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New understanding in obesity research*

Published online by Cambridge University Press:  03 November 2011

W. P. T. James*
Affiliation:
Rowett Research Institute, Greenburn Road, Bucksburn, Aberdeen AB21 9SB, UK
A. Ralph
Affiliation:
Rowett Research Institute, Greenburn Road, Bucksburn, Aberdeen AB21 9SB, UK
*
Corresponding author: Professor W. P. T. James, fax +44 (0)1224 716698, email wptj@rri.sari.ac.uk
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Abstract

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A public-health approach considers the relevance of nutritional research in the prevention and management of obesity. Well-defined and internationally-agreed definitions based on BMI allow an assessment of the worldwide prevalence of overweight and obesity. There are about 250 million obese adults in the world, and many more overweight. Obesity is emerging in the Third World, first in urban middle-aged women. With economic developments, obesity then occurs in men and younger women. In the West childhood obesity is rapidly emerging, with concern that early-onset obesity is especially hazardous. In Asians the risks of excess visceral fat occur at lower body weights than in Caucasians. The propensity to visceral obesity in Asians may relate to malnourished mothers and low birth weight. The International Obesity Task Force is considering many issues, including the health economics of obesity. It has developed a strategy to define childhood obesity, which in children over 6 years is likely to predict long-term weight and health problems. While the search for genetic markers of obesity continues, with particular interest in the leptin gene, it is clear that societal change, with the decline in physical activity and the passive overconsumption of high-fat diets are major contributors to the global increase in obesity. The public-health aspects of obesity research are therefore challenging.

Type
Joint symposium with British Dietetic Association on ‘Implementing dietary change: theory and practice’ Session 2.Obesity
Copyright
Copyright © The Nutrition Society 1999

Footnotes

*

This paper arrived too late for publication with the other papers in this symposium, which appear in Volume 58, no. 1.

