Weight Gain and Management Concerns in Patients on Insulin Therapy

Background: The benefits of tight glycemic control in preventing the onset and progression of microvascular complications in patients with type 2 diabetes mellitus (DM) are unarguable. The majority of patients with type 2 DM will eventually require insulin to achieve adequate glycemic control. Using insulin earlier rather than later in the course of type 2 DM may diminish the deleterious effects of hyperglycemia on β-cell function and therefore help prolong good glycemic control and prevent the occurrence of microvascular complications. However, weight gain is a potential adverse effect of insulin therapy.Objective: The goal of this article was to describe the benefit of insulin therapy early in the course of type 2 DM, review the association of weight gain with insulin therapy, and examine potential detrimental effects that insulin-associated weight gain could have in patients with type 2 DM.Methods: Materials used for this article were identified through a search of MEDLINE (1966–2006). English-language articles were chosen using the search terms diabetes mellitus type 2, insulin, and obesity.Results: Intensive insulin therapy is often associated with weight gain. Although there is concern that weight gain in patients with type 2 DM may have adverse effects on risk factors for cardiovascular disease, unfavorable changes in blood pressure and lipid levels have not been consistently observed in clinical trials. Furthermore, clinical evidence, including data from the United Kingdom Prospective Diabetes Study, supports the view that intensive insulin therapy does not increase the risk for cardiovascular disease.Conclusions: Early insulin therapy in patients with type 2 DM may be a strategy that will help patients achieve and maintain good glycemic control, thereby reducing the risk of developing microvascular complications. Although weight gain is commonly associated with insulin therapy, it does not appear to put these patients at greater risk for cardiovascular disease.     

Body Perception and Satisfaction in Obese,Severely Obese,and Normal Weight Female Patients

The objective of this study was to investigate body perception and the associated level of dissatisfaction among obese patients. Twenty patients from each category of obese, severely obese, and normal weight individuals had their pictures enlarged or thinned using a computer program to manipulate photographs taken from the front, profile angle, and back. The pictures were shown to patients to represent both the way they thought they appeared and the way they would like to appear. Our results show that severely obese patients correctly perceived themselves as being more corpulent than obese patients, who in turn correctly perceived themselves as being more corpulent than normal weight females. These results remained stable regardless of whether the pictures were taken from the front, profile angle, or back. These results are discussed in terms of clinical and therapeutic interventions.     

Racial/Ethnic Differences in Weight Perception

The objective of this research was to estimate the prevalence of weight misperception among adults using the most recent nationally representative data, according to measured weight category and to assess the relationship between weight misperception and race/ethnicity. Height and weight were measured as part of the 1999–2006 National Health and Nutrition Examination Survey. The study sample consisted of 17,270 adults aged ≥20 years. BMI was categorized as underweight (BMI < 18.5), healthy weight (18.5 ≤ BMI < 25), overweight (25 ≤ BMI < 30), and obese (BMI ≥ 30). Subjects reported self‐perception of weight status. Among study subjects, 31.7% of healthy weight adults, 38.1% of overweight adults, and 8.1% of obese adults incorrectly perceived their weight category. Among obese men, the odds of weight misperception were higher for non‐Hispanic blacks (odds ratio (OR) = 3.0; 95% confidence interval (CI) = 2.0–4.5) compared to non‐Hispanic whites and for persons with less than a high school education (OR = 2.1; 95% CI = 1.3–2.1), compared to those with some college education. Among obese women, the odds of weight misperception were higher for non‐Hispanic blacks (OR = 3.4; 95% CI = 1.4, 3.1) and Mexican Americans (OR = 1.9; 95% CI = 1.2, 3.2) compared to non‐Hispanic whites and for persons with less than high school education compared to those with some college education (OR = 5.5; 95% CI = 3.3–9.3). Weight misperception is highly prevalent in the US population, and more frequent in racial/ethnic minorities, males, and in persons with lower educational levels. Addressing the issue of weight misperception may help address the problem of obesity in the United States by increasing awareness of healthy weight levels, which may subsequently have an impact on weight‐related behavior change.     

