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Consequences of food energy excess and positive energy balance

  • Ricardo Uauy (a1) and Erik Díaz (a1)

This paper discusses possible consequences of energy excess throughout the life cycle. Firstly we consider the effects of foods on hunger, satiety and satiation. Also, the changes in food availability and consumption in relation to changes in social and economic determinants of energy excess. The relationship between physical activity and energy intake (EI) is also considered. Secondly we explore the definition of energy excess and the metabolic effects of macronutrients (mainly in relation to fuel partitioning oxidation/storage) on energy balance. The cellular and molecular regulation determined by specific genes involved in lipogenesis, fuel partitioning and/or in energy dissipation are explored. Thirdly, we examine the main consequences induced by energy excess and positive energy balance, starting with the alterations in glucose utilisation (insulin resistance) leading to type 2 diabetes and the linkage of energy excess with other non-communicable diseases (NCDs). Biological, social and psychological consequences during perinatal, childhood and adolescence periods are specifically analysed. Fourthly, the transition from energy deficit to excess, under the optic of a developing country is analysed with country examples drawn from Latin America. The possible role of supplementary food programmes in determining positive energy balance is discussed especially in relation to pre-school and school feeding programmes. Fifthly, we deal with the economic costs of energy excess and obesity related diseases. Finally, some areas where further research is needed are described; biological and genetic determinants of individual and population energy requirements, foods and food preparations as actually consumed, consumer education and research needs on social determinants of energy imbalances.

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1Schwartz, MW, Baskin, DG, Kaiyala, KJ, Woods, SC. Model for the regulation of energy balance by the central nervous system. American Journal of Clinical Nutrition 1999; 69: 584–96.
2Horn, CC, Addis, A, Friedman, MI. Neural substrate for an integrated metabolic control of feeding behavior. American Journal of Physiology 1999; 276: R113–9.
3Drewnosky, A. Macronutrient substitutes and weight reduction practices of obese, dieting and eating disordered women. Annals of the New York Academy of Sciences 1997; 819: 132–41.
4Green, SM, Blundell, JE. Subjective and objective indices of the satiation effects of foods. Can people predict how filling a food will be? European Journal of Clinical Nutrition 1996; 50: 798806.
5Grunwald, G, Seagle, H, Peters, J, Hill, J. Quantifying and separating the effects of macronutrient composition and non-macronutrients on energy density. British Journal of Nutrition 2001; 86: 265–76.
6Blundell, JE, Stubbs, RJ. High and low carbohydrate and fat intakes: limits imposed by appetite and palatability and their implications for energy balance. European Journal of Clinical Nutrition 1999; 53(Suppl. 1): S148–65.
7Stubbs, RJ, Harbron, CJ, Murgatroyd, P, Prentice, AM. Covert manipulations of dietary fat and energy density: effects on substrate flux and food intake in men eating ad libitum. American Journal of Clinical Nutrition 1995; 62: 316–29.
8Stubbs, RJ, O'Reilly, LM, Johnstone, AM, Reid, CA. An experimental model to assess macronutrient selection in humans. International Journal of Obesity 1997; 21(Suppl. 2): 213–7.
9O'Reilly, LM, Stubbs, RJ, Johnstone, AM, Mara, O, Robertson, K. Covert manipulation of the energy density of mixed diets on ad-libitum food intake in free-living humans. Proceedings of the Nutrition Society 1997; 56: 127.
10Bell, EA, Rolls, BJ. Energy density of foods affects energy intake across multiple levels of fat content in lean and obese women. American Journal of Clinical Nutrition 2001; 73: 1010–8.
11FAO Carbohydrates in human nutrition. Food and Agriculture Organization, Food and Nutrition Paper No. 66. Report of a Joint FAO/WHO Expert Consultation. Rome, 1998
12Ritz, P, Krempf, M, Cloarec, D, Charbonnel, B. Compartive continuous indirect calorimetry study of two carbohydrates with different glycemic indices. American Journal of Clinical Nutrition 1991; 54: 855–9.
13Blaak, EE, Saris, W. Postprandial thermogenesis and substrate utilization after ingestion of different dietary carbohydrates. Metabolism Clinical and Experimental 1996; 45: 1235–42.
14Sparti, A, Milon, H, Di Vetta, V, Schneller, P, Tappy, L, Jequier, E, Schutz, Y. Effects of diets high or low in unavailable and slowly digestible carbohydrates on the pattern of 24-h substarte oxidation and feelings of hunger in humans. American Journal of Clinical Nutrition 2000; 72: 1461–8.
15McDevitt, R, Poppitt, S, Murgatroyd, P, Prentice, AM. Macronutrient disposal during controlled overfeeding with glucose, fructose, sucrose, or fat in lean and obese women. American Journal of Clinical Nutrition 2000; 72: 369–77.
16Prentice, AM. Alcohol and obesity. International Journal of Obesity 1995; 19(Suppl. 5): S44S50.
