Clinics in dermatology
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Clinics in dermatology · Jul 2004
Review Comparative StudyDietary approaches to overweight and obesity.
For years dietary guidelines for the treatment of overweight and obesity have advised a low-fat, high carbohydrate diet. Recent meta-analyses have shown that weight loss achieved with ad libitum low-fat diets is typically in the range of 3-4 kg. ⋯ Both effectively reduce the glycemic load of the diet and early studies suggest they may be effective in increasing satiety, reducing ad libitum energy intake and may improve fat oxidation by reducing insulin demand. Both approaches can be used within the context of a reduced-fat diet, with evidence emerging to suggest this may improve weight and body composition outcomes.
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Over the last decade, the prevalence of obesity in Western and Westernizing countries has more than doubled. A standardized classification of overweight and obesity, based on the body mass index now allows a comparison of prevalence rates worldwide for the first time. In children, the International Obesity Taskforce age, sex, and BMI specific cut-off points are increasingly being used. ⋯ Prevalence rates for overweight and obese people are very different in each region with the Middle East, Central and Eastern Europe and North American having higher prevalence rates. Obesity is usually now associated with poverty even in developing countries. Relatively new data suggest that abdominal obesity in adults, with its associated enhanced morbidity, occurs particularly in those who had lower birth weights and early childhood stunting.
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Clinics in dermatology · Jul 2004
ReviewHow do we get fat? An epidemiologic and metabolic approach.
Obesity results when the energy intake exceeds expenditure for a long period. The first law of thermodynamics, which describes this relationship, does not provide insight into the failures to couple energy intake and expenditure. ⋯ Perhaps the greatest impact has resulted from the cloning of genes corresponding to the five mouse monogenic obesity syndromes and the subsequent characterization of the human counterparts to these syndromes. Extensive molecular and reverse genetic studies (mouse knockouts) have helped establish other critical pathways that regulate body fat and food intake, and also have either validated or refuted the importance of previously identified pathways.