothers were obese (BMI ≥30 kg/m²). Only maternal “pressure to eat” had a significant overall association with child BMI z‐score (r = ?0.16, p < 0.01). Both maternal “restriction” and “control” were positively associated with children's BMI z‐score in the case of obese mothers (r = 0.20, p = 0.03 and r = 0.24, p = 0.007, respectively), but this was not so in the case of non‐obese mothers (r = ?0.16, p = 0.05 and r = ?0.07, p = 0.39, respectively). Discussion: Among low‐income African Americans, the positive association between maternal restriction and control in feeding and their preschoolers’ BMI was limited to obese mothers. Relations between parent feeding strategies and child weight status in this population may differ on the basis of maternal weight status.     

Fasting ghrelin does not predict food intake after short-term energy restriction

Objective: To study the role of ghrelin as a hunger signal during energy restriction and to test the hypothesis that changes in fasting leptin concentrations during energy restriction are associated with changes in fasting ghrelin concentrations. Research Methods and Procedures: Thirty‐five healthy, lean men (23 ± 3 years of age; BMI: 22.3 ± 1.6 kg/m²) participated in a controlled intervention study. Fasting ghrelin and leptin concentrations were measured before and after 2 days of 62% energy restriction and after a 2‐day period of ad libitum food intake. Energy intake during the latter period was assessed. Results: On average, ghrelin concentrations did not change (0.05 μg/liter; 95% confidence interval, ?0.03; 0.12) during energy restriction. Changes in ghrelin concentration during energy restriction were not associated with energy intake during the ad libitum period (r = 0.07; not significant). Ad libitum energy intake was, however, associated with the change in ghrelin concentrations during the same period (r = ?0.34; p = 0.05). Ghrelin and leptin concentrations were not associated. In addition, the ratio of percentage changes in ghrelin and leptin during energy restriction was not correlated with ad libitum food intake after energy restriction (r = ?0.26; p = 0.14). Discussion: Fasting ghrelin concentrations did not rise after a 2‐day energy restriction regimen. Moreover, changes in ghrelin concentrations during energy restriction were not associated with subsequent ad libitum food intake, suggesting that fasting ghrelin does not act as a hunger signal to the brain. The data did not support our hypothesis that leptin suppresses ghrelin levels.     

Influence of Methylphenidate on Eating in Obese Men

Objective: Rapid synaptic dopamine transport or reduced brain dopamine receptor signaling may influence energy intake. Methylphenidate, a dopamine reuptake inhibitor, increases brain synaptic dopamine and produces anorexia, suggesting that it may reduce energy intake. We investigated the effects of two doses of short‐acting methylphenidate on energy intake over one meal in obese adult males. Research Methods and Procedures: Nine obese males (>85th BMI percentile) ingested a placebo or a moderate dose (0.5 mg/kg) or a high dose (1.0 mg/kg) of methylphenidate in a within‐subject double‐blind acute laboratory study. One hour after ingestion, pizza consumption was measured in a naturalistic laboratory setting. Results: Participants reduced energy intake by 23% for the moderate dose vs. the placebo (p < 0.02), but there was no significant difference for the high dose vs. the moderate dose (p > 0.05). Participants consumed 34% fewer kilocalories after ingesting the lowest effective dose of methylphenidate compared with placebo (725.7 ± 404.5 vs.1095 ± 271.1 kcal, p < 0.01). Seven of nine subjects responded to the moderate dose. The increase in perceived drug effect above placebo was correlated with the reduction in energy intake for both the moderate (r = ?0.85, p = 0.004) and the high (r = ?0.75 p = 0.021) doses. Hunger scores were not different across drug doses or placebo before drug administration. Discussion: Methylphenidate reduced energy intake of a highly palatable food over one meal by one‐third in obese adult males. Dopamine transport inhibition may be an effective component of a comprehensive treatment for obesity.     