17Jebb, S, Prentice, AM, Goldberg, G, Murgatroyd, P, Black, A, Coward, WA. Changes in macronutrient balance during over- and underfeeding assessed by 12-d continuous whole body calorimetry. American Journal of Clinical Nutrition 1996; 64: 259–66.
18Hellerstein, MK. De novo lipogenesis in humans; metabolic and regulatory aspects. European Journal of Clinical Nutrition 1999; 53: S63S65.
19Acheson, KJ, Scutz, Y, Bessard, T, Flatt, JP, Jequier, E. Carbohydrate metabolism and de novo lipogenesis in human obesity. American Journal of Clinical Nutrition 1987; 45: 7885.
20Ludwig, D, Majzoub, J, Al-Zahrani, A, Dallal, G, Blanco, I, Roberts, S. High glycemic index foods, overeating and obesity. Pediatrics 1999; 103: E261–6.
21Booth, DA, Chase, A, Campbell, AT. Relative efectiveness of protein in the late stages of appetite supression in man. Physiology and Behavior 1970; 5: 1299–302.
22Wadden, TA, Sunkard, AJ, Day, SC, Gould, RA, Rubin, CR. Less food, less hunger: reports of a protein-sparing modified fast. International Journal of Obesity 1987; 11: 239–49.
23Hill, Aj, Magson, LD, Blundell, JE. Hunger and palatability: tracking ratings of subjective experience before, during and after food consumption of preferred food. Appetite 1986; 5: 361–71.
24Geliebter, AA. Effects of equicaloric loads of protein, fat and carbohydrate on the food intake in the rat and man. Physiology and Behavior 1978; 22: 267–73.
25de Graaf, C, Hulshof, T, Westsrate, JA, Jas, P. Short term effects of different amounts of protein, fats, and carbohydrates on satiety. American Journal of Clinical Nutrition 1992; 55: 33–8.
26Sunkin, S, Garrow, J. The satiety value of protein. Human Nutrition Applied Nutrition 1982; 36: 197201.
27Araya, H, Hills, J, Alviña, M, Vera, G. Short-term satiety in preschool children: a comparison between high protein meal and a high complex carbohydrate meal. International Journal of Food Sciences and Nutrition 2000; 51: 119–24.
28Barkeling, B, Rossner, S, Bjorvell, H. Effects of a high protein meal (meat) and a high carbohydrate meal (vegetarian) on satiety measured by automated computerized monitoring of subsequent food intake, motivation to eat and food preferences. International Journal of Obesity 1990; 14: 743–51.
29Saris, W. Fit, fat and fat-free. International Journal of Obesity 1999; 22(Suppl. 2): S15S21.
30King, NA, Tremblay, A, Blundell, JE. Effects of exercise on appetite control: implications for energy balance. Medicine and Science in Sports and Exercise 1997; 29: 1076–89.
31King, NA. The relationships between physical activity and food intake. Proceedings of the Nutrition Society 1998; 57: 7784.
32Albala, C, Vio, F. Epidemiological transition in Latin America: the case of Chile. Public Health 1995; 109: 431–42.
33Popkin, BM. Nutritional patterns and transition. Population and Development Reviews 1993a; 19: 138–57.
34Ministry of Health. Performance report. Health care in Chile 1999. Department of management and control. Santiago: Ministry of Health, Communications and Public Relations, 1999.
35Panamerican Health Organization (PAHO), World Health Organization (WHO). Core data. United Nations, World Population Prospects 1996. Revision, 1998. Special Program on health Analysis. PAHO. Available on line
36National Institute of Statistics (INE). Demographic Annual Reports 1970 and 1998. Santiago: National Institute of Statistics.
37Berrios, X. Changing tendencies in the prevalence of risk factors for the chronic diseases: is a new epidemic coming? Revista Medica de Chile 1997; 125: 1405–7.
38Berríos, X, Jadue, L, Zenteno, J, Ross, MI, Rodriguez, H. Prevalence of risk factors for chronic diseases: a population study in the metropolitan area of Santiago Chile 1986–1987. Revista Medica de Chile 1990; 118: 597604.
39Berrios, X. Risk factors in adult chronic diseases. An example of epidemiologic research. Boletin Esc. Medicina P. Universidad Católica de Chile 1994; 23: 7389.
40Jadue, L, Vega, J, Escobar, MC, Delgado, I, Garrido, C, Lastra, P, Espejo, F, Peruga, A. Risk factors for chronic non communicable diseases: methods and results of CARMEN program basal survey. Revista Medica de Chile 1999; 127: 1004–13.
41Vega, J, Jadue, L, Escobar, MC, Jalil, J, Espejo, F, Delgado, I, Garrido, C, Lastra, P, Peruga, A. Prevalence of hypertension in Valparaíso: results of the base survey of CARMEN project. Revista Medica de Chile 1999; 127: 729–38.
42Vio, F, Albala, C. Nutrition policy in the Chilean transition. Public Health Nutrition 2000; 3: 4955.
43Valenzuela, A, Uauy, R. Consumption pattern of dietary fats in Chile: n3 and n6 fatty acids. International Journal of Food Sciences and Nutrition 1999; 50: 127–33.
