2014 |
Alderete, TL; Toledo-Corral, CM; Goran, MI Metabolic basis of ethnic differences in diabetes risk in overweight and obese youth Journal Article Curr. Diab. Rep., 14 (2), pp. 455, 2014. Abstract | BibTeX | Tags: diabetes risk @article{pmid24445905, title = {Metabolic basis of ethnic differences in diabetes risk in overweight and obese youth}, author = {TL Alderete and CM Toledo-Corral and MI Goran}, year = {2014}, date = {2014-02-01}, journal = {Curr. Diab. Rep.}, volume = {14}, number = {2}, pages = {455}, abstract = {The global pandemic of childhood obesity has led to increased risk for prediabetes and type 2 diabetes mellitus (T2DM). Studies have shown decreased insulin sensitivity and/or secretion with increasing adiposity and consistently observed greater risk for T2DM in obese, non-Caucasian youth. In the current review we describe recent advances in understanding how obesity and metabolic status in children and adolescents confers various risk profiles for T2DM among Latinos, African Americans, Caucasians, Asians, and Native Americans. These possible determinants include ectopic fat distribution, adipose tissue inflammation and fibrosis, and elevated plasma levels of nonesterified free fatty acids. Future work should aim to elucidate the ethnic-specific pathophysiology of T2DM in order to develop and implement appropriate prevention and treatment strategies based on different ethnic profiles of diabetes risk.}, keywords = {diabetes risk}, pubstate = {published}, tppubtype = {article} } The global pandemic of childhood obesity has led to increased risk for prediabetes and type 2 diabetes mellitus (T2DM). Studies have shown decreased insulin sensitivity and/or secretion with increasing adiposity and consistently observed greater risk for T2DM in obese, non-Caucasian youth. In the current review we describe recent advances in understanding how obesity and metabolic status in children and adolescents confers various risk profiles for T2DM among Latinos, African Americans, Caucasians, Asians, and Native Americans. These possible determinants include ectopic fat distribution, adipose tissue inflammation and fibrosis, and elevated plasma levels of nonesterified free fatty acids. Future work should aim to elucidate the ethnic-specific pathophysiology of T2DM in order to develop and implement appropriate prevention and treatment strategies based on different ethnic profiles of diabetes risk. |
Gyllenhammer, L E; Weigensberg, M J; Spruijt-Metz, D; Allayee, H; Goran, M I; Davis, J N Modifying influence of dietary sugar in the relationship between cortisol and visceral adipose tissue in minority youth Journal Article Obesity (Silver Spring), 22 (2), pp. 474–481, 2014. Abstract | BibTeX | Tags: sugar @article{pmid23929660, title = {Modifying influence of dietary sugar in the relationship between cortisol and visceral adipose tissue in minority youth}, author = {L E Gyllenhammer and M J Weigensberg and D Spruijt-Metz and H Allayee and M I Goran and J N Davis}, year = {2014}, date = {2014-02-01}, journal = {Obesity (Silver Spring)}, volume = {22}, number = {2}, pages = {474--481}, abstract = {Cortisol has been associated with preferential visceral adipose tissue (VAT) deposition; however, findings in humans are mixed, which may be clarified when diet is considered. Participants included 165 African-American and Latino, overweight adolescents (BMI% 97.2±3.2%, ages 13-18, 67% Latino, 66% female). Body composition was determined by dual energy X-ray absorptiometry, abdominal fat depots [VAT, subcutaneous (SAT)] by multiple-slice MRI, time-controlled serum sample to measure cortisol, and 2-day multi-pass 24-hour dietary recall. Linear regression analysis examined the cross-sectional relationship between cortisol, and the interaction of diet and cortisol on adiposity measures. Sex, race, age, and total body fat were a priori covariates. There was a significant interaction between cortisol and sugar (total and added) in the prediction of VAT (P(interaction) ≤ 0.05). Amongst participants with high total or added-sugar intake, cortisol was significantly associated with VAT (ß = 0.031 P < 0.001; ß = 0.026 P < 0.001), with no relationship in low consumers of total or added-sugar. Dietary sugar may play an important role in modifying the relationship between cortisol and VAT, such that cortisol is significantly associated with elevated VAT under conditions of high sugar intake.}, keywords = {sugar}, pubstate = {published}, tppubtype = {article} } Cortisol has been associated with preferential visceral adipose tissue (VAT) deposition; however, findings in humans are mixed, which may be clarified when diet is considered. Participants included 165 African-American and Latino, overweight adolescents (BMI% 97.2±3.2%, ages 13-18, 67% Latino, 66% female). Body composition was determined by dual energy X-ray absorptiometry, abdominal fat depots [VAT, subcutaneous (SAT)] by multiple-slice MRI, time-controlled serum sample to measure cortisol, and 2-day multi-pass 24-hour dietary recall. Linear regression analysis examined the cross-sectional relationship between cortisol, and the interaction of diet and cortisol on adiposity measures. Sex, race, age, and total body fat were a priori covariates. There was a significant interaction between cortisol and sugar (total and added) in the prediction of VAT (P(interaction) ≤ 0.05). Amongst participants with high total or added-sugar intake, cortisol was significantly associated with VAT (ß = 0.031 P < 0.001; ß = 0.026 P < 0.001), with no relationship in low consumers of total or added-sugar. Dietary sugar may play an important role in modifying the relationship between cortisol and VAT, such that cortisol is significantly associated with elevated VAT under conditions of high sugar intake. |
Weigensberg, M J; Lane, C J; Avila, Q; Konersman, K; Ventura, E; Adam, T; Shoar, Z; Goran, M I; Spruijt-Metz, D Imagine HEALTH: results from a randomized pilot lifestyle intervention for obese Latino adolescents using Interactive Guided ImagerySM Journal Article BMC Complement Altern Med, 14 , pp. 28, 2014. Abstract | BibTeX | Tags: diabetes risk @article{pmid24433565, title = {Imagine HEALTH: results from a randomized pilot lifestyle intervention for obese Latino adolescents using Interactive Guided ImagerySM}, author = {M J Weigensberg and C J Lane and Q Avila and K Konersman and E Ventura and T Adam and Z Shoar and M I Goran and D Spruijt-Metz}, year = {2014}, date = {2014-01-01}, journal = {BMC Complement Altern Med}, volume = {14}, pages = {28}, abstract = {There is an urgent need for innovative and developmentally appropriate lifestyle interventions to promote healthy lifestyle behaviors and to prevent the early onset of type 2 diabetes and cardiovascular disease risk in obese Latino adolescents. Guided imagery offers promise to reduce stress and promote lifestyle behavior change to reduce disease risk in obese adolescents. Our objectives were: 1) To pilot test a new 12-wk lifestyle intervention using a randomized trial design in obese Latino adolescents, in order to determine the effects of the mind-body modality of Interactive Guided ImagerySM (IGI), over and above those of a didactic lifestyle education, on insulin resistance, eating and physical activity behaviors, stress and stress biomarkers; and 2) To explore the role of intervention-related changes in stress and stress biomarkers on changes in metabolic outcomes, particularly insulin resistance. Obese (BMI > 95th percentile), Latino adolescents (n = 35, age 14-17) were randomized to receive either 12 weekly sessions of a lifestyle education plus guided imagery program (GI), or lifestyle education plus a digital storytelling computer program (DS). Between-group differences in behavioral, biological, and psychological outcomes were assessed using unpaired T-tests and ANCOVA in the 29 subjects who completed the intervention. The GI group demonstrated significant reductions in leisure sedentary behavior (p < .05) and increases in moderate physical activity (p < .05) compared to DS group, and a trend toward reduced caloric intake in GI vs DS (p = .09). Salivary cortisol was acutely reduced by stress-reduction guided imagery (p < .01). There were no group differences in adiposity, insulin resistance, perceived stress, or stress biomarkers across the 12-week intervention, though decrease in serum cortisol over the course of the intervention was associated with improved insulin sensitivity (p = .03) independent of intervention group and other relevant co-variates. The improvements in physical activity and stress biomarkers following this pilot intervention support the role of guided imagery in promoting healthy lifestyle behavior change and reducing metabolic disease risk in obese Latino adolescent populations. Future investigations will be needed to determine the full effects of the Imagine HEALTH intervention on insulin resistance, stress, and stress biomarkers. Clinicaltrials.gov Registry #: NCT01895595.}, keywords = {diabetes risk}, pubstate = {published}, tppubtype = {article} } There is an urgent need for innovative and developmentally appropriate lifestyle interventions to promote healthy lifestyle behaviors and to prevent the early onset of type 2 diabetes and cardiovascular disease risk in obese Latino adolescents. Guided imagery offers promise to reduce stress and promote lifestyle behavior change to reduce disease risk in obese adolescents. Our objectives were: 1) To pilot test a new 12-wk lifestyle intervention using a randomized trial design in obese Latino adolescents, in order to determine the effects of the mind-body modality of Interactive Guided ImagerySM (IGI), over and above those of a didactic lifestyle education, on insulin resistance, eating and physical activity behaviors, stress and stress biomarkers; and 2) To explore the role of intervention-related changes in stress and stress biomarkers on changes in metabolic outcomes, particularly insulin resistance. Obese (BMI > 95th percentile), Latino adolescents (n = 35, age 14-17) were randomized to receive either 12 weekly sessions of a lifestyle education plus guided imagery program (GI), or lifestyle education plus a digital storytelling computer program (DS). Between-group differences in behavioral, biological, and psychological outcomes were assessed using unpaired T-tests and ANCOVA in the 29 subjects who completed the intervention. The GI group demonstrated significant reductions in leisure sedentary behavior (p < .05) and increases in moderate physical activity (p < .05) compared to DS group, and a trend toward reduced caloric intake in GI vs DS (p = .09). Salivary cortisol was acutely reduced by stress-reduction guided imagery (p < .01). There were no group differences in adiposity, insulin resistance, perceived stress, or stress biomarkers across the 12-week intervention, though decrease in serum cortisol over the course of the intervention was associated with improved insulin sensitivity (p = .03) independent of intervention group and other relevant co-variates. The improvements in physical activity and stress biomarkers following this pilot intervention support the role of guided imagery in promoting healthy lifestyle behavior change and reducing metabolic disease risk in obese Latino adolescent populations. Future investigations will be needed to determine the full effects of the Imagine HEALTH intervention on insulin resistance, stress, and stress biomarkers. Clinicaltrials.gov Registry #: NCT01895595. |
Gyllenhammer, L E; Alderete, T L; Mahurka, S; Allayee, H; Goran, M I Adipose tissue 11βĦSĐ1 gene expression, βcell function and ectopic fat in obese African Americans versus Hispanics Journal Article Obesity (Silver Spring), 22 (1), pp. 14–18, 2014. Abstract | BibTeX | Tags: diabetes risk @article{pmid23836520, title = {Adipose tissue 11βĦSĐ1 gene expression, βcell function and ectopic fat in obese African Americans versus Hispanics}, author = {L E Gyllenhammer and T L Alderete and S Mahurka and H Allayee and M I Goran}, year = {2014}, date = {2014-01-01}, journal = {Obesity (Silver Spring)}, volume = {22}, number = {1}, pages = {14--18}, abstract = {This study examined the contribution of subcutaneous adipose tissue (SAT) 11βHSD1 to obese African Americans' (AA) elevated metabolic risk, despite a protective obesity phenotype of reduced visceral adipose tissue (VAT) and hepatic fat fraction (HFF) relative to obese Hispanics with similar metabolic risk. Obese AA and Hispanic adults (N = 36(16AA); BMI 35.2 ± 0.6 kg/m(2) , 18-25y) participated, with VAT, SAT, and HFF measured by MRI, SAT gene expression measured by HT-12 microarray and insulin sensitivity (SI), disposition index (DI) by IVGTT. Multiple linear regression examined relationships/interactions of ethnicity and 11βHSD1 expression on outcomes (covariates: age, sex, total fat mass), with standardized β (stβ) reported. SAT 11βHSD1 expression significantly associated with insulin parameters and this varied by ethnicity (Pinteraction <0.1). In AA, 11βHSD1 negatively associated with SI (stβ = -0.58}, keywords = {diabetes risk}, pubstate = {published}, tppubtype = {article} } This study examined the contribution of subcutaneous adipose tissue (SAT) 11βHSD1 to obese African Americans' (AA) elevated metabolic risk, despite a protective obesity phenotype of reduced visceral adipose tissue (VAT) and hepatic fat fraction (HFF) relative to obese Hispanics with similar metabolic risk. Obese AA and Hispanic adults (N = 36(16AA); BMI 35.2 ± 0.6 kg/m(2) , 18-25y) participated, with VAT, SAT, and HFF measured by MRI, SAT gene expression measured by HT-12 microarray and insulin sensitivity (SI), disposition index (DI) by IVGTT. Multiple linear regression examined relationships/interactions of ethnicity and 11βHSD1 expression on outcomes (covariates: age, sex, total fat mass), with standardized β (stβ) reported. SAT 11βHSD1 expression significantly associated with insulin parameters and this varied by ethnicity (Pinteraction <0.1). In AA, 11βHSD1 negatively associated with SI (stβ = -0.58 |
Walker, R W; Dumke, K A; Goran, M I Fructose content in popular beverages made with and without high-fructose corn syrup Journal Article Nutrition, 30 (7-8), pp. 928–935, 2014. Abstract | BibTeX | Tags: sugar @article{pmid24985013, title = {Fructose content in popular beverages made with and without high-fructose corn syrup}, author = {R W Walker and K A Dumke and M I Goran}, year = {2014}, date = {2014-01-01}, journal = {Nutrition}, volume = {30}, number = {7-8}, pages = {928--935}, abstract = {Excess fructose consumption is hypothesized to be associated with risk for metabolic disease. Actual fructose consumption levels are difficult to estimate because of the unlabeled quantity of fructose in beverages. The aims of this study were threefold: 1) re-examine the fructose content in previously tested beverages using two additional assay methods capable of detecting other sugars, especially maltose, 2) compare data across all methods to determine the actual free fructose-to-glucose ratio in beverages made either with or without high-fructose corn syrup (HFCS), and 3) expand the analysis to determine fructose content in commonly consumed juice products. Sugar-sweetened beverages (SSBs) and fruit juice drinks that were either made with or without HFCS were analyzed in separate, independent laboratories via three different methods to determine sugar profiles. For SSBs, the three independent laboratory methods showed consistent and reproducible results. In SSBs made with HFCS, fructose constituted 60.6% ± 2.7% of sugar content. In juices sweetened with HFCS, fructose accounted for 52.1% ± 5.9% of sugar content, although in some juices made from 100% fruit, fructose concentration reached 65.35 g/L accounting for 67% of sugars. Our results provide evidence of higher than expected amounts of free fructose in some beverages. Popular beverages made with HFCS have a fructose-to-glucose ratio of approximately 60:40, and thus contain 50% more fructose than glucose. Some pure fruit juices have twice as much fructose as glucose. These findings suggest that beverages made with HFCS and some juices have a sugar profile very different than sucrose, in which amounts of fructose and glucose are equivalent. Current dietary analyses may underestimate actual fructose consumption.}, keywords = {sugar}, pubstate = {published}, tppubtype = {article} } Excess fructose consumption is hypothesized to be associated with risk for metabolic disease. Actual fructose consumption levels are difficult to estimate because of the unlabeled quantity of fructose in beverages. The aims of this study were threefold: 1) re-examine the fructose content in previously tested beverages using two additional assay methods capable of detecting other sugars, especially maltose, 2) compare data across all methods to determine the actual free fructose-to-glucose ratio in beverages made either with or without high-fructose corn syrup (HFCS), and 3) expand the analysis to determine fructose content in commonly consumed juice products. Sugar-sweetened beverages (SSBs) and fruit juice drinks that were either made with or without HFCS were analyzed in separate, independent laboratories via three different methods to determine sugar profiles. For SSBs, the three independent laboratory methods showed consistent and reproducible results. In SSBs made with HFCS, fructose constituted 60.6% ± 2.7% of sugar content. In juices sweetened with HFCS, fructose accounted for 52.1% ± 5.9% of sugar content, although in some juices made from 100% fruit, fructose concentration reached 65.35 g/L accounting for 67% of sugars. Our results provide evidence of higher than expected amounts of free fructose in some beverages. Popular beverages made with HFCS have a fructose-to-glucose ratio of approximately 60:40, and thus contain 50% more fructose than glucose. Some pure fruit juices have twice as much fructose as glucose. These findings suggest that beverages made with HFCS and some juices have a sugar profile very different than sucrose, in which amounts of fructose and glucose are equivalent. Current dietary analyses may underestimate actual fructose consumption. |
Hsieh, S; Klassen, A C; Curriero, F C; Caulfield, L E; Cheskin, L J; Davis, J N; Goran, M I; Weigensberg, M J; Spruijt-Metz, D Fast-food restaurants, park access, and insulin resistance among Hispanic youth Journal Article Am J Prev Med, 46 (4), pp. 378–387, 2014. Abstract | BibTeX | Tags: built environment @article{pmid24650840, title = {Fast-food restaurants, park access, and insulin resistance among Hispanic youth}, author = {S Hsieh and A C Klassen and F C Curriero and L E Caulfield and L J Cheskin and J N Davis and M I Goran and M J Weigensberg and D Spruijt-Metz}, year = {2014}, date = {2014-00-01}, journal = {Am J Prev Med}, volume = {46}, number = {4}, pages = {378--387}, abstract = {Evidence of associations between the built environment and obesity risk has been steadily building, yet few studies have focused on the relationship between the built environment and aspects of metabolism related to obesity's most tightly linked comorbidity, type 2 diabetes. To examine the relationship between aspects of the neighborhood built environment and insulin resistance using accurate laboratory measures to account for fat distribution and adiposity. Data on 453 Hispanic youth (aged 8-18 years) from 2001 to 2011 were paired with neighborhood built environment and 2000 Census data. Analyses were conducted in 2011. Walking-distance buffers were built around participants' residential locations. Body composition and fat distribution were assessed using dual x-ray absorptiometry and waist circumference. Variables for park space, food access, walkability, and neighborhood sociocultural aspects were entered into a multivariate regression model predicting insulin resistance as determined by the homeostasis model assessment. Independent of obesity measures, greater fast-food restaurant density was associated with higher insulin resistance. Increased park space and neighborhood linguistic isolation were associated with lower insulin resistance among boys. Among girls, park space was associated with lower insulin resistance, but greater neighborhood linguistic isolation was associated with higher insulin resistance. A significant interaction between waist circumference and neighborhood linguistic isolation indicated that the negative association between neighborhood linguistic isolation and insulin resistance diminished with increased waist circumference. Reducing access to fast food and increasing public park space may be valuable to addressing insulin resistance and type 2 diabetes, but effects may vary by gender.}, keywords = {built environment}, pubstate = {published}, tppubtype = {article} } Evidence of associations between the built environment and obesity risk has been steadily building, yet few studies have focused on the relationship between the built environment and aspects of metabolism related to obesity's most tightly linked comorbidity, type 2 diabetes. To examine the relationship between aspects of the neighborhood built environment and insulin resistance using accurate laboratory measures to account for fat distribution and adiposity. Data on 453 Hispanic youth (aged 8-18 years) from 2001 to 2011 were paired with neighborhood built environment and 2000 Census data. Analyses were conducted in 2011. Walking-distance buffers were built around participants' residential locations. Body composition and fat distribution were assessed using dual x-ray absorptiometry and waist circumference. Variables for park space, food access, walkability, and neighborhood sociocultural aspects were entered into a multivariate regression model predicting insulin resistance as determined by the homeostasis model assessment. Independent of obesity measures, greater fast-food restaurant density was associated with higher insulin resistance. Increased park space and neighborhood linguistic isolation were associated with lower insulin resistance among boys. Among girls, park space was associated with lower insulin resistance, but greater neighborhood linguistic isolation was associated with higher insulin resistance. A significant interaction between waist circumference and neighborhood linguistic isolation indicated that the negative association between neighborhood linguistic isolation and insulin resistance diminished with increased waist circumference. Reducing access to fast food and increasing public park space may be valuable to addressing insulin resistance and type 2 diabetes, but effects may vary by gender. |