Laypeople's Health Concerns and Health Beliefs in Regard to Risk Perception of Mobile Communication

The consensus scientific view is that there is an absence of convincing scientific evidence for health risks of exposures to electromagnetic fields (EMF) at levels below those recommended in international guidelines. Nevertheless, some citizens are worried about EMF emitted by mobile communication and its consequences for health. The present study explored, by means of a mail survey, health concerns and the prevalence of health beliefs related to EMF in the general population. A random sample (n = 765, response rate 41%) of the German-speaking population in Switzerland was asked to assess various health beliefs. Results suggest that health concerns are widespread but lower than health concerns in regard to other hazards. About two-thirds of the respondents believed that some people suffer from electromagnetic hypersensitivity (EHS). Health beliefs items were analyzed using the Mokken scale. This scale was related to respondents' health concerns and showed that health beliefs differed in regard to sociodemographic variables. For example, analyses showed that females, younger respondents, and respondents who believed that some people are affected by EHS endorsed significantly more health beliefs than males, older respondents, and non-EHS respondents. Results indicate that it is important for policy-makers to develop a clear understanding of the possible effects of health beliefs on health concerns and risk perception. These findings may provide guidance for the further development of information materials and strategies.     

The Association between Weight Perception and BMI among High School Students

Objective: To assess the association between weight perception and BMI among a large, diverse sample of adolescents. This study used both measured and self‐reported height and weight to calculate BMI. Research Methods and Procedures: A convenience sample of students (n = 2032) in grades 9 through 12 completed a questionnaire assessing demographic characteristics, self‐reported height and weight, and body weight perception. These students were then weighed and had their height measured using a standard protocol. Results: Using BMI calculated from measured height and weight, 1.5% of students were classified as underweight or at risk for underweight, 51.2% of students were normal weight, and 47.4% were overweight or at risk for overweight. Among this same sample of students, however, 34.8% perceived themselves as underweight, 42.9% perceived themselves as about the right weight, and 22.3% perceived themselves as overweight. Even when using BMI calculated from self‐reported height and weight, >20% of students who were overweight or at risk for overweight perceived themselves as underweight. Discussion: Because perception of overweight is a key determinant of adolescent nutritional habits and weight management, many students who are overweight or at risk for overweight but who do not perceive themselves as such are unlikely to engage in weight control practices. Increasing awareness of medical definitions of overweight might improve accuracy of weight perceptions and lead to healthier eating and increased physical activity.     

Perception of Exercise Difficulty Predicts Weight Regain in Formerly Overweight Women

It has been previously reported that overweight and obese individuals perceive exercise as more difficult than their lean counterparts, and this difference may not be solely attributed to physiological differences. Therefore, we tested the hypothesis that individual differences in the perception of exercise difficulty during exercise, independent of concurrently measured physiological markers of exertion, are predictive of weight regain, after completion of a weight loss program. A total of 113 formerly overweight women who had previously completed a weight‐loss program to achieve a normal body weight (BMI <25 kg/m²) underwent a submaximal aerobic exercise task while measures of physiological and perceived exertion (rating of perceived exertion (RPE)) were recorded. Weight gain was assessed following a subsequent 1‐year free‐living period. Average weight regain 1 year following the intervention was 5.46 ± 3.95 kg. In regression modeling, RPE (β = 0.21, P = 0.01), but not physiological exertion (β = 0.02, P = 0.81), during the submaximal exercise task was positively associated with 1‐year weight regain following weight loss in premenopausal women, independent of measured confounding variables. The association between RPE and weight regain suggests that perception of exercise difficulty is an important predictor of weight regain following a weight‐loss intervention.     

