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Acanthosis nigricans

Marimuthu S, Menon BS

Arch Dis Child, 2009 Jun;94(6):477.
PMID: 19460927 DOI: 10.1136/adc.2008.155713
Matched MeSH terms: Obesity/complications*
Fulltext Nutritional status of children below five years in Malaysia: Anthropometric analyses from the Third National Health and Morbidity Survey III (NHMS, 2006)

Khor GL, Noor Safiza MN, Jamalludin AB, Jamaiyah H, Geeta A, Kee CC, et al.

Malays J Nutr, 2009 Sep;15(2):121-36.
PMID: 22691811 MyJurnal

The Third National Health and Morbidity Survey (NHMS III) was conducted in 2006 on a nationally representative sample of population in Malaysia. Over 21,000 children aged 0-17.9 years were measured for body weight and stature according to the protocol of the World Health Organization. This article describes the nutritional status of children aged 0-59.9 months. Mean z score for weightfor-age (WAZ), height-for-age (HAZ) and BMI-for-age were compared with the z-scores tables of the WHO standards. The overall prevalence of underweight and stunting of the children were 12.9% and 17.2% respectively. These levels included 2.4% severe underweight and 6.0% severe stunting. In terms of z scores, the age group of 0-5.9 months showed the best nutritional status with mean WAZ of -0.33 (95%CI: -0.52, 0.15) and -0.40 (-0.57, 0.24) for boys and girls respectively, while mean HAZ was 0.64 (0.38, 0.89) for boys and 0.76 (0.54, 0.98) for girls. Mean HAZ and WAZ status was least satisfactory after about 6 months, suggesting a faltering in growth rate at an age that coincides with dependence on complementary feeding. Prevalence of overweight based on BMI-for-age for the sexes combined was 6.4%, while that based on WAZ was 3.4%. The NHMS III results indicate that Malaysian children have better nutritional status compared to children under 5 years in neighbouring countries. In order to meet the targets set in the National Plan of Nutrition (2006-2015), more effective intervention programmes are needed to accelerate the reduction of underweight and stunting, and to arrest the rise of overweight in young children.
Study name: National Health and Morbidity Survey (NHMS-2006)

Matched MeSH terms: Obesity
Fulltext Body mass index (BMI) of adults: Findings of the Malaysian Adult Nutrition Survey (MANS)

Azmi MY, Junidah R, Siti Mariam A, Safiah MY, Fatimah S, Norimah AK, et al.

Malays J Nutr, 2009 Sep;15(2):97-119.
PMID: 22691810 MyJurnal

The Malaysian Adults Nutrition Survey (MANS) was carried out between October 2002 and July 2003, involving 6,775 men and 3,441 women aged 18 - 59 years. Anthropometric assessment showed that the overall mean body weight and BMI were 62.65 kg (CI: 62.20, 63.09) and 24.37 kg/m2 (CI: 24.21, 24.53) respectively. Based on the WHO (1998) classification of BMI, 12.15% (CI: 11.26, 13.10) were obese (BMI > 30 kg/m2), and 26.71% (CI: 25.50, 27.96) overweight (BMI > 25 - 29.9 kg/m2). Significantly, more women were obese [14.66% (CI: 13.37, 16.04)] while significantly more men were overweight [28.55% (CI: 26.77, 30.40)]. Ethnicitywise, prevalence of obesity was highest among the Malays [15.28% (CI: 13.91, 16.77)] while overweight was highest for the Indians [31.01% (CI: 26.64, 35.76)]. Both obesity and overweight were highest among those aged 40 - 49 years. Obesity was highest for those whose household income was between RM1,500 - 3,500 while overweight was more prevalent for those whose household income exceeded RM3,500. The prevalence of overweight was highest for those with primary education [31.90% (CI: 29.21, 34.72)]. There was no significant urban rural differential in both obesity and overweight. The study found 9.02% (CI:8.82, 10.61) with chronic energy deficiency (CED) (BMI < 18.5 kg/m2). The prevalence of CED was relatively higher in the indigenous population (Orang Asli) [14.53% (CI: 5.14, 34.77)], subjects aged 18-19 years [26.24% (CI: 21.12, 32.09)], and with monthly household income of < RM1,500 [10.85% (CI: 9.63, 12.20)]. The prevalence of CED was not significantly different among the geographical zones and educational levels, and between urban/rural areas and sexes. The results call for priority action to address the serious problem of overweight and obesity among Malaysian adults as it poses a grave burden to the country's resources and development.
Study name: Malaysian Adult Nutrition Survey (MANS-2003)