2013 |
Hasson, R E; Adam, T C; Davis, J N; Watanabe, R M; Goran, M I Compensatory responses to insulin resistance in obese African-American and Latina girls Journal Article Pediatr Obes, 8 (6), pp. 68–73, 2013. Abstract | BibTeX | Tags: diabetes risk @article{pmid23818490, title = {Compensatory responses to insulin resistance in obese African-American and Latina girls}, author = {R E Hasson and T C Adam and J N Davis and R M Watanabe and M I Goran}, year = {2013}, date = {2013-12-01}, journal = {Pediatr Obes}, volume = {8}, number = {6}, pages = {68--73}, abstract = {Insulin responses to oral and intravenous glucose markedly differ by ethnicity. This study examined whether ethnic differences in pancreatic insulin secretion, hepatic insulin extraction and clearance explain these disparate findings in 35 obese African-American and 41 Latina girls (Tanner Stages: IV-V; ages: 14-18; body mass index percentile: 85.9-99.8%). Pancreatic insulin secretion, hepatic insulin extraction and clearance were estimated by C-peptide and insulin modeling during an oral glucose tolerance test. Insulin sensitivity (SI), acute insulin response to glucose (AIRG ) and disposition index were derived from a frequently sampled intravenous glucose tolerance test. Compared to Latinas, obese African-American adolescents had lower pancreatic insulin secretion (21.3%; P < 0.01), glucose incremental area under the curve (IAUC) (41.7%}, keywords = {diabetes risk}, pubstate = {published}, tppubtype = {article} } Insulin responses to oral and intravenous glucose markedly differ by ethnicity. This study examined whether ethnic differences in pancreatic insulin secretion, hepatic insulin extraction and clearance explain these disparate findings in 35 obese African-American and 41 Latina girls (Tanner Stages: IV-V; ages: 14-18; body mass index percentile: 85.9-99.8%). Pancreatic insulin secretion, hepatic insulin extraction and clearance were estimated by C-peptide and insulin modeling during an oral glucose tolerance test. Insulin sensitivity (SI), acute insulin response to glucose (AIRG ) and disposition index were derived from a frequently sampled intravenous glucose tolerance test. Compared to Latinas, obese African-American adolescents had lower pancreatic insulin secretion (21.3%; P < 0.01), glucose incremental area under the curve (IAUC) (41.7% |
Walker, R W; Sinatra, F; Hartiala, J; Weigensberg, M; Spruijt-Metz, D; Alderete, T L; Goran, M I; Allayee, H Genetic and clinical markers of elevated liver fat content in overweight and obese Hispanic children Journal Article Obesity (Silver Spring), 21 (12), pp. E790–797, 2013. Abstract | BibTeX | Tags: genetic, liver fat @article{pmid23804528, title = {Genetic and clinical markers of elevated liver fat content in overweight and obese Hispanic children}, author = {R W Walker and F Sinatra and J Hartiala and M Weigensberg and D Spruijt-Metz and T L Alderete and M I Goran and H Allayee}, year = {2013}, date = {2013-12-01}, journal = {Obesity (Silver Spring)}, volume = {21}, number = {12}, pages = {E790--797}, abstract = {Genetic variation in six genes has been associated with elevated liver fat and nonalcoholic fatty liver disease in adults. The influence of these genes on liver fat and whether a genetic risk score (GRS) would improve upon the ability of common clinical risk factors to predict elevated liver fat content (ELF) in Hispanic children was determined. 223 obese Hispanic children were genotyped for six SNPs. MRI was used to measure liver fat. A GRS was tested for association with ELF using multivariate linear regression. Predictors were assessed via ROC curves and pair-wise analysis was used to determine significance alone and combined with clinical markers. Only variants in PNPLA3 and APOC3 genes were associated with liver fat (P < 0.001}, keywords = {genetic, liver fat}, pubstate = {published}, tppubtype = {article} } Genetic variation in six genes has been associated with elevated liver fat and nonalcoholic fatty liver disease in adults. The influence of these genes on liver fat and whether a genetic risk score (GRS) would improve upon the ability of common clinical risk factors to predict elevated liver fat content (ELF) in Hispanic children was determined. 223 obese Hispanic children were genotyped for six SNPs. MRI was used to measure liver fat. A GRS was tested for association with ELF using multivariate linear regression. Predictors were assessed via ROC curves and pair-wise analysis was used to determine significance alone and combined with clinical markers. Only variants in PNPLA3 and APOC3 genes were associated with liver fat (P < 0.001 |
Shih, M; Dumke, K A; Goran, M I; Simon, P A The association between community-level economic hardship and childhood obesity prevalence in Los Angeles Journal Article Pediatr Obes, 8 (6), pp. 411–417, 2013. @article{pmid23239616, title = {The association between community-level economic hardship and childhood obesity prevalence in Los Angeles}, author = {M Shih and K A Dumke and M I Goran and P A Simon}, year = {2013}, date = {2013-12-01}, journal = {Pediatr Obes}, volume = {8}, number = {6}, pages = {411--417}, abstract = {Neighbourhood social, economic and environmental factors are associated with childhood obesity. Childhood obesity disproportionately impacts those living in low-income neighbourhoods. Childhood obesity prevalence is strongly associated with community-level social and economic conditions as measured using a composite Economic Hardship Index. Childhood obesity prevalence among communities in the highest hardship quartile was more than double the prevalence among communities in the lowest hardship quartile (26.9 vs. 12.5%). The relationship between economic hardship and obesity differs by race/ethnicity. The association between community-level economic hardship and childhood obesity prevalence was examined in Los Angeles County, one of the largest and most racially and ethnically diverse regions in the United States. Data from the 2008-2009 California Department of Education's Physical Fitness Testing Program were analyzed to assess obesity prevalence among 5th, 7th and 9th grade students attending public schools (n = 298,485). Community-level socioeconomic conditions were compared using a census-tract-based Economic Hardship (EH) index. Mixed-effects modelling was used to examine the association between obesity prevalence and gender, grade, race/ethnicity and EH. Higher community-level EH was associated with higher childhood obesity prevalence (P < 0.001). The obesity prevalence among communities in the highest EH quartile (26.9%) was more than double the obesity prevalence among communities in the lowest EH quartile (12.5%). The slope of the association between EH and childhood obesity differed by racial/ethnic group. The slope was higher for non-Hispanic White students, Hispanics, and non-Hispanic Asians, and lower for non-Hispanic Black students. Racial/ethnic disparities were observed across the socioeconomic spectrum. Findings suggest that efforts to improve community socioeconomic conditions could reduce childhood obesity prevalence. Prevention efforts should target communities with high economic hardship and also focus on providing culturally relevant interventions that address disparities in obesity prevalence across communities.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Neighbourhood social, economic and environmental factors are associated with childhood obesity. Childhood obesity disproportionately impacts those living in low-income neighbourhoods. Childhood obesity prevalence is strongly associated with community-level social and economic conditions as measured using a composite Economic Hardship Index. Childhood obesity prevalence among communities in the highest hardship quartile was more than double the prevalence among communities in the lowest hardship quartile (26.9 vs. 12.5%). The relationship between economic hardship and obesity differs by race/ethnicity. The association between community-level economic hardship and childhood obesity prevalence was examined in Los Angeles County, one of the largest and most racially and ethnically diverse regions in the United States. Data from the 2008-2009 California Department of Education's Physical Fitness Testing Program were analyzed to assess obesity prevalence among 5th, 7th and 9th grade students attending public schools (n = 298,485). Community-level socioeconomic conditions were compared using a census-tract-based Economic Hardship (EH) index. Mixed-effects modelling was used to examine the association between obesity prevalence and gender, grade, race/ethnicity and EH. Higher community-level EH was associated with higher childhood obesity prevalence (P < 0.001). The obesity prevalence among communities in the highest EH quartile (26.9%) was more than double the obesity prevalence among communities in the lowest EH quartile (12.5%). The slope of the association between EH and childhood obesity differed by racial/ethnic group. The slope was higher for non-Hispanic White students, Hispanics, and non-Hispanic Asians, and lower for non-Hispanic Black students. Racial/ethnic disparities were observed across the socioeconomic spectrum. Findings suggest that efforts to improve community socioeconomic conditions could reduce childhood obesity prevalence. Prevention efforts should target communities with high economic hardship and also focus on providing culturally relevant interventions that address disparities in obesity prevalence across communities. |
Spruijt-Metz, D; Belcher, B R; Hsu, Y W; McClain, A D; Chou, C P; Nguyen-Rodriguez, S; Weigensberg, M J; Goran, M I Temporal relationship between insulin sensitivity and the pubertal decline in physical activity in peripubertal Hispanic and African American females Journal Article Diabetes Care, 36 (11), pp. 3739–3745, 2013. @article{pmid23846812, title = {Temporal relationship between insulin sensitivity and the pubertal decline in physical activity in peripubertal Hispanic and African American females}, author = {D Spruijt-Metz and B R Belcher and Y W Hsu and A D McClain and C P Chou and S Nguyen-Rodriguez and M J Weigensberg and M I Goran}, year = {2013}, date = {2013-11-01}, journal = {Diabetes Care}, volume = {36}, number = {11}, pages = {3739--3745}, abstract = {Little attention has been paid to possible intrinsic biological mechanisms for the decline in physical activity that occurs during puberty. This longitudinal observational study examined the association between baseline insulin sensitivity (SI) and declines in physical activity and increases in sedentary behavior in peripubertal minority females over a year. Participants were Hispanic and African American girls (n = 55; 76% Hispanic; mean age 9.4 years; 36% obese). SI and other insulin indices were measured at baseline using the frequently sampled intravenous glucose tolerance test. Physical activity was measured on a quarterly basis by accelerometry and self-report. Physical activity declined by 25% and time spent in sedentary behaviors increased by ∼13% over 1 year. Lower baseline SI predicted the decline in physical activity measured by accelerometry, whereas higher baseline acute insulin response to glucose predicted the decline in physical activity measured by self-report. Time spent in sedentary behavior increased by ~13% over 1 year, and this was predicted by lower baseline SI. All models controlled for adiposity, age, pubertal stage, and ethnicity. When evaluated using a longitudinal design with strong outcome measures, this study suggests that lower baseline SI predicts a greater decline in physical activity in peripubertal minority females.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Little attention has been paid to possible intrinsic biological mechanisms for the decline in physical activity that occurs during puberty. This longitudinal observational study examined the association between baseline insulin sensitivity (SI) and declines in physical activity and increases in sedentary behavior in peripubertal minority females over a year. Participants were Hispanic and African American girls (n = 55; 76% Hispanic; mean age 9.4 years; 36% obese). SI and other insulin indices were measured at baseline using the frequently sampled intravenous glucose tolerance test. Physical activity was measured on a quarterly basis by accelerometry and self-report. Physical activity declined by 25% and time spent in sedentary behaviors increased by ∼13% over 1 year. Lower baseline SI predicted the decline in physical activity measured by accelerometry, whereas higher baseline acute insulin response to glucose predicted the decline in physical activity measured by self-report. Time spent in sedentary behavior increased by ~13% over 1 year, and this was predicted by lower baseline SI. All models controlled for adiposity, age, pubertal stage, and ethnicity. When evaluated using a longitudinal design with strong outcome measures, this study suggests that lower baseline SI predicts a greater decline in physical activity in peripubertal minority females. |
Alderete, TL; Toledo-Corral, CM; Desai, P; Weigensberg, MJ; Goran, MI Liver fat has a stronger association with risk factors for type 2 diabetes in African-American compared with Hispanic adolescents Journal Article J. Clin. Endocrinol. Metab., 98 (9), pp. 3748–3754, 2013. Abstract | BibTeX | Tags: latino, liver fat @article{pmid23873990, title = {Liver fat has a stronger association with risk factors for type 2 diabetes in African-American compared with Hispanic adolescents}, author = {TL Alderete and CM Toledo-Corral and P Desai and MJ Weigensberg and MI Goran }, year = {2013}, date = {2013-09-01}, journal = {J. Clin. Endocrinol. Metab.}, volume = {98}, number = {9}, pages = {3748--3754}, abstract = {Although overweight and obese African-Americans (AAs) have less visceral adipose tissue (VAT) and liver fat (LF) than Hispanics, they have a similar risk for type 2 diabetes. We examined ethnic differences in the association between VAT and LF with risk factors for type 2 diabetes to help explain this paradox. We conducted a cross-sectional study in an academic pediatric care facility. Subjects were overweight and obese AA (n = 131; 15.5 ± 3.3 years old) and Hispanic adolescents (n = 227; 14.7 ± 3.0 years old). Outcome measures included insulin sensitivity (SI), acute insulin response (AIR), and disposition index (DI) by frequently sampled i.v. glucose tolerance test and minimal modeling. LF, not VAT, was inversely associated with SI, and the effect of high LF compared with low was more pronounced in AAs (P(interaction) < .05). In Hispanics, high LF was associated with a 24% lower SI (P < .01) and a 31% increase in AIR (P < .01) and was not associated with DI (P = .35). In AAs, high LF was associated with a 49% lower SI (P < .001), was not associated with an increase in AIR (P = .25), and was associated with a 42% lower DI (P < .01), indicating failure of compensatory insulin secretion/clearance in response to insulin resistance. Prediabetes changed the relationship between high/low LF and DI in Hispanics (P(interaction) = .002) but not AAs such that prediabetic Hispanics with high LF had a 43% lower DI (P = .03) with no difference in those without prediabetes (P = .06). LF has a stronger effect on SI compared with VAT. Our results suggest that the impact of high LF on poor β-cell compensation is more pronounced in AAs. In Hispanics, the combination of high LF and prediabetes contributes to poor β-cell compensation.}, keywords = {latino, liver fat}, pubstate = {published}, tppubtype = {article} } Although overweight and obese African-Americans (AAs) have less visceral adipose tissue (VAT) and liver fat (LF) than Hispanics, they have a similar risk for type 2 diabetes. We examined ethnic differences in the association between VAT and LF with risk factors for type 2 diabetes to help explain this paradox. We conducted a cross-sectional study in an academic pediatric care facility. Subjects were overweight and obese AA (n = 131; 15.5 ± 3.3 years old) and Hispanic adolescents (n = 227; 14.7 ± 3.0 years old). Outcome measures included insulin sensitivity (SI), acute insulin response (AIR), and disposition index (DI) by frequently sampled i.v. glucose tolerance test and minimal modeling. LF, not VAT, was inversely associated with SI, and the effect of high LF compared with low was more pronounced in AAs (P(interaction) < .05). In Hispanics, high LF was associated with a 24% lower SI (P < .01) and a 31% increase in AIR (P < .01) and was not associated with DI (P = .35). In AAs, high LF was associated with a 49% lower SI (P < .001), was not associated with an increase in AIR (P = .25), and was associated with a 42% lower DI (P < .01), indicating failure of compensatory insulin secretion/clearance in response to insulin resistance. Prediabetes changed the relationship between high/low LF and DI in Hispanics (P(interaction) = .002) but not AAs such that prediabetic Hispanics with high LF had a 43% lower DI (P = .03) with no difference in those without prediabetes (P = .06). LF has a stronger effect on SI compared with VAT. Our results suggest that the impact of high LF on poor β-cell compensation is more pronounced in AAs. In Hispanics, the combination of high LF and prediabetes contributes to poor β-cell compensation. |
Toledo-Corral, C M; Myers, S J; Li, Y; Hodis, H N; Goran, M I; Weigensberg, M J Blunted nocturnal cortisol rise is associated with higher carotid artery intima-media thickness (CIMŦ) in overweight African American and Latino youth Journal Article Psychoneuroendocrinology, 38 (9), pp. 1658–1667, 2013. Abstract | BibTeX | Tags: diabetes risk, IMT @article{pmid23433749, title = {Blunted nocturnal cortisol rise is associated with higher carotid artery intima-media thickness (CIMŦ) in overweight African American and Latino youth}, author = {C M Toledo-Corral and S J Myers and Y Li and H N Hodis and M I Goran and M J Weigensberg}, year = {2013}, date = {2013-09-01}, journal = {Psychoneuroendocrinology}, volume = {38}, number = {9}, pages = {1658--1667}, abstract = {Blunted diurnal cortisol variation has been associated with overt cardiovascular disease in adults. The relationship between the diurnal cortisol variation and subclinical atherosclerosis in youth has yet to be investigated. The objectives of this study were to (1) determine the relationship between overnight cortisol measures and CIMT in overweight and obese, African-American and Latino children; (2) assess ethnic differences in these relationships; and (3) explore whether overnight cortisol and CIMT relationships were independent of inflammatory markers, C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-∠(TNF-âˆ). One hundred fifty-six overweight and obese African-American and Latino children (ages 8-17, 86 M/70 F, 55 African-American/101 Latino) underwent measures of CIMT by B-mode ultrasound, nocturnal cortisol rise (NCR = salivary cortisol rise from 2200 h to awakening at 0530 h), cortisol awakening response (CAR = salivary cortisol from time of awakening to 30 min later), fasting serum cortisol and overnight urinary free cortisol. Using linear regression, salivary cortisol(0530 h) and NCR were negatively associated with CIMT (β(standardized) = -0.215 and -0.220, p < 0.01) independent of age, height, percent body fat, ethnicity and systolic blood pressure. Nocturnal salivary cortisol(2200 h), morning serum cortisol, and overnight urinary free cortisol were not associated with CIMT. Using ANCOVA, participants with LOW NCR (NCR < 0.44 μg/dL}, keywords = {diabetes risk, IMT}, pubstate = {published}, tppubtype = {article} } Blunted diurnal cortisol variation has been associated with overt cardiovascular disease in adults. The relationship between the diurnal cortisol variation and subclinical atherosclerosis in youth has yet to be investigated. The objectives of this study were to (1) determine the relationship between overnight cortisol measures and CIMT in overweight and obese, African-American and Latino children; (2) assess ethnic differences in these relationships; and (3) explore whether overnight cortisol and CIMT relationships were independent of inflammatory markers, C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-∠(TNF-âˆ). One hundred fifty-six overweight and obese African-American and Latino children (ages 8-17, 86 M/70 F, 55 African-American/101 Latino) underwent measures of CIMT by B-mode ultrasound, nocturnal cortisol rise (NCR = salivary cortisol rise from 2200 h to awakening at 0530 h), cortisol awakening response (CAR = salivary cortisol from time of awakening to 30 min later), fasting serum cortisol and overnight urinary free cortisol. Using linear regression, salivary cortisol(0530 h) and NCR were negatively associated with CIMT (β(standardized) = -0.215 and -0.220, p < 0.01) independent of age, height, percent body fat, ethnicity and systolic blood pressure. Nocturnal salivary cortisol(2200 h), morning serum cortisol, and overnight urinary free cortisol were not associated with CIMT. Using ANCOVA, participants with LOW NCR (NCR < 0.44 μg/dL |
