Abstract: To better estimate rates of certain benefits and risks of recreational running, we sent questionnaires to 1,250 randomly selected male and 1,250 female registrants for a 10-km road race. The response rate was 55% for men and 58% for women. Telephone interviews of a randomly selected group of nonrespondents indicated that the only significant differences between respondents and nonrespondents were that (1) respondents were older than nonrespondents, (2) more male nonrespondents had stopped running during the year after the race, and (3) more male nonrespondents had been hit by thrown objects. One year after the race, 89% of male and 79% of female respondents were still running regularly. Eighty-one percent of men and 75% of women who smoked cigarettes when they began running had stopped smoking after beginning recreational running. Giving up smoking was significantly more common for current runners than for "retired" runners. Weight loss was commonly associated with running and was greater in those persons who were overweight when they began running. More than a third of respondents had a musculoskeletal injury attributed to running in the year after the race and about one seventh of all respondents sought medical consultation for their injury. The risk of injury increased with increasing weekly mileage. This study uses epidemiologic methods to quantify some of the benefits and risks of running.

Abstract: WE are in a period in which the management of mild and moderate hypertension is being reevaluated. The U.S. Veterans Administration studies initiated nearly 20 years ago indicated that drug treatment of hypertension clearly reduced morbidity and mortality. Large scale controlled studies since that time have either compared the effect of one drug with another or of one or more drugs with that of usual care in the community. There is, however, an increasing uneasiness that many of the million of patients taking drugs with known and unknown longterm side effects may be doing so inappropriately. Some years ago in an extended trial of withdrawal of hypertension drugs or substitution of a placebo, Dustan et al. found that relatively few hypertension patients could sustain their reduction of blood pressure without medication. However, more recently Finnerty has shown in a large series of patients that the total dosage or the number of antihypertensive drugs can be reduced without impairing the antihypertensive effect and with considerable reduction in adverse symptoms of medication. In neither of these studies, however, was an attempt made to substitute nonpharmacologic for pharmacologic measures. It is noteworthy that hypertensives tend to be an overweight group of patients, with a mean of 30% above ideal weight in most large series, and that metabolic derangements such as noninsulin-dependent diabetes and hyperlipidemia are often associated. The 1979 Report of the Hypertension Task Force of the National Institutes of Health urged that attention be given to the special problems of the overweight

Abstract: To find out if subjects' knowledge of the complex nature of obesity increases with age, 447 nursery school, first grade, fifth grade, and adult subjects were asked if they knew anyone fat and, if so, who; what the causes of obesity are; and whose fault it is if someone is fat. Older subjects were increasingly likely to know people who were fat and to give complex causal explanations for obesity; moreover, adults were less likely than children to see the fat individual as responsible for his obesity. Female subjects were more likely than males to know someone fat and to give complex explanations of obesity. Anglo, Hispanic, Native American and black subjects did not differ on any measure. Children who were underweight, of average weight or overweight also did not differ in knowledge or beliefs. The results suggest that, although accuracy of knowledge increases with age, education about obesity at all age levels may be needed to reduce incorrect beliefs and accompanying negative attitudes toward obesity.

Abstract: Children with phenylketonuria (PKU) participating in the PKU Collaborative Study were found to be overweight on average by age 4, particularly the girls. A search was made for factors that were mos...

Abstract: This paper reviews key aspects of the relationship of diet to coronary heart disease, as demonstrated in epidemiologic and other research over the last 25 or more years. It summarizes the extensive findings that have demonstrated an etiologically significant association among dietary lipid, serum cholesterol, and coronary heart disease; between caloric imbalance and two of the major CHD risk factors, hypertension and hypercholesterolemia; on the relationship between habitual diet high in sodium and hypertension. It also reviews the data on the relationship of habitual dietary lipid intake of individuals within a population to the serum cholesterol and CHD risk of individuals, indicating that valid positive findings in this area are consistent with evidence from cross-population epidemiologic studies, controlled experiments on diet change in man, and findings from animal research. It delineates the controlled experiments on diet change in man, and findings from animal research. It delineates the methodological problems that have stood in the way of the sound elucidation of this matter, and of the similar ones making it difficult to fully resolve the issue of the relationship of habitual dietary sodium intake of individuals within a population to their blood pressure. It reviews recent findings on the relationship of diet, particularly dietary lipid and calorie balance, to fractions of plasma total cholesterol, i.e., LDL-cholesterol, VLDL-cholesterol, and HDL-cholesterol, and summarizes the evidence indicating that recommendations for improved nutrition in the United States--emphasizing sizable reduction in saturated fat and cholesterol intake, moderate decrease in intake of total fat and of refined and processed sugars, and of calories for overweight persons--produce changes in plasma lipidlipoprotein levels that are favorable in all respects. Finally, it summarizes the findings with respect to the marked decline in mortality from coronary heart disease, stroke, all cardiovascular diseases, and all causes in the United States from 1968 to 1978, and presents evidence indicating that improvements in life style (eating, smoking, and exercise habits) and control of high blood pressure have contributed significantly to these trends.

