Relationship of Physical Activity and Eating Behaviour with Obesity and Type 2 Diabetes Mellitus: Sofia Lifestyle (SLS) Study

Stefanov, Tsvetan; Vekova, Anna; Kurktschiev, Dimo P; Temelkova‐Kurktschiev, Theodora

doi:10.2478/v10153-010-0022-1

Cited by 13 publications

(16 citation statements)

References 16 publications

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“…Previous research has shown that physical inactivity plays a major role in the etiology of both T2D and obesity. BMI was negatively correlated with physical activity in our study population (data not shown), in accordance with previous studies [34, 37, 38]. Possible explanations for the role of physical activity as an effect modifier in this research may be that physical activity increases sensitivity to insulin [39], and can result in weight loss [40].…”

Section: Discussionsupporting

confidence: 91%

The predictive effect of body mass index on type 2 diabetes in the Norwegian women and cancer study

2014

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BackgroundSeveral studies have analyzed the association of body mass index (BMI) with either the prevalence or incidence of type 2 diabetes (T2D), but no study from Europe or North America has yet analyzed and compared the association of BMI with both incident and prevalent T2D cases.MethodsStratified logistic regression was used to calculate odds ratios (OR), and stratified Cox proportional hazards regression was used to calculate hazard ratios (HR) of the effect of BMI on the prevalence, and incidence of T2D. Wald chi-square statistics were applied when comparing the risk estimates.ResultsAmong prevalent T2D cases, overweight women (BMI 25–29.9 kg/m2) had an OR of 2.83 (95% confidence interval [CI], 1.92-4.18) and obese women (BMI ≥30 kg/m2) had an OR of 12.12 (95% CI, 8.32-17.68) when compared with normal weight women (BMI <25 kg/m2). Among incident T2D cases, overweight women had a HR of 5.01 (95% CI, 3.59-6.98) and obese women had a HR of 15.99 (95% CI, 11.39-22.46) when compared with normal weight women. After stratification by level of physical activity, and adjustment for age, smoking status, and education level, the Wald chi-square statistic for BMI was 180.90 for prevalent T2D cases, and 262.03 for incident T2D cases.ConclusionThe predictive effect of BMI was found to be stronger for T2D incidence than T2D prevalence.

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Section: Discussionsupporting

confidence: 91%

The predictive effect of body mass index on type 2 diabetes in the Norwegian women and cancer study

2014

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“…At the same time a healthier lifestyle comprising higher levels of PA and prudent food consumption have been found to signifi cantly reduce the risk ( Coakley et al, 1998 ;Kriska et al, 2003 ;Meisinger et al, 2005 ;Schulze et al, 2006 ;van Dam et al, 2002 ). In a recent paper we reported that low levels of leisure time and sport PA, as well as, binge eating behavior are associated with increased BMI and higher T2DM prevalence also among the urban population of Sofi a, Bulgaria ( Stefanov et al, 2011 ). Based on data analyses from the Nurses' Health Study Hu et al (2003a) concluded that around 30 % of the new cases of obesity and 43 % of T2DM could be prevented by adoption of a relatively active lifestyle.…”

