On the Futility of Screening for Genes That Make You Fat

J. Lennert Veerman discusses the implications for genetic screening of findings showing that physical activity substantially attenuates the effects of genetic variants which predispose towards obesity

The association between misperceptions around weight status and quality of life in adults in Australia

Objective: Limited evidence supports a possible association between a person’s perception of their weight status and their quality of life (QoL). This study evaluates whether misperception around weight status is associated with QoL and the impact of gender on this association. Methods: A cross-sectional survey of Australian adults (n=1,905 analysed) collected selfreported height and weight (used to estimate BMI), gender and QoL (described using the AQoL-8D). Participants reported whether they perceived their weight status to be ‘underweight’, ‘healthy weight’, ‘overweight’ or ‘obese’. Misperception around weight status was categorised based on perceived weight status and self-reported BMI. Ordinary least squares regression was used to test associations between self-reported overall, physical and psychosocial QoL, misperception of weight status, and gender, across different BMI categories, after controlling for income, education, relationship status and health conditions. Results: Compared to accurate perception, underestimation of weight status was associated with higher overall QoL for obese males and females and for overweight males. Overestimation of weight status was associated with higher overall QoL for underweight females and lower overall QoL for healthy weight males and females. The same pattern was seen for psychosocial QoL. Physical QoL was less sensitive to misperception than psychosocial QoL. Conclusions: Self-reported misperception around weight status is associated with overall, psychosocial and to a lesser extent physical QoL in Australian adults, although its role depends on BMI category and gender. Generally misperception in the direction of “healthy weight” is associated with higher QoL and overestimation of weight status by those who are of healthy weight is associated with lower QoL. Findings should be confirmed in datasets that contain measured as opposed to self-report height and weight

Efficacy of Behavioral Interventions on Biological Outcomes for Cardiovascular Disease Risk Reduction among Latinos: a Review of the Literature

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death among Latinos. Designing and delivering culturally appropriate interventions are critical for modifying behavioral and nutritional behavior among Latinos and preventing CVD. OBJECTIVE: This literature review provides information on evidence-based behavioral intervention strategies developed for and tested with at risk Latinos, which reported impacts on biological outcomes. METHODS: A literature search was performed in PubMed that identified 110 randomized controlled trials of behavioral interventions for CVD risk reduction with at risk Latinos (≥ 1 CVD risk factor, samples > 30% Latino), 4 of which met the inclusion criteria of reporting biological outcomes (BP, Cholesterol, LDL, HDL, and BMI). RESULTS: All the studies used promotoras(Hispanic/Latino community member with training that provides basic health education in the community without being a professional healthcare worker) to deliver culturally appropriate interventions that combined nutritional and physical activity classes, walking routes and/or support groups. One study reported statistically significant reductions in systolic blood pressure, and an increase in physical activity. One study reported reductions in cholesterol levels compared to the control group. Two studies did not have significant intervention effects. Most studies demonstrated no significant changes in LDL, HDL or BMI. Methodological limitations include issues related to sample sizes, study durations, and analytic methods. CONCLUSION: Few studies met the inclusion criteria, but this review provides some evidence that culturally appropriate interventions such as using promotoras, bilingual materials/classes, and appropriate cultural diet and exercise modifications provides potentially efficacious strategies for cardiovascular risk improvement among Latinos

Prevalence of attention deficit/hyperactivity disorder among adults in obesity treatment

<p>Abstract</p> <p>Background</p> <p>Bariatric patients showing poor "focus" during treatment more often failed to lose weight or maintain reduced weight. Evaluation of these patients identified a number having attention deficit/hyperactivity disorder (ADHD), evidently a potent factor limiting successful weight control. After searches found no published reports describing comorbid ADHD and obesity, this report was conceived to begin exploring the prevalence and characteristics of these patients.</p> <p>Method</p> <p>Clinical records of 215 patients receiving obesity treatment during 2000 were reviewed. Data collected and analyzed included age, sex, beginning and ending body mass index (BMI), number of clinic visits, months of treatment, and diagnostic category (ADHD, some ADHD symptoms, non-ADHD). DSM-IV criteria were used, except age of onset was modified to <= 12 years.</p> <p>Results</p> <p>Whole sample ADHD prevalence was 27.4% (CI:21.1,32.9), but 42.6% (CI: 36.3% to 48.9%) for BMI >= 40. Mean weight loss among obese patients with ADHD (OB+ADHD) was 2.6 BMI (kg/m²) vs. 4.0 for non-ADHD (NAD) (p < 0.002). For BMI >= 40, OB+ADHD had BMI loss 2.9 vs. 7.0 (NAD) (p < 0.004). OB+ADHD had more clinic visits, with a trend toward longer treatment duration.</p> <p>Conclusions</p> <p>ADHD was highly prevalent among obese patients and highest in those with extreme obesity. Comorbid obesity and ADHD symptoms rendered treatment less successful compared to NAD counterparts. Reasons for the comorbidity are unknown, but may involve brain dopamine or insulin receptor activity. If replicated in further studies, these findings have important implications for treatment of severe and extreme obesity.</p