Utilization of Healthcare Resources by HIV-Positive Children in the United States: A National Perspective.

Objective: We characterized and estimated the cost of inpatient hospital utilization by US pediatric patients who tested positive for the human immunodeficiency virus (HIV).

Methods: The 2012 Kids' Inpatient Database was analyzed to provide a descriptive assessment of national inpatient hospital utilization. We analyzed a stratified probability sampling of 3.

Food Addiction: A Barrier for Effective Weight Management for Obese Adolescents.

Background: Findings from studies of food addiction in adults suggest those with food addiction are less successful in weight-loss interventions. Little is known about food addiction in obesity treatment-seeking adolescents; therefore, the purpose of this study was to explore the prevalence of food addiction and correlates of food addiction symptoms in obese adolescents entering an outpatient, weight management program.

Methods: Obese adolescents (n = 26) were administered the Yale Food Addiction Scale for Children (YFAS-C), measures of appetitive responsiveness, and health-related quality of life (HRQOL) before and following a 12-week, outpatient, behavioral weight management program.

Heart Rate and Perceived Exertion in Healthy Weight and Obese Children During a Self-Selected Physical Activity Program.

Background: Compared with structured/organized activities, unstructured, self-selected physical activity (PA) may be more appealing for children in particular obese (OB) children. We examined whether both healthy-weight (HW) and OB children would engage in moderate to vigorous intensity PA during an unstructured PA program and compared heart rate (HR) and rate of perceived exertion (RPE) between the children.

Methods: Twenty-one children [9 OB (≥95th BMI percentile, 12 HW (5th - <85th), 8.

Resting energy expenditure and systolic blood pressure relationships in women across 4.5 years.

Recent studies have reported a strong association between blood pressure (BP) and resting energy expenditure (REE). However, it is not known whether this relationship persists over time. Therefore, the authors examined the temporal relationship between REE and systolic BP.

The effect of an unstructured, moderate to vigorous, before-school physical activity program in elementary school children on academics, behavior, and health.

Background: Physical inactivity has been deemed a significant, contributing factor to childhood overweight and obesity. In recent years, many school systems removed recess and/or physical education from their curriculum due to growing pressure to increase academic scores. With the vast majority of children's time spent in school, alternative strategies to re-introduce physical activity back into schools are necessary.

Influence of resting energy expenditure on blood pressure is independent of body mass and a marker of sympathetic tone.

Two recent examinations reported a strong association between blood pressure (BP) and resting energy expenditure (REE), independent of body mass and body composition. Both reports postulate that neurohumoral processes that contribute to variation in REE may partly mediate the body mass effect on BP. Therefore, we examined the relationship of REE and BP in 108 asymptomatic women (a) to confirm previous findings in a novel population and (b) to examine the impact of a marker of sympathetic tone on this relationship, as this was indicated as a potentially salient intermediary in previous reports.

Physical activity-induced improvements in markers of insulin resistance in overweight and obese children and adolescents.

Childhood obesity is a significant, worldwide, public health problem. Coinciding with the increasing prevalence of obesity in youth, Type 2 diabetes has emerged as a critical health condition in this population. In the U.

Self-reported low vitality, poor mental health, and low dietary restraint are associated with overperception of physical exertion.

Objective. We investigated whether perceived exertion, in comparison to the physiological response to exercise, was associated with self-reported vitality, mental health, and physical function during daily activities, or weight control behaviors. Design.

Endocrine disruptors and obesity: an examination of selected persistent organic pollutants in the NHANES 1999-2002 data.

Recent evidence suggests that endocrine disrupting chemicals (EDCs) may cause perturbations in endogenous hormonal regulation that predispose to weight gain. Using data from NHANES (1999-2002), we investigated the association between body mass index (BMI), waist circumference (WC) and selected persistent organic pollutants (POPs) via multiple linear regressions. Consistent interaction was found between gender, ln oxychlordane and ln p,p' DDT.

Ethnicity-specific anthropometric predictors of metabolic risk in women.

OBJECTIVE: The objective of this study was to determine associations of anthropometric measures of thigh and abdominal adipose tissue with metabolic risk factors, and whether these associations differed with ethnicity. We hypothesized that thigh circumference (ThC) would have an independent favorable association with insulin sensitivity, lipids, and blood pressure, whereas waist circumference (WC) would have an independent deleterious association with these variables in both African Americans (AA) and European Americans (EA). METHODS: Subjects were 228 healthy, overweight, premenopausal AA and EA women.

Exercise training prevents regain of visceral fat for 1 year following weight loss.

The purpose of this study was to determine what effect aerobic and resistance exercise training has on gain of visceral fat during the year following weight loss. After being randomly assigned to aerobic training, resistance training, or no exercise training, 45 European-American (EA) and 52 African-American (AA) women lost 12.3 +/- 2.

Perception of exercise difficulty predicts weight regain in formerly overweight women.

It has been previously reported that overweight and obese individuals perceive exercise as more difficult than their lean counterparts, and this difference may not be solely attributed to physiological differences. Therefore, we tested the hypothesis that individual differences in the perception of exercise difficulty during exercise, independent of concurrently measured physiological markers of exertion, are predictive of weight regain, after completion of a weight loss program. A total of 113 formerly overweight women who had previously completed a weight-loss program to achieve a normal body weight (BMI <25 kg/m(2)) underwent a submaximal aerobic exercise task while measures of physiological and perceived exertion (rating of perceived exertion (RPE)) were recorded.

Missing data in randomized clinical trials for weight loss: scope of the problem, state of the field, and performance of statistical methods.

Background: Dropouts and missing data are nearly-ubiquitous in obesity randomized controlled trails, threatening validity and generalizability of conclusions. Herein, we meta-analytically evaluate the extent of missing data, the frequency with which various analytic methods are employed to accommodate dropouts, and the performance of multiple statistical methods.