Matched MeSH terms: Obesity
Fulltext Association of major dietary patterns with obesity risk among Mongolian men and women

Dugee O, Khor GL, Lye MS, Luvsannyam L, Janchiv O, Jamyan B, et al.

Asia Pac J Clin Nutr, 2009;18(3):433-40.
PMID: 19786392

Mongolia is experiencing changes in its unique nomadic lifestyle and dietary habits in the last two decades with accompanying increase in obesity rate. The dietary pattern approach, which investigates the overall diet in relation to obesity risks, has become appealing in nutrition epidemiology. The aim of this study was to identify major dietary patterns of the Mongolian adults in relation to the risk of having obesity. Dietary intake of a total 418 adults aged ? 25 years was assessed by using a food frequency questionnaire with 68 items. An exploratory factor analysis resulted in three dietary patterns: transitional high in processed meat and potato, traditional rich in whole milk, fats and oils and healthy with greater intake of whole grains, mixed vegetables and fruits. Individuals in the upper quintile of the transitional pattern had significantly greater risk of obesity (BMI > or =25 kg/m2: OR=2.47; 95% CI=1.04-5.86) while subjects in the highest quintile of the healthy dietary pattern were found to have significantly decreased risk of obesity (OR: 0.49; 95% CI=0.25-0.95). Men in the highest quintile of the transitional pattern had greater risk of abdominal obesity WC > or =90 cm: OR= 4.08; 95% CI=1.11-14.97) than those in the lowest quintile. Women in the top quintile of the traditional pattern had a greater odds of having abdominal obesity (WC > or =80 cm: OR=4.59; 95% CI=1.58-13.30) than those in the lowest quintile. The study suggests that public health efforts be targeted at adults in Mongolia to address the undesirable aspects of the transitional and the traditional dietary patterns.

Matched MeSH terms: Obesity/ethnology; Obesity/etiology*
Fulltext Optimal cut-off levels to define obesity: body mass index and waist circumference, and their relationship to cardiovascular disease, dyslipidaemia, hypertension and diabetes in Malaysia

Mohd Zaher ZM, Zambari R, Chan SP, Muruga V, Ng B, Appannah G, et al.

Asia Pac J Clin Nutr, 2009;18(2):209-16.
PMID: 19713180

Many studies in Asia have demonstrated that Asian populations may require lower cut-off levels for body mass index (BMI) and waist circumference to define obesity and abdominal obesity respectively, compared to western populations. Optimal cut-off levels for body mass index and waist circumference were determined to assess the relationship between the two anthropometric- and cardiovascular indices. Receiver operating characteristics analysis was used to determine the optimal cut-off levels. The study sample included 1833 subjects (mean age of 44+/-14 years) from 93 primary care clinics in Malaysia. Eight hundred and seventy two of the subjects were men and 960 were women. The optimal body mass index cut-off values predicting dyslipidaemia, hypertension, diabetes mellitus, or at least one cardiovascular risk factor varied from 23.5 to 25.5 kg/m2 in men and 24.9 to 27.4 kg/m2 in women. As for waist circumference, the optimal cut-off values varied from 83 to 92 cm in men and from 83 to 88 cm in women. The optimal cut-off values from our study showed that body mass index of 23.5 kg/m2 in men and 24.9 kg/m2 in women and waist circumference of 83 cm in men and women may be more suitable for defining the criteria for overweight or obesity among adults in Malaysia. Waist circumference may be a better indicator for the prediction of obesity-related cardiovascular risk factors in men and women compared to BMI. Further investigation using a bigger sample size in Asia needs to be done to confirm our findings.
Study site: 93 primary care clinics (klinik kesihatan and general practice clinics) in Malaysia

