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Exercise interventions are powerful tools for helping many patient populations. For those who need to manage their weight, an exercise program combined with diet modification may be key to losing weight and keeping it off. Many patients who are already at healthy weights find that physical activity helps to prevent weight gain. The good news is that accumulating frequent short bouts of moderately intense activity can be as effective as performing longer exercise sessions less often. Aerobic exercise alone may not be enough to preserve lean muscle mass when weight is lost, but incorporating resistance exercise may prevent reductions in resting metabolic rate and lean body mass. [ABSTRACT FROM AUTHOR]

Objective: Among postmenopausal women, those with diabetes experience more cardiovascular diseases than those without diabetes. We examine the relationship of hormone replacement therapy (HRT) with indicators of lipid and glucose metabolism using a national sample of diabetic and nondiabetic postmenopausal women.Research Design and Methods: We used data from the Third National Health and Nutrition Examination Survey, conducted from 1988 to 1994. A total of 2,786 postmenopausal women aged 40-74 years participated in an oral glucose tolerance test, had blood drawn for lipid assessment, and responded to HRT questions.Results: Our results show that postmenopausal women with diabetes had increased dyslipidemia compared with nondiabetic women. Among diabetic women, current users of HRT had significant different lipid and glucose control levels than never users of HRT for the following variables: total cholesterol (225 vs. 241 mg/dl), non-HDL (169 vs. 188 mg/dl), apoA (171 vs. 147 mg/dl), fibrinogen (306 vs. 342 mg/dl), glucose (112 vs. 154 mg/dl), insulin (16.81 vs. 22.6 uU/ml), and GHb (6.03 vs. 7.13 mg/dl).Conclusions: Diabetic and nondiabetic postmenopausal women currently taking HRT had better lipoprotein profile than never or previous users of HRT. Diabetic women currently taking HRT had better glycemic control than never or previous users of HRT. [ABSTRACT FROM AUTHOR]

Neuropeptide Y (NPY) appears to play a critical role in the integration of appetite and energy expenditure through NPY Y1 and Y5 receptor subtypes. Moreover, the NPY Y1 receptor is highly expressed on human adipocytes, where it inhibits lipolysis. The genes encoding these receptors are transcribed co-ordinately in opposite directions from a common promoter in a region of chromosome 4 that has been previously linked to triglyceride and small low-density lipoprotein (LDL) particle concentration. Therefore, the purpose of this investigation was to examine the relationship between polymorphisms in the genes encoding NPY Y1 and Y5 and the development of obesity and dyslipidemia. We screened the promoter and coding regions and identified four polymorphic variants. One of these, a cytosine to thymine (C→T) substitution in the untranslated region between the genes for NPY Y1 and Y5 (allele frequency 0.11), was significantly associated with both lower fasting triglyceride level (152 vs 125 mg/dl), and higher high-density lipoprotein (HDL) concentrations (49 vs 45 mg/dl) (p < 0.01) in 306 obese subjects. Given the stimulatory effect of NPY on adipocyte lipoprotein lipase (LPL) activity, and the lack of association of other polymorphisms with serum lipid levels, we hypothesize that this is a gain-in-function polymorphism. [ABSTRACT FROM AUTHOR]

An active lifestyle can play an important role in helping overweight patients both lose and manage their weight. The traditional exercise prescription of regular bouts of continuous vigorous exercise may need to be modified to increase rates of adoption and compliance. Recent data suggest that accumulating several short bouts of moderate to vigorous activity each day may improve adherence to the program. Understanding the barriers to activity that overweight people face--such as fear or embarrassment--can help physicians prescribe appropriate exercise routines, which may ultimately help them with better weight management. [ABSTRACT FROM AUTHOR]