Schoeller, D A; Thomas, D; Archer, E; Heymsfield, S B; Blair, S N; Goran, M I; Hill, J O; Atkinson, R L; Corkey, B E; Foreyt, J; Dhurandhar, N V; Kral, J G; Hall, K D; Hansen, B C; Heitmann, B L; Ravussin, E; Allison, D B Self-report-based estimates of energy intake offer an inadequate basis for scientific conclusions Journal Article Am. J. Clin. Nutr., 97 (6), pp. 1413–1415, 2013. BibTeX | Tags: @article{pmid23689494, title = {Self-report-based estimates of energy intake offer an inadequate basis for scientific conclusions}, author = {D A Schoeller and D Thomas and E Archer and S B Heymsfield and S N Blair and M I Goran and J O Hill and R L Atkinson and B E Corkey and J Foreyt and N V Dhurandhar and J G Kral and K D Hall and B C Hansen and B L Heitmann and E Ravussin and D B Allison}, year = {2013}, date = {2013-06-01}, journal = {Am. J. Clin. Nutr.}, volume = {97}, number = {6}, pages = {1413--1415}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Kim, J Y; Goran, M I; Toledo-Corral, C M; Weigensberg, M J; Choi, M; Shaibi, G Q One-hour glucose during an oral glucose challenge prospectively predicts β-cell deterioration and prediabetes in obese Hispanic youth Journal Article Diabetes Care, 36 (6), pp. 1681–1686, 2013. Abstract | BibTeX | Tags: diabetes risk, methods @article{pmid23315601, title = {One-hour glucose during an oral glucose challenge prospectively predicts β-cell deterioration and prediabetes in obese Hispanic youth}, author = {J Y Kim and M I Goran and C M Toledo-Corral and M J Weigensberg and M Choi and G Q Shaibi}, year = {2013}, date = {2013-06-01}, journal = {Diabetes Care}, volume = {36}, number = {6}, pages = {1681--1686}, abstract = {In adults, 1-h glucose during an oral glucose tolerance test (OGTT) predicts the development of type 2 diabetes independent of fasting and 2-h glucose concentrations. The purpose of the current investigation was to examine the utility of elevated 1-h glucose levels to prospectively predict deterioration in β-cell function and the development of prediabetes in high-risk youth. Obese Latino youth with a family history of type 2 diabetes (133 male and 100 female; age 11.1 ± 1.7 years) completed a baseline OGTT and were divided into two groups based upon a 1-h glucose threshold of 155 mg/dL (<155 mg/dL}, keywords = {diabetes risk, methods}, pubstate = {published}, tppubtype = {article} } In adults, 1-h glucose during an oral glucose tolerance test (OGTT) predicts the development of type 2 diabetes independent of fasting and 2-h glucose concentrations. The purpose of the current investigation was to examine the utility of elevated 1-h glucose levels to prospectively predict deterioration in β-cell function and the development of prediabetes in high-risk youth. Obese Latino youth with a family history of type 2 diabetes (133 male and 100 female; age 11.1 ± 1.7 years) completed a baseline OGTT and were divided into two groups based upon a 1-h glucose threshold of 155 mg/dL (<155 mg/dL |
Toledo-Corral, C M; Alderete, T L; Hu, H H; Nayak, K; Esplana, S; Liu, T; Goran, M I; Weigensberg, M J Ectopic fat deposition in prediabetic overweight and obese minority adolescents Journal Article J. Clin. Endocrinol. Metab., 98 (3), pp. 1115–1121, 2013. @article{pmid23386647, title = {Ectopic fat deposition in prediabetic overweight and obese minority adolescents}, author = {C M Toledo-Corral and T L Alderete and H H Hu and K Nayak and S Esplana and T Liu and M I Goran and M J Weigensberg}, year = {2013}, date = {2013-03-01}, journal = {J. Clin. Endocrinol. Metab.}, volume = {98}, number = {3}, pages = {1115--1121}, abstract = {Optimizing effective prevention and treatment of type 2 diabetes in youth is limited by incomplete understanding of its pathophysiology and how this varies across ethnicities with high risk. The aim of this study was to examine the contribution of visceral adipose tissue (VAT), hepatic fat fraction (HFF), and pancreatic fat fraction (PFF) to prediabetes in overweight/obese African American (AA) and Latino youth. We conducted a cross-sectional study in an academic pediatric care facility. A total of 148 healthy, overweight/obese adolescents (56 AA, 92 Latino; 72 males, 76 females; age, 15.5 ± 1.2 y; BMI z-score, 2.1 ± 0.5) participated in the study. They were normal glucose tolerant (n = 106) and prediabetic (n = 42), based on fasting glucose of 100-125 mg/dL and/or 2-hour glucose of 140-199 mg/dL, and/or hemoglobin A1C 6.0-6.4%. We measured sc abdominal adipose tissue, VAT, HFF, and PFF by 3-Tesla magnetic resonance imaging and measured total body fat by dual-energy x-ray absorptiometry. Adolescents with prediabetes had 30% higher HFF (P = .001) and 31% higher PFF (P = .042), compared to those with normal glucose tolerance after controlling for age, sex, pubertal stage, ethnicity, total percentage body fat, and VAT. Logistic regression showed that PFF predicted prediabetes in AAs and HFF predicted prediabetes in Latinos, with the odds of having prediabetes increased by 66% for every 1% increase in PFF in African Americans, and increased by 22% for every 1% increase in HFF in Latinos. These data demonstrate that ectopic fat phenotypes associated with prediabetes are established by adolescence. Ethnic differences in the deposition of ectopic fat in adolescents with prediabetes may differ, with pancreatic fat in AAs, vs hepatic fat in Latino adolescents, being associated with diabetes risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Optimizing effective prevention and treatment of type 2 diabetes in youth is limited by incomplete understanding of its pathophysiology and how this varies across ethnicities with high risk. The aim of this study was to examine the contribution of visceral adipose tissue (VAT), hepatic fat fraction (HFF), and pancreatic fat fraction (PFF) to prediabetes in overweight/obese African American (AA) and Latino youth. We conducted a cross-sectional study in an academic pediatric care facility. A total of 148 healthy, overweight/obese adolescents (56 AA, 92 Latino; 72 males, 76 females; age, 15.5 ± 1.2 y; BMI z-score, 2.1 ± 0.5) participated in the study. They were normal glucose tolerant (n = 106) and prediabetic (n = 42), based on fasting glucose of 100-125 mg/dL and/or 2-hour glucose of 140-199 mg/dL, and/or hemoglobin A1C 6.0-6.4%. We measured sc abdominal adipose tissue, VAT, HFF, and PFF by 3-Tesla magnetic resonance imaging and measured total body fat by dual-energy x-ray absorptiometry. Adolescents with prediabetes had 30% higher HFF (P = .001) and 31% higher PFF (P = .042), compared to those with normal glucose tolerance after controlling for age, sex, pubertal stage, ethnicity, total percentage body fat, and VAT. Logistic regression showed that PFF predicted prediabetes in AAs and HFF predicted prediabetes in Latinos, with the odds of having prediabetes increased by 66% for every 1% increase in PFF in African Americans, and increased by 22% for every 1% increase in HFF in Latinos. These data demonstrate that ectopic fat phenotypes associated with prediabetes are established by adolescence. Ethnic differences in the deposition of ectopic fat in adolescents with prediabetes may differ, with pancreatic fat in AAs, vs hepatic fat in Latino adolescents, being associated with diabetes risk. |
Joshi, A A; Hu, H H; Leahy, R M; Goran, M I; Nayak, K S Automatic intra-subject registration-based segmentation of abdominal fat from water-fat MRI Journal Article J Magn Reson Imaging, 37 (2), pp. 423–430, 2013. Abstract | BibTeX | Tags: methods @article{pmid23011805, title = {Automatic intra-subject registration-based segmentation of abdominal fat from water-fat MRI}, author = {A A Joshi and H H Hu and R M Leahy and M I Goran and K S Nayak}, year = {2013}, date = {2013-02-01}, journal = {J Magn Reson Imaging}, volume = {37}, number = {2}, pages = {423--430}, abstract = {To develop an automatic registration-based segmentation algorithm for measuring abdominal adipose tissue depot volumes and organ fat fraction content from three-dimensional (3D) water-fat MRI data, and to evaluate its performance against manual segmentation. Data were obtained from 11 subjects at two time points with intermediate repositioning, and from four subjects before and after a meal with repositioning. Imaging was performed on a 3 Tesla MRI, using the IDEAL chemical-shift water-fat pulse sequence. Adipose tissue (subcutaneous--SAT, visceral--VAT) and organs (liver, pancreas) were manually segmented twice for each scan by a single trained observer. Automated segmentations of each subject's second scan were generated using a nonrigid volume registration algorithm for water-fat MRI images that used a b-spline basis for deformation and minimized image dissimilarity after the deformation. Manual and automated segmentations were compared using Dice coefficients and linear regression of SAT and VAT volumes, organ volumes, and hepatic and pancreatic fat fractions (HFF, PFF). Manual segmentations from the 11 repositioned subjects exhibited strong repeatability and set performance benchmarks. The average Dice coefficients were 0.9747 (SAT), 0.9424 (VAT), 0.9404 (liver), and 0.8205 (pancreas); the linear correlation coefficients were 0.9994 (SAT volume), 0.9974 (VAT volume), 0.9885 (liver volume), 0.9782 (pancreas volume), 0.9996 (HFF), and 0.9660 (PFF). When comparing manual and automated segmentations, the average Dice coefficients were 0.9043 (SAT volume), 0.8235 (VAT), 0.8942 (liver), and 0.7168 (pancreas); the linear correlation coefficients were 0.9493 (SAT volume), 0.9982 (VAT volume), 0.9326 (liver volume), 0.8876 (pancreas volume), 0.9972 (HFF), and 0.8617 (PFF). In the four pre- and post-prandial subjects, the Dice coefficients were 0.9024 (SAT), 0.7781 (VAT), 0.8799 (liver), and 0.5179 (pancreas); the linear correlation coefficients were 0.9889, 0.9902 (SAT, and VAT volume), 0.9523 (liver volume), 0.8760 (pancreas volume), 0.9991 (HFF), and 0.6338 (PFF). Automated intra-subject registration-based segmentation is potentially suitable for the quantification of abdominal and organ fat and achieves comparable quantitative endpoints with respect to manual segmentation.}, keywords = {methods}, pubstate = {published}, tppubtype = {article} } To develop an automatic registration-based segmentation algorithm for measuring abdominal adipose tissue depot volumes and organ fat fraction content from three-dimensional (3D) water-fat MRI data, and to evaluate its performance against manual segmentation. Data were obtained from 11 subjects at two time points with intermediate repositioning, and from four subjects before and after a meal with repositioning. Imaging was performed on a 3 Tesla MRI, using the IDEAL chemical-shift water-fat pulse sequence. Adipose tissue (subcutaneous--SAT, visceral--VAT) and organs (liver, pancreas) were manually segmented twice for each scan by a single trained observer. Automated segmentations of each subject's second scan were generated using a nonrigid volume registration algorithm for water-fat MRI images that used a b-spline basis for deformation and minimized image dissimilarity after the deformation. Manual and automated segmentations were compared using Dice coefficients and linear regression of SAT and VAT volumes, organ volumes, and hepatic and pancreatic fat fractions (HFF, PFF). Manual segmentations from the 11 repositioned subjects exhibited strong repeatability and set performance benchmarks. The average Dice coefficients were 0.9747 (SAT), 0.9424 (VAT), 0.9404 (liver), and 0.8205 (pancreas); the linear correlation coefficients were 0.9994 (SAT volume), 0.9974 (VAT volume), 0.9885 (liver volume), 0.9782 (pancreas volume), 0.9996 (HFF), and 0.9660 (PFF). When comparing manual and automated segmentations, the average Dice coefficients were 0.9043 (SAT volume), 0.8235 (VAT), 0.8942 (liver), and 0.7168 (pancreas); the linear correlation coefficients were 0.9493 (SAT volume), 0.9982 (VAT volume), 0.9326 (liver volume), 0.8876 (pancreas volume), 0.9972 (HFF), and 0.8617 (PFF). In the four pre- and post-prandial subjects, the Dice coefficients were 0.9024 (SAT), 0.7781 (VAT), 0.8799 (liver), and 0.5179 (pancreas); the linear correlation coefficients were 0.9889, 0.9902 (SAT, and VAT volume), 0.9523 (liver volume), 0.8760 (pancreas volume), 0.9991 (HFF), and 0.6338 (PFF). Automated intra-subject registration-based segmentation is potentially suitable for the quantification of abdominal and organ fat and achieves comparable quantitative endpoints with respect to manual segmentation. |
Hasson, R E; Adam, T C; Pearson, J; Davis, J N; Spruijt-Metz, D; Goran, M I Sociocultural and socioeconomic influences on type 2 diabetes risk in overweight/obese African-American and Latino-American children and adolescents Journal Article J Obes, 2013 , pp. 512914, 2013. Abstract | BibTeX | Tags: diabetes risk @article{pmid23762538, title = {Sociocultural and socioeconomic influences on type 2 diabetes risk in overweight/obese African-American and Latino-American children and adolescents}, author = {R E Hasson and T C Adam and J Pearson and J N Davis and D Spruijt-Metz and M I Goran}, year = {2013}, date = {2013-01-01}, journal = {J Obes}, volume = {2013}, pages = {512914}, abstract = {It is unclear whether sociocultural and socioeconomic factors are directly linked to type 2 diabetes risk in overweight/obese ethnic minority children and adolescents. This study examines the relationships between sociocultural orientation, household social position, and type 2 diabetes risk in overweight/obese African-American (n = 43) and Latino-American (n = 113) children and adolescents. Sociocultural orientation was assessed using the Acculturation, Habits, and Interests Multicultural Scale for Adolescents (AHIMSA) questionnaire. Household social position was calculated using the Hollingshead Two-Factor Index of Social Position. Insulin sensitivity (SI), acute insulin response (AIRG) and disposition index (DI) were derived from a frequently sampled intravenous glucose tolerance test (FSIGT). The relationships between AHIMSA subscales (i.e., integration, assimilation, separation, and marginalization), household social position and FSIGT parameters were assessed using multiple linear regression. For African-Americans, integration (integrating their family's culture with those of mainstream white-American culture) was positively associated with AIRG (β = 0.27 ± 0.09}, keywords = {diabetes risk}, pubstate = {published}, tppubtype = {article} } It is unclear whether sociocultural and socioeconomic factors are directly linked to type 2 diabetes risk in overweight/obese ethnic minority children and adolescents. This study examines the relationships between sociocultural orientation, household social position, and type 2 diabetes risk in overweight/obese African-American (n = 43) and Latino-American (n = 113) children and adolescents. Sociocultural orientation was assessed using the Acculturation, Habits, and Interests Multicultural Scale for Adolescents (AHIMSA) questionnaire. Household social position was calculated using the Hollingshead Two-Factor Index of Social Position. Insulin sensitivity (SI), acute insulin response (AIRG) and disposition index (DI) were derived from a frequently sampled intravenous glucose tolerance test (FSIGT). The relationships between AHIMSA subscales (i.e., integration, assimilation, separation, and marginalization), household social position and FSIGT parameters were assessed using multiple linear regression. For African-Americans, integration (integrating their family's culture with those of mainstream white-American culture) was positively associated with AIRG (β = 0.27 ± 0.09 |
Goran, M I Sugar-sweetened beverages, genetic risk, and obesity Journal Article N. Engl. J. Med., 368 (3), pp. 285–286, 2013. BibTeX | Tags: @article{pmid23323909, title = {Sugar-sweetened beverages, genetic risk, and obesity}, author = {M I Goran}, year = {2013}, date = {2013-01-01}, journal = {N. Engl. J. Med.}, volume = {368}, number = {3}, pages = {285--286}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Goran, M I; Ulijaszek, S J; Ventura, E E High fructose corn syrup and diabetes prevalence: a global perspective Journal Article Glob Public Health, 8 (1), pp. 55–64, 2013. @article{pmid23181629, title = {High fructose corn syrup and diabetes prevalence: a global perspective}, author = {M I Goran and S J Ulijaszek and E E Ventura}, year = {2013}, date = {2013-01-01}, journal = {Glob Public Health}, volume = {8}, number = {1}, pages = {55--64}, abstract = {The overall aim of this study was to evaluate, from a global and ecological perspective, the relationships between availability of high fructose corn syrup (HFCS) and prevalence of type 2 diabetes. Using published resources, country-level estimates (n =43 countries) were obtained for: total sugar, HFCS and total calorie availability, obesity, two separate prevalence estimates for diabetes, prevalence estimate for impaired glucose tolerance and fasting plasma glucose. Pearson's correlations and partial correlations were conducted in order to explore associations between dietary availability and obesity and diabetes prevalence. Diabetes prevalence was 20% higher in countries with higher availability of HFCS compared to countries with low availability, and these differences were retained or strengthened after adjusting for country-level estimates of body mass index (BMI), population and gross domestic product (adjusted diabetes prevalence=8.0 vs. 6.7%}, keywords = {}, pubstate = {published}, tppubtype = {article} } The overall aim of this study was to evaluate, from a global and ecological perspective, the relationships between availability of high fructose corn syrup (HFCS) and prevalence of type 2 diabetes. Using published resources, country-level estimates (n =43 countries) were obtained for: total sugar, HFCS and total calorie availability, obesity, two separate prevalence estimates for diabetes, prevalence estimate for impaired glucose tolerance and fasting plasma glucose. Pearson's correlations and partial correlations were conducted in order to explore associations between dietary availability and obesity and diabetes prevalence. Diabetes prevalence was 20% higher in countries with higher availability of HFCS compared to countries with low availability, and these differences were retained or strengthened after adjusting for country-level estimates of body mass index (BMI), population and gross domestic product (adjusted diabetes prevalence=8.0 vs. 6.7% |