Matched MeSH terms: Obesity/diagnosis*
Fulltext Adults' perceptions of being overweight or obese: a focus group study

Chang CT, Chang KH, Cheah WL

Asia Pac J Clin Nutr, 2009;18(2):257-64.
PMID: 19713186

The objective of this study was to explore the perception of, feelings and attitudes toward overweight or obesity, and the perceived barriers to weight loss among native adults from lower socio-economic background. A total of six gender- and ethnic-specific focus groups consisted of 38 overweight and obese purposefully and criterion selected adults (21 women and 17 men), participated in this study. An unstructured discussion guide based on the study objectives were used for the focus groups. The results showed that some participants perceived themselves as ugly, felt ashamed of their body size and were frustrated because they did not desire to be overweight. Due to their excess weight, most also expressed they were less effective in their work performances. Although some participants had negative attitudes toward themselves because of excess weight, this appeared to link to self-stigmatization rather than anti-obesity discrimination. The participants remained in the Pre-contemplation stage of losing weight probably because of perceived barriers such as difficulty to resist eating, lack of know how and previous failed attempts to lose weight. Importantly, this study provided some evidence that individuals in the Pre-contemplation stage are unable to take action to lose weight, even if effective strategies are suggested.

Matched MeSH terms: Obesity/psychology*
Fulltext Prevalence of the metabolic syndrome and its influencing factors among adolescent girls in Mashhad, Iran

Mirhosseini NZ, Yusoff NA, Shahar S, Parizadeh SM, Mobarhen MG, Shakery MT

Asia Pac J Clin Nutr, 2009;18(1):131-6.
PMID: 19329406

Introduction: This study sought to determine the prevalence of the metabolic syndrome, one of the major public-health challenges worldwide, and its influencing factors among 15 to 17 years old adolescent girls in Mashhad, Iran.
Methods: A total of 622 high school adolescents participated in a cross-sectional study. A self-administered questionnaire was used to assess socio-demographic characteristics and dietary habits. Anthropometric assessments, blood pressure measurement and biochemical assessment were done.
Results: Applying BMI Z-score for age and gender (WHO 2007), 14.6 % and 3.4 % of subjects were classified as overweight and obese, respectively. Enlarged WC (> 80 cm) was seen in 9.5% of subjects. The prevalence of combined hypertension was 6.1% which was increased by the severity of obesity. A total of 24.5% of subjects had hypertriglyceridemia and 57% of them had low level of HDL-cholesterol. Hyperglycemia was present in 16.7% of subjects. Based on the NCEP ATP III (2001) criteria, the prevalence of the metabolic syndrome was 6.5% and increased to 45.1% in obese subjects. Increasing BMI or WC, led to significant increment in the number of metabolic syndrome features (p < 0.001). High socioeconomic status of family, medical history of parents and dietary habits especially high consumption of carbohydrates were influencing factors in the prevalence of the metabolic syndrome.
Conclusion: Approximately 6.5% of all and 45% of obese subjects met the criteria for the metabolic syndrome. Dietary habits especially carbohydrate consumption, socioeconomic status of family and medical history of parents can be influential factors in the prevalence of the metabolic syndrome.

Matched MeSH terms: Obesity/complications; Obesity/epidemiology*
Fulltext Obesity among Mongolian adults from urban and rural Areas

Otgontuya, D., Khor, G.L., Lye, M.S., Norhaizan, M.E.

