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Nathan Goodyear

Obese Americans now outweigh the merely overweight | Reuters - 0 views

  • Numbers posted by the National Center for Health Statistics show that more than 34 percent of Americans are obese, compared to 32.7 percent who are overweight. It said just under 6 percent are "extremely" obese.
  • More than one-third of adults, or over 72 million people, were obese in 2005-2006, the NCHS said in its report
  • In May, the CDC reported that 32 percent of U.S. children fit the definition of being overweight, 16 percent were obese and 11 percent were extremely obese.
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    obesity in America
Nathan Goodyear

JAMA Network | JAMA | Trends in Obesity Among Adults in the United States, 2005 to 2014 - 0 views

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    Obesity trends continue in the wrong direction.  According to most recent stats, 40% of American women are obese and 35% of men are obese.  Severe obesity sits at 10% for American women.
Nathan Goodyear

Testosterone: a metabolic hormone in health and disease - 0 views

  • E2 and the inflammatory adipocytokines tumour necrosis factor α (TNFα) and interleukin 6 (IL6) inhibit hypothalamic production of GNRH and subsequent release of LH and FSH from the pituitary
  • Leptin, an adipose-derived hormone with a well-known role in regulation of body weight and food intake, also induces LH release under normal conditions via stimulation of hypothalamic GNRH neurons
  • In human obesity, whereby adipocytes are producing elevated amounts of leptin, the hypothalamic–pituitary axis becomes leptin resistant
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  • there is evidence from animal studies that leptin resistance, inflammation and oestrogens inhibit neuronal release of kisspeptin
  • Beyond hypothalamic action, leptin also directly inhibits the stimulatory action of gonadotrophins on the Leydig cells of the testis to decrease testosterone production; therefore, elevated leptin levels in obesity may further diminish androgen status
  • increasing insulin resistance assessed by glucose tolerence test and hypoglycemic clamp was shown to be associated with a decrease in Leydig cell testosterone secretion in men
  • ADT for the treatment of prostatic carcinoma in some large epidemiological studies has been shown to be associated with an increased risk of developing MetS and T2DM
  • Non-diabetic men undergoing androgen ablation show increased occurrence of new-onset diabetes and demonstrate elevated insulin levels and worsening glycaemic control
  • Prostate cancer patients with pre-existing T2DM show a further deterioration of insulin resistance and worsening of diabetic control following ADT
  • The response to testosterone replacement of insulin sensitivity is in part dependent on the androgen receptor (AR)
  • Low levels of testosterone have been associated with an atherogenic lipoprotein profile, characterised by high LDL and triglyceride levels
  • a positive correlation between serum testosterone and HDL has been reported in both healthy and diabetic men
  • up to 70% of the body's insulin sensitivity is accounted for by muscle
  • Testosterone deficiency is associated with a decrease in lean body mass
  • relative muscle mass is inversely associated with insulin resistance and pre-diabetes
  • GLUT4 and IRS1 were up-regulated in cultured adipocytes and skeletal muscle cells following testosterone treatment at low dose and short-time incubations
  • local conversion of testosterone to DHT and activation of AR may be important for glucose uptake
  • inverse correlation between testosterone levels and adverse mitochondrial function
  • orchidectomy of male Wistar rats and associated testosterone deficiency induced increased absorption of glucose from the intestine
  • (Kelley & Mandarino 2000). Frederiksen et al. (2012a) recently demonstrated that testosterone may influence components of metabolic flexibility as 6 months of transdermal testosterone treatment in aging men with low–normal bioavailable testosterone levels increased lipid oxidation and decreased glucose oxidation during the fasting state.
  • Decreased lipid oxidation coupled with diet-induced chronic FA elevation is linked to increased accumulation of myocellular lipid, in particular diacylglycerol and/or ceramide in myocytes
  • In the Chang human adult liver cell line, insulin receptor mRNA expression was significantly increased following exposure to testosterone
  • Testosterone deprivation via castration of male rats led to decreased expression of Glut4 in liver tissue, as well as adipose and muscle
  • oestrogen was found to increase the expression of insulin receptors in insulin-resistant HepG2 human liver cell line
  • FFA decrease hepatic insulin binding and extraction, increase hepatic gluconeogenesis and increase hepatic insulin resistance.
  • Only one, albeit large-scale, population-based cross-sectional study reports an association between low serum testosterone concentrations and hepatic steatosis in men (Völzke et al. 2010)
  • This suggests that testosterone may confer some of its beneficial effects on hepatic lipid metabolism via conversion to E2 and subsequent activation of ERα.
  • hypogonadal men exhibiting a reduced lean body mass and an increased fat mass, abdominal or central obesity
  • visceral adipose tissue was inversely correlated with bioavailable testosterone
  • there was no change in visceral fat mass in aged men with low testosterone levels following 6 months of transdermal TRT, yet subcutaneous fat mass was significantly reduced in both the thigh and the abdominal areas when analysed by MRI (Frederiksen et al. 2012b)
  • ADT of prostate cancer patients increased both visceral and subcutaneous abdominal fat in a 12-month prospective observational study (Hamilton et al. 2011)
  • Catecholamines are the major lipolysis regulating hormones in man and regulate adipocyte lipolysis through activation of adenylate cyclase to produce cAMP
  • deficiency of androgen action decreases lipolysis and is primarily responsible for the induction of obesity (Yanase et al. 2008)
  • may be some regional differences in the action of testosterone on subcutaneous and visceral adipose function
  • proinflammatory adipocytokines IL1, IL6 and TNFα are increased in obesity with a downstream effect that stimulates liver production of CRP
  • observational evidence suggests that IL1β, IL6, TNFα and CRP are inversely associated with serum testosterone levels in patients
  • TRT has been reported to significantly reduce these proinflammatory mediators
  • This suggests a role for AR in the metabolic actions of testosterone on fat accumulation and adipose tissue inflammatory response
  • testosterone treatment may have beneficial effects on preventing the pathogenesis of obesity by inhibiting adipogenesis, decreasing triglyceride uptake and storage, increasing lipolysis, influencing lipoprotein content and function and may directly reduce fat mass and increase muscle mass
  • Early interventional studies suggest that TRT in hypogonadal men with T2DM and/or MetS has beneficial effects on lipids, adiposity and parameters of insulin sensitivity and glucose control
  • Evidence that whole-body insulin sensitivity is reduced in testosterone deficiency and increases with testosterone replacement supports a key role of this hormone in glucose and lipid metabolism
  • Impaired insulin sensitivity in these three tissues is characterised by defects in insulin-stimulated glucose transport activity, in particular into skeletal muscle, impaired insulin-mediated inhibition of hepatic glucose production and stimulation of glycogen synthesis in liver, and a reduced ability of insulin to inhibit lipolysis in adipose tissue
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    Great review of the Hypogonadal-obesity-adipocytokine hypothesis.
Nathan Goodyear

