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Contributors
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- By Paul Appelbaum, Robert R. Bies, Kristin L. Bigos, Stanley N. Caroff, James J. Crowley, Sonia M. Davis, Vicki G. Davis, Donald C. Goff, Richard Kaczynski, Richard S. E. Keefe, Gary G. Koch, Douglas L. Leslie, Jeffrey A. Lieberman, Joseph P. McEvoy, Stephen R. Marder, Jonathan M. Meyer, Del D. Miller, John L. Olsen, Deborah A. Perlick, Bruce G. Pollock, Fred Reimherr, Sandra G. Resnick, Robert A. Rosenheck, T. Scott Stroup, Patrick F. Sullivan, Jeffrey Swanson, Marvin S. Swartz, Richard Van Dorn
- Edited by T. Scott Stroup, Columbia University, New York, Jeffrey A. Lieberman, Columbia University, New York
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- Book:
- Antipsychotic Trials in Schizophrenia
- Published online:
- 03 May 2010
- Print publication:
- 01 April 2010, pp ix-x
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IV.E.7 - Obesity
- from IV.E - Food-Related Disorders
- Edited by Kenneth F. Kiple, Bowling Green State University, Ohio, Kriemhild Coneè Ornelas
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- Book:
- The Cambridge World History of Food
- Published online:
- 28 March 2008
- Print publication:
- 07 December 2000, pp 1062-1077
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Summary
Obesity is a dimension of body image based on a society’s consideration of acceptable body size and, as such, is the focus of anthropological, sociological, and psychological study (de Garine and Pollock 1995). However, most of the research on obesity in Western societies has focused on medical issues ranging from genetic etiology to therapeutic interventions. Overfatness or obesity is a major health problem in countries that are affluent and is increasing in prevalence among the socioeconomic elite of those that are modernizing. An estimated 90 million Americans – one-third of the population – are substantially above their range of desirable body weight; in some other populations more than half of their members fit into this category.
Of course, some fat or adipose tissue is essential for life and serves a number of functions. It provides metabolic fuel; thermal insulation; a reservoir for vitamins, hormones, and other chemicals; and protection for the viscera and dermal constituents, such as blood vessels, nerves, and glands (Beller 1977). However, an excessive accumulation of fat is associated with an increased risk for diabetes, hypertension, cardiovascular and musculoskeletal problems, and in general, a reduced life expectancy. Moreover, in many societies, fatness elicits a psychosocial stigma.
Definitions and Diagnosis
Body weight is the most widely used anthropometric indicator of nutritional reserves, and weight relative to height is an acceptable measure of body size for growth monitoring and for most epidemiological surveys. Overweight and obesity, though often used synonymously, are not the same. S. Abraham and co-workers (1983) clearly made the distinction in analyzing data from the first U.S. National Health and Nutrition Examination (NHANES) survey. Overweight was defined as an excess in body weight relative to a range of weights for height. In this report, individuals over the 85th percentile of weight for height standards are considered overweight. Obesity was defined as an excess of body fat based on the sum of the triceps (upper arm) skinfold and subscapular (back) skinfold. Skinfold measurements using calipers that pinch a fold of skin and subcutaneous fat at specific sites (for example, waist, abdomen, thighs, upper arm, and back) are used in equations to estimate body fat stores and are compared with reference percentile tables (Himes 1991).
IV.F.1 - Diabetes
- from IV.F - Diet and Chronic Disease
- Edited by Kenneth F. Kiple, Bowling Green State University, Ohio, Kriemhild Coneè Ornelas
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- Book:
- The Cambridge World History of Food
- Published online:
- 28 March 2008
- Print publication:
- 07 December 2000, pp 1078-1086
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Summary
Diabetes mellitus (DM) is a heterogeneous group of endocrine disorders characterized by hyperglycemia (high blood sugar levels) during fasting or following a meal. Other characteristic symptoms of diabetes include excessive urination, urine containing sugar, hunger, thirst, fatigue, and weight loss. The disorder is caused by a resistance to the action of insulin, or a lack or insufficient production of insulin to transport glucose from the blood into cells where it is used as the primary energy source for cellular metabolism. Although diabetes has been a recognized disease for at least two millennia, only since the mid–1970s has there been a consensus on the classification and diagnosis of DM.
Insulin-dependent diabetes mellitus, also called juvenile diabetes or Type I diabetes, is an autoimmune disease that generally affects individuals under the age of 20 and has an acute onset. Noninsulin-dependent diabetes mellitus, Type II, or maturity onset diabetes mellitus, has a complex etiology often associated with obesity and most frequently occurs among individuals over 40 years of age. Ninety to 95 percent of diabetes worldwide is of the latter type. Gestational diabetes appears to be a subset of Type II diabetes, and there are rare genetic syndromes, such as hemochromatosis, drugs, and infections, associated with pancreatic diseases that can cause diabetes. The underlying pathophysiology of Type II diabetes involves the increasing resistance of cells, particularly muscle and adipose (fat) cells, to the transport of glucose across the cell membrane. This resistance or impaired glucose tolerance leads to the classic diagnostic criterion of abnormally high blood sugar concentrations.
VIII.34 - Diabetes
- from Part VIII - Major Human Diseases Past and Present
- Edited by Kenneth F. Kiple, Bowling Green State University, Ohio
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- Book:
- The Cambridge World History of Human Disease
- Published online:
- 28 March 2008
- Print publication:
- 29 January 1993, pp 665-676
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Summary
Diabetes mellitus (DM) is an endocrine disorder characterized by the lack or insufficient production of insulin by the pancreas. DM has been recognized as a disease for at least two millennia, but only since the mid–1970s has there been a consensus on its classification and diagnosis. The primary diagnostic criterion for DM is elevation of blood glucose levels during fasting or at 2 hours following a meal. Normal plasma glucose values for adults in the fasting state are 80 to 120 milligrams per deciliter (mg/dL) or 4.4 to 6.7 millimoles per liter (mmol/L). Definition of unequivocal DM requires a 2-hour postingestion plasma glucose level equal to or greater than 200 mg/dL (11.1 mmol/L) for the appearance of classical symptoms of diabetes. These symptoms, which include excessive urination, urine containing sugar, hunger, thirst, fatigue, and weight loss, are common to all types of DM.
Classification
Today the designation type I DM, or insulindependent diabetes, has replaced terms such as ketosis-prone, juvenile-onset, brittle, and so forth, whereas type II DM, or non-insulin-dependent diabetes, has replaced the terms ketosis-resistant, maturity-onset, and mild diabetes. Many terms were also used for impaired glucose tolerance, a condition that may be a precursor to overt diabetes. Some of these earlier terms include latent, sub-clinical, and chemical diabetes, or prediabetes. Other variants of DM include maturity-onset diabetes of youth (MODY), tropical or J-type diabetes, which shows characteristics of both insulin dependence and non-insulin dependence, and gestational diabetes, which occurs during the latter part of pregnancy Approximately 90 to 95 percent of all individuals with DM may be classified as non-insulin-dependent, and about 5 percent as classically insulindependent.