Malays J Nutr, 2009;15(2):185-194.
MyJurnal

Shifts in lifestyles and eating patterns have led to an increasing prevalence of chronic non-communicable diseases in the adult population in Mongolia. This article reports the prevalence of obesity, abdominal obesity and body fat among 408 Mongolian adults aged 25 years and above. The subjects included 61.2% from urban areas and 38.8% from rural areas, reflective of the 60: 40 urban rural ratio in the general population. Anthropometric measurements were taken according to standard methods. Classification of overweight/obesity was based on body mass index of WHO while abdominal obesity was based on WPRO for Asians. Men made up 47.8% (200) and women 52.2% (218) of the sample. The mean age of the subjects was 46.7±12.7 years. About one-third (32.8%) of the subjects were overweight and 10.5% obese. A higher proportion of women (13.3%) than men were obese (7.5%). The age groups of 35-54 years in men and 55-64 years in women showed the highest prevalence of overweight. Prevalence of abdominal obesity was found in 46.5% of the men and in 65.1% of the women. Women aged 55-64 years had the highest proportion (78.4%) of abdominal obesity. In terms of body fat, 20.0 % and 51.5% of the men had high and very high levels of body fat respectively, while among the women, 15.1% and 55.5% respectively had high and very high levels of body fat. Mongolian adults face serious risk of cardiovascular diseases and other aspects of ill-health brought about by obesity. Prevention and control of obesity should be targeted as an urgent public health agenda in Mongolia.

Matched MeSH terms: Obesity; Obesity, Abdominal
Fulltext The physiology of leptin: revisited

Singh, Harbindar Jeet

Medical Health Reviews, 2009;2009(1):95-133.
MyJurnal

Leptin, a 167 amino-acid product of the ob or LEP gene, was first reported in 1994 after a 40-year search that began following the emergence of a mutant strain of mice with hyperphagia, early on-set obesity, and delayed sexual maturation. Since then, leptin deficiency has also been reported in the rat, and more recently in humans. It is secreted constitutively primarily by the white adipose tissue, and in smaller quantities by a number of non-adipose tissues. It acts by binding to specific membrane bound leptin receptors, belonging to the class 1 cytokine receptor family, and activating the JAK-STAT system. Leptin regulates appetite and body weight mainly through its actions on the hypothalamus involving the NPYmelanocortin pathway, and, to a lesser extent, through increased energy expenditure by way of sympathoactivation and increased substrate cycling. Its effects on reproduction, puberty in particular, are mediated through actions on the hypothalamic-pituitary-gonadal axis and on the gonads. Leptin also appears to have permissive roles in CNS development during the neonatal period, bone growth and development, and in haemopoietic and immune functions. Although it was its deficiency state that first led to its discovery, it now appears that the clinical significance of leptin lies not only in the consequences of its deficiency but also when it is in excess as occurs in obesity. Emerging evidence is implicating leptin as a link between obesity associated cardiovascular disease risks and infertility. Besides this, leptin is also being implicated as a growth factor in cancer. The story that started with a search for a body weight regulating factor is now unfolding into one that is revealing roles for leptin that stretch beyond the regulation of appetite and body weight.

Matched MeSH terms: Obesity
Fulltext Factors influencing appetite and depression among institutionalised Chinese elderly in Penang

Suzana Shahar, Yow, Bee Charn

Jurnal Sains Kesihatan Malaysia, 2009;7(2):73-88.
MyJurnal

Poor appetite and inadequate food intake together with depression are associated with malnutrition, that will increase risk of morbidity and mortality among elderly people. Identifying factors associated with these conditions are essential for formulation of preventive strategies. Therefore, a study was conducted to identify factors associated with poor appetite and depression among institutionalised Chinese elderly people in Butterworth, Penang. A total of 100 Chinese elderly (49 men and 51 women) aged 60 years and above, (mean age ± SD of 74.7 ± 9.2 years), with no known terminal and mental illnesses from two nursing homes participated in this study. Subjects were interviewed to gather information on appetite using Council of Nutrition Appetite Questionnaire (CNAQ), depression using Geriatric Depression Scale (GDS) and also socio demographic and health status. Food intake was assessed using a combination of one-day food weighing and 24 hour diet recall. Body weight and height were measured. Results showed that the mean energy and nutrients intake did not achieve the Recommended Nutrient Intake of Malaysia (RNI), with the exception for vitamin C. Only 4% of the subjects were underweight and obese, 65% normal and 31% overweight. A total of 70% and 73% of subjects had poor appetite and depression, respectively. Subjects who had depression (adjusted OR = 2.78, 95% CI = 0.95-8.03), energy intake below RNI (adjusted OR = 2.34, 95% CI = 0.68-6.95) and difficulty to fall asleep at night (insomnia) (adjusted OR = 2.22, 95% CI = 0.72-6.82) were more likely to have poor appetite. Subjects who had poor appetite (adjusted OR = 3.36, 95% CI = 1.19-9.47) and insomnia (adjusted OR = 2.58, 95% CI = 0.83-7.98) were more likely to have depression. In conclusion, although the majority of subjects had normal body weight but the nutrient intake was inadequate. Poor appetite and depression were prevalent and interrelated and also strongly associated with insomnia.
Device, Scales & Questionnaire: Council of Nutrition Appetite Questionnaire (CNAQ-8); Geriatric Depression Scale (GDS-15)

