Obesity: King JC

Anonymous00043, Anonymous00044, Siega-Riz AM, King JC. · No affiliation provided · J Am Diet Assoc. · Pubmed #19412993 No free full text.

Abstract: Given the detrimental influence of maternal overweight and obesity on reproductive and pregnancy outcomes for the mother and child, it is the position of the American Dietetic Association and the American Society for Nutrition that all overweight and obese women of reproductive age should receive counseling on the roles of diet and physical activity in reproductive health prior to pregnancy,during pregnancy, and in the inter conceptional period, in order to ameliorate these adverse outcomes. The effect of maternal nutritional status prior to pregnancy on reproduction and pregnancy outcomes is of great public health importance. Obesity in the United States and worldwide has grown to epidemic proportions, with an estimated 33% of US women classified as obese. This position paper has two objectives: (a) to help nutrition professionals become aware of the risks and possible complications of overweight and obesity for fertility,the course of pregnancy, birth outcomes, and short- and long-term maternal and child health outcomes;and (b) related to the commitment to research by the American Dietetic Association and the American Society for Nutrition, to identify the gaps in research to improve our knowledge of the risks and complications associated with being overweight and obese before and during pregnancy.Only with an increased knowledge of these risks and complications can health care professionals develop effective strategies that can be implemented before and during pregnancy as well as during the inter conceptional period to ameliorate adverse outcomes.

King JC. · Children's Hospital Oakland Research Institute, the University of California at Berkeley, and the University of California at Davis, Oakland, California 94609, USA. · Annu Rev Nutr. · Pubmed #16704347 No free full text.

Abstract: About one third of all pregnant women in the United States are obese. Maternal obesity at conception alters gestational metabolic adjustments and affects placental, embryonic, and fetal growth and development. Neural tube defects and other developmental anomalies are more common in infants born to obese women; these defects have been linked to poor glycemic control. Preeclampsia, a gestational disorder occurring more frequently in obese women, appears to be due to a subclinical inflammatory state that impairs early placentation and development of its blood supply. Fetal growth and development during the last half of pregnancy depends on maternal metabolic adjustments dictated by placental hormones and the subsequent oxygen and nutrient supply. Maternal obesity affects these metabolic adjustments as well. Basal metabolic rates are significantly higher in obese women, and maternal fat gain is lower, possibly in response to altered leptin function. The usual increase in insulin resistance seen in late pregnancy is enhanced in obese mothers, causing marked postprandial increases in glucose, lipids, and amino acids and excessive fetal exposure to fuel sources, which in turn increases fetal size, fat stores, and risk for disease postnatally. Impaired glucose tolerance, gestational diabetes, and hyperlipidemia are more common among obese mothers. To date, little attention has been given to the role of diet among obese women in preventing these problems. However, studies of women with impaired glucose tolerance show that replacing refined carbohydrates and saturated fat with complex, low-glycemic carbohydrates and polyunsaturated fatty acids improves metabolic homeostasis and pregnancy outcomes. Thus, current dietary guidelines regarding the amount and type of carbohydrates and fat for nonpregnant women seem appropriate for pregnant women as well.

Sampath V, Havel PJ, King JC. · Western Human Nutrition Research Center, United States Department of Agriculture, Agricultural Research Service, University of California, Davis, California, USA. · Obesity (Silver Spring). · Pubmed #18719672 No free full text.

Abstract: Based on cell culture and studies in mice, increased dietary calcium appears to stimulate lipolysis and could possibly reduce body adiposity through hormonal influences on adipocyte calcium uptake. In this study, we investigated the effects of 1,500 mg supplemental calcium daily for 3 months on hormones regulating calcium and energy metabolism and rates of lipid oxidation and lipolysis in overweight women. Fifteen overweight (BMI > 25 kg/m(2)) premenopausal women were supplemented with 1,500 mg of calcium, as CaCO(3), per day for 3 months while maintaining their usual diets and activity levels. Baseline and endpoint measurements were obtained after the subjects consumed a standardized 25% fat diet for 4 days. Lipid oxidation was measured by indirect calorimetry, lipolysis by infusion of deuterated glycerol, and body fat by dual-energy X-ray absorptiometry. Urinary calcium, circulating levels of hormones involved in energy and lipid metabolism (insulin, leptin, and adiponectin) or calcium metabolism (25(OH)D, 1,25(OH)(2)D), and parathyroid hormone (PTH)) were also measured. Urinary levels of calcium (P = 0.005) increased and 1,25(OH)(2)D declined (P = 0.03). However other parameters, including body weight, body fat, PTH, insulin, leptin, adiponectin, 25(OH)D, as well as rates of lipid oxidation and lipolysis were not altered by calcium supplementation. Calcium supplementation for 3 months increased urinary calcium excretion, decreased circulating levels of 1,25(OH)(2)-D, but had no effect on rates of lipid oxidation or lipolysis, in these overweight women.

Streiff EL, Stanhope KL, Graham J, Havel PJ, King JC. · Department of Nutrition, University of California at Davis, One Shields Avenue, Davis, CA, USA. · Biol Trace Elem Res. · Pubmed #17848731 No free full text.

Abstract: The effects of low zinc, high fructose diet on growth and adipocyte metabolism were examined in rats. At 28 days of age, animals were assigned to diets either adequate in zinc (30 ppm) with water (AZW) or fructose solution (AZF), or low in zinc (5 ppm) with water (LZW) or fructose solution (LZF). Body weight and food and fructose solution intake were measured three times a week. Blood samples were collected at baseline, 4 weeks, and 8 weeks, and energy expenditure was measured. The rats were killed at 12 weeks. Adipocytes were cultured in medium containing C14-glucose and physiological insulin concentrations. The animals in the LZF group consumed less energy and gained less weight than the other groups. Serum zinc concentrations were lower in the LZF than the AZF group. Energy expenditure over a 24-h period did not differ between groups; however, the respiratory quotient in the fed state was higher in the groups consuming fructose solution than in those consuming water. The mesenteric adipocytes from the animals in the LZF group utilized more glucose. Thus, the addition of fructose to a LZ diet reduced energy intake and growth and altered adipocyte fuel metabolism in young growing rats.

Stookey JD, Burg M, Sellmeyer DE, Greenleaf JE, Arieff A, Van Hove L, Gardner C, King JC. · Children's Hospital of Oakland Research Institute, Oakland, CA 94609, USA. · Eur J Clin Nutr. · Pubmed #16855542 No free full text.

Abstract: Indices of plasma hypertonicity, elevated plasma concentrations of solutes that draw fluid out of cells by osmosis, are needed to pursue hypertonicity as a possible risk factor for obesity and chronic disease. This paper proposes a new index that may be more sensitive to mild hypertonicity in vivo at a point in time than traditional measures. The index compares mean corpuscular volume (MCV) estimates from diluted (in solution by automated cell counter) and nondiluted blood (calculated from manual hematocrit, MCV=Hct/RBC*10(6)). A larger Auto vs Manual MCV (>2 fl) in vitro indicates hypertonicity in vivo if the cell counter diluent is isotonic with the threshold for plasma vasopressin (PVP) release and PVP is detectable in plasma (>0.5 pg/ml). To evaluate this principle of concept, hypertonicity was induced by 24-h fluid restriction after a 20 ml/kg water load in four healthy men (20-46 years). Unlike serum and urine indices, the MCV difference-&-PVP index detected hypertonicity in all participants.