Primary care physicians can do much to explain the hazards of sedentary living, detail physical and mental benefits of moderate intensity exercise, and help patients safely increase their level of daily physical activity. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The present study assessed satisfaction with weight, shape, and physical appearance, as well as the frequency of weight reduction efforts, in four well-defined groups of adolescents: (1) normal-weight girls; (2) normal-weight boys; (3) obese girls; and (4) obese boys. METHOD: Subjects were selected from 453 females and 355 males from a parochial school. In addition to the measurements of height and weight, adolescents completed a series of questionnaires on weight and dieting, weight and figure satisfaction, parents' attitudes toward weight, and anxiety. RESULTS: Only 49% of obese boys had tried to lose weight over the past year as compared to 90% of the obese girls (p < .001). Only 13% of the obese boys were currently dieting as compared to 62% of the obese girls (p < .001). Despite the relative equivalence of weight in the obese boys and girls, the boys perceived themselves to be less overweight (p < .05) and happier with their looks (p < .001) than obese girls. Thirty-three percent of normal-weight girls were dieting, and 70% had attempted weight loss over the past year. They were significantly less happy with their weight and figure than were average-weight boys (p < .001) and, remarkably, did not differ significantly from overweight boys on these measures. DISCUSSION: Obese adolescent males, in particular, need to be educated about the potential liabilities of their excess weight and encouraged to take appropriate action to correct it. [ABSTRACT FROM AUTHOR]

Context: Physical inactivity contributes to weight gain, but only 22% of Americans are regularly active.Objective: To examine short- and long-term changes in weight, body composition, and cardiovascular risk profiles produced by diet combined with either structured aerobic exercise or moderate-intensity lifestyle activity.Design: Sixteen-week randomized controlled trial with 1-year follow-up, conducted from August 1995 to December 1996.Participants and Setting: Forty obese women (mean body mass index [weight in kilograms divided by the square of height in meters], 32.9 kg/m2; mean weight, 89.2 kg) with a mean age of 42.9 years (range, 21-60 years) seen in a university-based weight management program.Interventions: Structured aerobic exercise or moderate lifestyle activity; low-fat diet of about 1200 kcal/d.Main Outcome Measures: Changes in body weight, body composition, cardiovascular risk profiles, and physical fitness at 16 weeks and at 1 year.Results: Mean (SD) weight losses during the 16-week treatment program were 8.3 (3.8) kg for the aerobic group and 7.9 (4.2) kg for the lifestyle group (within groups, P<.001; between groups, P = .08). The aerobic group lost significantly less fat-free mass (0.5 [1.3] kg) than the lifestyle group (1.4 [1.3] kg; P = .03). During the 1-year follow-up, the aerobic group regained 1.6 [5.5] kg, while the lifestyle group regained 0.08 (4.6) kg. At week 16, serum triglyceride levels and total cholesterol levels were reduced significantly (P<.001) from baseline (16.3% and 10.1% reductions, respectively) but did not differ significantly between groups and were not different from baseline or between groups at week 68.Conclusions: A program of diet plus lifestyle activity may offer similar health benefits and be a suitable alternative to diet plus structured aerobic activity for obese women. [ABSTRACT FROM AUTHOR]

Context: Physical inactivity contributes to weight gain in adults, but whether this relationship is true for children of different ethnic groups is not well established.Objective: To assess participation in vigorous activity and television watching habits and their relationship to body weight and fatness in US children.Design: Nationally representative cross-sectional survey with an in-person interview and medical examination.Setting and Participants: Between 1988 and 1994, 4063 children aged 8 through 16 years were examined as part of the National Health and Nutrition Examination Survey III. Mexican Americans and non-Hispanic blacks were oversampled to produce reliable estimates for these groups.Main Outcome Measures: Episodes of weekly vigorous activity and daily hours of television watched, and their relationship to body mass index and body fatness.Results: Eighty percent of US children reported performing 3 or more bouts of vigorous activity each week. This rate was lower in non-Hispanic black and Mexican American girls (69% and 73%, respectively). Twenty percent of US children participated in 2 or fewer bouts of vigorous activity perweek, and the rate was higher in girls (26%) than in boys (17%). Overall, 26% of US children watched 4 or more hours of television per day and 67% watched at least 2 hours per day. Non-Hispanic black children had the highest rates of watching 4 or more hours of television per day (42%). Boys and girls who watch 4 or more hours of television each day had greater body fat (P<.001) and had a greater body mass index (P<.001) than those who watched less than 2 hours per day.Conclusions: Many US children watch a great deal of television and are inadequately vigorously active. Vigorous activity levels are lowest among girls, non-Hispanic blacks, and Mexican Americans. Intervention strategies to promote lifelong physical activity among US children are needed to stem the adverse health consequences of inactivity. [ABSTRACT FROM AUTHOR]