Matched MeSH terms: Obesity
Fulltext Food variety score is associated with dual burden of malnutrition in Orang Asli (Malaysian indigenous peoples) households: implications for health promotion

Saibul N, Shariff ZM, Lin KG, Kandiah M, Ghani NA, Rahman HA

Asia Pac J Clin Nutr, 2009;18(3):412-22.
PMID: 19786390

This paper reports on the presence of dual burden households in Orang Asli (OA, indigenous people) communities and its associated factors. A total of 182 OA households in two districts in Selangor with the required criteria (182 non-pregnant women of child bearing age and 284 children aged 2-9 years old) participated in the study. Height and weight of both women and children were measured. Energy intake and food variety score (FVS) were determined using three 24-hour diet recalls. While 58% were underweight and 64% of the children were stunted, the prevalence of overweight and obesity in women were 31% and 20% respectively. The percentage of dual burden households (overweight mother/underweight child) was 25.8% while 14.8% households had normal weight mother/normal weight child. The mean food variety score (FVS) was similar for women (7.0+/-2.1) and children (6.9+/-1.9). Dual burden households were associated with women's employment status (OR: 3.18, 95% CI: 2.65-5.66), FVS of children (OR: 0.71, 95% CI: 0.51-0.95) and FVS of women (OR: 1.39, 95% CI: 1.02- 1.89). The FVS of children (OR: 0.49, 95% CI: 0.25-0.89) and women (OR: 1.92, 95% CI: 1.64-2.77) remained significant even when dual burden households were compared to only households with normal weight mother/normal weight child. In these OA communities, food variety may predict a healthier diet in children, but may increase the risk of overweight and obesity in adults. Efforts to address households with dual burden malnutrition should consider promotion of healthy diets and lifestyle for all members.

Matched MeSH terms: Obesity/ethnology; Obesity/epidemiology
Facial profile shape, malocclusion and palatal morphology in Malay obstructive sleep apnea patients

Banabilh SM, Samsudin AR, Suzina AH, Dinsuhaimi S

Angle Orthod, 2010 Jan;80(1):37-42.
PMID: 19852637 DOI: 10.2319/011509-26.1

To test the null hypothesis that there is no difference in facial profile shape, malocclusion class, or palatal morphology in Malay adults with and without obstructive sleep apnea (OSA).

Matched MeSH terms: Obesity/complications
Fulltext The prevalence of obesity among clinical students in a Malaysian medical school