Goran, M I How growing up sweet can turn sour Journal Article Pediatr Obes, 8 (4), pp. 237–241, 2013. BibTeX | Tags: @article{pmid23852811, title = {How growing up sweet can turn sour}, author = {M I Goran}, year = {2013}, date = {2013-00-01}, journal = {Pediatr Obes}, volume = {8}, number = {4}, pages = {237--241}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Schembre, S M; Wen, C K; Davis, J N; Shen, E; Nguyen-Rodriguez, S T; Belcher, B R; Hsu, Y W; Weigensberg, M J; Goran, M I; Spruijt-Metz, D Eating breakfast more frequently is cross-sectionally associated with greater physical activity and lower levels of adiposity in overweight Latina and African American girls Journal Article Am. J. Clin. Nutr., 98 (2), pp. 275–281, 2013. Abstract | BibTeX | Tags: diabetes risk, diet, pediatric obesity @article{pmid23803890, title = {Eating breakfast more frequently is cross-sectionally associated with greater physical activity and lower levels of adiposity in overweight Latina and African American girls}, author = {S M Schembre and C K Wen and J N Davis and E Shen and S T Nguyen-Rodriguez and B R Belcher and Y W Hsu and M J Weigensberg and M I Goran and D Spruijt-Metz}, year = {2013}, date = {2013-00-01}, journal = {Am. J. Clin. Nutr.}, volume = {98}, number = {2}, pages = {275--281}, abstract = {Eating breakfast is believed to promote a healthy body weight. Yet, few studies have examined the contribution of energy balance-related behavioral factors to this relation in minority youth. We assessed the associations between breakfast consumption and dietary intake, physical activity (PA), and adiposity before and after accounting for energy intake and PA in minority girls. Cross-sectional data were obtained on body mass index (BMI), percentage body fat (measured by BodPod), dietary intake (measured with 3-d dietary records), and PA (measured with 7-d accelerometry) from 87 Latina and African American girls 8-17 y of age (75% Latina, 80% overweight). Dietary records were used to categorize girls as more frequent breakfast eaters (MF; 2 or 3 of 3 d; n = 57) or less frequent breakfast eaters (LF; 0 or 1 of 3 d; n = 30). Chi-square tests, ANCOVA, and multiple regression analyses were conducted. Mediation was assessed with a Sobel test. Compared with the MF group, the LF group spent 30% less time (12.6 min/d) in moderate-to-vigorous-intensity PA (MVPA; P = 0.004) and had a higher percentage body fat (P = 0.029). MVPA accounted for 25% (95% CI: -8.8%, 58.1%; P = 0.139) of the relation between breakfast consumption and percentage body fat. We were unable to show that energy intake or MVPA was a significant mediator of the relation between breakfast consumption and adiposity in this sample. Evidence suggests that among predominantly overweight minority girls, MVPA, but not energy intake, was associated with both breakfast consumption and adiposity; however, a lack of power reduced our ability to detect a significant mediation effect. Other unobserved variables likely contribute to this relation.}, keywords = {diabetes risk, diet, pediatric obesity}, pubstate = {published}, tppubtype = {article} } Eating breakfast is believed to promote a healthy body weight. Yet, few studies have examined the contribution of energy balance-related behavioral factors to this relation in minority youth. We assessed the associations between breakfast consumption and dietary intake, physical activity (PA), and adiposity before and after accounting for energy intake and PA in minority girls. Cross-sectional data were obtained on body mass index (BMI), percentage body fat (measured by BodPod), dietary intake (measured with 3-d dietary records), and PA (measured with 7-d accelerometry) from 87 Latina and African American girls 8-17 y of age (75% Latina, 80% overweight). Dietary records were used to categorize girls as more frequent breakfast eaters (MF; 2 or 3 of 3 d; n = 57) or less frequent breakfast eaters (LF; 0 or 1 of 3 d; n = 30). Chi-square tests, ANCOVA, and multiple regression analyses were conducted. Mediation was assessed with a Sobel test. Compared with the MF group, the LF group spent 30% less time (12.6 min/d) in moderate-to-vigorous-intensity PA (MVPA; P = 0.004) and had a higher percentage body fat (P = 0.029). MVPA accounted for 25% (95% CI: -8.8%, 58.1%; P = 0.139) of the relation between breakfast consumption and percentage body fat. We were unable to show that energy intake or MVPA was a significant mediator of the relation between breakfast consumption and adiposity in this sample. Evidence suggests that among predominantly overweight minority girls, MVPA, but not energy intake, was associated with both breakfast consumption and adiposity; however, a lack of power reduced our ability to detect a significant mediation effect. Other unobserved variables likely contribute to this relation. |
Goran, M I; Dumke, K; Bouret, S G; Kayser, B; Walker, R W; Blumberg, B The obesogenic effect of high fructose exposure during early development Journal Article Nat Rev Endocrinol, 9 (8), pp. 494–500, 2013. @article{pmid23732284, title = {The obesogenic effect of high fructose exposure during early development}, author = {M I Goran and K Dumke and S G Bouret and B Kayser and R W Walker and B Blumberg}, year = {2013}, date = {2013-00-01}, journal = {Nat Rev Endocrinol}, volume = {9}, number = {8}, pages = {494--500}, abstract = {Obesogens are compounds that disrupt the function and development of adipose tissue or the normal metabolism of lipids, leading to an increased risk of obesity and associated diseases. Evidence for the adverse effects of industrial and agricultural obesogens, such as tributyltin, bisphenol A and other organic pollutants is well-established. Current evidence suggests that high maternal consumption of fat promotes obesity and increased metabolic risk in offspring, but less is known about the effects of other potential nutrient obesogens. Widespread increase in dietary fructose consumption over the past 30 years is associated with chronic metabolic and endocrine disorders and alterations in feeding behaviour that promote obesity. In this Perspectives, we examine the evidence linking high intakes of fructose with altered metabolism and early obesity. We review the evidence suggesting that high fructose exposure during critical periods of development of the fetus, neonate and infant can act as an obesogen by affecting lifelong neuroendocrine function, appetite control, feeding behaviour, adipogenesis, fat distribution and metabolic systems. These changes ultimately favour the long-term development of obesity and associated metabolic risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Obesogens are compounds that disrupt the function and development of adipose tissue or the normal metabolism of lipids, leading to an increased risk of obesity and associated diseases. Evidence for the adverse effects of industrial and agricultural obesogens, such as tributyltin, bisphenol A and other organic pollutants is well-established. Current evidence suggests that high maternal consumption of fat promotes obesity and increased metabolic risk in offspring, but less is known about the effects of other potential nutrient obesogens. Widespread increase in dietary fructose consumption over the past 30 years is associated with chronic metabolic and endocrine disorders and alterations in feeding behaviour that promote obesity. In this Perspectives, we examine the evidence linking high intakes of fructose with altered metabolism and early obesity. We review the evidence suggesting that high fructose exposure during critical periods of development of the fetus, neonate and infant can act as an obesogen by affecting lifelong neuroendocrine function, appetite control, feeding behaviour, adipogenesis, fat distribution and metabolic systems. These changes ultimately favour the long-term development of obesity and associated metabolic risk. |
Davis, J N; Gunderson, E P; Gyllenhammer, L E; Goran, M I Impact of gestational diabetes mellitus on pubertal changes in adiposity and metabolic profiles in Latino offspring Journal Article J. Pediatr., 162 (4), pp. 741–745, 2013. Abstract | BibTeX | Tags: diabetes risk, GDM @article{pmid23149173, title = {Impact of gestational diabetes mellitus on pubertal changes in adiposity and metabolic profiles in Latino offspring}, author = {J N Davis and E P Gunderson and L E Gyllenhammer and M I Goran}, year = {2013}, date = {2013-00-01}, journal = {J. Pediatr.}, volume = {162}, number = {4}, pages = {741--745}, abstract = {To examine the impact of maternal gestational diabetes mellitus (GDM) status on longitudinal changes in adiposity and metabolic variables in overweight Latino offspring (from age 8-20 years) across puberty. This longitudinal cohort of 210 overweight Latino children was measured annually for a period of 3 ± 1 years for Tanner stage through physical examination, adiposity by dual-energy X-ray absorptiometry and magnetic resonance imaging, lipids, and glucose and insulin action via the oral glucose tolerance test and frequently sampled intravenous glucose tolerance test. Linear mixed-effects modeling estimated the impact of maternal GDM status on baseline and changes in adiposity and metabolic variables across puberty. In our cohort, 22% of offspring were from GDM pregnancies. At baseline, the GDM offspring were heavier at birth, more likely to have a family history of type 2 diabetes, and less likely to have been breastfed (for any duration). Compared with the non-GDM offspring, the GDM offspring had greater increases in total body fat (+6.5% vs +4.5%; P = .03) and steeper declines in acute insulin response (-39% vs -17%; P < .001) and disposition index (-57% vs -35%; P < .001) across Tanner stages, independent of ethnicity, sex, breastfeeding status, family history of diabetes, and baseline and changes in body composition. These findings confirm the elevated risk for excess adiposity and type 2 diabetes in GDM offspring, and further underscore the need for interventions targeting Latino GDM and their offspring.}, keywords = {diabetes risk, GDM}, pubstate = {published}, tppubtype = {article} } To examine the impact of maternal gestational diabetes mellitus (GDM) status on longitudinal changes in adiposity and metabolic variables in overweight Latino offspring (from age 8-20 years) across puberty. This longitudinal cohort of 210 overweight Latino children was measured annually for a period of 3 ± 1 years for Tanner stage through physical examination, adiposity by dual-energy X-ray absorptiometry and magnetic resonance imaging, lipids, and glucose and insulin action via the oral glucose tolerance test and frequently sampled intravenous glucose tolerance test. Linear mixed-effects modeling estimated the impact of maternal GDM status on baseline and changes in adiposity and metabolic variables across puberty. In our cohort, 22% of offspring were from GDM pregnancies. At baseline, the GDM offspring were heavier at birth, more likely to have a family history of type 2 diabetes, and less likely to have been breastfed (for any duration). Compared with the non-GDM offspring, the GDM offspring had greater increases in total body fat (+6.5% vs +4.5%; P = .03) and steeper declines in acute insulin response (-39% vs -17%; P < .001) and disposition index (-57% vs -35%; P < .001) across Tanner stages, independent of ethnicity, sex, breastfeeding status, family history of diabetes, and baseline and changes in body composition. These findings confirm the elevated risk for excess adiposity and type 2 diabetes in GDM offspring, and further underscore the need for interventions targeting Latino GDM and their offspring. |
2012 |
Goran, M I; Ventura, E E Genetic predisposition and increasing dietary fructose exposure: the perfect storm for fatty liver disease in Hispanics in the UṠ Journal Article Dig Liver Dis, 44 (9), pp. 711–713, 2012. BibTeX | Tags: @article{pmid22595618, title = {Genetic predisposition and increasing dietary fructose exposure: the perfect storm for fatty liver disease in Hispanics in the UṠ}, author = {M I Goran and E E Ventura}, year = {2012}, date = {2012-09-01}, journal = {Dig Liver Dis}, volume = {44}, number = {9}, pages = {711--713}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Goran, M I; Walker, R; Allayee, H Genetic-related and carbohydrate-related factors affecting liver fat accumulation Journal Article Curr Opin Clin Nutr Metab Care, 15 (4), pp. 392–396, 2012. @article{pmid22617559, title = {Genetic-related and carbohydrate-related factors affecting liver fat accumulation}, author = {M I Goran and R Walker and H Allayee}, year = {2012}, date = {2012-07-01}, journal = {Curr Opin Clin Nutr Metab Care}, volume = {15}, number = {4}, pages = {392--396}, abstract = {To summarize recent findings that have examined dietary, genetic and gene-diet interactions that contribute to fat accumulation in the liver during growth and development, with particular focus on contributions relating to dietary carbohydrate and sugar consumption. In addition, this review highlights how some of these contributions to liver fat vary across the population in terms of ethnic-specific effects. Dietary carbohydrate, and especially sugars contribute to increased liver fat accumulation due to the lipogenic potential of fructose during liver metabolism. In addition, recent genome-wide studies have identified several polymorphisms that contribute to increased liver fat accumulation, with some of these genes relating to dietary carbohydrate and sugar consumption. In particular, the patatin-like phospholipase domain-containing protein 3 (PNPLA3) gene, which is highly prevalent in Hispanics, contributes to excessive liver fat beginning at a young age, especially in the context of high sugar consumption. Dietary sugar contributes to liver fat accumulation, with this being explained by de-novo lipogenesis from fructose in the liver. Certain genetic factors, including PNPLA3, glucokinase regulatory protein and APOC3 contribute to increased liver fat accumulation, with these effects being manifested at an early age. Hispanics in particular are at elevated risk for liver fat accumulation because of the higher frequency of genetic variants such as PNPLA3 and glucokinase regulatory protein as well as an interaction between the PNPLA3 and dietary sugar.}, keywords = {}, pubstate = {published}, tppubtype = {article} } To summarize recent findings that have examined dietary, genetic and gene-diet interactions that contribute to fat accumulation in the liver during growth and development, with particular focus on contributions relating to dietary carbohydrate and sugar consumption. In addition, this review highlights how some of these contributions to liver fat vary across the population in terms of ethnic-specific effects. Dietary carbohydrate, and especially sugars contribute to increased liver fat accumulation due to the lipogenic potential of fructose during liver metabolism. In addition, recent genome-wide studies have identified several polymorphisms that contribute to increased liver fat accumulation, with some of these genes relating to dietary carbohydrate and sugar consumption. In particular, the patatin-like phospholipase domain-containing protein 3 (PNPLA3) gene, which is highly prevalent in Hispanics, contributes to excessive liver fat beginning at a young age, especially in the context of high sugar consumption. Dietary sugar contributes to liver fat accumulation, with this being explained by de-novo lipogenesis from fructose in the liver. Certain genetic factors, including PNPLA3, glucokinase regulatory protein and APOC3 contribute to increased liver fat accumulation, with these effects being manifested at an early age. Hispanics in particular are at elevated risk for liver fat accumulation because of the higher frequency of genetic variants such as PNPLA3 and glucokinase regulatory protein as well as an interaction between the PNPLA3 and dietary sugar. |
Rhodes, E T; Goran, M I; Lieu, T A; Lustig, R H; Prosser, L A; Songer, T J; Weigensberg, M J; Weinstock, R S; Gonzalez, T; Rawluk, K; Zoghbi, R M; Ludwig, D S; Laffel, L M Health-related quality of life in adolescents with or at risk for type 2 diabetes mellitus Journal Article J. Pediatr., 160 (6), pp. 911–917, 2012. Abstract | BibTeX | Tags: diabetes risk @article{pmid22217471, title = {Health-related quality of life in adolescents with or at risk for type 2 diabetes mellitus}, author = {E T Rhodes and M I Goran and T A Lieu and R H Lustig and L A Prosser and T J Songer and M J Weigensberg and R S Weinstock and T Gonzalez and K Rawluk and R M Zoghbi and D S Ludwig and L M Laffel}, year = {2012}, date = {2012-06-01}, journal = {J. Pediatr.}, volume = {160}, number = {6}, pages = {911--917}, abstract = {To evaluate how adolescents with or at risk for type 2 diabetes mellitus (T2DM) and their parent/guardians (parents) perceive adolescents' health-related quality of life. We interviewed overweight/obese, 12- to 18-year-old youth with T2DM, prediabetes, or insulin resistance and one parent from 5 US sites. Assessments included Pediatric Quality of Life Inventory (PedsQL), Health Utilities Index, family conflict, and diabetes burden. In 108 adolescents, diagnoses included 40.7% with T2DM, 25.0% with prediabetes, and 34.3% with insulin resistance. PedsQL summary score (SS) was higher in adolescents than parents (P=.02). Parents rated physical functioning lower than adolescents (P<.0001), but there were no differences in psychosocial health. Adolescent PedsQL SS did not differ with diagnosis, but was inversely associated with adolescent body mass index z-score (P=.0004) and family conflict (P<.0001) and associated with race/ethnicity (P<.0001). Number of adolescent co-morbidities (P=.007) and burden of diabetes care (P<.05) were inversely associated with parent PedsQL SS. There were no differences in the Health Utilities Index-Mark 3 multi-attribute utility score. Parents perceive their adolescents' physical functioning as more impaired than adolescents themselves. Contextual factors including severity of obesity, race/ethnicity, family conflict, and burden of diabetes care influence health-related quality of life. Family-based approaches to treatment and prevention of T2DM may benefit from increased attention to the biopsychosocial context.}, keywords = {diabetes risk}, pubstate = {published}, tppubtype = {article} } To evaluate how adolescents with or at risk for type 2 diabetes mellitus (T2DM) and their parent/guardians (parents) perceive adolescents' health-related quality of life. We interviewed overweight/obese, 12- to 18-year-old youth with T2DM, prediabetes, or insulin resistance and one parent from 5 US sites. Assessments included Pediatric Quality of Life Inventory (PedsQL), Health Utilities Index, family conflict, and diabetes burden. In 108 adolescents, diagnoses included 40.7% with T2DM, 25.0% with prediabetes, and 34.3% with insulin resistance. PedsQL summary score (SS) was higher in adolescents than parents (P=.02). Parents rated physical functioning lower than adolescents (P<.0001), but there were no differences in psychosocial health. Adolescent PedsQL SS did not differ with diagnosis, but was inversely associated with adolescent body mass index z-score (P=.0004) and family conflict (P<.0001) and associated with race/ethnicity (P<.0001). Number of adolescent co-morbidities (P=.007) and burden of diabetes care (P<.05) were inversely associated with parent PedsQL SS. There were no differences in the Health Utilities Index-Mark 3 multi-attribute utility score. Parents perceive their adolescents' physical functioning as more impaired than adolescents themselves. Contextual factors including severity of obesity, race/ethnicity, family conflict, and burden of diabetes care influence health-related quality of life. Family-based approaches to treatment and prevention of T2DM may benefit from increased attention to the biopsychosocial context. |
Toledo-Corral, C M; Vargas, L G; Goran, M I; Weigensberg, M J Hemoglobin A1c above threshold level is associated with decreased β-cell function in overweight Latino youth Journal Article J. Pediatr., 160 (5), pp. 751–756, 2012. Abstract | BibTeX | Tags: diabetes risk @article{pmid22137671, title = {Hemoglobin A1c above threshold level is associated with decreased β-cell function in overweight Latino youth}, author = {C M Toledo-Corral and L G Vargas and M I Goran and M J Weigensberg}, year = {2012}, date = {2012-05-01}, journal = {J. Pediatr.}, volume = {160}, number = {5}, pages = {751--756}, abstract = {To examine whether a hemoglobin A1c (HbA1c)-identified prediabetic state (HbA1c ≥ 6.0%-6.4%) is associated with decreased insulin sensitivity (SI) and β-cell dysfunction, known factors in the pathogenesis of type 2 diabetes, in an overweight pediatric population. A total of 206 healthy overweight Latino adolescents (124 males and 82 females; mean age, 13.1 ± 2.0 years) were divided into 2 groups: lower risk (n=179), with HbA1c <6.0%, and higher risk (n=27), with HbA1c 6.0%-6.4%. Measurements included HbA1c, oral glucose tolerance testing, fasting and 2-hour glucose and insulin, SI, acute insulin response, and disposition index (an index of β-cell function) by the frequently sampled intravenous glucose tolerance test with minimal modeling. Body fat was determined by dual-energy X-ray absorptiometry. Compared with the lower risk group, the higher risk group had 21% lower SI (1.21 ± 0.06 vs 1.54 ± 0.13; P<.05), 30% lower acute insulin response (928 ± 102 vs 1342 ± 56; P<.01), and a 31% lower disposition index (1390 ± 146 vs 2023 ± 83; P=.001) after adjusting for age and total percent body fat. These data provide clear evidence of greater impairment of β-cell function in overweight Latino children with HbA1c 6.0%-6.4%, and thereby support the adoption of the International Expert Committee's HbA1c-determined definition of high-risk state for overweight children at risk for type 2 diabetes.}, keywords = {diabetes risk}, pubstate = {published}, tppubtype = {article} } To examine whether a hemoglobin A1c (HbA1c)-identified prediabetic state (HbA1c ≥ 6.0%-6.4%) is associated with decreased insulin sensitivity (SI) and β-cell dysfunction, known factors in the pathogenesis of type 2 diabetes, in an overweight pediatric population. A total of 206 healthy overweight Latino adolescents (124 males and 82 females; mean age, 13.1 ± 2.0 years) were divided into 2 groups: lower risk (n=179), with HbA1c <6.0%, and higher risk (n=27), with HbA1c 6.0%-6.4%. Measurements included HbA1c, oral glucose tolerance testing, fasting and 2-hour glucose and insulin, SI, acute insulin response, and disposition index (an index of β-cell function) by the frequently sampled intravenous glucose tolerance test with minimal modeling. Body fat was determined by dual-energy X-ray absorptiometry. Compared with the lower risk group, the higher risk group had 21% lower SI (1.21 ± 0.06 vs 1.54 ± 0.13; P<.05), 30% lower acute insulin response (928 ± 102 vs 1342 ± 56; P<.01), and a 31% lower disposition index (1390 ± 146 vs 2023 ± 83; P=.001) after adjusting for age and total percent body fat. These data provide clear evidence of greater impairment of β-cell function in overweight Latino children with HbA1c 6.0%-6.4%, and thereby support the adoption of the International Expert Committee's HbA1c-determined definition of high-risk state for overweight children at risk for type 2 diabetes. |