44Albala, C, Vio, F, Kain, J. Obesity: an unresolved challenge in Chile. Revista Medica de Chile 1998; 126: 1001–9.
45Castillo, C, Atalah, E, Benavides, M, Urteaga, C. Patrones alimentarios en adultos que asisten a consultorio de atención primaria en la región Metropolitana. Revista Medica de Chile 1997; 125: 283–9.
46Prentice, AM. Fires of life: the struggles of an ancient metabolism in a modern world. Food and Nutrition Bulletin 2001; 26: 1327.
47Leyton, J, Drury, P, Crawford, M. Differential oxidation of saturated and unsaturated fatty acids in vivo in the rat. British Journal of Nutrition 1987; 57: 383–93.
48Raclot, T, Groscolas, R. Diferential mobilization of white adipose tissue fatty acids according to chain length, unsaturation, and positional isomerism. Journal of Lipid Research 1993; 34: 1515–26.
49Connor, W, Lin, D, Colvis, C. Differential mobilization of fatty acids from adipose tissue. Journal of Lipid Research 1996; 37: 290–8.
50DeLany, J, Windhauser, M, Champagne, C, Bray, G. Differential oxidation of individual dietary fatty acids in humans. American Journal of Clinical Nutrition 2000; 72: 905–11.
51Power, G, Newsholme, E. Dietary fatty acids influence the activity and metabolic control of mitochondrial carnitine palmitoyltransferase I in rat heart and skeletal muscle. Journal of Nutrition 1997; 127: 2142–50.
52Kabir, Y, Ide, T. Activity of hepatic fatty acid oxidation enzymes in rats fed alpha-linolenic. Biochimica et Biophysica Acta 1996; 1304: 105–19.
53Ide, T, Murata, M, Sugano, M. Stimulation of the activities of hepatic fatty acid oxidation enzymes by dietary fat rich in alpha-linolenic acid in rats. Journal of Lipid Research 1996; 37(3): 448–63.
54Forbes, GB, Brown, M, Welle, S, Lipinsky, B. Deliberate overfeeding in women and men: energy cost and composition of weight gain. British Journal of Nutrition 1986; 56: 19.
55Stock, M. Gluttony and thermogenesis revisited. International Journal of Obesity 1999; 23: 1105–17.
56Schutz, Y. Human overfeeding experiments: potentials and limitations in obesity research. British Journal of Nutrition 2000; 84: 135–7.
57Jebb, S, Murgatroyd, P, Goldberg, G, Prentice, AM, Coward, WA. In vivo measurements of changes in body composition: description of methods and their validation against 12-d continuous whole-body calorimetry. American Journal of Clinical Nutrition 1993; 58: 455–62.
58Horton, TJ, Drougas, H, Brachey, A, Reed, GW, Peters, JC, Hill, JO. Fat and carbohydrate overfeeding in humans: different effects on energy storage. American Journal of Clinical Nutrition 1995; 62: 1929.
59Diaz, E, Prentice, AM, Goldberg Murgatroyd, P, Coward, WA. Metabolic response to experimental overfeeding in lean and overweight healthy volunteers. American Journal of Clinical Nutrition 1992; 56: 641–55.
60Miller, DS, Mumford, P, Gluttony, L. An experimental study of overeating on high protein diets. American Journal of Clinical Nutrition 1967; 20: 1212–22.
61Allison, DB, Kaprio, J, Korkeila, M, Koskenvuo, M, Neale, MC, Kayakawa, K. The heritability of body mass index among an international sample of monocygotic twins reared apart. International Journal of Obesity 1996; 20: 501–6.
62Krief, S, Lonnqvist, F, Raimbault, S, Baude, B, Van Spronsen, A, Arner, P, Strosberg, A, Rickier, D, Emorine, L. Tissue distribution of beta-3 adrenergic receptor mRNA in man. Journal of Clinical Investigation 1993; 91: 344–9.
63Lohnnqvist, F, Thorne, A, Nilsell, K, Hofftedt, J, Arner, P. A pathogenetic role of visceral fat beta-3 adrenoreceptors in obesity. Journal of Clinical Investigation 1995; 95: 1109–16.
64Sakane, N, Yoshida, T, Umekawa, T, Kondo, M, Sakai, Y, Takahashi, T. Beta-3 adrenergic receptor polymorphism: a genetic marker for visceral fat obesity and the insulin resistance syndrome. Diabetologia 1997; 40: 200–4.
65Clement, K, Ruiz, J, Cassard-Doulcier, A. Additive effect of the UCP protein gene and the Trp64Arg mutation of the beta-3-adrenergic receptor gene on weight gain in morbid obesity. International Journal of Obesity 1996; 20: 1062–6.
66Large, V, Hellstrom, L, Reynisdottir, S, Lonnqvist, F, Ericksson, P, Lannfelt, L, Arner, P. Human beta-2 adrenoceptor gene polimorphisms adrenoceptor function. Journal of Clinical Investigation 1997; 100: 3005–13.