Boo NY, Chia GJ, Wong LC, Chew RM, Chong W, Loo RC

Singapore Med J, 2010 Feb;51(2):126-32.
PMID: 20358151

INTRODUCTION: This study aimed to determine the prevalence of obesity among medical students and its relationship with their dietary intake and physical activities.
METHODS:This observational study was carried out on 240 medical students during the clinical phase of their medical course in a private medical school. Their body weight and height were measured, and a standardised questionnaire was used to collect information on their physical activities and dietary intake.
RESULTS: The median body weight of the participants was 59.0 kg (interquartile range: 51.3-66.8), the mean body height was 166.1 cm (standard deviation [SD] 8.5 cm), and the mean body mass index (BMI) was 21.8 kg/m2 (SD 3.4 kg/m2). Based on the World Health Organization BMI cut-offs for the Asian population, 30.1 percent (n is equal to 72) of the students were overweight or obese, with a BMI that was equal to or greater than 23.0 kg/m2. Logistic regression analysis showed that, after controlling for various potential confounders, the only significant risk factors associated with overweight/obesity among these students were: male gender (adjusted odds ratio [OR] 2.1; 95 percent confidence intervals [CI] of 1.1 and 4.1; p is equal to 0.03), Malay ethnic group (adjusted OR 2.4; 95 percent CI 1.0 and 5.7; p is equal to 0.04), Indian ethnic group (adjusted OR 3.6; 95 percent CI 1.5 and 8.9; p is equal to 0.005), and the number of soft drinks consumed per week (adjusted OR 1.3; 95 percent CI 1.0 and 1.5; p is equal to 0.02). Skipping breakfast, the frequency of physical exercise per week, the number of hours of sleep per day, and eating noodles or roti canai (a type of Malaysian pancake) for breakfast were not significant risk factors.
CONCLUSION: Obesity remains a common problem among medical students in their clinical years.

Matched MeSH terms: Obesity/epidemiology*
Fulltext Role of excitatory amino acid input in rostral ventrolateral medulla neurons in rats with obesity-induced hypertension

Suhaimi FW, Yusoff NH, Dewa A, Yusof AP

Acta Neurol Belg, 2010 Mar;110(1):57-64.
PMID: 20514927

Obesity is intimately associated with hypertension; increases in blood pressure are closely related to the magnitude of weight gain. The present study aims to determine whether the excitatory amino acid input to rostral ventrolateral medulla (RVLM) contributes to elevated blood pressure in rats with diet-induced obesity. Male Sprague-Dawley rats weighing 280 to 300 grams were fed with a low-fat diet (10% kcal from fat) or moderately high-fat diet (32% kcal from fat) for 16 weeks. At week 16, rats on the moderate high-fat diet were segregated into obesity-prone and obesity-resistant rats based on body weight distribution. Baseline mean arterial pressure (MAP) was significantly higher in obesity-prone rats as compared to obesity-resistant and rats on a low-fat diet. Bilateral injection of kynurenic acid (KYN) (40 nM) into the RVLM of the obesity-prone rats reduced MAP to levels significantly different from those observed in rats on a low-fat diet and obesity-resistant rats (no change in MAP). At a lower concentration (4 nM), KYN injection did not produce any change in MAP in any group. The results obtained suggest that excitatory amino acid input to the RVLM does contribute to the development of hypertension in rats with diet-induced obesity.

Matched MeSH terms: Obesity/complications*; Obesity/etiology
Fulltext Malaysia Shape of the Nation (MySoN): a primary care based study of abdominal obesity in Malaysia

Zaki M, Robaayah Z, Chan SP, Vadivale M, Lim TO

Med J Malaysia, 2010 Jun;65 Suppl A:143-9.
PMID: 21488476

Abdominal obesity (AO), measured by waist circumference (WC), is a stronger predictor of subsequent development of cardiovascular disease (CVD) than generalised obesity, which is measured by body mass index (BMI). This study aimed to measure WC and prevalence of AO in Malaysians visiting primary care physicians. 1893 patients between the ages of 18 and 80 attending primary care clinics in Malaysia were recruited over two days for this multi-centre cross-sectional study. Pregnant women were excluded, their medical history, weight, height and WC were examined. The prevalence of co-morbidities were as follows: (1) CVD-4%, lipid disorder-17%, hypertension-26%, diabetes-14% and any of the clinical characteristics of CVD/lipid disorder/hypertension/diabetes-38%. The mean BMI for men and women was 25.62 +/- 4.73 kg/m2 and 26.63 +/- 5.72 kg/m2, respectively. Based on WHO criteria for BMI (overweight, 25-29.9 kg/m2; obese, > 30 kg/m2), 34.2% were overweight and 20.4% were obese. The mean WC for men and women was 89.03 +/- 13.45 cm and 84.26 +/- 12.78 cm, respectively. Overall, 55.6% had AO and there was higher prevalence among women (based on International Diabetes Federation criteria: WC > or = 90 cm for men and > or = 80 cm for women). AO was present in approximately 71% patients with lipid disorder, in 76% with hypertension and in 75% with diabetes. Patients with AO were also at a higher risk of developing co-morbidities. Malaysia has a high prevalence of AO and associated cardiovascular risk factors. This needs to be addressed by public health programs, which should also include routine measurement of WC.