Methodology/principal Findings: We searched PubMed and Cochrane databases (2000-2006) for articles published in English and manually searched bibliographic references.

Sample size in obesity trials: patient perspective versus current practice.

Objective: To evaluate patient opinions on acceptable risks in exchange for a given degree of weight loss and their implications for sample size determination in obesity randomized clinical trials (RCTs).

Design: . Survey of patients entering RCTs for weight loss in a university-based clinical research setting and power calculations based on their responses.

Fat distribution, aerobic fitness, blood lipids, and insulin sensitivity in African-American and European-American women.

The purpose of this study was to determine independent relationships of intra-abdominal adipose tissue (IAAT), leg fat, and aerobic fitness with blood lipids and insulin sensitivity (S(i)) in European-American (EA) and African-American (AA) premenopausal women. Ninety-three EA and ninety-four AA with BMI between 27 and 30 kg/m(2) had IAAT by computed tomography, total fat and leg fat by dual-energy X-ray absorptiometry, aerobic fitness by a graded exercise test, African admixture (AFADM) by ancestry informative markers, blood lipids by the Ektachem DT system, and S(i) by glucose tolerance test. Independent of age, aerobic fitness, AFADM, and leg fat, IAAT was positively related to low-density lipoprotein-cholesterol (LDL-C), cholesterol-high-density lipoprotein (HDL) ratio, triglycerides (TGs), and fasting insulin (standardized beta varying 0.

Perception of others' body size influences weight loss and regain for European American but not African American women.

Objective: The authors investigated whether European American (EA) and African American (AA) women took longer to lose weight, and were less likely to maintain weight loss if they perceived others to be overweight.

Design: Overweight EA and AA women completed a Figure Rating Scale and the Three-Factor Eating Questionnaire prior to a weight loss intervention. Body composition was assessed by dual energy X-ray absorptiometry prior to and following weight loss.

Effects of exercise training intensity on nocturnal growth hormone secretion in obese adults with the metabolic syndrome.

Context: Abdominal adiposity is associated with reduced spontaneous GH secretion, and an increased incidence of the metabolic syndrome, type 2 diabetes, and cardiovascular disease. Exercise training increases GH secretion, induces abdominal visceral fat loss, and has been shown to improve the cardiometabolic risk factor profile. However, little is known about the effects of endurance training intensity on spontaneous GH release in obese individuals.

Association between insufficiently physically active and the prevalence of obesity in the United States.

Background: Numerous public health organizations have adopted national physical activity recommendations. Despite these recommendations, over half of the US population does not meet the minimum recommendation for physical activity, with large variations across individual US states.

Methods: Using the 2005 Behavioral Risk Factor Surveillance System (BRFSS) prevalence data for physical activity and obesity by state, we performed a weighted least squares regression using prevalence of obesity (BMI>or=30 kg/m2) as the dependent variable and insufficiently physically active (included completely sedentary), age, race, gender, and median household income as the independent variables.

Ethnicity and weight status affect the accuracy of proxy indices of insulin sensitivity.

This study tested the hypotheses that correlations between direct measures of insulin sensitivity and proxy indices of insulin sensitivity derived from fasting values, (i) would not be affected by ethnicity, and (ii) would be stronger in overweight vs. weight-reduced states. We further hypothesized that associations between proxy indices and fat distribution would be similar to those between directly measured insulin sensitivity and fat distribution.

Effect of exercise training intensity on abdominal visceral fat and body composition.

Unlabelled: The metabolic syndrome is a complex clustering of metabolic defects associated with physical inactivity, abdominal adiposity, and aging.

Purpose: To examine the effects of exercise training intensity on abdominal visceral fat (AVF) and body composition in obese women with the metabolic syndrome.

Methods: Twenty-seven middle-aged obese women (mean +/- SD; age = 51 +/- 9 yr and body mass index = 34 +/- 6 kg x m(-2)) with the metabolic syndrome completed one of three 16-wk aerobic exercise interventions: (i) no-exercise training (Control): seven participants maintained their existing levels of physical activity; (ii) low-intensity exercise training (LIET): 11 participants exercised 5 d x wk(-1) at an intensity < or = lactate threshold (LT); and (iii) high-intensity exercise training (HIET): nine participants exercised 3 d x wk(-1) at an intensity > LT and 2 d x wk(-1) < or = LT.

Heart rate recovery does not predict endothelial function in obese women.

The purpose of the present study was to examine the relationship between heart rate recovery (HR(REC)) and endothelial function in obese women with the metabolic syndrome. The metabolic syndrome has been associated with increased cardiometabolic risk including endothelial dysfunction. However, measurement of endothelial function via flow-mediated dilation (FMD) requires expensive equipment and qualified medical personnel, and therefore may be impractical in some healthcare settings.

The metabolic syndrome, hypertriglyceridemic waist, and cardiometabolic risk factor profile in obese women.

The hypertriglyceridemic waist (HTGW) and metabolic syndrome (MS) are associated with increased cardiometabolic risk. We evaluated the impact of the HTGW on cardiometabolic risk factors in obese women diagnosed with the MS. Thirty-six abdominally obese women with the MS as defined by the International Diabetes Federation (IDF) [(mean (SD); age 49 (11) y, ht 165 (6) cm, wt 95 (16) kg] participated.

NIH ImageJ and Slice-O-Matic computed tomography imaging software to quantify soft tissue.

Objective: To compare reliability and limits of agreement of soft tissue cross-sectional areas obtained using Slice-O-Matic and NIH ImageJ medical imaging software packages.

Research Methods And Procedures: Abdominal and midthigh images were obtained using single-slice computed tomography. Two trained investigators analyzed each computed tomography image in duplicate.