References

American Obesity Association (1997) Shape Up America 1997. Guidance for Treatment of Adult Obesity. Bethesda, MD: American Obesity Association.Google Scholar
Andrews, JF (1998) Leptin: energy regulation and beyond to a hormone with pan-physiological function. Proceedings of the Nutrition Society 57, 403411.CrossRefGoogle ScholarPubMed
Arch, JRS, Stock, MJ & Trayhurn, P (1998) Leptin resistance in obese humans: does it exist and what does it mean? International Journal of Obesity 22, 15.CrossRefGoogle ScholarPubMed
Astrup, A & MacDonald, IA (1997) Sympathoadrenal system and metabolism. In Handbook on Obesity, pp. 491512 [Bray, GA, Bouchard, C and James, WPT, editors]. New York: Marcel Dekker Inc.Google Scholar
Astrup, A, Toubro, S, Raben, A & Skov, AR (1997) The role of low fat diets and fat substitutes in body weight management: what have we learned from clinical studies? Journal of the American Dietetic Association 97, Suppl., S82S87.CrossRefGoogle ScholarPubMed
Beegom, R, Niaz, MA & Singh, RB (1995) Diet, central obesity and prevalence of hypertension in the urban population of South India. International Journal of Cardiology 51, 183191.CrossRefGoogle ScholarPubMed
Bennett, N, Dodd, T, Flatley, J, Freeth, S & Bolling, K (1995) Health Survey of England 1993. London: H.M. Stationery Office.Google Scholar
Blair, SN (1993) Evidence for the success of exercise in weight loss and control. Annals of Internal Medicine 119, 702705.CrossRefGoogle ScholarPubMed
Blundell, JE & Stubbs, RJ (1997) Diet composition and the control of food intake in humans. In Handbook of Obesity, pp. 243272 [Bray, GA, Bouchard, C and James, WPT, editors]. New York: Marcel Dekker Inc.Google Scholar
Bouchard, C, Perusse, L, Rice, T & Rao, DC (1997) The genetics of human obesity. In Handbook of Obesity, pp. 157190 [Bray, GA, Bouchard, C and James, WPT, editors]. New York: Marcel Dekker Inc.Google Scholar
Bray, GA (1990 a) Preoptic area injection of corticotrophin-releasing hormone stimulates sympathetic activity. American Journal of Physiology 259, R799R806.Google Scholar
Bray, GA (1990 b) The Mona Lisa Hypothesis. Most obesities known are low in sympathetic activity. In Progress in Obesity Research, pp. 6166 [Oomura, Y, Tarui, S, Inoue, S and Shimazu, T, editors]. London: John Libbey.Google Scholar
Brunner, E (1997) Socio-economic determinants of health, stress and the biology of inequality. British Medical Journal 314, 14721476.CrossRefGoogle Scholar
Buemann, B, Toubro, S & Astrup, A (1998) Substrate oxidation and thyroid hormone response to the introduction of a high fat diet in formerly obese women. International Journal of Obesity 22, 869877.CrossRefGoogle Scholar
Campfield, LA & Smith, FJ (1998) Overview: neurobiology of OB protein (leptin). Proceedings of the Nutrition Society 57, 429440.CrossRefGoogle ScholarPubMed
Cawthorne, MA, Morton, NM, Pallett, AL, Liu, Y-L & Emilsson, V (1998) Peripheral metabolic actions of leptin. Proceedings of the Nutrition Society 57, 449453.CrossRefGoogle ScholarPubMed
Cole, TJ, Bellizzi, MC, Flegal, KM & Dietz, WH (1998) An international reference dataset and cut-off for body mass index to define child and adolescent underweight, overweight and obesity. American Journal of Clinical Nutrition (In the Press).Google Scholar
Cole, TJ, Freemen, JV & Preece, MA (1990) Body mass index reference curves for the UK, 1990. Archives of Diseases in Childhood 73, 2529.CrossRefGoogle Scholar
Department of Health (1995) Obesity: Reversing the Increasing Problem of Obesity in England. A Report from the Nutrition and Physical Activity Task Forces. London: Department of Health.Google Scholar
Farooqi, S, Ran, H, Whitehead, J & O'Rahilly, S (1998) Ob gene mutations and human obesity. Proceedings of the Nutrition Society 57, 471475.CrossRefGoogle ScholarPubMed