Plasma stearoyl‐CoA desaturase indices: Association with lifestyle,diet, and body composition

Objective:

Stearoyl‐coenzyme A desaturase‐1 (SCD1) is a key enzyme in fatty acid and energy metabolism. Increased hepatic SCD1 activity is associated with obesity and obesity‐related diseases. We examined the relations of two plasma SCD activity indices (16:1n‐7/16:0, 18:1n‐9/18:0) with body composition, and the association of lifestyle and dietary variables with the plasma SCD indices.

Design and Methods:

This population‐based, cross‐sectional study of 2021 elderly (71–74 y) men and women from the Hordaland Health Study in Western Norway was conducted using a validated food frequency questionnaire, body composition measurements by dual‐energy X‐ray absorptiometry and determination of the plasma fatty acid profile.

Results:

In multivariate regression analyses, plasma SCD indices were positively associated with BMI and body fat (P < 0.001 for both). From the 2.5th to 97.5th percentiles of plasma SCD‐16 and SCD‐18 indices, fat mass differed by about 8 kg and 5 kg, respectively. Intake of polyunsaturated fatty acids were negatively associated with SCD‐16 (partial r = ?0.30) and SCD‐18 (partial r = ?0.24) (P < 0.001 for both). Alcohol intake was positively associated with SCD‐16 (partial r = 0.26) and SCD‐18 (partial r = 0.16) (P < 0.001 for both), whereas coffee consumption and physical activity were inversely associated with SCD‐16 (P = 0.026 and P = 0.006, respectively) and SCD‐18 (P = 0.001 and P = 0.022, respectively).

Conclusions:

In this elderly population, plasma markers of SCD1 activity are associated with increased adiposity. Furthermore, modifiable dietary habits and lifestyle are associated with plasma SCD indices. These results suggest that SCD1 activity may be a promising target for weight control.

     

Adiposity and eating behaviors in patients under second generation antipsychotics

Background: Second generation antipsychotics (SGA) induce substantial weight gain but the mechanisms responsible for this phenomenon remain speculative. Objective: To explore eating behaviors among SGA‐treated patients and compare them with nonschizophrenic healthy sedentary individuals (controls). Methods and Procedures: Appetite sensations were recorded before and after a standardized breakfast using visual analog scales. Three hours after breakfast, a buffet‐type meal was offered to participants to document spontaneous food intake and food preferences. Satiety quotients (SQs) were calculated to determine the satiation of both meals and the Three‐Factor Eating Questionnaire (TFEQ) was used to document eating behaviors. Body composition and abdominal fat distribution were assessed. Results: Compared with controls (n = 20), SGA‐treated patients (n = 18) showed greater adiposity indices (P ≤ 0.04). Patients' degree of hunger was also higher following the standardized breakfast (P = 0.03). Moreover, patients had significantly higher cognitive dietary restraint, disinhibition, and susceptibility to hunger scores than the reference group (P ≤ 0.05). Disinhibition in the reference group was positively associated with hunger triggered by external cues (r = 0.48, P = 0.03) whereas internal cues seem to mainly regulate emotional susceptibility to disinhibition in patients (r = 0.56, P = 0.02). Higher strategic restraint behavior in patients was associated with decreased satiation right after the buffet‐type meal (r = ?0.56, P = 0.02). Discussion: These exploratory findings suggest that patients under SGA seem to develop disordered eating behaviors in response to altered appetite sensations and increased susceptibility to hunger, a factor which may influence the extent of body weight gain triggered by these drugs.     