Davis, J N; Ventura, E E; Tung, A; Munevar, M A; Hasson, R E; Byrd-Williams, C; Vanni, A K; Spruijt-Metz, D; Weigensberg, M; Goran, M I Effects of a randomized maintenance intervention on adiposity and metabolic risk factors in overweight minority adolescents Journal Article Pediatr Obes, 7 (1), pp. 16–27, 2012. Abstract | BibTeX | Tags: diabetes risk, trial @article{pmid22434736, title = {Effects of a randomized maintenance intervention on adiposity and metabolic risk factors in overweight minority adolescents}, author = {J N Davis and E E Ventura and A Tung and M A Munevar and R E Hasson and C Byrd-Williams and A K Vanni and D Spruijt-Metz and M Weigensberg and M I Goran}, year = {2012}, date = {2012-02-01}, journal = {Pediatr Obes}, volume = {7}, number = {1}, pages = {16--27}, abstract = {The objective of this study was to assess the effects of a maintenance programme (monthly newsletters vs. monthly group classes and telephone behavioural sessions) on obesity and metabolic disease risk at 1 year in overweight minority adolescents. After a 4-month nutrition and strength training intervention, 53 overweight Latino and African-American adolescents (15.4 ± 1.1 years) were randomized into one of two maintenance groups for 8 months: monthly newsletters (n = 23) or group classes (n = 30; monthly classes + individualized behavioural telephone sessions). The following outcomes were measured at months 4 (immediately following the intense intervention) and 12: height, weight, blood pressure, body composition via BodPodâ„¢ (Life Measurement Instruments, Concord, CA, USA), lipids and glucose/insulin indices via frequently sampled intravenous glucose tolerance test. There were no significant group by time interactions for any of the health outcomes. There were significant time effects in several outcomes for both groups from months 4 to 12: bench press and leg press decreased by 5% and 14%, respectively (P = 0.004 & P = 0.01), fasting insulin and acute insulin response decreased by 26% and 16%, respectively (P < 0.001 & P = 0.046); while high-density lipoprotein cholesterol and insulin sensitivity improved by 5% and 14% (P = 0.042 & P = 0.039). Newsletters as opposed to group classes may suffice as follow-up maintenance programmes to decrease type 2 diabetes and cardiovascular risk in overweight minority adolescents.}, keywords = {diabetes risk, trial}, pubstate = {published}, tppubtype = {article} } The objective of this study was to assess the effects of a maintenance programme (monthly newsletters vs. monthly group classes and telephone behavioural sessions) on obesity and metabolic disease risk at 1 year in overweight minority adolescents. After a 4-month nutrition and strength training intervention, 53 overweight Latino and African-American adolescents (15.4 ± 1.1 years) were randomized into one of two maintenance groups for 8 months: monthly newsletters (n = 23) or group classes (n = 30; monthly classes + individualized behavioural telephone sessions). The following outcomes were measured at months 4 (immediately following the intense intervention) and 12: height, weight, blood pressure, body composition via BodPodâ„¢ (Life Measurement Instruments, Concord, CA, USA), lipids and glucose/insulin indices via frequently sampled intravenous glucose tolerance test. There were no significant group by time interactions for any of the health outcomes. There were significant time effects in several outcomes for both groups from months 4 to 12: bench press and leg press decreased by 5% and 14%, respectively (P = 0.004 & P = 0.01), fasting insulin and acute insulin response decreased by 26% and 16%, respectively (P < 0.001 & P = 0.046); while high-density lipoprotein cholesterol and insulin sensitivity improved by 5% and 14% (P = 0.042 & P = 0.039). Newsletters as opposed to group classes may suffice as follow-up maintenance programmes to decrease type 2 diabetes and cardiovascular risk in overweight minority adolescents. |
Walker, R W; Lê, K A; Davis, J; Alderete, T L; Cherry, R; Lebel, S; Goran, M I High rates of fructose malabsorption are associated with reduced liver fat in obese African Americans Journal Article J Am Coll Nutr, 31 (5), pp. 369–374, 2012. Abstract | BibTeX | Tags: fructose, liver fat @article{pmid23529994, title = {High rates of fructose malabsorption are associated with reduced liver fat in obese African Americans}, author = {R W Walker and K A Lê and J Davis and T L Alderete and R Cherry and S Lebel and M I Goran}, year = {2012}, date = {2012-01-01}, journal = {J Am Coll Nutr}, volume = {31}, number = {5}, pages = {369--374}, abstract = {African Americans commonly have lower liver fat accumulation than Hispanics, despite a similar propensity for obesity. Both ethnicities exhibit high consumption of fructose-containing beverages, which has been associated with high liver fat owing to the lipogenic properties of fructose. Therefore, differences in fructose absorption may be an important factor in regulating liver fat deposition. We hypothesized that fructose malabsorption in African Americans may reduce hepatic delivery of fructose, thus contributing to lower liver fat deposition compared to Hispanics. Thirty-seven obese young adults aged 21.4 ± 2.1 years (16 African American, 21 Hispanic) underwent a 3-hour hydrogen (H2) breath test to assess fructose malabsorption. Magnetic resonance imaging was used to determine visceral and subcutaneous adipose tissue volume and liver fat. Fructose malabsorption was expressed as an area under the curve for H2 production (H2 AUC). Compared to Hispanics, African Americans had lower liver fat (5.4% ± 5.0% vs 8.9% ± 2.3%}, keywords = {fructose, liver fat}, pubstate = {published}, tppubtype = {article} } African Americans commonly have lower liver fat accumulation than Hispanics, despite a similar propensity for obesity. Both ethnicities exhibit high consumption of fructose-containing beverages, which has been associated with high liver fat owing to the lipogenic properties of fructose. Therefore, differences in fructose absorption may be an important factor in regulating liver fat deposition. We hypothesized that fructose malabsorption in African Americans may reduce hepatic delivery of fructose, thus contributing to lower liver fat deposition compared to Hispanics. Thirty-seven obese young adults aged 21.4 ± 2.1 years (16 African American, 21 Hispanic) underwent a 3-hour hydrogen (H2) breath test to assess fructose malabsorption. Magnetic resonance imaging was used to determine visceral and subcutaneous adipose tissue volume and liver fat. Fructose malabsorption was expressed as an area under the curve for H2 production (H2 AUC). Compared to Hispanics, African Americans had lower liver fat (5.4% ± 5.0% vs 8.9% ± 2.3% |
Goran, M I; Alderete, T L Targeting adipose tissue inflammation to treat the underlying basis of the metabolic complications of obesity Journal Article Nestle Nutr Inst Workshop Ser, 73 , pp. 49–60, 2012. @article{pmid23128765, title = {Targeting adipose tissue inflammation to treat the underlying basis of the metabolic complications of obesity}, author = {M I Goran and T L Alderete}, year = {2012}, date = {2012-01-01}, journal = {Nestle Nutr Inst Workshop Ser}, volume = {73}, pages = {49--60}, abstract = {The prevalence of obesity has increased throughout the last three decades due to genetic, metabolic, behavioral, and environmental factors [1]. Obesity in turn increases risk for a number of metabolic diseases including type 2 diabetes, cardiovascular disease, fatty liver disease and some forms of cancer [1]. Despite the well-known link between obesity and increased morbidity, the mechanism of this remains elusive. Thus, the question 'why does increased body fat cause increased metabolic comorbidities' remains unanswered. By understanding the underlying basis of obesity-associated metabolic diseases, different therapies could be designed to target relevant pathways. Although we lack a full understanding of the underlying mechanisms that result in disease, several putative explanations exist for why fat affects metabolic health. One such theory is based on the anatomic location of fat deposition and ectopic fat accumulation [2]. Specifically, current literature suggests that visceral, liver and skeletal fat accumulation affects organ function and contributes to the development of insulin resistance, fatty liver, and the metabolic syndrome [3]. However, even in individuals matched for body fat and fat distribution, significant differences can exist in metabolic outcomes, and the phenomenon of metabolically healthy obese has been well described [4]. More recent data suggest the alternative hypothesis relating excess adipose tissue to disease risk based on the metabolic function and morphological properties of adipose tissue. In this scenario, excess adipose tissue is hypothesized to contribute to a state of chronic inflammation which promotes development of insulin resistance as well as other metabolic complications by stimulating nuclear factor-ĸB and Jun N-terminal kinase pathways in adipocytes and the liver [5]. In this paper, we will review the hypothesis linking excess adipose tissue to increased disease risk through adipose tissue inflammation.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The prevalence of obesity has increased throughout the last three decades due to genetic, metabolic, behavioral, and environmental factors [1]. Obesity in turn increases risk for a number of metabolic diseases including type 2 diabetes, cardiovascular disease, fatty liver disease and some forms of cancer [1]. Despite the well-known link between obesity and increased morbidity, the mechanism of this remains elusive. Thus, the question 'why does increased body fat cause increased metabolic comorbidities' remains unanswered. By understanding the underlying basis of obesity-associated metabolic diseases, different therapies could be designed to target relevant pathways. Although we lack a full understanding of the underlying mechanisms that result in disease, several putative explanations exist for why fat affects metabolic health. One such theory is based on the anatomic location of fat deposition and ectopic fat accumulation [2]. Specifically, current literature suggests that visceral, liver and skeletal fat accumulation affects organ function and contributes to the development of insulin resistance, fatty liver, and the metabolic syndrome [3]. However, even in individuals matched for body fat and fat distribution, significant differences can exist in metabolic outcomes, and the phenomenon of metabolically healthy obese has been well described [4]. More recent data suggest the alternative hypothesis relating excess adipose tissue to disease risk based on the metabolic function and morphological properties of adipose tissue. In this scenario, excess adipose tissue is hypothesized to contribute to a state of chronic inflammation which promotes development of insulin resistance as well as other metabolic complications by stimulating nuclear factor-ĸB and Jun N-terminal kinase pathways in adipocytes and the liver [5]. In this paper, we will review the hypothesis linking excess adipose tissue to increased disease risk through adipose tissue inflammation. |
Davis, J N; Whaley, S E; Goran, M I Effects of breastfeeding and low sugar-sweetened beverage intake on obesity prevalence in Hispanic toddlers Journal Article Am. J. Clin. Nutr., 95 (1), pp. 3–8, 2012. Abstract | BibTeX | Tags: breastfeeding, sugar @article{pmid22170357, title = {Effects of breastfeeding and low sugar-sweetened beverage intake on obesity prevalence in Hispanic toddlers}, author = {J N Davis and S E Whaley and M I Goran}, year = {2012}, date = {2012-01-01}, journal = {Am. J. Clin. Nutr.}, volume = {95}, number = {1}, pages = {3--8}, abstract = {Few studies have examined the independent and additive effects of breastfeeding (BF) and sugar-sweetened beverage (SSB) intake in early life on overweight and obesity prevalence. The objective was to assess the effects of BF and SSB intake on the prevalence of overweight and obesity in Hispanic toddlers. Nutrition data were collected via phone surveys with caregivers of 1483 Hispanic children (2-4 y of age) from the Los Angeles County Women, Infants, and Children (WIC) program. BF history at 2-4 y of age was categorized as follows: no BF, >1 wk to <6 mo BF, 6 to <12 mo BF, and ≥12 mo BF. SSB intake at 2-4 y of age was categorized as follows: high SSB (≥2 SSBs/d), mid SSB (1 SSB/d), and no SSB. The height and weight of the children were measured by WIC staff and stored in the Integrated Statewide Information System. Binary logistic regressions assessed the effects of BF and SSB categories on overweight and obesity prevalence. In comparison with the no-BF participants, the odds of obesity were lower in the ≥12-mo-BF participants (OR: 0.55; 95% CI: 0.37, 0.83; P = 0.004). In comparison with high-SSB participants, the odds of obesity were lower in the no-SSB participants (OR: 0.69; 95% CI: 0.47, 1.00; P = 0.047). In comparison with the combined no-BF/high-SSB participants, the odds of obesity were lower in the ≥12-mo BF/no-SSB participants (OR: 0.39; 95% CI: 0.19, 0.80; P = 0.01). The results suggest that BF for ≥1 y and low SSB intake during the toddler years can have profound effects on reducing the prevalence of obesity in Hispanic toddlers.}, keywords = {breastfeeding, sugar}, pubstate = {published}, tppubtype = {article} } Few studies have examined the independent and additive effects of breastfeeding (BF) and sugar-sweetened beverage (SSB) intake in early life on overweight and obesity prevalence. The objective was to assess the effects of BF and SSB intake on the prevalence of overweight and obesity in Hispanic toddlers. Nutrition data were collected via phone surveys with caregivers of 1483 Hispanic children (2-4 y of age) from the Los Angeles County Women, Infants, and Children (WIC) program. BF history at 2-4 y of age was categorized as follows: no BF, >1 wk to <6 mo BF, 6 to <12 mo BF, and ≥12 mo BF. SSB intake at 2-4 y of age was categorized as follows: high SSB (≥2 SSBs/d), mid SSB (1 SSB/d), and no SSB. The height and weight of the children were measured by WIC staff and stored in the Integrated Statewide Information System. Binary logistic regressions assessed the effects of BF and SSB categories on overweight and obesity prevalence. In comparison with the no-BF participants, the odds of obesity were lower in the ≥12-mo-BF participants (OR: 0.55; 95% CI: 0.37, 0.83; P = 0.004). In comparison with high-SSB participants, the odds of obesity were lower in the no-SSB participants (OR: 0.69; 95% CI: 0.47, 1.00; P = 0.047). In comparison with the combined no-BF/high-SSB participants, the odds of obesity were lower in the ≥12-mo BF/no-SSB participants (OR: 0.39; 95% CI: 0.19, 0.80; P = 0.01). The results suggest that BF for ≥1 y and low SSB intake during the toddler years can have profound effects on reducing the prevalence of obesity in Hispanic toddlers. |
Dulin-Keita, A; Casazza, K; Fernandez, J R; Goran, M I; Gower, B Do neighbourhoods matter? Neighbourhood disorder and long-term trends in serum cortisol levels Journal Article J Epidemiol Community Health, 66 (1), pp. 24–29, 2012. Abstract | BibTeX | Tags: environment @article{pmid20736487, title = {Do neighbourhoods matter? Neighbourhood disorder and long-term trends in serum cortisol levels}, author = {A Dulin-Keita and K Casazza and J R Fernandez and M I Goran and B Gower}, year = {2012}, date = {2012-01-01}, journal = {J Epidemiol Community Health}, volume = {66}, number = {1}, pages = {24--29}, abstract = {Characteristics associated with low socioeconomic status neighbourhoods may put children at risk for unique chronic stressors that affect cortisol levels. This research sought to explore whether neighbourhood stressor exposure affected serum cortisol levels among children. A total of 148 African and European-American children with an average age of 8.28 years participated in a longitudinal study evaluating ethnic differences in body composition and disease risk. Five waves of data were included in analyses. Mixed modelling was used to explore neighbourhood stressors, which was a composite index of five items for zip code level poverty and physical disorder, and serum cortisol outcomes for the full sample, by race/ethnicity and gender. Adjustments were made for individual level correlates age, pubertal status, gender and total fat mass. Neighborhood disorder was predictive of lower serum cortisol levels among African-American children (p<0.05), such that higher neighbourhood stressor exposure resulted in lower serum cortisol over time compared with individuals in socially ordered neighbourhoods. Neighbourhood disorder was marginally significant and predictive of higher serum cortisol among European-American children (p<0.10). Transition to a higher pubertal status, nested in age was also predictive of lower serum cortisol levels (p<0.01) among European-American children. Children who are exposed to negative socioenvironmental climates over time are more likely to have altered serum cortisol levels. This may be an adaptive mechanism to cope with stress; however, disrupted cortisol levels may have negative effects on general physical and mental health.}, keywords = {environment}, pubstate = {published}, tppubtype = {article} } Characteristics associated with low socioeconomic status neighbourhoods may put children at risk for unique chronic stressors that affect cortisol levels. This research sought to explore whether neighbourhood stressor exposure affected serum cortisol levels among children. A total of 148 African and European-American children with an average age of 8.28 years participated in a longitudinal study evaluating ethnic differences in body composition and disease risk. Five waves of data were included in analyses. Mixed modelling was used to explore neighbourhood stressors, which was a composite index of five items for zip code level poverty and physical disorder, and serum cortisol outcomes for the full sample, by race/ethnicity and gender. Adjustments were made for individual level correlates age, pubertal status, gender and total fat mass. Neighborhood disorder was predictive of lower serum cortisol levels among African-American children (p<0.05), such that higher neighbourhood stressor exposure resulted in lower serum cortisol over time compared with individuals in socially ordered neighbourhoods. Neighbourhood disorder was marginally significant and predictive of higher serum cortisol among European-American children (p<0.10). Transition to a higher pubertal status, nested in age was also predictive of lower serum cortisol levels (p<0.01) among European-American children. Children who are exposed to negative socioenvironmental climates over time are more likely to have altered serum cortisol levels. This may be an adaptive mechanism to cope with stress; however, disrupted cortisol levels may have negative effects on general physical and mental health. |