Abstract: Several blood-pressure-regulating factors including exchangeable sodium, blood volume, plasma renin, aldosterone, norepinephrine (NE), and epinephrine (E) levels, urinary catecholamine excretion rates, and cardiovascular responsiveness to infused NE and angiotensin II (AII) were compared among age-matched subgroups of normal subjects (15 with normal weight, 15 with overweight) and patients with essential hypertension (15 with either normal weight, overweight, or obesity). Exchangeable sodium, blood volume, plasma and urinary sodium and potassium, plasma renin, aldosterone and epinephrine levels, and NE or E excretion rates did not differ significantly among the five subgroups. Minimal differences included a slightly higher heart rate in overweight patients than in overweight normal subjects (p less than 0.01) and a tendency for a higher plasma NE in overweight than in normal weight patients. Plasma NE obtained immediately before NE infusion as well as the plasma clearance of NE did not differ among the five subgroups except, however, for a somewhat low NE clearance in obese patients. The NE pressor dose tended to be lower in normal-weight hypertensive than in normal-weight normotensive subjects. No alteration was apparent in overweight or obese hypertensive patients. Pressor responses to AII were similar in the different subgroups. These findings suggest that overweight does not confer a unique aberration in the body sodium-volume state, circulating renin, aldosterone or catecholamines, or cardiovascular responses to NE or AII which result in hypertension.

Abstract: The motor development of a group of fat babies was compared with that of a group of normal weight babies. A significant correlation was found between excessive weight and gross motor delay. Over the ensuing year, both weight and development reverted to normal in the majority of infants. The possible relationship between observations is discussed, and a plea is made that a comprehensive evaluation of the motor-delayed overweight infant be performed before concluding that the delay is due solely to the excessive weight.

Abstract: The relations between adipose tissue development at birth, later expansion of fat mass and the behavior of fat mass and fat cell growth from birth to 12 mo of age have been studied in normal children born to normal, obese or diabetic mothers and maintained on strictly controlled calorie intake. A simple method for fat cell size determination on microsamples of fat tissue, specifically designed for small children, is reported. In the first 3 mo of life, a marked increase of fatty tissue from 13.4 ± 0.4 to 20.3 ± 0.8 percent of total body mass was observed. Subsequently, a sharp decrease in the relative amount of fat mass occurs, probably related to an increased energy expenditure or to a slightly higher protein content in the diet. No sex related differences in body weight, body fat mass, sum of skinfold thickness or fat cell weight were found throughout the study. No significant differences in body fat mass, sum of skinfold thickness and body fat mass as percent of body weight was observed at birth and at 3 or 6 mo of age in children of obese or gestational diabetic mothers, in comparison with children of normal mothers, and no significant correlation was found between maternal adiposity (sum of skinfold thickness or pre-gravidic overweight) or glucose tolerance (blood glucose area after OGTT) and adipose tissue development in the first 6 mo of life. Thus, in children on strictly controlled intake, obesity or diabetes in the mother do not relate to the rate of fat accumulation. Moreover, no relations were found between adipose tissue development at birth and subsequent rate of fat enlargement in the first year of life. Thus, when the interference of a different calorie intake is excluded, adiposity at birth has no predictive value for possible fatness later in infancy.

Abstract: SummaryLower social class, several children, an overweight partner and increasing age were factors significantly associated with overweight in parents aged 20–55 years in England and Scotland. These associations were greater for women than men in both countries. These results support the contention that social circumstances contribute to overweight in adults. However, both the magnitude of the explained variation and the relative risk of each factor for overweight were low. We conclude that the selection of families for preventive health measures using the above risk factors would exclude a large proportion of the population who will become obese.