Ferro-Luzzi, A & Martino, L (1996) Obesity and physical activity. In The Origins and Consequences of Obesity, pp. 207227 [Chadwick, D and Cardew, G, editors]. Chichester: John Wiley & Sons Ltd.Google Scholar
Francois, P & James, WPT (1994) An assessment of nutritional factors affecting the body mass index of a population. European Journal of Clinical Nutrition 48, Suppl. 3, S110S114.Google ScholarPubMed
Garrow, JS (1981) Treat Obesity Seriously. London: Churchill Livingstone.Google Scholar
Gong, D-W, He, Y, Karas, M & Reitman, M (1997) Uncoupling protein-3 is a mediator of thermogenesis regulated by thyroid hormone, β-adrenergic agonists and leptin. Journal of Biological Chemistry 272, 2412924132.CrossRefGoogle ScholarPubMed
Gortmaker, SL, Must, A, Sobol, AM, Peterson, K, Colditz, GA & Dietz, WH (1996) Television viewing as a cause of increasing obesity among children in the United States 1986–1990. Archives of Pediatric and Adolescent Medicine 150, 356362.CrossRefGoogle ScholarPubMed
Health Education Authority and Sports Council (1992) Allied Dunbar National Fitness Survey. London: Health Education Authority and Sports Council.Google Scholar
Heitmann, BL, Lissner, I, Sorensen, TIA & Bengtsson, C (1995) Dietary fat intake and weight gain in women genetically predisposed to obesity. American Journal of Clinical Nutrition 61, 12131217.CrossRefGoogle ScholarPubMed
Hwa, JJ, Fawzi, AB, Graziano, MP, Ghibaudi, L, Williams, P, van Heek, M, Davis, H, Rudinskia, M, Sybertz, E & Strader, CD (1997) Leptin increases energy expenditure and selectivity promotes fat metabolism in ob/ob mice. American Journal of Physiology 272, R1204R1209.Google ScholarPubMed
Ismail, MN, Zawiah, H, Chee, SS & Ng, KK (1995) Prevalence of obesity and chronic energy deficiency (CED) in adult Malaysians. Malaysian Journal of Nutrition 1, 19.Google ScholarPubMed
James, WPT (1995) Assessing energy needs. Proceedings of the Nutrition Society of India 42, 114.Google Scholar
James, WPT (1997) Long term fetal programming of body composition and longevity. Nutrition Reviews 55, S31S34.CrossRefGoogle ScholarPubMed
James, WPT, Davies, HL, Bailes, J & Dauncey, MJ (1978) Elevated metabolic rates in obesity. Lancet i, 11221125.CrossRefGoogle Scholar
James, WPT, Ferro-Luzzi, A & Waterlow, JC (1988) Definition of chronic energy deficiency in adults. Report of a working party of the International Dietary Energy Consultative Group. European Journal of Clinical Nutrition 42, 969981.Google ScholarPubMed
James, WPT, Ralph, A & Ferro-Luzzi, A (1989) Energy needs of the elderly. A new approach. In Nutrition, Ageing and the Elderly, pp. 129150 [Munro, HN and Danford, DE, editors]. New York and London: Plenum Press.CrossRefGoogle Scholar
James, WPT & Reeds, P (1997) Nutrient partitioning. In Handbook of Obesity, pp. 555571 [Bray, GA, Bouchard, C and James, WPT, editors]. New York: Marcel Dekker Inc.Google Scholar
Jenkendrup, AE, Saris, WHM & Wagenmakers, AJ (1998) Fat metabolism during exercise: a review. Part 1: fatty acid mobilization and muscle metabolism. International Journal of Sports Medicine 19, 231244.CrossRefGoogle Scholar
Jung, RT & James, WPT (1980) Is obesity metabolic? British Journal of Hospital Medicine 24, 503509.Google Scholar
Karlsson, J, Sjostrom, L & Sullivan, M (1998) Swedish obese subjects (SOS) – an intervention study of obesity. Two year follow up of health-related quality of life (HRQL) and eating behaviour after gastric surgery for severe obesity. International Journal of Obesity 22, 113126.CrossRefGoogle ScholarPubMed
Katan, MB, Grundy, SM & Willett, WC (1997) Beyond low fat diets. New England Journal of Medicine 337, 563566.Google ScholarPubMed
Keys, A (1980) Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease. Cambridge, MA: Harvard University Press.CrossRefGoogle Scholar
Koyama, K, Chen, G, Lee, Y & Unger, RH (1997) Tissue triglycerides, insulin resistance and insulin production: implications for hyperinsulinemia of obesity. American Journal of Physiology 273, E708E713.Google ScholarPubMed
