Excess body weight. An underrecognized contributor to high blood cholesterol levels in white American men

Denke, Margo A.; Sempos, Christopher T.; Grundy, Scott M.

doi:10.1001/archinte.153.9.1093

Cited by 171 publications

(139 citation statements)

References 67 publications

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“…This suggests that obesity counteracts the promotive effects of menopause on IHD. On the other hand, although obesity is not a direct risk factor for IHD, 37,38 it causes elevated blood pressure 39 and hypercholesterolemia 40 and, therefore, can be deemed an indirect coronary risk factor. In view of the complex interactions between obesity and IHD risk factors, no simple conclusion can be reached about whether obesity has a promotive or suppressive effect on IHD in women.…”

Section: Discussionmentioning

confidence: 99%

The effects of body mass index on age at menopause

et al. 2002

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OBJECTIVE:We examined which of body mass index (BMI, kg=m 2 ), serum cholesterol (mg=dl), or systolic blood pressure (SBP, mm Hg) affected age at natural menopause. DESIGN: A population-based follow-up program. METHODS: We determined the age at natural menopause in 1136 women followed biennially since their first examination in 1958 -1959 through the 16th examination in 1988 -1989. Four-hundred and ninety-three naturally menopausal women were classified into three groups by BMI, serum cholesterol and SBP measurement levels at age 40 or 41 y: the upper 25%, middle 50%, and lower 25%. We then studied whether there was a difference in age at menopause among the three groups thus classified. The 1136 natural menopausal women were also classified as early (n ¼ 454; 45 -49 y at menopause (48.3 AE 1.2 y)) or late (n ¼ 682; ! 50 y at menopause (52.3 AE 1.6 y)) menopausal and compared for premenopausal trends in BMI, serum cholesterol and SBP in the early and late menopausal women by means of a longitudinal data analysis model. RESULTS: When women were classified into the three groups based on a BMI that was measured at 40 or 41 y, age at menopause in the upper 25% (50.4 AE 2.8 y) was significantly higher (P < 0.05) than that in the lower 25% (49.7 AE 2.8 y). The entire premenopausal trend in BMI in late menopausal women shifted upward compared to that in early menopausal women. On the other hand, the premenopausal trend more than 4 y before menopause in serum cholesterol and the entire premenopausal trend in SBP in late menopausal women were identical to those in early menopausal women. CONCLUSION: Among the variables studied, only BMI is related to age at menopause, and the greater the BMI, the later the age at menopause.

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Section: Discussionmentioning

confidence: 99%

The effects of body mass index on age at menopause

et al. 2002

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“…High serum lipids commonly accompany the obese state (Eckel, 1999;National Heart, Lung and Blood Institute, NIH, 1998;Denke et al, 1993). The NCEP recommends a step-wise dietary therapy with emphasis on reducing dietary saturated fat and cholesterol with weight loss, if patients are overweight (NCEP, 1993).…”

Section: Lipoprotein Response To Weight Loss Hh Ditschuneit Et Almentioning

confidence: 99%

“…The report also addressed the need for improving weight control and physical activity. This new emphasis on weight control is partially credited to the growing body of information demonstrating a causal relationship between reduced body weight and improved serum lipids (National Heart, Lung and Blood Institute, NIH, 1998;Denke et al, 1993).…”

Section: Introductionmentioning

confidence: 99%

Lipoprotein responses to weight loss and weight maintenance in high-risk obese subjects