Adult Obesity in the United States: The State of Obesity - 0 views

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    startling obesity trends that don't show much sign of leveling off.
Nathan Goodyear

Products - Health E Stats - Overweight, Obesity, and Extreme Obesity Among Adults 2007-... - 0 views

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    scary statistics of the prevalence and the trends of obesity in the US.
Nathan Goodyear

Obesity and Overweight for Professionals: Data and Statistics: Adult Obesity - DNPAO - CDC - 0 views

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    new obesity rates published by CDC for 2011
Nathan Goodyear

Young Adult Cancer: Influence of the Obesity Pandemic - Berger - 2018 - Obesity - Wiley... - 0 views

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    The obesity epidemic is increasing cancer risk and changing the cancer aggressiveness in younger and younger adults. The cancer of today is different than the cancer of yesterday. It behaves differently.
Nathan Goodyear

BMC Public Health | Abstract | High prevalence of vitamin D insufficiency and its assoc... - 0 views

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    Malaysians with metabolic syndrome and obesity found to have high prevalence of vitamin D insufficiency.  Role for vitamin D therapy for those with metabolic syndrome and obesity.
Nathan Goodyear

Central obesity and increased risk of dementia mor... [Neurology. 2008] - PubMed result - 0 views

  • Fifty percent of adults have central obesity
  • Central obesity in midlife increases risk of dementia independent of diabetes and cardiovascular comorbidities
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    central obesity and dementia
Nathan Goodyear

The Relation of Childhood BMI to Adult Adiposity: The Bogalusa Heart Study - 0 views

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    Childhood obesity continues to adulthood for a significant percentage of people.
Nathan Goodyear

Elevated C-Reactive Protein Levels in Overweight and Obese Adults - 0 views

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    Overweight and obese adults, irregardless of age, were associated with elevated CRP. This indicates inflammation and creates the link between adipose induced inflammation and a direct contribution to CVD and other associated disease of aging.
Nathan Goodyear