Katzmarzyk, P T; Shen, W; Baxter-Jones, A; Bell, J D; Butte, N F; Demerath, E W; Gilsanz, V; Goran, M I; Hirschler, V; Hu, H H; Maffeis, C; Malina, R M; Miller, M J; Pietrobelli, A; Wells, J C Adiposity in children and adolescents: correlates and clinical consequences of fat stored in specific body depots Journal Article Pediatr Obes, 7 (5), pp. 42–61, 2012. @article{pmid22911903, title = {Adiposity in children and adolescents: correlates and clinical consequences of fat stored in specific body depots}, author = {P T Katzmarzyk and W Shen and A Baxter-Jones and J D Bell and N F Butte and E W Demerath and V Gilsanz and M I Goran and V Hirschler and H H Hu and C Maffeis and R M Malina and M J Miller and A Pietrobelli and J C Wells}, year = {2012}, date = {2012-00-01}, journal = {Pediatr Obes}, volume = {7}, number = {5}, pages = {42--61}, abstract = {The 2011 Pennington Biomedical Research Center's Scientific Symposium focused on adiposity in children and adolescents. The symposium was attended by 15 speakers and other invited experts. The specific objectives of the symposium were to (i) integrate the latest published and unpublished findings on the laboratory and clinical assessment of depot-specific adiposity in children and adolescents, (ii) understand the variation in depot-specific adiposity and related health outcomes associated with age, sex, maturation, ethnicity and other factors and (iii) identify opportunities for incorporating new markers of abdominal obesity into clinical practice guidelines for obesity in children and adolescents. This symposium provided an overview of important new advances in the field and identified directions for future research. The long-term goal of the symposium is to aid in the early identification of children and adolescents who are at increased health risk because of obesity and obesity-related conditions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The 2011 Pennington Biomedical Research Center's Scientific Symposium focused on adiposity in children and adolescents. The symposium was attended by 15 speakers and other invited experts. The specific objectives of the symposium were to (i) integrate the latest published and unpublished findings on the laboratory and clinical assessment of depot-specific adiposity in children and adolescents, (ii) understand the variation in depot-specific adiposity and related health outcomes associated with age, sex, maturation, ethnicity and other factors and (iii) identify opportunities for incorporating new markers of abdominal obesity into clinical practice guidelines for obesity in children and adolescents. This symposium provided an overview of important new advances in the field and identified directions for future research. The long-term goal of the symposium is to aid in the early identification of children and adolescents who are at increased health risk because of obesity and obesity-related conditions. |
Samara, A; Ventura, E E; Alfadda, A A; Goran, M I Use of MRI and CŦ for fat imaging in children and youth: what have we learned about obesity, fat distribution and metabolic disease risk? Journal Article Obes Rev, 13 (8), pp. 723–732, 2012. @article{pmid22520361, title = {Use of MRI and CŦ for fat imaging in children and youth: what have we learned about obesity, fat distribution and metabolic disease risk?}, author = {A Samara and E E Ventura and A A Alfadda and M I Goran}, year = {2012}, date = {2012-00-01}, journal = {Obes Rev}, volume = {13}, number = {8}, pages = {723--732}, abstract = {Childhood obesity is a matter of great concern for public health. Efforts have been made to understand its impact on health through advanced imaging techniques. An increasing number of studies focus on fat distribution and its associations with metabolic risk, in interaction with genetics, environment and ethnicity, in children. The present review is a qualitative synthesis of the existing literature on visceral and subcutaneous abdominal, intrahepatic and intramuscular fat. Our search revealed 80 original articles. Abdominal as well as ectopic fat depots are prevalent already in childhood and contribute to abnormal metabolic parameters, starting early in life. Visceral, hepatic and intramuscular fat seem to be interrelated but their patterns as well as their independent contribution on metabolic risk are not clear. Some ethnic-specific characteristics are also prevalent. These results encourage further research in childhood obesity by using imaging techniques such as magnetic resonance imaging and computed tomography. These imaging methods can provide a better understanding of fat distribution and its relationships with metabolic risk, compared to less detailed fat and obesity assessment. However, studies on bigger samples and with a prospective character are warranted.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Childhood obesity is a matter of great concern for public health. Efforts have been made to understand its impact on health through advanced imaging techniques. An increasing number of studies focus on fat distribution and its associations with metabolic risk, in interaction with genetics, environment and ethnicity, in children. The present review is a qualitative synthesis of the existing literature on visceral and subcutaneous abdominal, intrahepatic and intramuscular fat. Our search revealed 80 original articles. Abdominal as well as ectopic fat depots are prevalent already in childhood and contribute to abnormal metabolic parameters, starting early in life. Visceral, hepatic and intramuscular fat seem to be interrelated but their patterns as well as their independent contribution on metabolic risk are not clear. Some ethnic-specific characteristics are also prevalent. These results encourage further research in childhood obesity by using imaging techniques such as magnetic resonance imaging and computed tomography. These imaging methods can provide a better understanding of fat distribution and its relationships with metabolic risk, compared to less detailed fat and obesity assessment. However, studies on bigger samples and with a prospective character are warranted. |
Increasing Physical Activity Đecreases Ħepatic Fat and Metabolic Risk Factors Journal Article J Exerc Physiol Online, 15 (2), pp. 40–54, 2012. Abstract | BibTeX | Tags: liver fat, physical activity @article{pmid23814456, title = {Increasing Physical Activity Đecreases Ħepatic Fat and Metabolic Risk Factors}, year = {2012}, date = {2012-00-01}, journal = {J Exerc Physiol Online}, volume = {15}, number = {2}, pages = {40--54}, abstract = {This study assessed the changes in time spent in moderate to vigorous physical activity (MVPA) on fat depots, insulin action, and inflammation. Longitudinal data were generated from 66 Hispanic adolescents (15.6±1.1 yr; BMI percentile 97.1±3.0) who participated in a 16-wk nutrition or nutrition+exercise intervention. There were no effects of the intervention on PA, but there were inter-individual changes in PA. For purposes of this analysis, all intervention groups were combined to assess how changes in PA during 16 wk affected changes in adiposity, insulin action, and markers of inflammation. MVPA was assessed by 7-day accelerometry, total body fat via DXA, liver fat by MRI, and insulin, glucose and HOMA-IR via a fasting blood draw. A repeated measures ANCOVA was used to assess the effect of MVPA on fat depots, insulin action, and inflammatory markers. Sixty-two percent of participants increased MVPA (mean increase, 19.7±16.5 min/day) and 38% decreased MVPA (mean decrease, 10.7±10.1 min/day). Those who increased MVPA by as little as 20 min per day over 16 wk, compared to those who decreased MVPA, had significant reductions in liver fat (-13% vs. +3%; P=0.01), leptin levels (-18% vs. +4%; P=0.02), and fasting insulin (-23% vs. +5%; P=0.05). These findings indicate that a modest increase in MVPA can improve metabolic health in sedentary overweight Hispanic adolescents.}, keywords = {liver fat, physical activity}, pubstate = {published}, tppubtype = {article} } This study assessed the changes in time spent in moderate to vigorous physical activity (MVPA) on fat depots, insulin action, and inflammation. Longitudinal data were generated from 66 Hispanic adolescents (15.6±1.1 yr; BMI percentile 97.1±3.0) who participated in a 16-wk nutrition or nutrition+exercise intervention. There were no effects of the intervention on PA, but there were inter-individual changes in PA. For purposes of this analysis, all intervention groups were combined to assess how changes in PA during 16 wk affected changes in adiposity, insulin action, and markers of inflammation. MVPA was assessed by 7-day accelerometry, total body fat via DXA, liver fat by MRI, and insulin, glucose and HOMA-IR via a fasting blood draw. A repeated measures ANCOVA was used to assess the effect of MVPA on fat depots, insulin action, and inflammatory markers. Sixty-two percent of participants increased MVPA (mean increase, 19.7±16.5 min/day) and 38% decreased MVPA (mean decrease, 10.7±10.1 min/day). Those who increased MVPA by as little as 20 min per day over 16 wk, compared to those who decreased MVPA, had significant reductions in liver fat (-13% vs. +3%; P=0.01), leptin levels (-18% vs. +4%; P=0.02), and fasting insulin (-23% vs. +5%; P=0.05). These findings indicate that a modest increase in MVPA can improve metabolic health in sedentary overweight Hispanic adolescents. |
Kim, J S; Lê, K A; Mahurkar, S; Davis, J N; Goran, M I Influence of elevated liver fat on circulating adipocytokines and insulin resistance in obese Hispanic adolescents Journal Article Pediatr Obes, 7 (2), pp. 158–164, 2012. Abstract | BibTeX | Tags: liver fat @article{pmid22434756, title = {Influence of elevated liver fat on circulating adipocytokines and insulin resistance in obese Hispanic adolescents}, author = {J S Kim and K A Lê and S Mahurkar and J N Davis and M I Goran}, year = {2012}, date = {2012-00-01}, journal = {Pediatr Obes}, volume = {7}, number = {2}, pages = {158--164}, abstract = {We performed this study to examine the metabolic differences arising from higher liver fat accumulation in obese Hispanic adolescents, with a particular focus on circulating levels of adipocytokines and insulin resistance. Forty-one obese Hispanic adolescents (15.3 ± 1.0 years, body mass index percentile: 97.0 ± 3.9) were assessed for: visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and hepatic fat fraction (HFF) by magnetic resonance imaging; fasting measures of serum glucose, insulin and adipocytokines; homeostasis model assessment of insulin resistance (HOMA-IR); and insulin sensitivity (SI) and the acute insulin response to glucose (AIR) by intravenous glucose tolerance test. Subjects with normal levels of HFF (below 5%; n = 25) were compared to those with HFF > 5% (n = 16). The two groups differing in HFF were similar for total body fat, VAT and SAT. The group with HFF > 5% had significantly (P < 0.05) higher interleukin-8 (IL-8) (6.1 ± 1.6 vs. 3.2 ± 0.4 pg mL(-1) ), NGF (30.2 ± 9.9 vs. 13.9 ± 1.6 pg mL(-1) ), HOMA-IR (8.8 ± 1.1 vs. 5.5 ± 0.5), AIR (1869 ± 206 vs. 1092 ± 165) and a tendency for lower SI (1.2 ± 0.4 vs. 2.1 ± 0.3; P = 0.06), with no significant differences in any of other factors measured. These data suggest that elevated liver fat is most closely associated with elevated serum IL-8 and NGF levels as well as increased AIR and HOMA-IR. These elevated factors may play significant roles in the metabolic abnormalities associated with elevated liver fat in obese Hispanics.}, keywords = {liver fat}, pubstate = {published}, tppubtype = {article} } We performed this study to examine the metabolic differences arising from higher liver fat accumulation in obese Hispanic adolescents, with a particular focus on circulating levels of adipocytokines and insulin resistance. Forty-one obese Hispanic adolescents (15.3 ± 1.0 years, body mass index percentile: 97.0 ± 3.9) were assessed for: visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and hepatic fat fraction (HFF) by magnetic resonance imaging; fasting measures of serum glucose, insulin and adipocytokines; homeostasis model assessment of insulin resistance (HOMA-IR); and insulin sensitivity (SI) and the acute insulin response to glucose (AIR) by intravenous glucose tolerance test. Subjects with normal levels of HFF (below 5%; n = 25) were compared to those with HFF > 5% (n = 16). The two groups differing in HFF were similar for total body fat, VAT and SAT. The group with HFF > 5% had significantly (P < 0.05) higher interleukin-8 (IL-8) (6.1 ± 1.6 vs. 3.2 ± 0.4 pg mL(-1) ), NGF (30.2 ± 9.9 vs. 13.9 ± 1.6 pg mL(-1) ), HOMA-IR (8.8 ± 1.1 vs. 5.5 ± 0.5), AIR (1869 ± 206 vs. 1092 ± 165) and a tendency for lower SI (1.2 ± 0.4 vs. 2.1 ± 0.3; P = 0.06), with no significant differences in any of other factors measured. These data suggest that elevated liver fat is most closely associated with elevated serum IL-8 and NGF levels as well as increased AIR and HOMA-IR. These elevated factors may play significant roles in the metabolic abnormalities associated with elevated liver fat in obese Hispanics. |
Hasson, R E; Adam, T C; Davis, J N; Kelly, L A; Ventura, E E; Byrd-Williams, C E; Toledo-Corral, C M; Roberts, C K; Lane, C J; Azen, S P; Chou, C P; Spruijt-Metz, D; Weigensberg, M J; Berhane, K; Goran, M I Randomized controlled trial to improve adiposity, inflammation, and insulin resistance in obese African-American and Latino youth Journal Article Obesity (Silver Spring), 20 (4), pp. 811–818, 2012. Abstract | BibTeX | Tags: diabetes risk, trial @article{pmid21293446, title = {Randomized controlled trial to improve adiposity, inflammation, and insulin resistance in obese African-American and Latino youth}, author = {R E Hasson and T C Adam and J N Davis and L A Kelly and E E Ventura and C E Byrd-Williams and C M Toledo-Corral and C K Roberts and C J Lane and S P Azen and C P Chou and D Spruijt-Metz and M J Weigensberg and K Berhane and M I Goran}, year = {2012}, date = {2012-00-01}, journal = {Obesity (Silver Spring)}, volume = {20}, number = {4}, pages = {811--818}, abstract = {The purpose of this study was to examine ethnic differences in the metabolic responses to a 16-week intervention designed to improve insulin sensitivity (SI), adiposity, and inflammation in obese African-American and Latino adolescents. A total of 100 participants (African Americans: n = 48, Latino: n = 52; age: 15.4 ± 1.1 years, BMI percentile: 97.3 ± 3.3) were randomly assigned to interventions: control (C; n = 30), nutrition (N; n = 39, 1×/week focused on decreasing sugar and increasing fiber intake), or nutrition + strength training (N+ST; n = 31, 2×/week). The following were measured at pre- and postintervention: strength, dietary intake, body composition (dual-energy X-ray absorptiometry/magnetic resonance imaging) and glucose/insulin indexes (oral glucose tolerance test (OGTT)/intravenous glucose tolerance test (IVGTT)) and inflammatory markers. Overall, N compared to C and N+ST reported significant improvements in SI (+16.5% vs. -32.3% vs. -6.9% respectively, P < 0.01) and disposition index (DI: +15.5% vs. -14.2% vs. -13.7% respectively, P < 0.01). N+ST compared to C and N reported significant reductions in hepatic fat fraction (HFF: -27.3% vs. -4.3% vs. 0% respectively, P < 0.01). Compared to N, N+ST reported reductions in plasminogen activator inhibitor-1 (PAI-1) (-38.3% vs. +1.0%, P < 0.01) and resistin (-18.7% vs. +11.3%}, keywords = {diabetes risk, trial}, pubstate = {published}, tppubtype = {article} } The purpose of this study was to examine ethnic differences in the metabolic responses to a 16-week intervention designed to improve insulin sensitivity (SI), adiposity, and inflammation in obese African-American and Latino adolescents. A total of 100 participants (African Americans: n = 48, Latino: n = 52; age: 15.4 ± 1.1 years, BMI percentile: 97.3 ± 3.3) were randomly assigned to interventions: control (C; n = 30), nutrition (N; n = 39, 1×/week focused on decreasing sugar and increasing fiber intake), or nutrition + strength training (N+ST; n = 31, 2×/week). The following were measured at pre- and postintervention: strength, dietary intake, body composition (dual-energy X-ray absorptiometry/magnetic resonance imaging) and glucose/insulin indexes (oral glucose tolerance test (OGTT)/intravenous glucose tolerance test (IVGTT)) and inflammatory markers. Overall, N compared to C and N+ST reported significant improvements in SI (+16.5% vs. -32.3% vs. -6.9% respectively, P < 0.01) and disposition index (DI: +15.5% vs. -14.2% vs. -13.7% respectively, P < 0.01). N+ST compared to C and N reported significant reductions in hepatic fat fraction (HFF: -27.3% vs. -4.3% vs. 0% respectively, P < 0.01). Compared to N, N+ST reported reductions in plasminogen activator inhibitor-1 (PAI-1) (-38.3% vs. +1.0%, P < 0.01) and resistin (-18.7% vs. +11.3% |
2011 |
Hsu, Y W; Belcher, B R; Ventura, E E; Byrd-Williams, C E; Weigensberg, M J; Davis, J N; McClain, A D; Goran, M I; Spruijt-Metz, D Physical activity, sedentary behavior, and the metabolic syndrome in minority youth Journal Article Med Sci Sports Exerc, 43 (12), pp. 2307–2313, 2011. @article{pmid21552153, title = {Physical activity, sedentary behavior, and the metabolic syndrome in minority youth}, author = {Y W Hsu and B R Belcher and E E Ventura and C E Byrd-Williams and M J Weigensberg and J N Davis and A D McClain and M I Goran and D Spruijt-Metz}, year = {2011}, date = {2011-12-01}, journal = {Med Sci Sports Exerc}, volume = {43}, number = {12}, pages = {2307--2313}, abstract = {This study aimed to determine the associations among physical activity, sedentary behavior, and the metabolic syndrome (MetS) in Latino and African American youth using both subjective and objective measures of activity levels. Cross-sectional data from 105 participants from three pediatric obesity studies that share a core set of methods and measures (Latino 74%, female 75%, mean age = 13 ± 3 yr) were used. Measures included moderate-to-vigorous physical activity and sedentary behavior by accelerometry and 3-Day Physical Activity Recall (3DPAR), fat and lean tissue mass by BodPodâ„¢, fasting glucose, lipids, blood pressure, and waist circumference. Associations between physical activity, sedentary behavior, and MetS were examined using ANCOVA, Pearson correlations, partial correlations, and logistic regressions with adjustments for age, sex, ethnicity, fat and lean mass, and pubertal Tanner stage. Accelerometry data showed that greater time engaging in moderate-to-vigorous physical activity was related to lower odds of the MetS (odds ratio = 0.49, 95% confidence interval = 0.25-0.98), independent of sedentary behavior and covariates, and inversely correlated with fasting glucose (r = -0.21}, keywords = {}, pubstate = {published}, tppubtype = {article} } This study aimed to determine the associations among physical activity, sedentary behavior, and the metabolic syndrome (MetS) in Latino and African American youth using both subjective and objective measures of activity levels. Cross-sectional data from 105 participants from three pediatric obesity studies that share a core set of methods and measures (Latino 74%, female 75%, mean age = 13 ± 3 yr) were used. Measures included moderate-to-vigorous physical activity and sedentary behavior by accelerometry and 3-Day Physical Activity Recall (3DPAR), fat and lean tissue mass by BodPodâ„¢, fasting glucose, lipids, blood pressure, and waist circumference. Associations between physical activity, sedentary behavior, and MetS were examined using ANCOVA, Pearson correlations, partial correlations, and logistic regressions with adjustments for age, sex, ethnicity, fat and lean mass, and pubertal Tanner stage. Accelerometry data showed that greater time engaging in moderate-to-vigorous physical activity was related to lower odds of the MetS (odds ratio = 0.49, 95% confidence interval = 0.25-0.98), independent of sedentary behavior and covariates, and inversely correlated with fasting glucose (r = -0.21 |
Lê, K A; Mahurkar, S; Alderete, T L; Hasson, R E; Adam, T C; Kim, J S; Beale, E; Xie, C; Greenberg, A S; Allayee, H; Goran, M I Subcutaneous adipose tissue macrophage infiltration is associated with hepatic and visceral fat deposition, hyperinsulinemia, and stimulation of NF-κB stress pathway Journal Article Diabetes, 60 (11), pp. 2802–2809, 2011. @article{pmid22025778, title = {Subcutaneous adipose tissue macrophage infiltration is associated with hepatic and visceral fat deposition, hyperinsulinemia, and stimulation of NF-κB stress pathway}, author = {K A Lê and S Mahurkar and T L Alderete and R E Hasson and T C Adam and J S Kim and E Beale and C Xie and A S Greenberg and H Allayee and M I Goran}, year = {2011}, date = {2011-11-01}, journal = {Diabetes}, volume = {60}, number = {11}, pages = {2802--2809}, abstract = {To examine in obese young adults the influence of ethnicity and subcutaneous adipose tissue (SAT) inflammation on hepatic fat fraction (HFF), visceral adipose tissue (VAT) deposition, insulin sensitivity (SI), β-cell function, and SAT gene expression. SAT biopsies were obtained from 36 obese young adults (20 Hispanics, 16 African Americans) to measure crown-like structures (CLS), reflecting SAT inflammation. SAT, VAT, and HFF were measured by magnetic resonance imaging, and SI and β-cell function (disposition index [DI]) were measured by intravenous glucose tolerance test. SAT gene expression was assessed using Illumina microarrays. Participants with CLS in SAT (n = 16) were similar to those without CLS in terms of ethnicity, sex, and total body fat. Individuals with CLS had greater VAT (3.7 ± 1.3 vs. 2.6 ± 1.6 L; P = 0.04), HFF (9.9 ± 7.3 vs. 5.8 ± 4.4%; P = 0.03), tumor necrosis factor-α (20.8 ± 4.8 vs. 16.2 ± 5.8 pg/mL; P = 0.01), fasting insulin (20.9 ± 10.6 vs. 9.7 ± 6.6 mU/mL; P < 0.001) and glucose (94.4 ± 9.3 vs. 86.8 ± 5.3 mg/dL; P = 0.005), and lower DI (1,559 ± 984 vs. 2,024 ± 829 × 10(-4) min(-1); P = 0.03). Individuals with CLS in SAT exhibited upregulation of matrix metalloproteinase-9 and monocyte antigen CD14 genes, as well as several other genes belonging to the nuclear factor-κB (NF-κB) stress pathway. Adipose tissue inflammation was equally distributed between sexes and ethnicities. It was associated with partitioning of fat toward VAT and the liver and altered β-cell function, independent of total adiposity. Several genes belonging to the NF-κB stress pathway were upregulated, suggesting stimulation of proinflammatory mediators.}, keywords = {}, pubstate = {published}, tppubtype = {article} } To examine in obese young adults the influence of ethnicity and subcutaneous adipose tissue (SAT) inflammation on hepatic fat fraction (HFF), visceral adipose tissue (VAT) deposition, insulin sensitivity (SI), β-cell function, and SAT gene expression. SAT biopsies were obtained from 36 obese young adults (20 Hispanics, 16 African Americans) to measure crown-like structures (CLS), reflecting SAT inflammation. SAT, VAT, and HFF were measured by magnetic resonance imaging, and SI and β-cell function (disposition index [DI]) were measured by intravenous glucose tolerance test. SAT gene expression was assessed using Illumina microarrays. Participants with CLS in SAT (n = 16) were similar to those without CLS in terms of ethnicity, sex, and total body fat. Individuals with CLS had greater VAT (3.7 ± 1.3 vs. 2.6 ± 1.6 L; P = 0.04), HFF (9.9 ± 7.3 vs. 5.8 ± 4.4%; P = 0.03), tumor necrosis factor-α (20.8 ± 4.8 vs. 16.2 ± 5.8 pg/mL; P = 0.01), fasting insulin (20.9 ± 10.6 vs. 9.7 ± 6.6 mU/mL; P < 0.001) and glucose (94.4 ± 9.3 vs. 86.8 ± 5.3 mg/dL; P = 0.005), and lower DI (1,559 ± 984 vs. 2,024 ± 829 × 10(-4) min(-1); P = 0.03). Individuals with CLS in SAT exhibited upregulation of matrix metalloproteinase-9 and monocyte antigen CD14 genes, as well as several other genes belonging to the nuclear factor-κB (NF-κB) stress pathway. Adipose tissue inflammation was equally distributed between sexes and ethnicities. It was associated with partitioning of fat toward VAT and the liver and altered β-cell function, independent of total adiposity. Several genes belonging to the NF-κB stress pathway were upregulated, suggesting stimulation of proinflammatory mediators. |
