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BACKGROUND: Transcription factor 7-like 2 (TCF7L2) rs7903146 associates with type 2 diabetes and may operate via impaired glucagon-like peptide 1 secretion, which is stimulated more by fat than by carbohydrate ingestion. OBJECTIVE: The objective was to examine the interaction between TCF7L2 rs7903146 and dietary fat and carbohydrate [high-fat, low-carbohydrate: 40-45% of energy as fat (HF); compared with low-fat, high-carbohydrate: 20-25% of energy as fat (LF)] in obese individuals' responses to a 10-wk hypoenergetic diet (-600 kcal/d). DESIGN: European, obese participants (n = 771) were randomly assigned to receive an HF or an LF diet. Body weight, fat mass (FM), fat-free mass (FFM), waist circumference (WC), resting energy expenditure (REE), fasting fat oxidation in percentage of REE (FatOx), homeostasis model assessed insulin release (HOMA-beta), and HOMA-insulin resistance (HOMA-IR) were determined at baseline and after the intervention; 739 individuals were genotyped for rs7903146. RESULTS: Average weight loss was 6.9 kg with the LF and 6.6 kg with the HF (difference between diets, NS) diet. Among individuals who were homozygous for the T-risk allele, those in the HF diet group experienced smaller weight losses (Deltaweight) (2.6 kg; P = 0.009; n = 622), smaller DeltaFFM (1.6 kg; P = 0.027; n = 609), smaller DeltaWC (3.3 cm; P = 0.010; n = 608), and a smaller DeltaHOMA-IR (1.3 units; P = 0.004; n = 615) than did the LF diet group. For C allele carriers, there were no differences between the HF and LF diet groups. For the HF diet group, each additional T allele was associated with a reduced loss of FM (0.67 kg; P = 0.019; n = 609). TCF7L2 rs7903146 was not associated with DeltaREE, DeltaFatOx, DeltaHOMA-beta, or dropout. CONCLUSION: Our results suggest that obese individuals who are homozygous for the TCF7L2 rs7903146 T-risk allele are more sensitive to LF than to HF weight-loss diets. © 2010 American Society for Nutrition. [ABSTRACT FROM AUTHOR]

Morphine is an analgesic drug used to treat acute and chronic pain. Obesity is frequently associated with pain of various origins (e.g. arthritis, fibromyalgia, cancer), which increases the need for analgesic drugs. Obesity changes drug pharmacokinetics, and for certain drugs, specific modalities of prescription have been proposed for obese patients. However, scant data are available regarding the pharmacokinetics and pharmacodynamics of morphine in obesity. Prescription of morphine depends on pain relief but the occurrence of respiratory adverse effects correlates with obesity, and is not currently taken into account. Variations in the volume of distribution, elimination half-life and oral clearance of morphine, as well as recent advances in the respective roles of drug-metabolizing enzymes, catechol-O-methyltransferase and the mu opioid receptor in morphine pharmacokinetics and pharmacodynamics, may contribute to differences between obese and non-obese patients. In addition, drug-drug interactions may alter the disposition of morphine and its glucuronide metabolites, which may either increase the risk of adverse effects or reduce drug efficacy. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationships of two main physical activity domains (during leisure and at work) with cardiovascular risk factors and eating habits.Design: Cross-sectional study.Setting: Preventive medicine centre.Subjects: In 5478 adults (32% women, aged 20-80 years) who consecutively underwent a standardised health examination, leisure-time physical activity (LTPA; i.e. non-sport leisure and sport activities), occupational physical activity (OPA) and eating habits were assessed by self-administered questionnaires. We analysed sex-specific relationships of LTPA and OPA (in quartiles) with (1) various cardiovascular risk factors and (2) eating habits using analysis of variance and logistic regression, respectively.Results: In both genders, with and without adjustment for education in addition to age, LTPA was associated negatively with body mass index, body fat, waist circumference, resting heart rate, diastolic blood pressure and triglycerides, and positively associated with high-density lipoprotein cholesterol (all P < or = 0.005). OPA adjusted for age only was positively associated with most cardiovascular risk factors but these associations were not significant after further adjustment on education (except for waist circumference in women). Age- and education-adjusted LTPA was associated with increased frequency of consumption of fruits (odds ratio (OR) = 2.05, 95% confidence interval (CI) 1.68-2.52 in men; OR = 1.90, 95% CI 1.41-2.05 in women) and vegetables (OR = 1.81, 95% CI 1.48-2.21 in men; OR = 2.22, 95% CI 1.66-2.97 in women).Conclusions: The data emphasise the favourable associations of LTPA, a modifiable behaviour, with various cardiovascular risk factors and healthy eating habits. The results also suggest that the relationships of OPA with cardiovascular risk factors depend, at least in part, on socio-economic status as reflected by educational level. [ABSTRACT FROM AUTHOR]