BMI and Rates of Suicide in the United States: An Ecological Analysis

BMI has been inversely associated with risk of completed suicide in several cohort studies, but putative mechanisms for this association and its generalizability throughout the United States are uncertain. We ascertained recent population‐based, state‐level data on rates of obesity, completed suicide (by method), firearm ownership, smoking, major depression, income, education, white race, and nonmetropolitan residence, compiled from federal agencies and surveys, and determined the adjusted population‐weighted correlations of statewide obesity rates with measures of completed and attempted suicide. Statewide prevalence of obesity was strongly inversely correlated with age adjusted suicide rate (multivariable‐adjusted r = ?0.66; P < 0.001). The correlation was somewhat stronger for rates of nonfirearm‐related (r = ?0.75; P < 0.001) than firearm‐related suicides (r = ?0.53; P < 0.001), and was of similar magnitude as the positive correlations of firearm prevalence with suicide rate (r = 0.75; P < 0.001) or of obesity with prevalence of diabetes (r = 0.41; P = 0.006). In analyses of fatal and nonfatal suicidal acts, obesity rates were inversely correlated with rates of suicidal acts using firearms (r = ?0.53; P = 0.02) and suffocation (r = ?0.76; P < 0.001) but not other methods. Obesity rates were also inversely correlated with the case–fatality ratios of acts using poisoning (r = ?0.51; P = 0.01). Thus, statewide rates of obesity are strongly inversely correlated with rates of completed suicide in multivariable analyses, a finding that appears to relate to fewer attempts by suffocation and a lower case–fatality ratio for poisonings, although the mechanism for the inverse correlation with firearm‐related suicides requires further elucidation.     

Longitudinal study of breastfeeding structure and women's work in the Brazilian Amazon

It is well established that breast milk is the ideal food for infants and that breastfeeding has short‐ and long‐term health benefits for the mother and child. However, there is variation in breastfeeding patterns between populations. Women's work is thought to influence breastfeeding patterns and timing of supplementation and it is often assumed that women in subsistence‐oriented societies can more easily integrate their productive and reproductive activities. This article reports longitudinal data, collected in three rounds (resguardo [<40 days], peak [2–4 months], and late [14–16 months] lactation), on breastfeeding structure, infant care, and work patterns of 17 rural Amazonian women in an effort to understand how breastfeeding structure and maternal time allocation changed over time, as well as the strategies women used to integrate their productive and reproductive roles. Women breastfed 10.6 ± 3.1, 9.4 ± 3.4, and 9.6 ± 5.5 times per 9‐h period in the three rounds, respectively. Breastfeeding structure, specifically session duration, changed over time (P < 0.05). As lactation progressed, women spent less time breastfeeding and in infant care and more time in subsistence work. In peak lactation, subsistence work was negatively correlated with infant care (r = ?0.4, P = 0.01), breastfeeding (r = ?0.29, P = 0.05) and session duration (r = ?0.39, P < 0.01) and in late lactation was negatively correlated with time spent breastfeeding (r = ?0.39, P < 0.01) and in infant care (r = ?0.50, P < 0.01) and positively correlated with inter‐session interval (r = 0.40, P < 0.01). Generally, women reduced time in subsistence work when breastfeeding was more intense and returned to normal activity patterns once infants were being supplemented. The costs and benefits associated with women's strategies are discussed. Am J Phys Anthropol, 2011. © 2010 Wiley‐Liss, Inc.     

Short-term effects of a "health-at-every-size" approach on eating behaviors and appetite ratings

Objective: To assess the effects of a “Health‐At‐Every‐Size” (HAES) intervention on eating behaviors and appetite ratings in 144 premenopausal overweight women. Research Methods and Procedures: Women were randomly assigned to one of the 3 groups: HAES group, social support (SS) group, and control group (N = 48 in each group). Interventions were conducted over a 4‐month period, and measurements were taken before and after this period. Eating behaviors (cognitive dietary restraint, disinhibition, and susceptibility to hunger) were evaluated by the Three‐Factor Eating Questionnaire. Appetite ratings (desire to eat, hunger, fullness, and prospective food consumption) were assessed by visual analogue scales before and after a standardized breakfast. Results: More important decreases in susceptibility to hunger and external hunger were observed in the HAES group when compared with the SS group (p = 0.05, for susceptibility to hunger) and the control group (p = 0.02 and p = 0.005, for susceptibility to hunger and external hunger, respectively). In addition, women from the HAES group had more important decreases in postprandial area under the curve for desire to eat (p = 0.02) and hunger (p = 0.04) when compared with the control group. The change in the desire to eat noted in the HAES group was also different from the one observed in SS group (p = 0.02). Women from the HAES group experienced significant weight loss at 4 months (?1.6 ± 2.5 kg, p < 0.0001), which did not differ significantly from the SS and control groups (p = 0.09). An increase in flexible restraint was significantly related to a greater weight loss in both HAES and SS groups (r = ?0.39, p < 0.01; and r = ?0.37, p < 0.05, respectively). A decrease in habitual susceptibility to disinhibition was also associated with a greater weight loss in HAES and control groups (r = 0.31, p < 0.05; and r = 0.44, p < 0.05, respectively). Discussion: These results suggest that a HAES intervention could have significant effects on eating behaviors and appetite ratings in premenopausal overweight women, when compared with an SS intervention or a control group.     