67Oberkofler, H, Esterbauer, H, Hell, E, Krempler, F, Patsch, W. The Gln27Glu polymorphism in the beta-2 adrenergic receptor gene is not associated with morbid obesity in Austrian women. International Journal of Obesity 2000; 24: 388–90.
68Meirhaeghe, A, Hebecque, N, Cottel, D, Amouyel, P. Beta-2 adrenoceptor gene poimorphism, body weight and physical activity. Lancet 1999; 353: 896.
69Rosmond, R, Ukkola, O, Chagnon, M, Bouchard, C, Bjorntorp, P. Polymorphisms of the beta-2 adrenergic receptor gene in relation to cardiovascular risk factors in men. Journal of Internal Medicine 2000; 248: 239–44.
70Klannemark, M, Orho, M, Groop, L. No relationship between variants in the UCP2 gene and energy expenditure. European Journal of Endocrinology European Federation of Endocrine Societies 1998; 139: 217–21.
71Chung, M, Luke, A, Cooper, R. Genetic and physiologic analysis of the role of UCP3 in human energy homeostasis. Diabetes 1999; 48: 1890–5.
72Greens, I. Activation of a member of the steroid hormone receptor superfamily by peroxisome proliferators. Nature 1990; 347: 1070–6.
73Schoonjans, K, Staels, B, Auwerx, J. Role of the peroxisome proliferator-activated receptor (PPAR) in mediating the effects of fibrates and fatty acids on gene expression. Journal of Lipid Research 1996; 37: 907–25.
74Shalev, A, Siegrist-Kaiser, C, Yen, P, Wahli, W, Burger, A, Chin, W, Meier, C. The peroxisome proliferator-activated receptor a is a phosphoprotein: regulation by insulin. Endocrinology 1996; 137: 4499–505.
75Vidal-Puig, A, Considine, R, Jimenez-Liñan, M, Werman, A, Pories, W, Caro, J, Flier, J. Peroxisome proliferator-activated receptor gene expression in human tissues. Journal of Clinical Investigation 1997; 99: 2416–22.
76Ristow, M, Muller-Wieland, D, Pfeiffer, A, Krone, W, Kahn, R. Obesity associated with a mutation in a genetic regulator of adipocyte differentiation. New England Journal of Medicine 1998; 339: 953–9.
77Moller, DE, Flier, JS. Insulin resistance: mechanisms, syndromes, and implications. New England Journal of Medicine 1991; 325: 938–48.
78Moitra, J, Mason, MM, Olive, M, Krylov, D, Gavrilova, O, Marcus, B, Feigenbaum, L, Lee, E, Aoyama, T, Eckhaus, M, Reitmann, ML, Vinson, C. Life without fat: a transgenic mouse. Genes and Development 1998; 12: 3168–81.
79Martin, G, Schoonjans, K, Staels, B, Auwerx, J. PPAR-γ activators improve glucose homeostasis by stimulating fatty acid uptake in the adipocytes. Atherosclerosis 1998; 137: 7580.
80Wu, Z, Xie, Y, Morrison, RF, Bucher, NL, Farmer, SR. PPAR-γ induces the insulin dependent glucose transporter GLUT-4 in abscence of C/EBP α during the conversion of 3T3 fibroblast into adipocytes. Journal of Clinical Investigation 1998; 101: 2232.
81Rocchi, S, Auwerx, J. Peroxisome proliferator activated receptor-γ, the ultimate liaison between fat and transcription. British Journal of Nutrition 2000; 84(Suppl. 2): S223–7.
82Deeb, S, Fajas, L, Nemoto, M, Laakso, M, Fujimoto, W, Auwerx, J. A Pro12Ala substitution in the human peroxisome PPAR-γ2 is associated with decreased receptor activity, improved insulin sensitivity, and lowered body mass index. Nature Genetics 1998; 20: 284–7.
83Yen, CJ, Beamer, BA, Negri, C, Silver, K, Brown, KA, Yarnall, DP, Burns, DK, Roth, J, Shuldiner, AR. Mollecular scanning of the human PPAR gamma gene in diabetics caucasians; identification of a Pro12Ala PPAR gamma 2 missense mutation. Biochemical and Biophysical Research Communications 1997; 241: 270–4.
84Beamer, BA, Yen, CJ, Andersen, , et al. Association of the Pro12Ala variant in PPAR gamma 2 gene with obesity in two Caucasian populations. Diabetes 1998; 47: 1806–8.
85Mori, Y, Kim-Motoyama, H, Katakura, T, Yasuda, K, Kadowaki, H, Beamer, BA, Shuldiner, AR, Akanuma, Y, Yazaki, Y, Kadowaki, T. Effect of the Pro12Ala variant of the human PPAR gamma 2 on adiposity, fat distribution and insulin sensitivity in Japanese men. Biochemical and Biophysical Research Communications 1998; 251: 195–8.
86Ek, J, Urhammer, SA, Sorensen, TI, Andersen, T, Auwerx, J, Pedersen, O. Homozygosity of the Pro12Ala variant of PPAR gamma 2: divergent modulating effects on body mass index in obese and lean men of Caucasian origin. Diabetologia 1999; 42: 892–5.