Abstract: Attitudes to, and knowledge of, health and nutrition, together with presence of major coronary risk factors, were assessed in New south Wales high-school students at the start of an experimental healthy lifestyle programme. Data were obtained for 2596 children (mean age, 12.5 to 15.5 years), of whom 1971 lived in Sydney and 625 in rural Inverell. Girls had higher scores than boys on questions related to nutrition and fitness attitudes. Girls' scores on questions related to health attitudes and knowledge and nutrition attitudes and knowledge increased with age. The earliest precursors of coronary heart disease and chronic lung diseases were present in this group of children, of whom 20% to 30% were smoking cigarettes, 30% were overweight or obese, 8% to 15% of boys and 2% to 7% of girls had high blood pressure, and 9% had hypercholesterolaemia.

Abstract: Summary The study reported here is a replication of an earlier study exploring association of body image with other personality characteristics. In both studies it was predicted that overweight body image would be associated with more negative personality characteristics than normal weight body image, and evidence was found supporting the predictions. In this second study 290 college students were asked to write stories about drawings of normal and overweight males or females and to describe the personalities they created on a personality scale. They were also asked to rank groups of people including overweight and obese persons on a social distance scale. In general the replication supported the findings of the first study.

Abstract: Maternal undernutrition may result in a greater deprivation of the fetus than has previously been believed. The infant not only may be "light for dates" but also has an increased risk of perinatal disability or death secondary to gross neurologic and developmental abnormalities. This article reviews current knowledge of the energy, protein, iron, vitamin, sodium and calcium requirements in pregnancy, with special reference to the management of the underweight and overweight pregnant women.

Abstract: Fibrinolytic response to venous occlusion and other clotting parameters were studied in 34 obese children and 16 controls. The obese children (mean age 9 2/12 years) had a mean overweight of 51.8% +/- 15.6, higher blood glucose and cholesterol levels, and increased baseline and glucose-induced insulinemia. However, baseline ELT did not differ significantly; ELT after 5 min venous occlusion was 203.2 +/- 110.9 min in the obese children and 114.7 +/- 67.9 min in the control group (p less than 0.01) with a mean percent decrease respectively of 14.9% and 29.2%. Poor fibrinolytic responders did not correlate with age, overweight, or metabolic indices. Lower levels of ATIII (p less than 0.01) and no changes in F VIII: C and F VIII: R Ag were also found in the obese. Furthermore, in a larger group of 84 prepubertal obese children (mean age 10 years; mean overweight 48.2%) and in 39 normal prepubertal children (mean age 10 4/12 years) we also studied platelet aggregation capacity according to Breddin. This parameter was altered in a high proportion of the obese children (p less than 0.05). The obese children were also poor fibrinolytic responders, similarly to obese adults, and exhibited early alteration of the clotting balance.

Abstract: There have been many investigations of body image in cases of anorexia nervosa in adolescent females. However, there has been limited research with normal adolescent girls who happen to be overweight. In this study, 27 girls found to be obese (at least 20 percent above average body weight for age, sex and height) among 203 girls in home economics classes of four suburban high schools were compared to 20 girls seeking help for their obesity on an outpatient basis in hospital-affiliated programs for weight reduction in a nearby city. The two groups were assessed and compared regarding body image factors. The clinical subjects showed a significantly greater difference in their selection of outline drawings of the female figure perceived to represent their actual as compared to ideal body sizes. No significant difference was found in articulation of body concept as revealed in human figure drawings judged according to Witkin's Articulation of Body Concept (ABC) Scale, and in the mean number of uncomplimentary adjectives used to describe present appearance. However, the difference between the mean scores of the two groups in the latter two variables, when submitted to t tests, were shown to approach significance (.017 less than p less than .05).

Abstract: Summary. The aim of the present study was to analyse to what extent serum lipoproteins are determined by overweight and physical fitness. Fifty-eight middle-aged males were divided into lean, overweight and obese subgroups according to their body mass indices, which characterization was also well in accordance with two skinfold thicknesses. Maximal oxygen consumption per body weight was lowest in the obese. HDL cholesterol was decreased in the obese compared to the lean. HDL cholesterol correlated separately significantly with maximal oxygen consumption and body mass index when all the three groups were combined. Physical fitness was a less dominant determinant of HDL cholesterol than body mass index. The importance of physical fitness as a determinant of HDL cholesterol was less marked in the obese than in the lean and overweight suggesting a need for certain level of physical activity before it can influence serum lipoprotein levels.