Appetite‐Regulating Hormone Changes in Patients With Craniopharyngioma

Patients with craniopharyngioma (CP), an embryological tumor located in the hypothalamic and/or pituitary region, often suffer from uncontrolled eating and severe obesity. We aimed to compare peripherally secreted hormones involved in controlling food intake in normal weight and obese children and adolescents with CP vs. controls. Plasma insulin, glucose, total ghrelin, and peptide‐YY (PYY) levels were assessed under fasting conditions as well as 60 min after liquid mixed meal in four groups: Normal weight (n = 12) and obese (n = 15) CP patients, and 12 normal weight and 15 obese otherwise healthy BMI‐, gender‐ and age‐matched controls. Homeostasis model assessment of insulin resistance (HOMA_IR), as well as quantitative insulin sensitivity check index (QUICKI) were calculated. Obese CP subjects had significantly higher HOMA_IR, higher baseline and postmeal insulin but lower ghrelin levels, weaker postmeal changes for PYY, and lower QUICKI compared to obese controls. QUICKI data from all CP patients correlated positively with ghrelin and PYY % postmeal changes (ghrelin: r = 0.38, P = 0.023; PYY r = 0.40, P = 0.017) and negatively with standard deviation score‐BMI (SDS‐BMI: r = ?0.49, P = 0.002). Tumor growth of 87% obese and 58% of normal weight CP patients affected the hypothalamic area which was associated with higher SDS‐BMI and weaker % postmeal ghrelin changes (P = 0.014) compared to CP patients without hypothalamic tumor involvement. Blunted postmeal ghrelin and PYY responses in obese CP subjects are likely due to their higher degree of insulin resistance and lower insulin sensitivity compared to matched obese controls. Thus, insulin resistance in CP patients seems to affect eating behavior by affecting meal responses of gut peptides.     

Use of an operant task to estimate food reinforcement in adult humans with and without BED

Objective: The purpose of this study was to demonstrate the utility of food‐reinforced operant task performance in modeling binge‐eating disorder (BED). We hypothesized that food reinforcement after a caloric preload would be related to BED status, but not hunger. Methods and Procedures: We investigated the association between reports of hunger, binge tendency, and food reinforcement in a sample of 18 women (12 non‐BED, 7 lean, 5 obese, and 6 obese BED). Participants completed two sessions of operant task performance after consuming 600 ml of flavored water or 600 ml of a 1 kcal/ml liquid meal. Results: Under the water condition, food reinforcement did not differ between the non‐BED and BED groups, and was positively correlated with hunger ratings across all participants (r = 0.55, P = 0.023). Under the liquid meal condition, food reinforcement was significantly decreased compared with the water condition in the non‐BED group (t = ?2.6, P = 0.026). There was also a significant difference between the non‐BED and BED groups in the fed condition (41 ± 40, 117 ± 60, F = 10.3, P = 0.005, non‐BED vs. BED, respectively, mean ± s.d.). The correlation between food reinforcement and hunger remained significant only in the non‐BED group (r = 0.69, P = 0.011). Discussion: Our results support the hypothesis that food reinforcement measured after a caloric preload is related to BED status but not hunger in those subjects with BED. The data also suggest that operant task performance can be useful in modeling BED criteria such as “eating when not physically hungry.”     