Preferences Predict Food Intake From 5 to 11 Years,but Not in Girls With Higher Weight Concerns,Dietary Restraint,and %Body Fat

Food preferences (FP) predict food intake in childhood; however, the predictive power of FP may decline among girls as weight concerns (WC) and dietary restraint (DR) increase during preadolescence. To examine longitudinal change in the preference‐intake (P‐I) relation and assess whether this relation weakens among non‐Hispanic white girls (n = 197) with a history of WC and DR from age 5 to 11. Girls' preferences for and intake (kcal) of 10 palatable snack foods were assessed biennially. Height, weight, percent body fat (%BF), WC, and DR were measured. Individual correlation coefficients were calculated per girl to capture within‐person P‐I correlations at each time of measurement. Overall, FP predicted girls' snack food calorie intakes between 5 and 11 years, but latent profile analysis (LPA) revealed three distinct patterns of change in P‐I correlations over time: “strong/stable” P‐I correlations were relatively high and became stronger with age; “increasing/later null” P‐I correlations were initially weak and became stronger between 5 and 9 years, but dropped to near 0 at 11 years; “initially weak/later strong” P‐I correlations were initially null and increased with age. Mixed models revealed that the “increasing/later null” group had greater increases in %BF, and higher WC, DR, and BMI percentiles from 5 to 11 years, compared to the other groups. In summary, FP predicted snack food calorie intake among most girls during childhood, but waned as a predictor of calorie intake at age 11 for a subset of girls with increasing %BF, and higher WC, DR, and BMIs.     

烟台甜樱桃柱头的可授性、形态特征与坐果率

采用数码照相、电镜扫描、联苯胺-过氧化氢测试及去雄套袋等技术手段,对烟台甜樱桃（Cerasus avium）花期不同发育阶段柱头的可授性、形态特征和坐果状况进行了观察。结果表明,烟台甜樱桃在套袋状态下,柱头可授期从开花前1天开始可持续5–7天。从杯状花期到花瓣平展期,柱头逐渐有乳突细胞破裂并呈现分泌液,出现渐强的可授性;从花瓣平展期到花瓣脱落期,柱头由暗黄渐变至暗黑,逐渐萎缩并丧失可授性。去雄套袋及人工授粉实验结果显示,在大蕾期、杯状花期、花瓣展放期、花瓣平展期和花瓣脱落期进行人工授粉,烟台甜樱桃的坐果率分别为60.50%、58.33%、62.08%、57.14%和39.13%。在自然条件下烟台甜樱桃的坐果率一般为30%–42%,传粉成功的最佳期主要发生在杯状花期至花瓣平展期。     

烟台甜樱桃柱头的可授性、形态特征与坐果率

采用数码照相、电镜扫描、联苯胺-过氧化氢测试及去雄套袋等技术手段, 对烟台甜樱桃(Cerasus avium)花期不同发育阶段柱头的可授性、形态特征和坐果状况进行了观察。结果表明, 烟台甜樱桃在套袋状态下, 柱头可授期从开花前1天开始可持续5–7天。从杯状花期到花瓣平展期, 柱头逐渐有乳突细胞破裂并呈现分泌液, 出现渐强的可授性; 从花瓣平展期到花瓣脱落期, 柱头由暗黄渐变至暗黑, 逐渐萎缩并丧失可授性。去雄套袋及人工授粉实验结果显示, 在大蕾期、杯状花期、花瓣展放期、花瓣平展期和花瓣脱落期进行人工授粉, 烟台甜樱桃的坐果率分别为60.50%、58.33%、62.08%、57.14%和39.13%。在自然条件下烟台甜樱桃的坐果率一般为30%–42%, 传粉成功的最佳期主要发生在杯状花期至花瓣平展期。     

Bioenergy Plants: Hopes,Concerns and Prospectives

There are major concerns over both the security of energy supplies (declining supplies and political control) and the environmental costs associated with energy generation and use.The global consumption of carbon-containing fossil fuels for