Section: Lessons From Epidemiological Studiesmentioning

confidence: 82%

Lifestyle and Genetics in Obesity and type 2 Diabetes

Temelkova‐Kurktschiev

Stefanov

2011

Exp Clin Endocrinol Diabetes

112

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Obesity and type 2 diabetes mellitus are multifactorial health threats caused by a complex interplay between genetic predisposition and the environment with dramatically increasing worldwide prevalence. The role of heritability in their etiology is well recognized, however, the numerous attempts made in order certain genetic variants determining individual susceptibility to be identified have had limited success, until recently. At present the advancements in human genetics and the utilization of the genome-wide association approach have led to the identification of over 20 genetic loci associated with, respectively obesity and type 2 diabetes. Most of the genes identified to date, however, have modest effect on disease risk suggesting that both diseases are unlikely to develop without the individual being exposed to obesity- and/or type 2 diabetes-promoting environment. Indeed, unhealthy lifestyle, characterized by physical inactivity and food overconsumption is an unequivocally established risk factor for obesity and type 2 diabetes. Numerous epidemiological studies and randomized controlled trials, on the other hand, have demonstrated that lifestyle modification is effective in obesity and type 2 diabetes prevention. Furthermore, gene-lifestyle interaction studies suggest that genetic susceptibility to obesity and type 2 diabetes may be partially or totally kept under control by healthy lifestyle or lifestyle modification and that lifestyle determines whether an individual is likely to develop the disease. Inherited factors, however, seem to influence individual response to a lifestyle intervention program and even the motivation for lifestyle change. Personalized interventions according to genotype may be, therefore, considered in the future. By then lifestyle modification targeting dietary change and increased physical activity may be recommended for successful obesity and type 2 diabetes prevention irrespectively of genetic susceptibility.

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“…Here, we found a first example of a molecular signal foul-up between motor hyperactivity and anorexia, providing a common pathway of control. This would lead us to reconsider the belief that patients with anorexia nervosa intend to accelerate their weight loss with over-exercise 3, 31, 32, 33 because hyperactivity could be more inevitable than deliberate.…”

Section: Discussionmentioning

confidence: 99%

The nucleus accumbens 5-HTR4-CART pathway ties anorexia to hyperactivity

et al. 2012

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In mental diseases, the brain does not systematically adjust motor activity to feeding. Probably, the most outlined example is the association between hyperactivity and anorexia in Anorexia nervosa. The neural underpinnings of this ‘paradox', however, are poorly elucidated. Although anorexia and hyperactivity prevail over self-preservation, both symptoms rarely exist independently, suggesting commonalities in neural pathways, most likely in the reward system. We previously discovered an addictive molecular facet of anorexia, involving production, in the nucleus accumbens (NAc), of the same transcripts stimulated in response to cocaine and amphetamine (CART) upon stimulation of the 5-HT4 receptors (5-HTR4) or MDMA (ecstasy). Here, we tested whether this pathway predisposes not only to anorexia but also to hyperactivity. Following food restriction, mice are expected to overeat. However, selecting hyperactive and addiction-related animal models, we observed that mice lacking 5-HTR1B self-imposed food restriction after deprivation and still displayed anorexia and hyperactivity after ecstasy. Decryption of the mechanisms showed a gain-of-function of 5-HTR4 in the absence of 5-HTR1B, associated with CART surplus in the NAc and not in other brain areas. NAc-5-HTR4 overexpression upregulated NAc-CART, provoked anorexia and hyperactivity. NAc-5-HTR4 knockdown or blockade reduced ecstasy-induced hyperactivity. Finally, NAc-CART knockdown suppressed hyperactivity upon stimulation of the NAc-5-HTR4. Additionally, inactivating NAc-5-HTR4 suppressed ecstasy's preference, strengthening the rewarding facet of anorexia. In conclusion, the NAc-5-HTR4/CART pathway establishes a ‘tight-junction' between anorexia and hyperactivity, suggesting the existence of a primary functional unit susceptible to limit overeating associated with resting following homeostasis rules.

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Relationship of Physical Activity and Eating Behaviour with Obesity and Type 2 Diabetes Mellitus: Sofia Lifestyle (SLS) Study

Abstract: We found a strong inverse relationship between the level of PA during leisure time (including sport), BMI, and the prevalence of T2DM. Uncontrolled eating behaviour was also found to have a significant effect on BMI.

Cited by 13 publications

References 16 publications

The predictive effect of body mass index on type 2 diabetes in the Norwegian women and cancer study

The predictive effect of body mass index on type 2 diabetes in the Norwegian women and cancer study

Lifestyle and Genetics in Obesity and type 2 Diabetes

The nucleus accumbens 5-HTR4-CART pathway ties anorexia to hyperactivity

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