International Journal of Obesity - Abstract of article: Pubertal timing and adult obesi... - 0 views

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    Earlier puberty associated with increased risk of MetS and obesity.
Nathan Goodyear

Akkermansia muciniphila and improved metabolic health during a dietary intervention in ... - 0 views

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    akkermansia muciniphila bacteria associated with improved metabolism following calorie restriction in obese adults.  Again, gut flora effects metabolism
Nathan Goodyear

Health and economic burden of the projected obesity trends in the USA and the UK : The ... - 0 views

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    1 in 2 adult Americans projected to be obese by 2030.  This study estimates an additional $66 billion /year to the medical costs in USA....unsustainable.
Nathan Goodyear

Trends in Obesity Prevalence in Adults With a History of Cancer: Results From the US Na... - 0 views

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    cancer survivors at higher risk of obesity
Nathan Goodyear

Associations of Maternal Prepregnancy Body Mass Index and Gestational Weight Gain With ... - 0 views

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    Obesity of pregnant mothers effect the future cardiovascular health of their future children. The time to work on the health of your future children, is before couples actually get pregnant.
Nathan Goodyear

PLOS ONE: Mode of Delivery and Offspring Body Mass Index, Overweight and Obesity in Adu... - 0 views

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    Caesarean Section appears to be associated with increased obesity rates, according to meta-analysis.
Nathan Goodyear

Diagnosing Growth Hormone Deficiency in Adults - 0 views

  • it is clear that serum IGF-1 and or IGFBP-3 can be normal in patients with undisputed GHD
  • Various investigators have reported normal IGF-1 values in 37–70% of GH deficient adults
  • The co-administration of arginine and GHRH (the combined test) is a powerful stimulus for GH production and has gained increasing acceptance as a useful method of diagnosing GHD [34]. This test has been advocated as a suitable alternative to ITT
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  • The glucagon stimulation test (GST) is a reliable, safe alternative to the ITT in the diagnosis of GHD
  • An intravenous infusion of arginine (0.5 g/kg body weight) together with an intravenous bolus of GHRH (1 mcg/kg body weight) is administered [30]. Serum samples for GH are then obtained every 15–30 minutes for two hours.
  • Obesity, particularly marked obesity, is associated with blunted GH secretion in response to provocative stimuli
  • It has also been suggested that that even mildly increased BMI (25–30 kg/m2) can result in diminished stimulated GH production in 13% of healthy subjects
  • Corneli et al. have defined BMI-specific cut-off points for diagnosing adult-onset GHD using GHRH + arginine—11.5 ng/mL for those with BMI < 25 kg/m2, 8.0 ng/mL for BMI 25–30 kg/m2, 4.2 ng/mL for those with BMI > 30 kg/m2
  • GH levels are higher during the luteal phase in comparison with the follicular phase of the cycle
  • Oral, in contrast to transdermal oestrogen, lowers IGF-1 levels and is associated with increased GH levels
  • Adequate pituitary replacement with thyroxine and hydrocortisone are needed for optimal GH production
  • one cannot rely on a low IGF-1 to diagnose GHD in women taking oral oestrogen preparations.
  • Numerous GH secretagogues are available with the insulin tolerance test being the gold standard and the glucagon stimulation test or the GHRH + arginine as acceptable alternatives
  • ain et al. found the GST to be at least as good as the ITT in provoking GH secretion
  • the GST is safe, with almost no contraindications, it causes nausea and sometimes vomiting in 15–20% of subjects
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    Nice, more recent analysis, of HGH testing.
Nathan Goodyear

Longer sleep duration associates with lower adiposity gain in adult short sleepers. - 0 views

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    shorter sleep associated with obesity.
Nathan Goodyear

Obesity, Abdominal Obesity, Physical Activity, and Caloric Intake in US Adults: 1988 to... - 0 views

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    Observational study finds BMI increase of 0.375 in both men and women per year.  The waist circumference also increased by 0.37% per year in women compared to 0.27% in men.  There was a significant reduction in physical activity over the same time period.  In women, the reporting of physical inactivity increased to 52% FROM 19% compared to 44% FROM 11% in men.  The authors found no association with change in calories.  However, an assessment in quality of calories would have likely shown a glaring difference.  Clear causation can not be concluded due to the fact that the study was observational.
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