Davis, J N; Gyllenhammer, L E; Vanni, A A; Meija, M; Tung, A; Schroeder, E T; Spruijt-Metz, D; Goran, M I Startup circuit training program reduces metabolic risk in Latino adolescents Journal Article Med Sci Sports Exerc, 43 (11), pp. 2195–2203, 2011. @article{pmid21502883, title = {Startup circuit training program reduces metabolic risk in Latino adolescents}, author = {J N Davis and L E Gyllenhammer and A A Vanni and M Meija and A Tung and E T Schroeder and D Spruijt-Metz and M I Goran}, year = {2011}, date = {2011-11-01}, journal = {Med Sci Sports Exerc}, volume = {43}, number = {11}, pages = {2195--2203}, abstract = {This study aimed to test the effects of a circuit training (CT; aerobic + strength training) program, with and without motivational interviewing (MI) behavioral therapy, on reducing adiposity and type 2 diabetes risk factors in Latina teenagers. Thirty-eight Latina adolescents (15.8 ± 1.1 yr) who are overweight/obese were randomly assigned to control (C; n = 12), CT (n = 14), or CT + MI (n = 12). The CT classes were held twice a week (60-90 min) for 16 wk. The CT + MI group also received individual or group MI sessions every other week. The following were measured before and after intervention: strength by one-repetition maximum; cardiorespiratory fitness (V·O 2max) by submaximal treadmill test; physical activity by accelerometry; dietary intake by records; height, weight, waist circumference; total body composition by dual-energy x-ray absorptiometry; visceral adipose tissue, subcutaneous adipose tissue, and hepatic fat fraction by magnetic resonance imaging; and glucose/insulin indices by fasting blood draw. Across-intervention group effects were tested using repeated-measures ANOVA with post hoc pairwise comparisons. CT and CT + MI participants, compared with controls, significantly increased fitness (+16% and +15% vs -6%}, keywords = {}, pubstate = {published}, tppubtype = {article} } This study aimed to test the effects of a circuit training (CT; aerobic + strength training) program, with and without motivational interviewing (MI) behavioral therapy, on reducing adiposity and type 2 diabetes risk factors in Latina teenagers. Thirty-eight Latina adolescents (15.8 ± 1.1 yr) who are overweight/obese were randomly assigned to control (C; n = 12), CT (n = 14), or CT + MI (n = 12). The CT classes were held twice a week (60-90 min) for 16 wk. The CT + MI group also received individual or group MI sessions every other week. The following were measured before and after intervention: strength by one-repetition maximum; cardiorespiratory fitness (V·O 2max) by submaximal treadmill test; physical activity by accelerometry; dietary intake by records; height, weight, waist circumference; total body composition by dual-energy x-ray absorptiometry; visceral adipose tissue, subcutaneous adipose tissue, and hepatic fat fraction by magnetic resonance imaging; and glucose/insulin indices by fasting blood draw. Across-intervention group effects were tested using repeated-measures ANOVA with post hoc pairwise comparisons. CT and CT + MI participants, compared with controls, significantly increased fitness (+16% and +15% vs -6% |
Ball, G D; Mackenzie-Rife, K A; Newton, M S; Alloway, C A; Slack, J M; Plotnikoff, R C; Goran, M I One-on-one lifestyle coaching for managing adolescent obesity: Findings from a pilot, randomized controlled trial in a real-world, clinical setting Journal Article Paediatr Child Health, 16 (6), pp. 345–350, 2011. Abstract | BibTeX | Tags: pediatric obesity, trial @article{pmid22654546, title = {One-on-one lifestyle coaching for managing adolescent obesity: Findings from a pilot, randomized controlled trial in a real-world, clinical setting}, author = {G D Ball and K A Mackenzie-Rife and M S Newton and C A Alloway and J M Slack and R C Plotnikoff and M I Goran}, year = {2011}, date = {2011-06-01}, journal = {Paediatr Child Health}, volume = {16}, number = {6}, pages = {345--350}, abstract = {Interventions for obese adolescents in real-world, clinical settings need to be evaluated because most weight management care occurs in this context. To determine whether a lifestyle intervention that includes motivational interviewing and cognitive behavioural therapy (Health Initiatives Program [HIP]) leads to weight management that is superior to a similar lifestyle intervention (Youth Lifestyle Program [YLP]) that does not include these techniques; and to determine whether the HIP and YLP interventions are superior to a wait list control (WLC) group. Obese adolescents were randomly assigned to a YLP (n=15), HIP (n=17) or WLC (n=14) group. The YLP and HIP were 16-session, one-on-one interventions. The primary outcome was the percentage change of body mass index z-score. Completers-only analyses revealed 3.9% (YLP) and 6.5% (HIP) decreases in the percentage change of body mass index z-score compared with a 0.8% (WLC) increase (P<0.001). Levels of attrition did not differ among groups, but were relatively high (approximately 20% to 40%). Lifestyle interventions delivered in a real-world, clinical setting led to short-term improvements in the obesity status of adolescents.}, keywords = {pediatric obesity, trial}, pubstate = {published}, tppubtype = {article} } Interventions for obese adolescents in real-world, clinical settings need to be evaluated because most weight management care occurs in this context. To determine whether a lifestyle intervention that includes motivational interviewing and cognitive behavioural therapy (Health Initiatives Program [HIP]) leads to weight management that is superior to a similar lifestyle intervention (Youth Lifestyle Program [YLP]) that does not include these techniques; and to determine whether the HIP and YLP interventions are superior to a wait list control (WLC) group. Obese adolescents were randomly assigned to a YLP (n=15), HIP (n=17) or WLC (n=14) group. The YLP and HIP were 16-session, one-on-one interventions. The primary outcome was the percentage change of body mass index z-score. Completers-only analyses revealed 3.9% (YLP) and 6.5% (HIP) decreases in the percentage change of body mass index z-score compared with a 0.8% (WLC) increase (P<0.001). Levels of attrition did not differ among groups, but were relatively high (approximately 20% to 40%). Lifestyle interventions delivered in a real-world, clinical setting led to short-term improvements in the obesity status of adolescents. |
Toledo-Corral, C M; Davis, J N; Alderete, T L; Weigensberg, M J; Ayala, C T; Li, Y; Hodis, H N; Goran, M I Subclinical atherosclerosis in Latino youth: progression of carotid intima-media thickness and its relationship to cardiometabolic risk factors Journal Article J. Pediatr., 158 (6), pp. 935–940, 2011. Abstract | BibTeX | Tags: diabetes risk, ectopic fat, IMT @article{pmid21238987, title = {Subclinical atherosclerosis in Latino youth: progression of carotid intima-media thickness and its relationship to cardiometabolic risk factors}, author = {C M Toledo-Corral and J N Davis and T L Alderete and M J Weigensberg and C T Ayala and Y Li and H N Hodis and M I Goran}, year = {2011}, date = {2011-06-01}, journal = {J. Pediatr.}, volume = {158}, number = {6}, pages = {935--940}, abstract = {To assess carotid artery intima-media thickness (CIMT) change over 2 years in overweight Latino adolescents and examine its relationship to cardiometabolic risk. Seventy-two healthy overweight male and female Latino adolescents (mean age, 14.5 ± 1.7 years; mean body mass index, 31.5 ± 6.9 kg/m(2)) were evaluated at baseline and 2 years later for CIMT by high-resolution B-mode ultrasound, the metabolic syndrome and its features, body composition by dual-energy x-ray absorptiometry and magnetic resonance imaging, glucose/insulin measures by fasting blood, and oral and intravenous glucose tolerance tests. Baseline CIMT did not differ from 2-year follow-up; however, 38 participants increased CIMT (0.017 ± 0.003 mm; +2.8%) and 34 decreased or remained the same (-0.019 ± 0.002 mm; -3.1%). ANCOVA analyses showed that participants with CIMT progression had higher baseline low-density lipoprotein (LDL)-cholesterol and total cholesterol (91.3 ± 3.4 and 150.3 ± 3.9 mg/dL) compared with those with CIMT non-progression (78.1 ± 3.6 and 135.6 ± 4.2 mg/dL, P < .05), independent of sex, baseline CIMT, age, and height. In multivariate regression, LDL-cholesterol was the sole predictor of CIMT progression, but the effect was small (odds of CIMT progression increased by 3% for each 1 mg/dL higher baseline LDL-cholesterol; 95% CI, 1.004 to 1.006}, keywords = {diabetes risk, ectopic fat, IMT}, pubstate = {published}, tppubtype = {article} } To assess carotid artery intima-media thickness (CIMT) change over 2 years in overweight Latino adolescents and examine its relationship to cardiometabolic risk. Seventy-two healthy overweight male and female Latino adolescents (mean age, 14.5 ± 1.7 years; mean body mass index, 31.5 ± 6.9 kg/m(2)) were evaluated at baseline and 2 years later for CIMT by high-resolution B-mode ultrasound, the metabolic syndrome and its features, body composition by dual-energy x-ray absorptiometry and magnetic resonance imaging, glucose/insulin measures by fasting blood, and oral and intravenous glucose tolerance tests. Baseline CIMT did not differ from 2-year follow-up; however, 38 participants increased CIMT (0.017 ± 0.003 mm; +2.8%) and 34 decreased or remained the same (-0.019 ± 0.002 mm; -3.1%). ANCOVA analyses showed that participants with CIMT progression had higher baseline low-density lipoprotein (LDL)-cholesterol and total cholesterol (91.3 ± 3.4 and 150.3 ± 3.9 mg/dL) compared with those with CIMT non-progression (78.1 ± 3.6 and 135.6 ± 4.2 mg/dL, P < .05), independent of sex, baseline CIMT, age, and height. In multivariate regression, LDL-cholesterol was the sole predictor of CIMT progression, but the effect was small (odds of CIMT progression increased by 3% for each 1 mg/dL higher baseline LDL-cholesterol; 95% CI, 1.004 to 1.006 |
Shaibi, G Q; Davis, J N; Weigensberg, M J; Goran, M I Improving insulin resistance in obese youth: choose your measures wisely Journal Article Int J Pediatr Obes, 6 (2-2), pp. e290–296, 2011. Abstract | BibTeX | Tags: methods @article{pmid21070095, title = {Improving insulin resistance in obese youth: choose your measures wisely}, author = {G Q Shaibi and J N Davis and M J Weigensberg and M I Goran}, year = {2011}, date = {2011-06-01}, journal = {Int J Pediatr Obes}, volume = {6}, number = {2-2}, pages = {e290--296}, abstract = {The purpose of this investigation was to compare the homeostasis model assessment of insulin resistance (HOMA-IR) to more direct measures of insulin action before and after lifestyle interventions in obese Latino youth. Eleven obese Latino boys (age 15.1 ± 1.6 years, body mass index (BMI) percentile 97.3 ± 3.5%) and twenty obese Latina girls (age 14.7 ± 1.8 years, BMI percentile 96.6 ± 3.6%) participated in two distinct lifestyle interventions. Boys participated in a 16-week exercise intervention and girls participated in a 12-week nutrition education program. Insulin sensitivity was determined by the frequently sampled intravenous glucose tolerance test (FSIVGTT) in boys and by a 3-hour oral glucose tolerance test with multiple sampling calculations for the whole-body insulin sensitivity index (WBISI) in girls. HOMA-IR was measured for both groups. HOMA-IR was correlated at baseline to the FSIVGTT (r = -0.57}, keywords = {methods}, pubstate = {published}, tppubtype = {article} } The purpose of this investigation was to compare the homeostasis model assessment of insulin resistance (HOMA-IR) to more direct measures of insulin action before and after lifestyle interventions in obese Latino youth. Eleven obese Latino boys (age 15.1 ± 1.6 years, body mass index (BMI) percentile 97.3 ± 3.5%) and twenty obese Latina girls (age 14.7 ± 1.8 years, BMI percentile 96.6 ± 3.6%) participated in two distinct lifestyle interventions. Boys participated in a 16-week exercise intervention and girls participated in a 12-week nutrition education program. Insulin sensitivity was determined by the frequently sampled intravenous glucose tolerance test (FSIVGTT) in boys and by a 3-hour oral glucose tolerance test with multiple sampling calculations for the whole-body insulin sensitivity index (WBISI) in girls. HOMA-IR was measured for both groups. HOMA-IR was correlated at baseline to the FSIVGTT (r = -0.57 |
Hu, H H; Nayak, K S; Goran, M I Assessment of abdominal adipose tissue and organ fat content by magnetic resonance imaging Journal Article Obes Rev, 12 (5), pp. e504–515, 2011. @article{pmid21348916, title = {Assessment of abdominal adipose tissue and organ fat content by magnetic resonance imaging}, author = {H H Hu and K S Nayak and M I Goran}, year = {2011}, date = {2011-05-01}, journal = {Obes Rev}, volume = {12}, number = {5}, pages = {e504--515}, abstract = {As the prevalence of obesity continues to rise, rapid and accurate tools for assessing abdominal body and organ fat quantity and distribution are critically needed to assist researchers investigating therapeutic and preventive measures against obesity and its comorbidities. Magnetic resonance imaging (MRI) is the most promising modality to address such need. It is non-invasive, utilizes no ionizing radiation, provides unmatched 3-D visualization, is repeatable, and is applicable to subject cohorts of all ages. This article is aimed to provide the reader with an overview of current and state-of-the-art techniques in MRI and associated image analysis methods for fat quantification. The principles underlying traditional approaches such as T(1) -weighted imaging and magnetic resonance spectroscopy as well as more modern chemical-shift imaging techniques are discussed and compared. The benefits of contiguous 3-D acquisitions over 2-D multislice approaches are highlighted. Typical post-processing procedures for extracting adipose tissue depot volumes and percent organ fat content from abdominal MRI data sets are explained. Furthermore, the advantages and disadvantages of each MRI approach with respect to imaging parameters, spatial resolution, subject motion, scan time and appropriate fat quantitative endpoints are also provided. Practical considerations in implementing these methods are also presented.}, keywords = {}, pubstate = {published}, tppubtype = {article} } As the prevalence of obesity continues to rise, rapid and accurate tools for assessing abdominal body and organ fat quantity and distribution are critically needed to assist researchers investigating therapeutic and preventive measures against obesity and its comorbidities. Magnetic resonance imaging (MRI) is the most promising modality to address such need. It is non-invasive, utilizes no ionizing radiation, provides unmatched 3-D visualization, is repeatable, and is applicable to subject cohorts of all ages. This article is aimed to provide the reader with an overview of current and state-of-the-art techniques in MRI and associated image analysis methods for fat quantification. The principles underlying traditional approaches such as T(1) -weighted imaging and magnetic resonance spectroscopy as well as more modern chemical-shift imaging techniques are discussed and compared. The benefits of contiguous 3-D acquisitions over 2-D multislice approaches are highlighted. Typical post-processing procedures for extracting adipose tissue depot volumes and percent organ fat content from abdominal MRI data sets are explained. Furthermore, the advantages and disadvantages of each MRI approach with respect to imaging parameters, spatial resolution, subject motion, scan time and appropriate fat quantitative endpoints are also provided. Practical considerations in implementing these methods are also presented. |
Alderete, TL; Byrd-Williams, CE; Toledo-Corral, CM; Conti, DV; Weigensberg, MJ; Goran, MI Relationships between IGF-1 and IGFBP-1 and adiposity in obese African-American and Latino adolescents Journal Article Obesity (Silver Spring), 19 (5), pp. 933–938, 2011. @article{pmid20885383, title = {Relationships between IGF-1 and IGFBP-1 and adiposity in obese African-American and Latino adolescents}, author = {TL Alderete and CE Byrd-Williams and CM Toledo-Corral and DV Conti and MJ Weigensberg and MI Goran}, year = {2011}, date = {2011-05-01}, journal = {Obesity (Silver Spring)}, volume = {19}, number = {5}, pages = {933--938}, abstract = {The purpose of this study was to examine interrelationships between insulin-like growth factor 1 (IGF-1), IGF binding proteins (IGFBPs), and adiposity in 49 African-American and 77 Latino obese adolescents (15.3 ± 0.1 and 15.4 ± 0.2 years; BMI: 33.0 ± 0.7 and 35.0 ± 1.0 kg/m(2), respectively). Immunoradiometric assays were used to measure IGF-1, IGFBP-1, and IGFBP-3. Total fat and soft lean tissue were measured by dual-energy X-ray absorptiometry and visceral adipose tissue (VAT), subcutaneous abdominal adipose tissue (SAAT), and hepatic fat fraction (HFF) were measured by magnetic resonance imaging. IGF-1 levels were 23.1% higher and IGFBP-1 were 40.4% higher in African Americans compared to Latinos after adjustment for total lean and total fat mass. IGF-1 and IGFBP-1 were inversely correlated with BMI, total fat mass, VAT, and HFF (r = -0.20 to -0.33, P < 0.05) while IGFBP-1 was inversely correlated with SAAT (r = -0.22, P < 0.05). These relationships did not differ by ethnicity, however, the relationship between IGF-1 and SAAT, as well as IGFBP-1 and HFF, differed by ethnicity. Predicted mean IGF-1 levels were 30.7% higher for African Americans at the 75th compared to 25th percentile of SAAT and only 11.7% higher for Latinos. Predicted mean IGFBP-1 levels were 158% higher for African Americans at the 25th compared to the 75th percentile of HFF while IGFBP-1 levels were 1.7% higher for Latinos at the 75th compared to the 25th percentile. These results demonstrate that the relationship between IGF-1 and SAAT as well as IGFBP-1 and HFF are different in African-American and Latino adolescents and may contribute to the higher IGF-1 levels in African-Americans.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The purpose of this study was to examine interrelationships between insulin-like growth factor 1 (IGF-1), IGF binding proteins (IGFBPs), and adiposity in 49 African-American and 77 Latino obese adolescents (15.3 ± 0.1 and 15.4 ± 0.2 years; BMI: 33.0 ± 0.7 and 35.0 ± 1.0 kg/m(2), respectively). Immunoradiometric assays were used to measure IGF-1, IGFBP-1, and IGFBP-3. Total fat and soft lean tissue were measured by dual-energy X-ray absorptiometry and visceral adipose tissue (VAT), subcutaneous abdominal adipose tissue (SAAT), and hepatic fat fraction (HFF) were measured by magnetic resonance imaging. IGF-1 levels were 23.1% higher and IGFBP-1 were 40.4% higher in African Americans compared to Latinos after adjustment for total lean and total fat mass. IGF-1 and IGFBP-1 were inversely correlated with BMI, total fat mass, VAT, and HFF (r = -0.20 to -0.33, P < 0.05) while IGFBP-1 was inversely correlated with SAAT (r = -0.22, P < 0.05). These relationships did not differ by ethnicity, however, the relationship between IGF-1 and SAAT, as well as IGFBP-1 and HFF, differed by ethnicity. Predicted mean IGF-1 levels were 30.7% higher for African Americans at the 75th compared to 25th percentile of SAAT and only 11.7% higher for Latinos. Predicted mean IGFBP-1 levels were 158% higher for African Americans at the 25th compared to the 75th percentile of HFF while IGFBP-1 levels were 1.7% higher for Latinos at the 75th compared to the 25th percentile. These results demonstrate that the relationship between IGF-1 and SAAT as well as IGFBP-1 and HFF are different in African-American and Latino adolescents and may contribute to the higher IGF-1 levels in African-Americans. |