Lean, MEJ & James, WPT (1986) Diabetes: prescription of diabetic drugs in the 1980s. Lancet i, 723725.CrossRefGoogle Scholar
McDiarmid, JI, Cade, JE & Blundell, JE (1996) High and low fat consumers and their macronutrient intake and body mass index: further analysis of the National Diet and Nutrition Surveys of British Adults. European Journal of Clinical Nutrition 50, 505512.Google Scholar
McKeigue, PM, Shah, B & Marmot, MG (1991) Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet 337, 382386.CrossRefGoogle ScholarPubMed
Manson, JE, Willett, WC & Stampfer, MJ (1995) Body weight and mortality among women. New England Journal of Medicine 333, 677685.CrossRefGoogle ScholarPubMed
Marin, P, Darin, N, Aemeniya, T, Andersson, B, Jervis, S & Bjorntorp, P (1992) Cortisol secretion in relation to body fat distribution in obese, premenopausal women. Metabolism 41, 882886.CrossRefGoogle ScholarPubMed
Marmot, MG, Bosma, H, Hemingway, H, Brunner, E & Stansfield, S (1997) Contribution of job control and other risk factors to social variations in coronary heart disease incidence. Lancet 359, 235239.CrossRefGoogle Scholar
National Heart, Lung and Blood Institute Expert Panel on the Identification, Evaluation and Treatment of Overweight in Adults (1998) Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults: executive summary. American Journal of Clinical Nutrition 68, 899917.CrossRefGoogle Scholar
National Institute of Medicine Committee to Develop Criteria for Evaluating the Outcomes of Approaches to Prevent and Treat Obesity within the Food and Nutrition Board of the National Institute of Medicine (1995) In Weighing the Options: Criteria of Evaluation Weight-management Programs [Thomas, PR, editor]. Washington, DC: National Academy Press.CrossRefGoogle Scholar
Perusse, L, Despres, J-P, Lemieux, S, Rice, T, Rao, DC & Bouchard, C (1996) Familial aggregation of abdominal visceral fat levels: results from the Quebec Family Study. Metabolism 45, 378382.CrossRefGoogle ScholarPubMed
Prentice, AM & Jebb, SA (1995) Obesity in Britain; gluttony or sloth? British Medical Journal 311, 437439.CrossRefGoogle ScholarPubMed
Raben, A, Holst, JJ, Christensen, NJ & Astrup, A (1996) Determinants of postprandial appetite sensations: macronutrient intake and glucose metabolism. International Journal of Obesity 20, 161169.Google ScholarPubMed
Rice, T, Depres, J-P, Daw, EW, Gaguon, J, Boreck, IB, Perusse, L, Leon, AJ, Skinner, JS, Wilmore, JH, Rao, DC & Bouchard, C (1997) Familial resemblances for abdominal visceral fat: the HERMITAGE family study. International Journal of Obesity 21, 10241031.CrossRefGoogle Scholar
Rose, G (1991) Population distribution of risk of disease. Nutrition Metabolism and Cardiovascular Disease 1, 3740.Google Scholar
Rosenbaum, M, Leibel, RL & Hirsch, J (1997) Obesity. New England Journal of Medicine 337, 396407.CrossRefGoogle ScholarPubMed
Royal College of Physicians (1983) Obesity. A report of the Royal College of Physicians. Journal of the Royal College of Physicians 17, 158.Google Scholar
Scottish Intercollegiate Guidelines Network (1996) Obesity in Scotland. Integrating Prevention with Weight Management. Edinburgh: Scottish Intercollegiate Guidelines Network.Google Scholar
Shimabukuro, M, Koyamak, K, Chen, G, Wang, MY, Trieu, F, Lee, Y, Newgard, CB & Unger, RH (1997) Direct antidiabetic effect of the leptin through triglyceride depletion of tissues. Proceedings of the National Academy of Sciences USA 94, 46374641.CrossRefGoogle ScholarPubMed
Shock, NW, Greulich, R, Andres, R, Arenberg, D, Costa, PT, Lakatta, EG & Tobin, JD. (editors) (1984) In Normal Human Aging: The Baltimore Longitudinal Study of Aging. NIH Publication no. 84/2450. Washington, DC: DHHS.Google Scholar