Maintenance of weight loss in overweight middle-aged women through the Internet

Objective: The purpose of this study was to compare weight regain in a group of perimenopausal women (48.0 ± 4.4 years old), randomized to a 12‐month weight maintenance Internet intervention or to self‐directed weight maintenance after a 4‐month weight loss treatment. Methods and Procedures: After a 4‐month behavioral weight loss program, 135 women were randomized to either Internet or self‐directed groups. The Internet group (n = 66) used a website to gain information and complete logs concerning their weight, diet, and exercise progress over a 12‐month follow‐up. The 69 self‐directed women had no contact with study staff. All women were measured for weight and body composition, and diet intake, and were interviewed using the 7‐day physical activity questionnaires at baseline, 4 months, and 16 months. Results: At the end of the 12‐month follow‐up, the Internet and self‐directed groups had regained on average 0.4 ± 5.0 kg and 0.6 ± 4.0 kg, respectively (P = 0.5). In within‐group analyses, Internet diet‐log entries were correlated with follow‐up weight change (r = ?0.29; P < 0.05) and moderately with change in exercise energy expenditure (EEE; r = 0.44; P < 0.01). Follow‐up weight change was not correlated with change in dietary intake. Discussion: While significant weight loss was maintained over follow‐up by both groups of women, Internet use did not surpass self‐direction in helping to sustain weight loss. Among Internet users, Internet use was related to weight change and EEE.     

Assessment of Atrial Electromechanical Delay by Tissue Doppler Echocardiography in Obese Subjects

Our aim was to evaluate whether atrial electromechanical delay measured by tissue Doppler imaging (TDI), which is an early predictor of atrial fibrillation (AF) development, is prolonged in obese subjects. A total of 40 obese and 40 normal‐weight subjects with normal coronary angiograms were included in this study. P‐wave dispersion (PWD) was calculated on the 12‐lead electrocardiogram (ECG). Systolic and diastolic left ventricular (LV) functions, inter‐ and intra‐atrial electromechanical delay were measured by TDI and conventional echocardiography. Inter‐ and intra‐atrial electromechanical delay were significantly longer in the obese subjects compared with the controls (44.08 ± 10.06 vs. 19.35 ± 5.94 ms and 23.63 ± 6.41 vs. 5.13 ± 2.67 ms, P < 0.0001 for both, respectively). PWD was higher in obese subjects (53.40 ± 5.49 vs. 35.95 ± 5.93 ms, P < 0.0001). Left atrial (LA) diameter, LA volume index and LV diastolic parameters were significantly different between the groups. Interatrial electromechanical delay was correlated with PWD (r = 0.409, P = 0.009), high‐sensitivity C‐reactive protein (hsCRP) levels (r = 0.588, P < 0.0001). Interatrial electromechanical delay was positively correlated with LA diameter, LA volume index, and LV diastolic function parameters consisting of mitral early wave (E) deceleration time (DT) and isovolumetric relaxation time (IVRT; r = 0.323, P = 0.042; r = 0.387, P = 0.014; r = 0.339, P = 0.033; r = 0.325, P = 0.041; respectively) and, negatively correlated with mitral early (E) to late (A) wave ratio (E/A) (r = ?0.380, P = 0.016) and myocardial early‐to‐late diastolic wave ratio (E_m/A_m) (r = ?0.326, P = 0.040). This study showed that atrial electromechanical delay is prolonged in obese subjects. Prolonged atrial electromechanical delay is due to provoked low‐grade inflammation as well as LA enlargement and early LV diastolic dysfunction in obese subjects.     