Ditschuneit

Frier²,

Flechtner-Mors

2002

Eur J Clin Nutr

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and 2 Slim-Fast Foods Company, West Palm Beach, Florida, USA Objective: To examine changes in plasma lipids and lipoproteins after 51 months of reduced energy intake and sustained weight loss. Methods: One-hundred patients were randomized to one of two dietary interventions for 3 months (weight loss period). Groups A and B received an energy-restricted diet plan of 5.2 -6.3 MJ=day but group B was further instructed to replace two of three meals with a nutrient-fortified liquid meal replacement (MR). Upon completion of the weight loss period, all patients were given the same instructions regarding energy intake and were advised to use one MR daily. Body weight and 7 day food diaries were measured monthly or bimonthly and blood lipids at baseline, 3, 9 and 51 months. Results: Of the original 100 patients 75 had completed 4 y. Of those 75, 73 had complete lipid records. Baseline body weights of Groups A and B were 90.7 AE 14.0 and 91.6 AE 9.8 kg, respectively. The percentage change in total cholesterol (%DTC) decreased in a linear fashion with increasing weight loss, when all data was combined, but did not approach statistical significance (P 0.26, r ¼ 0.02). Further regression analysis found a significant negative linear relationship (P 0.0001, r ¼ 0.69) between initial total cholesterol (TC) concentrations and %DTC. Hence, data from 27 of the 73 completers who exhibited an elevated serum total cholesterol ( ! 6.2 mmol=l) were isolated and analyzed further. Baseline TC was 6.75 AE 0.64, 5.85 AE 0.63 at 9 months (P < 0.05) and 5.76 AE 0.52 mmol=l at 51 months (P < 0.05). Similar values for VLDL-cholesterol were 1.33 AE 0.80, 0.74 AE 0.24 and 0.66 AE 0.21 mmol=l by 51 months (P < 0.05). Weight decreased by 5.2 AE 5.1, 7.6 AE 4.9 and 6.7 AE 4.6% at 3, 9 and 51 months, respectively. Conclusion: Continuous energy restriction associated with a clinically meaningful weight loss significantly improved the lipid profile of high-risk patients. Similar weight and diet changes occurring in patients with normal plasma cholesterol were either increased or without affect.

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“…8,9,12,38 Several studies have found patterns of fat distribution, particularly abdominal or central obesity, to be more closely related than body weight or BMI to serum risk factors for cardiovascular disease. 39,40 Other studies have concluded that overall obesity is as important as fat distribution, especially for associations with lipidalipoprotein concentrations.…”

Section: Cross-sectional Comparisonsmentioning

confidence: 99%

Changes in patterns of fatness in adult men in relation to serum indices of cardiovascular risk: the Normative Aging Study

Tucker

Vokonas

et al. 2000

Int J Obes

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BACKGROUND: Overweight andaor excessive weight gain, as well as changes in central fat deposition, have been implicated in increased incidence of coronary disease and type 2 diabetes. OBJECTIVE: We related adiposity (BMI, kgam 2 , and waist circumference, WC, cm) to biochemical risk factors (cholesterol, triglyceride and glucose concentrations) for cardiovascular disease and diabetes. DESIGN: Associations were examined both cross-sectionally and longitudinally, among 867 men enrolled in the Normative Aging Study (NAS). We included all participants with complete anthropometric and clinical data at both enrollment (average age 45 y) and after approximately 15 y of follow-up (average age 60 y). We used multiple linear regression analysis to test relationships between body fatness and change in body fatness and the biochemical indices. RESULTS: In adulthood, concurrent BMI and waist circumference related signi®cantly to triglyceride and glucose concentrations and to 2 h glucose responses at two time points. Measures of fatness 15 y earlier were also predictive of later triglyceride and glucose measures. When included together, BMI, but not WC, remained independently associated with triglycerides at both time points, while WC, but not BMI, remained signi®cantly associated with fasting glucose concentrations and glucose response at the follow-up observation. In contrast, gains in weight and abdominal fat from entry to follow-up related more strongly to serum cholesterol concentrations than did concurrent measures. CONCLUSION: Attained weight, weight gain, and location of weight contribute differentially to these indices of cardiovascular and diabetes risk.

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Excess body weight. An underrecognized contributor to high blood cholesterol levels in white American men

Cited by 171 publications

References 67 publications

The effects of body mass index on age at menopause

The effects of body mass index on age at menopause

Lipoprotein responses to weight loss and weight maintenance in high-risk obese subjects

Changes in patterns of fatness in adult men in relation to serum indices of cardiovascular risk: the Normative Aging Study

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