A review of 144 published studies of the relationship between socioeconomic status (SES) and obesity reveals a strong inverse relationship among women in developed societies. The relationship is inconsistent for men and children in developed societies. In developing societies, however, a strong direct relationship exists between SES and obesity among men, women, and children. A review of social attitudes toward obesity and thinness reveals values congruent with the distribution of obesity by SES in different societies. Several variables may mediate the influence of attitudes toward obesity and thinness among women in developed societies that result in the inverse relationship between SES and obesity. They include dietary restraint, physical activity, social mobility, and inheritance.

Socioeconomic Status and Obesity: A Review of the Literature

OBJECTIVE To investigate the relation between obesity, fat distribution, and weight gain through adulthood and the risk of non-insulin-dependent diabetes melli-tus (NIDDM). RESEARCH DESIGN AND METHODS We analyzed data from a cohort of 51,529 U.S. male health professionals, 40-75 years of age in 1986, who completed biennial questionnaires sent out in 1986, 1988, 1990, and 1992. During 5 years of follow-up (1987-1992), 272 cases of NIDDM were diagnosed among men without a history of diabetes, heart disease, and cancer in 1986 and who provided complete health information. Relative risks (RRs) associated with different anthropometrie measures were calculated controlling for age, and multivariate RRs were calculated controlling for smoking, family history of diabetes, and age. RESULTS We found a strong positive association between overall obesity as measured by body mass index (BMI) and risk of diabetes. Men with a BMI of ≥35 kg/m 2 had a multivariate RR of 42.1 (95% confidence interval [CI] 22.0-80.6) compared with men with a BMI 2 . BMI at age 21 and absolute weight gain throughout adulthood were also significant independent risk factors for diabetes. Fat distribution, measured by waist-to-hip ratio (WHR), was a good predictor of diabetes only among the top 5%, while waist circumference was positively associated with the risk of diabetes among the top 20% of the cohort. CONCLUSIONS These data suggest that waist circumference may be a better indicator than WHR of the relationship between abdominal adiposity and risk of diabetes. Although early obesity, absolute weight gain throughout adulthood, and waist circumference were good predictors of diabetes, attained BMI was the dominant risk factor for NIDDM; even men of average relative weight had significantly elevated RRs.

Obesity, Fat Distribution, and Weight Gain as Risk Factors for Clinical Diabetes in Men

Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index

See related commentary by Kanis, page [1829][1]

Since the publication of the Osteoporosis Canada guidelines in 2002, there has been a paradigm shift in the prevention and treatment of osteoporosis and fractures. [1][2],[2][3] The focus now is on preventing fragility fractures and their negative

/pdf/2010-clinical-practice-guidelines-for-the-diagnosis-and-4ttqfkm9wl.pdf

2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary

Background. The declining activity of the growth hormone-insulin-like growth factor I (IGF-I) axis with advancing age may contribute to the decrease in lean body mass and the increase in mass of adipose tissue that occur with aging. Methods. To test this hypothesis, we studied 21 healthy men from 61 to 81 years old who had plasma IGF-I concentrations of less than 350 U per liter during a six-month base-line period and a six-month treatment period that followed. During the treatment period, 12 men (group 1) received approximately 0.03 mg of biosynthetic human growth hormone per kilogram of body weight subcutaneously three times a week, and 9 men (group 2) received no treatment. Plasma IGF-I levels were measured monthly. At the end of each period we measured lean body mass, the mass of adipose tissue, skin thickness (epidermis plus dermis), and bone density at nine skeletal sites. In group 1, the mean plasma IGF-I level rose into the youthful range of 500 to 1500 U per liter during treatment, where...

Effects of Human Growth Hormone in Men over 60 Years Old

SUMMARY
2-Thiobarbituric acid (TBA) values of raw pork were determined by distillation and extraction methods and those of raw beef were determined by the latter method during storage at 4° and –20°C. TBA values of these tissues were low compared to values usually reported for cooked tissue from these animals in similar environments. There were significant animal differences in TBA values of beef and pork; there were significant changes in TBA values of these tissues during storage at 4°C, but changes during storage at –20°C were insignificant. pH and TBA values were inversely related. Mathematical relationships between TBA values of pork and beef during storage at 4°C. between TBA values and pH and between results obtained by the two procedures for determining TBA values of pork during storage are discussed. The extraction method is an acceptable method for determining TBA values and is easier to use than the distillation method. The TBA test has limited use for meat samples that have been frozen.