Association of Pericardial Fat With Liver Fat and Insulin Sensitivity After Diet‐Induced Weight Loss in Overweight Women

Pericardial adipose tissue (PAT) is positively associated with fatty liver and obesity‐related insulin resistance. Because PAT is a well‐known marker of visceral adiposity, we investigated the impact of weight loss on PAT and its relationship with liver fat and insulin sensitivity independently of body fat distribution. Thirty overweight nondiabetic women (BMI 28.2–46.8 kg/m², 22–41 years) followed a 14.2 ± 4‐weeks low‐calorie diet. PAT, abdominal subcutaneous (SAT), and visceral fat volumes (VAT) were measured by magnetic resonance imaging (MRI), total fat mass, trunk, and leg fat by dual‐energy X‐ray absorptiometry and intrahepatocellular lipids (IHCL) by (¹)H‐magnetic resonance spectroscopy. Euglycemic hyperinsulinemic clamp (M) and homeostasis model assessment of insulin resistance (HOMA_IR) were used to assess insulin sensitivity or insulin resistance. At baseline, PAT correlated with VAT (r = 0.82; P < 0.001), IHCL (r = 0.46), HOMA_IR (r = 0.46), and M value (r = ?0.40; all P < 0.05). During intervention, body weight decreased by ?8.5%, accompanied by decreases of ?12% PAT, ?13% VAT, ?44% IHCL, ?10% HOMA2‐%B, and +24% as well as +15% increases in HOMA2‐%S and M, respectively. Decreases in PAT were only correlated with baseline PAT and the loss in VAT (r = ?0.56; P < 0.01; r = 0.42; P < 0.05) but no associations with liver fat or indexes of insulin sensitivity were observed. Improvements in HOMA_IR and HOMA2‐%B were only related to the decrease in IHCL (r = 0.62, P < 0.01; r = 0.65, P = 0.002) and decreases in IHCL only correlated with the decrease in VAT (r = 0.61, P = 0.004). In conclusion, cross‐sectionally PAT is correlated with VAT, liver fat, and insulin resistance. Longitudinally, the association between PAT and insulin resistance was lost suggesting no causal relationship between the two.     

Variations in HDL-carried miR-223 and miR-135a concentrations after consumption of dietary trans fat are associated with changes in blood lipid and inflammatory markers in healthy men - an exploratory study

A high consumption of trans fatty acids (TFAs) is associated with an increased risk of cardiovascular diseases (CVDs). High-density lipoproteins (HDLs) have many cardioprotective properties and transport functional microRNAs (miRNAs) to recipient cells. We hypothesized that dietary TFAs modify the HDL-carried miRNA profile, therefore modulating its cardioprotective properties. We assessed whether consumption of dietary TFAs modifies HDL-carried miR-223-3p and miR-135a-3p concentration and the inter-relationship between diet-induced changes in HDL-carried miRNA concentration and CVD risk markers. In a double blind, randomized, crossover, controlled study, 9 men were fed each of 3 experimental isoenergetic diets: 1) High in industrial TFA (iTFA; 3.7% energy); 2) High in TFA from ruminants (rTFA; 3.7% energy); 3) Low in TFA (control; 0.8% energy) for 4 weeks each. HDLs were isolated by ultracentrifugation and miRNAs were quantified by RT-qPCR. Variations in HDL-miR-223-3p concentration were negatively correlated with variations in HDL-cholesterol after the iTFA diet (r_s = 0.82; P = 0.007), and positively correlated with variations in C-reactive protein concentration after the rTFA diet (r_s = 0.75; P = 0.020). Variations in HDL-miR-135a-3p concentration were positively correlated with variations in total triglyceride (TG) concentration following the iTFA diet (r_s = ?0.82; P = 0.007), and with variations in low-density lipoprotein (LDL)-TG concentration following the rTFA diet (r_s = 0.83; P = 0.005), compared to the control diet. However, the consumption of dietary TFAs has no significant unidirectional impact on HDL-carried miR-223-3p and miR-135a-3p concentrations. Our results suggest that the variability in the HDL-carried miRNAs response to TFA intake, by being associated with variations in CVD risk factors, might reflect physiological changes in HDL functions.