87Reaven, GM. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595–607.
88Rosenblum, A, Joe, JR, Young, RS, Winter, WE. Emerging epidemic of type II diabetes in youth. Diabetes Care 1999; 22: 345–54.
89Stumvoll, M, Jacob, S. Multiple sites of insulin resistance: muscle, liver and adipose tissue. Experimental and Clinical Endocrinology and Diabetes: Official Journal, German Society of Endocrinology and German Diabetes Association 1999; 107: 107–10.
90Storlien, L, Pan, D, Kriketos, A, Connor, J, Caterson, I, Cooney, G, Jenkins, AB, Baur, LA. Skeletal muscle membrane lipids and insulin resistance. Lipids 1996; 31: S261–5.
91Pan, D, Lillioja, S, Milner, M, Kriketos, A, Baur, L, Bogardus, C, Storlien, LH. Skeletal muscle membrane lipid composition is related to adiposity and insulin action. Journal of Clinical Investigation 1995; 96: 2802–8.
92Shulman, GI. Cellular mechanisms of insulin resistance. Journal of Clinical Investigation 2000; 106(2): 171–6.
93Hotamisligil, G, Shargill, N, Spiegelman, B. Adipose expression of Tumor Necrosis Factor-α: direct role in obesity-linked insulin resistance. Science 1993; 259: 8793.
94Saghizadeh, M, Ong, J, Garvey, T, Henry, R, Kern, P. The expression of TNF-α by human muscle. Journal of Clinical Investigation 1996; 97: 1111–6.
95Ferrannini, E, Natali, A, Bell, P, Cavallo-Perin, P, Lalic, N, Mingrone, G. Insulin resistance and hypersecretion in obesity. Journal of Clinical Investigation 1997; 100: 1166–73 on behalf of the European Group for the Study of Insulin Resistance (EGIR).
96Lillioja, S, Mott, DM, Howard, BV, Bennett, PH, Yki-Jarvinen, H, Freymond, D, Nyomba, BL, Zurlo, F, Swinburn, B, Bogardus, C. Impaired glucose tolerance as a disorder of insulin action. Longitudinal and cross-sectional studies in Pima indians. New England Journal of Medicine 1988; 318: 1217–25.
97Granner, DK, O'Brien, RM. Molecular physiology and genetics of NIDDM. Diabetes Care 1992; 15: 369–95.
98Hales, CN, Barker, DJ. Type 2 (non-insulin dependent) diabetes mellitus: the thrifty phenotype hypothesis. Diabetologia 1992; 35: 595601.
99Depres, JP, Mauriege, P, Cantin, B, Dagenais, GR, Moorjani, S, Lupien, PJ. Hyperinsulinemia as an independent risk factor for ischemic heart disease. New England Journal of Medicine 1996; 334: 952–7.
100Feskens, EJM, Kromhout, D. Hyperinsulinemia, risk factors and coronary heart disease. The Zuphen elderly study. Arteriosclerosis and Thrombosis: a Journal of Vascular Biology American Heart Association 1994; 14: 1641–7.
101Bjorntorp, P, Rosmond, R. The metabolic syndrome – a neuroendocrine disorder? British Journal of Nutrition 2000; 83(Suppl. 1): S49S57.
102Sessler, AM, Ntambi, JM. Polyunsaturated fatty acid regulation of gene expression. Journal of Nutrition 1998; 128: 923–6.
103Cheema, SK, Clandinin, MT. Diet fat alters expression of genes for enzymes of lipogenesis in lean and obese mice. Biochimica et Biophysica Acta 1996; 1299: 284–8.
104Bergman, R, Mittelman, S. Central role of the adipocyte in insulin resistance. Journal of Basic and Clinical Physiology and Pharmacology 1998; 9(2–4): 205–21.
105McGarry, JD. Glucose fatty acid interactions in health and disease. American Journal of Clinical Nutrition 1998; 67: 5500–4.
106Colberg, SR, Simoneau, JA, Thaete, FL, Kelley, DE. Skeletal muscle utilization of free fatty acid in women with visceral obesity. Journal of Clinical Investigation 1995; 95: 1846–53.
107Van Baak, MA, Schiffelers, SLH, Saris, WHM. Increased NEFA availability leads to a similar increase in energy expenditure and fat oxidation inlean and obese men. International Journal of Obesity 1998; 22: S157.
108Shimabukuro, M, Zhou, YT, Levi, M, Unger, RH. Fatty acid-induced beta cell apoptosis: a link between obesity and diabetes. Proceedings of the National Academy of Sciences of the United States of America 1998; 95: 2498–502.
109Maslowska, M, Scantebury, T, Germinario, R, Cianflone, K. Acute in vitro production of ASP in differentiated adipocytes. Journal of Lipid Research 1997; 38: 2131.
110Scantlebury, T, Maslowska, M, Cianflone, K. Chylomicron specific enhancement of acylation stimulating protein (ASP) and precursor protein C3 production in differentiated human adipocytes. Journal of Biological Chemistry 1998; 273: 20903–9.
