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4 results

  • 12 - Airway management

  • from Section 3 - Intra-operative management
  • Edited by Adrian Alvarez, Jay B. Brodsky, Stanford University School of Medicine, California, Hendrikus J. M. Lemmens, Stanford University School of Medicine, California, John M. Morton, Stanford University School of Medicine, California
  • Book:
    Morbid Obesity
    Published online:
    04 May 2010
    Print publication:
    11 March 2010, pp -

  • Summary

    This chapter looks at several aspects of metabolic and digestive diseases associated with obesity. Obesity is associated with a dual problem for these metabolic processes: excessive delivery of fat and carbohydrate to the liver and reduced effectiveness of insulin in regulating fat metabolism. It is now believed that type 2 diabetes (T2D) is a disease characterized by hepatic steatosis as well as dysregulation of glucose metabolism. Non-alcoholic steatohepatitis (NASH) is an inflammatory disease that results from hepatic steatosis. Insulin resistance is commonly associated with, but not unique to, obesity. The distribution of body fat has significant impact on the development of metabolic disease. Obesity is not an essential component of metabolic syndrome (MetS); however, there is a strong correlation between visceral fat deposits and MetS. Although there are no data implicating stress hyperglycemia and adverse outcomes in bariatric surgery, substantial data exists in other clinical and laboratory conditions.

  • Overweight, obesity and fat distribution in 50- to 64-year-old participants in the European Prospective Investigation into Cancer and Nutrition (EPIC)

  • M Haftenberger, PH Lahmann, S Panico, CA Gonzalez, JC Seidell, H Boeing, MC Giurdanella, V Krogh, HB Bueno-de-Mesquita, PHM Peeters, G Skeie, A Hjartåker, M Rodriguez, JR Quirós, G Berglund, U Janlert, KT Khaw, EA Spencer, K Overvad, A Tjønneland, F Clavel-Chapelon, B Tehard, AB Miller, K Klipstein-Grobusch, V Benetou, G Kiriazi, E Riboli, N Slimani
  • Journal:
    Public Health Nutrition / Volume 5 / Issue 6b / December 2002
    Published online by Cambridge University Press:
    02 January 2007, pp. 1147-1162
    • Article
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  • Objective:

    To describe anthropometric characteristics of participants of the European Prospective Investigation into Cancer and Nutrition (EPIC).

    Design:

    A cross-sectional analysis of baseline data of a European prospective cohort study.

    Subjects:

    This analysis includes study populations from 25 centres in nine European countries. The British populations comprised both a population-based and a ‘health-conscious’ group. The analysis was restricted to 83 178 men and 163 851 women aged 50–64 years, this group being represented in all centres.

    Methods:

    Anthropometric examinations were undertaken by trained observers using standardised methods and included measurements of weight, height, and waist and hip circumferences. In the ‘health-conscious’ group (UK), anthropometric measures were predicted from self-reports.

    Results:

    Except in the ‘health-conscious’ group (UK) and in the French centres, mean body mass index (BMI) exceeded 25.0 kg m-2. The prevalence of obesity (BMI≥30 kg m-2) varied from 8% to 40% in men, and from 5% to 53% in women, with high prevalences (>25%) in the centres from Spain, Greece, Ragusa and Naples (Italy) and the lowest prevalences (<10%) in the French centres and the ‘health-conscious’ group (UK). The prevalence of a large waist circumference or a high waist-to-hip ratio was high in centres from Spain, Greece, Ragusa and Naples (Italy) and among women from centres in Germany and Bilthoven (The Netherlands).

    Conclusions:

    Anthropometric measures varied considerably within the EPIC population. These data provide a strong base for further investigation of anthropometric measures in relation to the risk of chronic diseases, especially cancer.

  • The effects of birth weight and postnatal linear growth retardation on body mass index, fatness and fat distribution in mid and late childhood

  • Susan P Walker, Pamela S Gaskin, Christine A Powell, Franklyn I Bennett
  • Journal:
    Public Health Nutrition / Volume 5 / Issue 3 / June 2002
    Published online by Cambridge University Press:
    02 January 2007, pp. 391-396
    • Article
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  • Objective:

    To determine the effects of birth weight and early childhood stunting on body mass index (BMI), body fat and fat distribution at ages 7 and 11 years, and the change from 7 to 11 years.

    Design:

    Prospective cohort study.

    Setting:

    Kingston, Jamaica.

    Subjects:

    One hundred and sixteen stunted children (height-for-age below two standard deviations (<-2SD) of the National Center for Health Statistics (NCHS) references) and 190 non-stunted children (height-for-age > -1SD), identified at age 9–24 months. The stunted group was divided into a previously stunted group (height-for-age at 11 years ≥ -1SD) and a chronically stunted group (height-for-age <-1SD).

    Results:

    Birth weight was positively related to the children's BMI but not to measures of body fat. Birth weight was negatively associated with the subscapular/triceps skinfold (SSF/TSF) ratio at age 11 years, and to the change between 7 and 11 years. Controlling for birth weight, the chronically stunted group remained significantly smaller than the non-stunted children at both ages and increased less from 7 to 11 years in all measures except the SSF/TSF ratio, which was significantly greater at age 7 years. The previously stunted group had significantly lower BMI and percentage body fat at age 7 years than the non-stunted group. Change from 7 to 11 years was not significantly different from that of the non-stunted group except for a smaller increase in TSF. At age 11 years they had significantly lower TSF and percentage body fat1.

    Conclusions:

    Children stunted in early childhood had less fat and lower BMI than non-stunted children but had a more central fat distribution that was partially explained by their lower birth weights. The association between birth weight and central fat distribution developed between 7 and 11 years.

  • Body composition and fat distribution during the first 2 weeks of gestation in ad lib.-fed and energy-restricted rats

  • Annica Sohlström, Nazma Kabir, Aija Sadurskis, Elisabet Forsum
  • Journal:
    British Journal of Nutrition / Volume 71 / Issue 3 / March 1994
    Published online by Cambridge University Press:
    17 March 2008, pp. 317-333
    Print publication:
    March 1994
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  • Knowledge about changes in body composition during gestation is of interest when estimating energy requirements during pregnancy, and relevant since reproduction is often surprisingly well maintained in malnourished females. Due to difficulties in conducting such studies in humans, studies in rats are of interest. Therefore, maternal retention of fat and fat-free weight was estimated in rats during the first 2 weeks of gestation and during a corresponding time period in virgin controls. Groups fed ad lib. or 70 % of ad lib. intake during the 4 weeks preceding conception and during gestation were studied. Retention was estimated by comparing pregnant and virgin rats with rats killed at the time of conception. Body fat was analysed chemically and fat-free weight was body weight minus body fat. Each rat was divided into twelve to fourteen parts and the fat content of each part was analysed. Pregnant ad lib.-fed rats retained more fat and fat-free weight than did virgin ad lib.-fed controls. In the energy-restricted group the pregnant rats retained more fat-free weight while virgin rats retained slightly more fat than did pregnant rats. The difference between pregnant and virgin rats with respect to the amount of fat in the different body parts was small in both feeding groups. Thus, the statement that fat stored at specific sites in the maternal body represents an important source of energy for use during lactation was not supported. The findings suggest that pregnancy stimulates growth of the maternal body and that chronic moderate energy restriction curtails this growth.