Abstract: Both the intervention and the control group included each 5000 men aged 40-60 years, randomly selected by their home address in five districts of the city of Bucharest. The intervention group underwent an "at entry" examination for risk factor detection (high serum cholesterol, high blood pressure, overweight, diabetes, minor ECG abnormalities, family history) and subsequently a five-year multifactorial intervention aimed to reduce the risk factors. Both groups were followed up in this lapse of time for major end-points: myocardial infarction, stroke, sudden death. The qualitative analysis of the results used ten evolution indices based on a quantal counting and lead to a classification of risk factors which allowed the setting up of a strategy for their correction. The quantitative analysis showed the following decreases between the first and the last examination in the intervention group: for serum cholesterol greater than or equal to 250 mg/dl -17%; for cigarettes/day greater than or equal to 15-53%; for overweight greater than or equal to 30% - 13.57%; for high blood pressure -8%; for the overall risk computed by multiple regression -33.8%.

Abstract: An epidemiological study of 299 Black patients attending the Ga-Rankuwa Diabetic Clinic was undertaken in order to establish a management baseline and identify specific problem areas. The survey revealed several management problems, such as overweight patients, a low percentage of patients being controlled by diet only, and a high incidence of hypertension. One-third of the patients had not eaten on the morning of the visit, which made the value of urine glucose measurements questionable. In addition, no patient wore any form of 'Medicalert' identification. Considering these factors, a plan of action has been developed. Identification bracelets have been supplied and a system for doing urine glucose tests at home introduced. Greater attention is being given to the diet and the feasibility of Hb A1C measurements is under consideration.

Abstract: According to the 1976 nutrition report by the German Association for Nutrition,29 56% of the male and 47% of the female population in the Federal Republic of Germany are at least 15% overweight by the Broca scale.* While it is almost unanimously accepted today that excess weight is the consequence of a positive caloric balance,18,63 the causes leading to this disturbance of the caloric balance in the obese but not in the normal-weight person are unknown.19 There are no doubts on the correlation of an increased morbidity and mortality rate with excess weight.44,70 S. von Basch pointed out the frequent coincidence of overweight and elevated blood pressure as early as 1893.7 Numerous epidemiologic studies show hypertension to be one of the first-order risk factors for atherosclerotic diseases.100a

Abstract: The results of the present trial, aimed at elucidating and improving the treatment situation of hypertensives, show that—within the domain of the Finnish community health centres—it continues to be unsatisfactory. The prevalence of the male hypertensives (those without treatment and with a permanent diastolic pressure level of at least 100 mmHg and those under treatment) aged 35 to 49 years, was 12.8%. Only half of them were receiving treatment and of these the treatment was adequate (diastolic pressure 27.0 kg/m2) while 15.7% had at least 30% overweight (BMI >32.0 kg/m2). There were no differences worth noting in overweight between treated and untreated cases. With respect to tobacco smoking there was a clear difference in favour of the hypertensives receiving treatment, among whom only 26.1% were regular smokers, while the corresponding figure for untreated hype...

Abstract: Anthropometric measurements in one hundred girls and one hundred boys from 4.6 to 5.5 years of age were carried out in order to study the correspondence between the criteria of obesity according to weight for stature (BW-HT) and according to the magnitude of fat body mass (FM calculated of two different regression equations, one developed starting from body weight (BW), height (HT) and two skinfolds, and another one, using only BW and HT. Employing the criterion of obesity based upon BW-HT above 120%, a number of heavy but not fatty subjects (mainly boys) were included as obese, and three of the girls studied were fatty but not overweight. Conversely, if we calculate FM using the regression equation based on BW and HT, and the criterion of obesity based upon body fat percent, the incidence of obesity could be underestimated. The best results were given by regression equations which include BW, HT and two skinfolds (triceps and subscapular). Though the usefulness of BW and HT in nutritional assessment is not discussed, the diagnostic limitations of these measurements used alone or in combination are evident and therefore it is necessary to include skinfold measurements if we wish to obtain a correct diagnosis of obesity.

Abstract: Behavioral treatments for overweight children have not fared well in achieving or maintaining clinically significant weight losses. The use of more appropriate dependent measures which also take height, sex, and age into consideration is suggested. A multiple-baseline analysis of the behavioral treatment of seven overweight children was conducted. Results support the contention that a more clinically significant outcome emerges when appropriate measures are used.