111Saleh, J, Summers, LKM, Cianflone, K, Fielding, BA, Sniderman, AD, Frayn, KN. Coordinated release of acylation stimulating protein (ASP) and triacylglicerol clearance by human adipose tissue in vivo in the postprandial period. Journal of Lipid Research 1998; 39: 884–91.
112Ferrannini, E, Buzzigoli, G, Giorico, MA, Oleggini, M, Graziadei, L, Pedrinelli, R, Brandi, L, Bevilacqua, S. Insulin resistance in essential hypertension. New England Journal of Medicine 1987; 317: 350–7.
113Reaven, GM. Relationship between insulin resistance and hypertension. Diabetes Care 1991; 14: 33–8.
114De Fronzo, RA, Ferranini, E. Insulin resistance: a multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia and atheroesclerotic cardiovascular disease. Diabetes Care 1991; 14: 173–94.
115Davis, MA, Neuhaus, JM, Ettinger, WH, Mueller, WH. Body fat distribution and osteoarthritis. American Journal of Epidemiology 1990; 132: 701–7.
116Roubenoff, R, Klag, MJ, Mead, LA, Liang, KY, Seidler, AJ, Hochberg, MC. Incidence and risk factors for gout in white men. Journal of the American Medical Association 1991; 266: 3004–7.
117Felson, DT, Zhang, Y, Anthony, JM, Naimark, A, Anderson, JJ. Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham study. Annals of Internal Medicine 1992; 116: 535–9.
118Vgontzas, AN, Tan, TL, Bixler, EO, Martin, LF, Shubert, D, Kales, K. Sleep apnea and sleep disruption in obese patients. Archives of Internal Medicine 1994; 154: 1705–11.
119Strollo, PJ, Rogers, RM. Current concepts: obstructive sleep apnea. New England Journal of Medicine 1996; 334: 99104.
120Abraham, A, Collins, G, Nordsieck, M. Relationship of childhood weight status to morbidity in adults. HSMHA Health Reports 1971; 86: 73.
121Guo, SS, Roche, AF, Chumlea, WC, Gardner, JD, Siervogel, RM. The predictive value of childhood body mass index values for overweight at age 35 y. American Journal of Clinical Nutrition 1994; 59: 810–19.
122Must, A, Jacques, PF, Dallal, GE, Bajema, CJ, Dietz, WH. Long-term morbidity and mortality of overweight adolescents. New England Journal of Medicine 1992; 327: 1350–5.
123Qing, H, Karlberg, J. BMI in childhood and its association with height gain, timing of puberty, and final height. Pediatric Research 2001; 49: 244–51.
124Hill, AJ, Silver, EK. Fat, friendless and unhealthy: 9 year old children's perception of body shape stereotypes. International Journal of Obesity 1995; 19: 423–30.
125Klesges, RC, Haddock, CK, Stein, RJ, Klesges, LM, Eck, LH, Hanson, CL. Relationship between psychosocial functioning and body fat in preschool children: a longitudinal investigation Journal of Consulting and Clinical Psychology 1992; 60: 793–6.
126Strauss, R. Childhood obesity and self-esteem. Pediatrics 2000; 105: 15.
127Feldman, W, Feldman, E, Goodman, JT. Culture versus biology: children's attitudes toward fatness and thinness. Pediatrics 1988; 81: 190–4.
128Fairburn, CG, Cooper, Z. New perspectives on dietary and behavioral treatment for obesity. International Journal of Obesity 1996; 20(Suppl.): S9S13.
129Sinaiko, A, Donahue, R, Jacbos, D, Prineas, R. Relation of weight and rate of increase in weight during childhood and adolescence to body size, blood pressure, fasting insulin, and lipids in young adults. The Minneapolis children's blood pressure study. Circulation 1999; 99: 1471–6.
130Lauer, RM, Connor, WE, Leaverton, PE, Reiter, MA, Clarke, WR. Coronary heart disease risk factors in school children: The Muscatine study. Journal of Pediatrics 1975; 86: 697706.
131Steinberger, J, Morehead, C, Katch, V, Rocchini, AP. Relationship between insulin resistance and abnormal lipid profile in obese adolescents. Journal of Pediatrics 1995; 126: 690–5.
132Brambilla, P, Manzoni, P, Sironi, S, Simone, P, Del Maschio, A, di Natale, B, Chiumello, G. Peripheral and abdominal adiposity in childhood obesity. International Journal of Obesity 1994; 18: 795800.
133Pinhas-Hamiel, O, Dolan, L, Daniels, S, Standiford, D, Khoury, P, Zeitler, P. Increased incidence of non-insulin dependent diabetes mellitus among adolescents. Journal of Pediatrics 1996; 128: 608–15.
134Bao, W, Strinivasan, SR, Wattigney, WA, Berenson, GS. Persistence of multiple cardiovascular risk clustering related to syndrome X from childhood to young adulthood. The Bogalusa heart study. Archives of Internal Medicine 1994; 154: 1842–7.