Matched MeSH terms: Obesity, Abdominal/complications; Obesity, Abdominal/diagnosis; Obesity, Abdominal/epidemiology*
Trends in overweight and obese adults in Malaysia (1996-2009): a systematic review

Khambalia AZ, Seen LS

Obes Rev, 2010 Jun;11(6):403-12.
PMID: 20233309 DOI: 10.1111/j.1467-789X.2010.00728.x

Like other nations experiencing rapid industrialization, urbanization and a nutrition transition, there is concern in Malaysia of a possible escalation in the prevalence of overweight and obesity. In 1996, the National Health and Morbidity Survey reported a 16.6% and 4.4% prevalence of overweight and obesity, respectively. In the following decade, there have been several national and community surveys on overweight and obesity in Malaysia. The objective of this systematic review is to describe the trend from 1996 to 2009 in the prevalence of overweight and obesity in adults in Malaysia nationally and by gender, age and race. Results indicate that there has been a small rise in overweight adults in the years 1996, 2003 and 2006 (20.7%, 26.7% and 29.1%) and a much more dramatic increase in obesity in 1996, 2003, 2004 and 2006 (5.5%, 12.2%, 12.3% and 14.0%). Evidence showed a greater risk for overweight and obesity among women compared with men. Based on the highest-quality studies, overweight and obesity levels were highest among adults 40-59 years old. Overweight levels were highest among Indians, followed by Malays, Chinese and Aboriginals, with less consistency across studies on the order of risk or obesity by ethnicity.

Matched MeSH terms: Obesity/epidemiology*
Fulltext Pharmaceutical quality of nine generic orlistat products compared with Xenical(r)

Taylor PW, Arnet I, Fischer A, Simpson IN

Obes Facts, 2010 Aug;3(4):231-7.
PMID: 20823686 DOI: 10.1159/000319450

OBJECTIVE: To compare the pharmaceutical quality of Xenical (chemically produced orlistat) with nine generic products, each produced by fermentation processes.
METHODS: Xenical 120 mg capsules (Roche, Basel, Switzerland) were used as reference material. Generic products were from India, Malaysia, Argentina, Philippines, Uruguay, and Taiwan. Colour, melting temperature, crystalline form, particle size, capsule fill mass, active pharmaceutical ingredient content, amount of impurities, and dissolution were compared. Standard physical and chemical laboratory tests were those developed by Roche for Xenical.
RESULTS: All nine generic products failed the Xenical specifications in four or more tests, and two generic products failed in seven tests. A failure common to all generic products was the amount of impurities present, mostly due to different by-products, including side-chain homologues not present in Xenical. Some impurities were unidentified. Two generic products tested failed the dissolution test, one product formed a capsule-shaped agglomerate on storage and resulted in poor (=15%) dissolution. Six generic products were powder formulations.
CONCLUSIONS: All tested generic orlistat products were pharmaceutically inferior to Xenical. The high levels of impurities in generic orlistat products are a major safety and tolerability concern.

Matched MeSH terms: Anti-Obesity Agents/standards*; Anti-Obesity Agents/chemistry
Fulltext Comparison of cardiovascular protective effects of tropical seaweeds, Kappaphycus alvarezii, Caulerpa lentillifera, and Sargassum polycystum, on high-cholesterol/high-fat diet in rats