A new extraction method for determining 2‐thiobarbituric acid values of pork and beef during storage

Calcium homeostasis and bone metabolism during pregnancy, lactation, and postweaning: a longitudinal study.

Because so much medical and media attention has been drawn to the alleged benefits of dehydroepiandrosterone (DHEA) and its sulfate ester (DHEAS), it is important to evaluate the effects of replacement therapy objectively using double blind, cross-over, randomized research methodology. In this 9-month study, healthy older men (n = 39) received replacement dose DHEA. Lean body mass, blood hematology, chemistry and endocrine values, as well as urological and psychological data were measured. Data showed some mild and temporary, but significant, changes during oral use of 100 mg DHEA for 3 months compared with placebo taken for 3 months. Body composition did not change during the 6 months of treatment, nor did any urological parameters. Concomitant with the endocrine changes, some small but, significant, variations in blood values (blood urea nitrogen, creatinine, uric acid, alanine transaminase, cholesterol, high density lipoprotein, and potassium) were found. After cessation of DHEA and placebo, followed by 3 months of no treatment, all values previously found to be altered returned to entry baseline. Well publicized effects of the drug reported by others, such as a sense of well-being or improved sexual function, were not found in this study.

/pdf/dehydroepiandrosterone-replacement-in-aging-humans-42tdbplyj7.pdf

Dehydroepiandrosterone replacement in aging humans.

Total body potassium in aging humans: a longitudinal study.

A randomized clinical intervention trial to determine effects of lactation and 1 g of calcium (Ca) on bone remodeling was conducted in 15 women (calcium = 7, placebo [P] = 8) consuming 1.3-2.4 g of Ca/day from diet + prenatal supplement. Study periods were baseline, ≤2 weeks postpartum ; lactation, 3 months lactation ; and postweaning, 3 months postweaning. Bone mineral density (BMD) corrected for body weight was determined by dual-energy X-ray absorptiometry (DXA). Indicators of calcium metabolism, bone turnover, and lactation were measured : calcium metabolism, parathyroid hormone (PTH), 25-hydroxyvitamin D (25[OH]D), 1,25-dihydroxyvitamin D (1,25[OH] 2 D) ; bone turnover, formation, procollagen I carboxypeptides (PICP), osteocalcin, and bone alkaline phosphatase (B-ALP), resorption, tartrate resistant acid phosphatase (TRAP) ; and lactation, prolactin (PRL). Mean BMD changes differed by site : baseline to lactation -43% (P) (p < 0.04) and -6.3% (Ca) (p < 0.01) at the lumbar spine (L2-L4) and 5.7% gains of the ultradistal (UD) radius (Ca) (p < 0.04) ; lactation to postweaning, -6% to -11% at all sites of the radius and ulna (Ca, P) (p < 0.04) +3% at L2-L4 (Ca) (p < 0.03) ; baseline to postweaning, (UD) radius -5.2% (P) (p < 0.03), UD radius + ulna -6% to -8% (Ca, P) (p < 0.04) but no significant loss of L2-L4 or total body. Bone turnover markers were higher at lactation than postweaning : PICP (+34%, p < 0.001), osteocalcin (+25%, p < 0.01), TRAP (+11%, p < 0.005) as was PRL (+81%, p < 0.001). Indicators of calcium metabolism were higher postweaning than lactation for PTH (+40%, p < 0.01) and 25(OH)D (+45%, p < 0.02) but not for 1,25(OH) 2 D. There were no differences between P or Ca for indices of calcium metabolism, bone turnover, or PRL. An increase in markers of bone turnover and a loss of BMD of the spine during lactation appears to be part of the physiological changes of lactation and not preventable by increasing calcium intake above the recommended dietary allowance (RDA). A return of BMD toward baseline of the spine but not the arm, was associated with an increase in PTH without an increase in 1,25(OH) 2 D postweaning. Loss of estrogen during lactation and a return postweaning may play an important role.

Gary F. Krause

Papers

A new extraction method for determining 2‐thiobarbituric acid values of pork and beef during storage

Calcium homeostasis and bone metabolism during pregnancy, lactation, and postweaning: a longitudinal study.

Dehydroepiandrosterone replacement in aging humans.

Total body potassium in aging humans: a longitudinal study.

Changes in bone mineral density and markers of bone remodeling during lactation and postweaning in women consuming high amounts of calcium.