Singh, RB, Niaz, MA, Agarwal, P, Beegum, R, Rastogi, GG & Singh, NK (1995) Epidemiological study of central obesity, insulin resistance and associated disturbances in the urban population of North India. Acta Cardiologica 1, 215225.Google Scholar
Singh, RB, Sainani, GS, Rastogi, GG, Madhu, SV, Krishnaswami, S, Wander, GS, Shah, NA, Gupta, R, Shantaram, V, Yeolekar, ME, Bhatnagar, D, Postiglione, A & Janus, E (1996) Diet and lifestyle guidelines and desirable levels of risk factors for prevention of coronary heart disease in Indians. Journal of Internal Medicine 7, 4649.Google Scholar
Sjostrom, L, Rissanen, A, Andersen, T, Boldrin, M, Golay, A, Koppeschaar, HP & Krempf, M (1998) Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight gain in obese patients. European Multicentre Orlistat Study Group. Lancet 352, 167172.CrossRefGoogle Scholar
Solanes, G, Vidal-Puig, A, Grujk, D, Flier, JS & Lowell, BB (1997) The human uncoupling protein-3 gene. Genomic structure, chromosomal localisation and genetic basis for short and long form transcripts. Journal of Biological Chemistry 272, 2543325436.CrossRefGoogle Scholar
Stubbs, RJ (1998) Appetite, feeding behaviour and energy balance in human subjects. Proceedings of the Nutrition Society 57, 341356.CrossRefGoogle ScholarPubMed
Stubbs, RJ, Harbron, CG, Murgatroyd, P & Prentice, AM (1995) Covert manipulation of dietary fat and energy density: effect on substrate flux and food intake in men eating ad libitum. American Journal of Clinical Nutrition 62, 316329.CrossRefGoogle ScholarPubMed
Stubbs, RJ, Ritz, P, Coward, WA & Prentice, AM (1995) Covert manipulation of the ratio of dietary fat to carbohydrate and energy density; effect on food intake and energy balance in free-living men eating ad libitum. American Journal of Clinical Nutrition 62, 330337.CrossRefGoogle ScholarPubMed
Toubro, S & Astrup, A (1997) Randomised comparisons of diets for maintaining obese subjects' weight after major weight loss: ad lib, low fat, high carbohydrate diet versus fixed energy intake. British Medical Journal 314, 2934.CrossRefGoogle Scholar
Trayhurn, P, Duncan, JS, Hoggard, N & Rayner, DV (1998) Regulation of leptin production. A dominant role for the sympathetic nervous system? Proceedings of the Nutrition Society 57, 413419.CrossRefGoogle ScholarPubMed
Trayhurn, P, Hoggard, N, Mercer, JG & Rayner, DV (1998) Leptin: fundamental aspects. International Journal of Obesity (In the Press).Google Scholar
Wang, J, Liu, R, Hawkins, M, Barzilai, N & Rossetti, L (1998) A nutrient-sensing pathway regulates leptin gene expression in muscle and fat. Nature 393, 684688.CrossRefGoogle ScholarPubMed
Weinsier, RL, Bracco, D & Schutz, Y (1993) Predicted effects of small decreases in energy expenditure on weight gain in adult women. International Journal of Obesity 17, 693700.Google ScholarPubMed
World Health Organization (1995) Physical Status: The Use and Interpretation of Anthropometry. Technical Report Series no. 854. Geneva: WHO.Google Scholar
World Health Organization MONICA project (1988) Geographical variation in the major risk factors of coronary heart disease in men and women aged 35–64. World Health Statistics Quarterly 41, 115140.Google Scholar
Willett, WC (1997) Is dietary fat a major determinant of body fat? American Journal of Clinical Nutrition 67, 556S562S.CrossRefGoogle Scholar
Willett, WC, Mauren, JE, Stampfer, MJ, Colditz, GA, Hunter, DJ & Hankinson, SE (1995) Weight, weight change and coronary heart disease in women. Risk within the ‘normal' weight range. Journal of the American Medical Association 273, 461465.CrossRefGoogle ScholarPubMed
World Cancer Research Fund (1997) Food, Nutrition and the Prevention of Cancer: A Global Perspective. Washington, DC: American Institute of Cancer Research.Google Scholar
York, DA & Hansen, B (1997) Animal models of obesity. In Handbook of Obesity, pp. 191221 [Bray, GA, Bouchard, C and James, WPT, editors]. New York: Marcel Dekker Inc.Google Scholar