Matanjun P, Mohamed S, Muhammad K, Mustapha NM

J Med Food, 2010 Aug;13(4):792-800.
PMID: 20482284 DOI: 10.1089/jmf.2008.1212

This study was designed to investigate the comparative in vivo cardiovascular protective effects of red, green, and brown tropical seaweeds, namely, Kappaphycus alvarezii (or Eucheuma cottonii), Caulerpa lentillifera, and Sargassum polycystum, in rats fed on high-cholesterol/high-fat (HCF) diets. Male Sprague-Dawley rats (weighing 260-300 g) on the HCF diet had significantly increased body weight, plasma total cholesterol (TC), plasma low-density lipoprotein cholesterol (LDL-C), plasma triglycerides (TG), lipid peroxidation, and erythrocyte glutathione peroxidase (GSH-Px) and superoxide dismutase levels after 16 weeks. Supplementing 5% seaweeds to HCF diet significantly reduced plasma TC (-11.4% to -18.5%), LDL-C (-22% to -49.3%), and TG (-33.7% to -36.1%) levels and significantly increased HDL-C levels (16.3-55%). Among the seaweeds, S. polycystum showed the best anti-obesity and blood GSH-Px properties, K. alvarezii showed the best antihyperlipemic and in vivo antioxidation effects, and C. lentillifera was most effective at reducing plasma TC. All seaweeds significantly reduced body weight gain, erythrocyte GSH-Px, and plasma lipid peroxidation of HCF diet rats towards the values of normal rats.

Matched MeSH terms: Obesity/diet therapy*; Obesity/metabolism
Prevalence of obesity and factors associated with it in a worksite setting in Malaysia

Cheong SM, Kandiah M, Chinna K, Chan YM, Saad HA

J Community Health, 2010 Dec;35(6):698-705.
PMID: 20458526 DOI: 10.1007/s10900-010-9274-1

Socio-economic status, lifestyle behaviors, and psychosocial factors have been implicated in the development of overweight and obesity. This study aims to observe the prevalence of overweight and obesity in an academic worksite and to examine the possible association between variables such as socio-economic characteristics, work factors, psychosocial factors, and weight control behaviors and obesity. In this study, the target population were full-time academic and non-academic staff. Body mass index (BMI) and waist circumference (WC) were computed to determine obesity. A pretested self-administered questionnaire was used to obtain information on socio-demographic factors, work related factors, psychosocial factors, and weight control behaviors. Data were obtained on 367 adults of whom 39.2% were males and 60.8% females. Overweight was seen in 31.9% of males and 26.5% of females while 16.1% of them were obese, irrespective of gender. Central obesity was noted in about 37% of males and 39% of females. The results showed that socio-demographic factors (age, gender, and education) and psychosocial factors (perceived health status, body weight perception, and weight-control goals) were significantly associated with BMI. Working hours were also significantly associated with BMI. However, weight control practices (diet-control practices and physical activity practices) were not significantly associated with BMI. In conclusion, this study found a higher prevalence of overweight and obesity among employees of a selected public university in comparison to the general population. Socio-demographic, psychosocial factors, and working hours were found to contribute to obesity in this sample of adults.

Matched MeSH terms: Obesity/epidemiology*
Fulltext Glycyrrhizic acid improved lipoprotein lipase expression, insulin sensitivity, serum lipid and lipid deposition in high-fat diet-induced obese rats

Eu CH, Lim WY, Ton SH, bin Abdul Kadir K

Lipids Health Dis, 2010;9:81.
PMID: 20670429 DOI: 10.1186/1476-511X-9-81

The metabolic syndrome, known also as the insulin resistance syndrome, refers to the clustering of several risk factors for atherosclerotic cardiovascular disease. Dyslipidaemia is a hallmark of the syndrome and is associated with a whole body reduction in the activity of lipoprotein lipase (LPL), an enzyme under the regulation of the class of nuclear receptors known as peroxisome proliferator-activated receptor (PPAR). Glycyrrhizic acid (GA), a triterpenoid saponin, is the primary bioactive constituent of the roots of the shrub Glycyrrhiza glabra. Studies have indicated that triterpenoids could act as PPAR agonists and GA is therefore postulated to restore LPL expression in the insulin resistant state.

Matched MeSH terms: Obesity/blood; Obesity/metabolism; Obesity/physiopathology*; Anti-Obesity Agents/pharmacology; Anti-Obesity Agents/therapeutic use

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