135Raitakari, OT, Porkka, KV, Rasanen, L, Ronnemaa, T, Viikari, JS. Clustering and six year cluster-tracking of serum total cholesterol, HDL-cholesterol and diastolic blood pressure in children and young adults. The cardiovascular risk in young Finns study. Journal of Clinical Epidemiology 1994; 47: 1085–93.
136Noguchi, H, Tazawa, Y, Nishinomiya, F, Takada, G. The relationship between serum transaminase activities and fatty liver in children with simple obesity. Acta Paediatrica Japonica 1995; 37: 621–5.
137Loder, RT. The demographics, of slipped capital femoral epiphysis. An international multicenter study. Clinical Orthopaedics and Related Research 1996; 322: 827.
138Dietz, WH, Gross, WL, Kirkpatrick, JA. Blount disease (tibia vara): another skeletal disorder associated with childhood obesity. Journal of Pediatrics 1982; 101: 735–7.
139Henderson, RC, Greene, WB. Etiology of late-onset tibia vara: is varus alignment a prerequisite? Journal of Pediatric Orthopedics 1994; 14: 143–6.
140Silvestri, JM, Weese-Mayer, DE, Bass, MT, Kenny, AS, Hauptman, SA, Pearsall, SM. Polysomnography in obese children with a history of sleep-associated breathing disorders. Pediatric Pulmonology 1993; 16: 124–9.
141Young, T, Peppard, P. Sleep disordered breathing and cardiovascular disease: epidemiologic evidence for a relationship. Sleep 2000; 23: S1226.
142Riley, DJ, Santiago, TV, Edelman, NH. Complications of obesity-hypoventilation syndrome in childhood. American Journal of Diseases in Childhood 1976; 130: 671–4.
143Spiegel, K, Leproult, R, Van Cauter, E. Impact on sleep debt on endocrine and metabolic function. Lancet 1999; 354: 1435–9.
144Galtier-Dereure, F, Boegner, C, Bringer, J. Obesity and pregnancy: complications and cost. American Journal of Clinical Nutrition 2000; 71: Suppl. S1242–S8.
145Crane, SS, Wojtowycz, , Dye, TD, Aubry, RH, Artal, R. Association between prepregnancy obesity and the risk of cesarean delivery. Obstetrics and Gynecology 1997; 89: 213–6.
146Cogswell, ME, Perry, GS, Schieve, LA, Dietz, WH. Obesity in Women of Childbearing Age: Risks, Prevention, and Treatment. Submitted for publication in Primary Care Update for OB/GYNS, 2000.
147Kallen, K. Maternal smoking, body mass index, and neural tube defects. American Journal of Epidemiology 1998; 147: 1103–11.
148Shaw, GM, Velie, EM, Schaffer, D. Risk of neural tube defect affected pregnancies among obese women. Journal of the American Medical Association 1996; 275: 1093–6.
149Waller, D, Mills, JL, Simpson, JL, Cunningham, GC, Conley, MR, Lassman, MR, Rhoads, GG. Are obese women at higher risk for producing malformed offspring? American Journal of Obstetrics and Gynecology 1994; 170: 54–8.
150Watkins, M, Scanlon, K, Mulinare, J, Khoury, M. Is Maternal obesity a risk factor for anencephaly and spina bifida? American Journal of Epidemiology 1994; 139: S11.
151Werler, MM, Louik, C, Shapiro, S, Mitchell, AA. Pre-pregnant weight in relation to risk of neural tube defects. Journal of the American Medical Association 1996; 275: 1089–92.
152Cnattinguis, S, Bergstrom, R, Lipworth, L, Kramer, S. Prepregnancy weight and the risk of adverse pregnancy outcomes. New England Journal of Medicine 1998; 338: 147–52.
153Solomon, CG, Wilett, WC, Carey, VJ, Rich-Edwards, J, Hunter, DJ, Colditz, GA, Stampfer, MJ, Speizer, FE, Spiegelman, D, Manson, JE. A prospective study of pregravid determinants of gestational diabetes mellitus. JAMA Journal of the American Medical Association 1997; 278: 1078–83.
154Magee, MS, Walden, CE, Benedetti, TJ, Knopp, RH. Influence of diagnostic criteria on the incidence of gestational diabetes and perinatal morbidity. JAMA Journal of the American Medical Association 1992; 269: 609–15.
155Thadhani, R, Stampfer, MJ, Hunter, DJ, Manson, JE, Solomon, CG, Curhan, GC. High body mass index and hypercholesterolemia: risk of hypertensive disorders of pregnancy. Obstetrics and Gynecology 1999; 94: 543–50.
156Rich-Edwards, JW, Goldman, MB, Willett, WC, Hunter, DJ, Stampfer, MJ, Colditz, GA. Adolescent body mass index and infertility caused by ovulatory disorder. American Journal of Obstetrics and Gynecology 1994; 171: 171–7.
157Balen, AH, Conway, GS, Kaltsas, G, Techatrasak, K, Manning, PJ, West, C, Jacobs, HS. Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients. Human Reproduction 1995; 10: 2107–11.