Kelly, L A; Lane, C J; Weigensberg, M J; Toledo-Corral, C M; Goran, M I Pubertal changes of insulin sensitivity, acute insulin response, and β-cell function in overweight Latino youth Journal Article J. Pediatr., 158 (3), pp. 442–446, 2011. Abstract | BibTeX | Tags: diabetes risk, puberty @article{pmid20888012, title = {Pubertal changes of insulin sensitivity, acute insulin response, and β-cell function in overweight Latino youth}, author = {L A Kelly and C J Lane and M J Weigensberg and C M Toledo-Corral and M I Goran}, year = {2011}, date = {2011-03-01}, journal = {J. Pediatr.}, volume = {158}, number = {3}, pages = {442--446}, abstract = {To examine changes in insulin sensitivity (SI), compensatory acute insulin response (AIR), and β-cell function/disposition index (DI) across puberty in overweight Latino boys and girls. Latino children (n = 253) were followed annually for up to 5 years. Longitudinal modeling was used to examine changes in SI, AIR, DI, and fasting and 2-hour glucose and insulin across Tanner stage. In boys, SI decreased in early puberty with a recovery by late puberty. The compensatory increase in AIR was appropriate in early maturation, but after Tanner stage 3, AIR declined by more than that predicted from the recovery in SI. For girls, SI decreased in early puberty and across all stages of maturation. In early maturation, there was an appropriate compensatory increase in AIR, but after Tanner stage 3, AIR decreased. Thus, DI deteriorated across puberty in boys and girls. In overweight Hispanic youth, compensatory changes in insulin secretion fails after Tanner stage 3 in both sexes, indicating β-cell deterioration during this critical period of development, thus increasing risk for type 2 diabetes.}, keywords = {diabetes risk, puberty}, pubstate = {published}, tppubtype = {article} } To examine changes in insulin sensitivity (SI), compensatory acute insulin response (AIR), and β-cell function/disposition index (DI) across puberty in overweight Latino boys and girls. Latino children (n = 253) were followed annually for up to 5 years. Longitudinal modeling was used to examine changes in SI, AIR, DI, and fasting and 2-hour glucose and insulin across Tanner stage. In boys, SI decreased in early puberty with a recovery by late puberty. The compensatory increase in AIR was appropriate in early maturation, but after Tanner stage 3, AIR declined by more than that predicted from the recovery in SI. For girls, SI decreased in early puberty and across all stages of maturation. In early maturation, there was an appropriate compensatory increase in AIR, but after Tanner stage 3, AIR decreased. Thus, DI deteriorated across puberty in boys and girls. In overweight Hispanic youth, compensatory changes in insulin secretion fails after Tanner stage 3 in both sexes, indicating β-cell deterioration during this critical period of development, thus increasing risk for type 2 diabetes. |
Lê, K A; Ventura, E E; Fisher, J Q; Davis, J N; Weigensberg, M J; Punyanitya, M; Hu, H H; Nayak, K S; Goran, M I Ethnic differences in pancreatic fat accumulation and its relationship with other fat depots and inflammatory markers Journal Article Diabetes Care, 34 (2), pp. 485–490, 2011. Abstract | BibTeX | Tags: diabetes risk, ectopic fat @article{pmid21270204, title = {Ethnic differences in pancreatic fat accumulation and its relationship with other fat depots and inflammatory markers}, author = {K A Lê and E E Ventura and J Q Fisher and J N Davis and M J Weigensberg and M Punyanitya and H H Hu and K S Nayak and M I Goran}, year = {2011}, date = {2011-02-01}, journal = {Diabetes Care}, volume = {34}, number = {2}, pages = {485--490}, abstract = {Visceral adipose tissue (VAT) and hepatic fat are associated with insulin resistance and vary by sex and ethnicity. Recently, pancreatic fat fraction (PFF) has also been linked with increasing obesity. Our aim was to assess ethnic and sex differences in PFF and its relationship to other fat depots, circulating free fatty acids (FFA), insulin secretion and sensitivity, and inflammation in obese adolescents and young adults. We examined 138 (40 males, 98 females) obese Hispanics and African Americans (13-25 years). Subcutaneous adipose tissue and VAT volumes, hepatic fat fraction (HFF), and PFF were determined by magnetic resonance imaging. Insulin sensitivity and β-cell function were assessed during an intravenous glucose tolerance test. Hispanics had higher PFF than African Americans (7.3 ± 3.8 vs. 6.2 ± 2.6%}, keywords = {diabetes risk, ectopic fat}, pubstate = {published}, tppubtype = {article} } Visceral adipose tissue (VAT) and hepatic fat are associated with insulin resistance and vary by sex and ethnicity. Recently, pancreatic fat fraction (PFF) has also been linked with increasing obesity. Our aim was to assess ethnic and sex differences in PFF and its relationship to other fat depots, circulating free fatty acids (FFA), insulin secretion and sensitivity, and inflammation in obese adolescents and young adults. We examined 138 (40 males, 98 females) obese Hispanics and African Americans (13-25 years). Subcutaneous adipose tissue and VAT volumes, hepatic fat fraction (HFF), and PFF were determined by magnetic resonance imaging. Insulin sensitivity and β-cell function were assessed during an intravenous glucose tolerance test. Hispanics had higher PFF than African Americans (7.3 ± 3.8 vs. 6.2 ± 2.6% |
Hu, H H; Li, Y; Nagy, T R; Goran, M I; Nayak, K S Quantification of Absolute Fat Mass by Magnetic Resonance Imaging: a Validation Study against Chemical Analysis Journal Article Int J Body Compos Res, 9 (3), pp. 111–122, 2011. @article{pmid23204926, title = {Quantification of Absolute Fat Mass by Magnetic Resonance Imaging: a Validation Study against Chemical Analysis}, author = {H H Hu and Y Li and T R Nagy and M I Goran and K S Nayak}, year = {2011}, date = {2011-01-01}, journal = {Int J Body Compos Res}, volume = {9}, number = {3}, pages = {111--122}, abstract = {OBJECTIVE: To develop a magnetic resonance imaging (MRI)-based approach for quantifying absolute fat mass in organs, muscles, and adipose tissues, and to validate its accuracy against reference chemical analysis (CA). METHODS: Chemical-shift imaging can accurately decompose water and fat signals from the acquired MRI data. A proton density fat fraction (PDFF) can be computed from the separated images, and reflects the relative fat content on a voxel-by-voxel basis. The PDFF is mathematically closely related to the fat mass fraction and can be converted to absolute fat mass in grams by multiplying by the voxel volume and the mass density of fat. In this validation study, 97 freshly excised and unique samples from four pigs, comprising of organs, muscles, and adipose and lean tissues were imaged by MRI and then analyzed independently by CA. Linear regression was used to assess correlation, agreement, and measurement differences between MRI and CA. RESULTS: Considering all 97 samples, a strong correlation and agreement was obtained between MRI and CA-derived fat mass (slope = 1.01}, keywords = {}, pubstate = {published}, tppubtype = {article} } OBJECTIVE: To develop a magnetic resonance imaging (MRI)-based approach for quantifying absolute fat mass in organs, muscles, and adipose tissues, and to validate its accuracy against reference chemical analysis (CA). METHODS: Chemical-shift imaging can accurately decompose water and fat signals from the acquired MRI data. A proton density fat fraction (PDFF) can be computed from the separated images, and reflects the relative fat content on a voxel-by-voxel basis. The PDFF is mathematically closely related to the fat mass fraction and can be converted to absolute fat mass in grams by multiplying by the voxel volume and the mass density of fat. In this validation study, 97 freshly excised and unique samples from four pigs, comprising of organs, muscles, and adipose and lean tissues were imaged by MRI and then analyzed independently by CA. Linear regression was used to assess correlation, agreement, and measurement differences between MRI and CA. RESULTS: Considering all 97 samples, a strong correlation and agreement was obtained between MRI and CA-derived fat mass (slope = 1.01 |
Goran, M I; Ventura, E E International journal of pediatric obesity: year in review 2010 Journal Article Int J Pediatr Obes, 6 (3-4), pp. 163–168, 2011. BibTeX | Tags: @article{pmid21751832, title = {International journal of pediatric obesity: year in review 2010}, author = {M I Goran and E E Ventura}, year = {2011}, date = {2011-00-01}, journal = {Int J Pediatr Obes}, volume = {6}, number = {3-4}, pages = {163--168}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Fasting indicators of insulin sensitivity: effects of ethnicity and pubertal status Journal Article Diabetes Care, 34 (4), pp. 994–999, 2011. @article{pmid21357795, title = {Fasting indicators of insulin sensitivity: effects of ethnicity and pubertal status}, year = {2011}, date = {2011-00-01}, journal = {Diabetes Care}, volume = {34}, number = {4}, pages = {994--999}, abstract = {To examine the relationship of fasting indicators of insulin sensitivity with a more invasive measure of insulin sensitivity (frequently sampled intravenous glucose tolerance test [FSIVGTT]) and the effect of Tanner stage and ethnicity on that relationship. Data were analyzed from 149 overweight girls (97 Hispanic and 52 African American) who were either in the early stages of maturation defined by Tanner stages 1 or 2 (52 Hispanic and 18 African American) or in the later stages of maturation defined by Tanner stages 4 and 5 (45 Hispanic and 34 African American). Fasting indicators of insulin sensitivity (IS) included fasting insulin and glucose and the homeostasis model assessment of insulin resistance (HOMA-IR). IS was derived from an FSIVGTT with minimal modeling. In Tanner stages 1 and 2, all fasting indicators were significantly associated with IS: (fasting insulin: r = -0.67, P < 0.01; HOMA: r = -0.66, P < 0.01) with no significant influence of ethnicity on these relationships. In Tanner stages 4 and 5, however, all fasting indicators were associated with IS in African American girls (fasting insulin: r = -0.55, P < 0.01; HOMA: r = -0.47, P < 0.01), but none of the indicators were significantly associated with IS in Hispanic girls. Fasting indicators were reflective of IS for girls in Tanner stages 1 and 2, regardless of ethnicity and may provide a clinical measure of future risk for type 2 diabetes. In the latter stages of maturation, however, more invasive measures are warranted to adequately determine IS in clinical practice.}, keywords = {}, pubstate = {published}, tppubtype = {article} } To examine the relationship of fasting indicators of insulin sensitivity with a more invasive measure of insulin sensitivity (frequently sampled intravenous glucose tolerance test [FSIVGTT]) and the effect of Tanner stage and ethnicity on that relationship. Data were analyzed from 149 overweight girls (97 Hispanic and 52 African American) who were either in the early stages of maturation defined by Tanner stages 1 or 2 (52 Hispanic and 18 African American) or in the later stages of maturation defined by Tanner stages 4 and 5 (45 Hispanic and 34 African American). Fasting indicators of insulin sensitivity (IS) included fasting insulin and glucose and the homeostasis model assessment of insulin resistance (HOMA-IR). IS was derived from an FSIVGTT with minimal modeling. In Tanner stages 1 and 2, all fasting indicators were significantly associated with IS: (fasting insulin: r = -0.67, P < 0.01; HOMA: r = -0.66, P < 0.01) with no significant influence of ethnicity on these relationships. In Tanner stages 4 and 5, however, all fasting indicators were associated with IS in African American girls (fasting insulin: r = -0.55, P < 0.01; HOMA: r = -0.47, P < 0.01), but none of the indicators were significantly associated with IS in Hispanic girls. Fasting indicators were reflective of IS for girls in Tanner stages 1 and 2, regardless of ethnicity and may provide a clinical measure of future risk for type 2 diabetes. In the latter stages of maturation, however, more invasive measures are warranted to adequately determine IS in clinical practice. |
2014 |
Journal Article Curr. Diab. Rep., 14 (2), pp. 455, 2014. | Metabolic basis of ethnic differences in diabetes risk in overweight and obese youth
Journal Article Obesity (Silver Spring), 22 (2), pp. 474–481, 2014. | Modifying influence of dietary sugar in the relationship between cortisol and visceral adipose tissue in minority youth
Journal Article BMC Complement Altern Med, 14 , pp. 28, 2014. | Imagine HEALTH: results from a randomized pilot lifestyle intervention for obese Latino adolescents using Interactive Guided ImagerySM
Journal Article Obesity (Silver Spring), 22 (1), pp. 14–18, 2014. | Adipose tissue 11βĦSĐ1 gene expression, βcell function and ectopic fat in obese African Americans versus Hispanics
Journal Article Nutrition, 30 (7-8), pp. 928–935, 2014. | Fructose content in popular beverages made with and without high-fructose corn syrup
Journal Article Am J Prev Med, 46 (4), pp. 378–387, 2014. | Fast-food restaurants, park access, and insulin resistance among Hispanic youth
2013 |
Journal Article Pediatr Obes, 8 (6), pp. 68–73, 2013. | Compensatory responses to insulin resistance in obese African-American and Latina girls
Journal Article Obesity (Silver Spring), 21 (12), pp. E790–797, 2013. | Genetic and clinical markers of elevated liver fat content in overweight and obese Hispanic children
Journal Article Pediatr Obes, 8 (6), pp. 411–417, 2013. | The association between community-level economic hardship and childhood obesity prevalence in Los Angeles
Journal Article Diabetes Care, 36 (11), pp. 3739–3745, 2013. | Temporal relationship between insulin sensitivity and the pubertal decline in physical activity in peripubertal Hispanic and African American females
Journal Article J. Clin. Endocrinol. Metab., 98 (9), pp. 3748–3754, 2013. | Liver fat has a stronger association with risk factors for type 2 diabetes in African-American compared with Hispanic adolescents
Journal Article Psychoneuroendocrinology, 38 (9), pp. 1658–1667, 2013. | Blunted nocturnal cortisol rise is associated with higher carotid artery intima-media thickness (CIMŦ) in overweight African American and Latino youth
Journal Article Am. J. Clin. Nutr., 97 (6), pp. 1413–1415, 2013. | Self-report-based estimates of energy intake offer an inadequate basis for scientific conclusions
Journal Article Diabetes Care, 36 (6), pp. 1681–1686, 2013. | One-hour glucose during an oral glucose challenge prospectively predicts β-cell deterioration and prediabetes in obese Hispanic youth
Journal Article J. Clin. Endocrinol. Metab., 98 (3), pp. 1115–1121, 2013. | Ectopic fat deposition in prediabetic overweight and obese minority adolescents
Journal Article J Magn Reson Imaging, 37 (2), pp. 423–430, 2013. | Automatic intra-subject registration-based segmentation of abdominal fat from water-fat MRI
Journal Article J Obes, 2013 , pp. 512914, 2013. | Sociocultural and socioeconomic influences on type 2 diabetes risk in overweight/obese African-American and Latino-American children and adolescents
Journal Article N. Engl. J. Med., 368 (3), pp. 285–286, 2013. | Sugar-sweetened beverages, genetic risk, and obesity
Journal Article Glob Public Health, 8 (1), pp. 55–64, 2013. | High fructose corn syrup and diabetes prevalence: a global perspective
Journal Article Pediatr Obes, 8 (4), pp. 237–241, 2013. | How growing up sweet can turn sour
Journal Article Am. J. Clin. Nutr., 98 (2), pp. 275–281, 2013. | Eating breakfast more frequently is cross-sectionally associated with greater physical activity and lower levels of adiposity in overweight Latina and African American girls
Journal Article Nat Rev Endocrinol, 9 (8), pp. 494–500, 2013. | The obesogenic effect of high fructose exposure during early development
Journal Article J. Pediatr., 162 (4), pp. 741–745, 2013. | Impact of gestational diabetes mellitus on pubertal changes in adiposity and metabolic profiles in Latino offspring
2012 |
Journal Article Dig Liver Dis, 44 (9), pp. 711–713, 2012. | Genetic predisposition and increasing dietary fructose exposure: the perfect storm for fatty liver disease in Hispanics in the UṠ
Journal Article Curr Opin Clin Nutr Metab Care, 15 (4), pp. 392–396, 2012. | Genetic-related and carbohydrate-related factors affecting liver fat accumulation
Journal Article J. Pediatr., 160 (6), pp. 911–917, 2012. | Health-related quality of life in adolescents with or at risk for type 2 diabetes mellitus
Journal Article J. Pediatr., 160 (5), pp. 751–756, 2012. | Hemoglobin A1c above threshold level is associated with decreased β-cell function in overweight Latino youth
Journal Article Pediatr Obes, 7 (1), pp. 16–27, 2012. | Effects of a randomized maintenance intervention on adiposity and metabolic risk factors in overweight minority adolescents
Journal Article J Am Coll Nutr, 31 (5), pp. 369–374, 2012. | High rates of fructose malabsorption are associated with reduced liver fat in obese African Americans
Journal Article Nestle Nutr Inst Workshop Ser, 73 , pp. 49–60, 2012. | Targeting adipose tissue inflammation to treat the underlying basis of the metabolic complications of obesity
Journal Article Am. J. Clin. Nutr., 95 (1), pp. 3–8, 2012. | Effects of breastfeeding and low sugar-sweetened beverage intake on obesity prevalence in Hispanic toddlers
Journal Article J Epidemiol Community Health, 66 (1), pp. 24–29, 2012. | Do neighbourhoods matter? Neighbourhood disorder and long-term trends in serum cortisol levels
Journal Article Pediatr Obes, 7 (5), pp. 42–61, 2012. | Adiposity in children and adolescents: correlates and clinical consequences of fat stored in specific body depots
Journal Article Obes Rev, 13 (8), pp. 723–732, 2012. | Use of MRI and CŦ for fat imaging in children and youth: what have we learned about obesity, fat distribution and metabolic disease risk?
Increasing Physical Activity Đecreases Ħepatic Fat and Metabolic Risk Factors Journal Article J Exerc Physiol Online, 15 (2), pp. 40–54, 2012. |
Journal Article Pediatr Obes, 7 (2), pp. 158–164, 2012. | Influence of elevated liver fat on circulating adipocytokines and insulin resistance in obese Hispanic adolescents
Journal Article Obesity (Silver Spring), 20 (4), pp. 811–818, 2012. | Randomized controlled trial to improve adiposity, inflammation, and insulin resistance in obese African-American and Latino youth
2011 |
Journal Article Med Sci Sports Exerc, 43 (12), pp. 2307–2313, 2011. | Physical activity, sedentary behavior, and the metabolic syndrome in minority youth
Journal Article Diabetes, 60 (11), pp. 2802–2809, 2011. | Subcutaneous adipose tissue macrophage infiltration is associated with hepatic and visceral fat deposition, hyperinsulinemia, and stimulation of NF-κB stress pathway
Journal Article Med Sci Sports Exerc, 43 (11), pp. 2195–2203, 2011. | Startup circuit training program reduces metabolic risk in Latino adolescents
Journal Article Paediatr Child Health, 16 (6), pp. 345–350, 2011. | One-on-one lifestyle coaching for managing adolescent obesity: Findings from a pilot, randomized controlled trial in a real-world, clinical setting
Journal Article J. Pediatr., 158 (6), pp. 935–940, 2011. | Subclinical atherosclerosis in Latino youth: progression of carotid intima-media thickness and its relationship to cardiometabolic risk factors
Journal Article Int J Pediatr Obes, 6 (2-2), pp. e290–296, 2011. | Improving insulin resistance in obese youth: choose your measures wisely
Journal Article Obes Rev, 12 (5), pp. e504–515, 2011. | Assessment of abdominal adipose tissue and organ fat content by magnetic resonance imaging
Journal Article Obesity (Silver Spring), 19 (5), pp. 933–938, 2011. | Relationships between IGF-1 and IGFBP-1 and adiposity in obese African-American and Latino adolescents
Journal Article J. Pediatr., 158 (3), pp. 442–446, 2011. | Pubertal changes of insulin sensitivity, acute insulin response, and β-cell function in overweight Latino youth
Journal Article Diabetes Care, 34 (2), pp. 485–490, 2011. | Ethnic differences in pancreatic fat accumulation and its relationship with other fat depots and inflammatory markers
Journal Article Int J Body Compos Res, 9 (3), pp. 111–122, 2011. | Quantification of Absolute Fat Mass by Magnetic Resonance Imaging: a Validation Study against Chemical Analysis
Journal Article Int J Pediatr Obes, 6 (3-4), pp. 163–168, 2011. | International journal of pediatric obesity: year in review 2010
Fasting indicators of insulin sensitivity: effects of ethnicity and pubertal status Journal Article Diabetes Care, 34 (4), pp. 994–999, 2011. |