158Bates, GW, Whitworth, NS. Effect of body weight reduction of plasma androgens in obese, infertile women. Fertility and Sterility 1982; 38: 406–9.
159Clark, AM, Ledger, W, Galletly, C, Tomlinson, T, Blaney, F, Wang, X, Norman, RJ. Weight loss results in significant improvement in pregnancy and ovulation rates in anovulatory obese women. Human Reproduction 1995; 10: 2705–12.
160Harlass, FE, Pylmate, SR, Fariss, BL, Belts, RP. Weight loss is associated with correction of gonadotrophin and sex steroid abnormalities in the obese annovulatory female. Fertility and Sterility 1984; 42: 649–52.
161Hollmann, M, Runnebaum, B, Gerhard, I. Effects of weight loss on the hormonal profile in obese, infertile women. Human Reproduction 1996; 11: 1884–91.
162Kiddy, DS, Hamilton-Fairley, D, Seppala, M, Koistinem, R, Jones, VH, Reed, MJ, Franks, S. Diet-Induced changes in sex hormone binding globulin and free testosterone in women with normal or polycstic overies: Correlation with serum, insulin and insulin-like growth factor-1. Clinical Endocrinology 1989; 31: 757–63.
163Kiddy, DS, Hamilton-Fairley, D, Bush, A, Short, F, Anyaoku, V, Reed, MJ, Franks, S. Improvement in endocrine and ovarian function during dietary treatment of obese women with polycystic ovary syndrome. Clinical Endocrinology 1992; 36: 105–11.
164Chapman, DJ, Perez-Escamilla, R. Identification of risk factors for delayed onset of lactation. Journal of the American Dietetic Association 1999; 99: 450–4.
165Donath, SM, Amir, LH. Does maternal obesity adversely affect breastfeeding initiation and duration? Breastfeeding Review Professional Publication of the Nursing Mothers' Association of Australia 2000; 8: 2933.
166Hales, CN, Barker, DJ, Clark, PM, Cox, LJ, Fall, C, Osmond, C, Winter, PD. Fetal and infant growth and impaired glucose tolerance at age 64. British Medical Journal 1991; 303: 1019–22.
167Robinson, S, Walton, RJ, Clark, PM, Barker, DJ, Hales, CN, Osmond, C. The relation of fetal growth to plasma glucose in young men. Diabetologia 1992; 35: 444–6.
168Snoeck, A, Remacle, C, Reussens, B, Hoet, JJ. Effect of a low protein diet during pregnancy on the fetal rat endocrine pancreas. Biology of the Neonate 1990; 57: 107–8.
169Dahri, S, Snoeck, A, Reussens-Billen, B, Remacle, C, Hoett, JJ. Islet function in offspring of mothers on low-protein diet during gestation. Diabetes 1991; 40(Suppl. 2): 115–20.
170Dahri, S, Reussens, B, Remacle, C, Hoett, JJ. Nutrirional influences on pancreatic development and potential links with non-insulin dependent diabetes. Proceedings of the Nutrition Society 1995; 54: 345–56.
171Mitchell, BD, Valdez, R, Hazuda, HP, Haffner, SM, Monterrosa, A, Stren, MP. Differences in the prevalence of diabetes and impaired glucose tolerance according to maternal or paternal history of diabetes. Diabetes Care 1993; 16: 1262–7.
172Pettitt, DJ, Baird, HR, Carraher, MJ, Bennett, PH, Knowler, WC. Congenital susceptibility to NIDDM. Role of intrauterine environment. Diabetes 1988; 37: 622–8.
173Langford, K, Blum, W, Nicolaides, K, Jones, J, Mc Gregor, A, Miell, J. The pathophysiology of the insulin like growth axis in fetal growth failure: a basis for programming by undernutrition? European Journal of Clinical Investigation 1994; 24(12): 851–6.
174De Onis, M, Blossner, M. Prevalence of overweight among preschool children in developing countries. American Journal of Clinical Nutrition 2000; 72: 1032–9.
175Uauy, R, Mize, C, Castillo-Durán, C. Fat intake during childhood: metabolic responses and effects on growth. American Journal of Clinical Nutrition 2000; 72(Suppl.): S1354–S60.
176Kain, J, Pizarro, F. Effect of an enhanced supplementary feeding program on infant's length. Archivos Latinoamericanos de Nutricion 2000; 47: 101–4.
177Uauy, R, Riumallo, J. Work plan in support of guidelines on formulating and implementing nutrition programs (FINP) at the country level. Case Study: Chile. FAO, Rome 1997.
178Rojas, J, Uauy, R. Need to prevent obesity without neglecting the protection of children at risk of malnutrition. Revista Chilena de Nutricion: Organo Oficial de la Sociedad Chilena de Nutricion Bromatologia y Toxicologia 1999; 26: 35–9.
179The World Health Report. Conquering Suffering, Enriching Humanity. Geneva: WHO, 1997.
180Murray, CJ, Lopez, AD. The Global Burden of Disease. Boston: Harvard University Press, 1996.
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Public Health Nutrition
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