The obesity treatment dilemma: Why dieting is both the answer and the problem? A mechanistic overview.

Restricted-calorie diets are the most worldwide used treatments for obesity. Although such strategies are based on the first law of thermodynamics, the real life clinical practice demonstrates that the observed weight losses are divergent from those theoretically predicted. Loosely adherence to recommendations is one of the main causes for the limited efficacy of dieting, but many additional factors can be involved in the hurdles to weight loss.

Effect on blood lipids of two daily servings of Camembert cheese. An intervention trial in mildly hypercholesterolemic subjects.

As a concentrated source of saturated fat, cheese consumption is considered to be associated with increased cholesterolemia and generally forbidden in dietary guidelines for adults with hypercholesterolemia. The aim of this study was to evaluate the impact of saturated fatty acids on lipid parameters and blood pressure with regards to different types of dairy products: Camembert and full-fat yoghurt. One-hundred and fifty-nine moderate hypercholesterolemic subjects without treatment were instructed to consume two full-fat yoghurts (2 × 125 g) per day for 3 weeks (run-in period) and then for a further period of 5 weeks, either two full-fat yoghurts or two 30 g servings of Camembert cheese per day.

[Type 2 diabetes complications].

People with type 2 diabetes are at increased risk of many complications, which are mainly due to complex and interconnected mechanisms such as hyperglycemia, insulino-resistance, low-grade inflammation and accelerated atherogenesis. Cardi-cerebrovascular disease are frequently associated to type 2 diabetes and may become life threatening, particularly coronaropathy, stroke and heart failure. Their clinical picture are sometimes atypical and silencious for a long time.

[Radical complications of obesity].

Obesity increases overall morbidity mainly by the increased mass of fat tissues and by the hyperproduction of pro-inflammatory molecules by the abdominal tissue. Coronary artery disease, metabolic syndrome or diabetes mellitus are the main complications linked to the inflammatory low-grade syndrome whereas arthritis is linked to the adipocytes mass. Many other complications are associated with obesity: steato-hepatitis, glomerulo-sclerosis, digestive diseases such as gallstones, hypofertility, psychosocial dysfunction and depression and certain cancers.

Impact of altered alveolar volume on the diffusing capacity of the lung for carbon monoxide in obesity.

Background: Studies on the diffusing capacity of the lung for carbon monoxide (DL(CO)) in obese patients are conflicting, some studies showing increased DL(CO) and others unaltered or reduced values in these subjects.

Objectives: To compare obese patients to controls, examine the contribution of alveolar volume (VA) and CO transfer coefficient (K(CO)) to DL(CO), and calculate DL(CO) values adjusted for VA.

Methods: We measured body mass index (BMI), waist circumference (WC), spirometry and DL(CO) in 98 adult obese patients without cardiopulmonary or smoking history and 48 healthy subjects.

[Nutrition approaches to prevent chronic disease].

Chronic diseases such as obesity, diabetes, macrovascular disease including coronaropathy and stroke, osteoporosis and various cancer have, in one way or another, food and nutritional determinants and may be considered as nutritionally or environmental-related diseases. There is a growing literature indicating that specific dietary constituents or diet are able to influence the development and the outcome of chronic disease. Long term prospective clinical trials are yet locking to confirm on evidences-based medicine criteria the correlation described between food and disease.

Subclinical hyperthyroidism: considerations in defining the lower limit of the thyrotropin reference interval.

Background: Although numerous reports have discussed the upper limit of the thyrotropin (TSH) reference interval, none have dealt with the lower limit. Recent recommendations regarding subclinical thyroid dysfunction give different advice about its management, depending on whether the TSH concentration is <0.1 mIU/L or 0.

[Hyperglycemia in the critically ill: meaning and treatment].

Hyperglycemia is commun in critically ill patients without previously known diabetes. Hyperglycemia occurring in these patients is mainly a consequence of stress associated to complex glucose metabolism abnormalities which have deleterious effects on tissues and vascular function. Several epidemiologic and intervention studies had established that hyperglycemia is related to morbidity and mortality.

Effect of an educational program (PEGASE) on cardiovascular risk in hypercholesterolaemic patients.

Background: Many studies have demonstrated a gap between guidelines for the prevention of cardiovascular disease (CVD) and their implementation in clinical practice.

Aim: The PEGASE education program has been devised with an aim to improve the management of patients at high risk of CVD.

Methods: In a multicentre study carried out from 2001-2004 in France, 96 participating physicians were randomized into a "trained" group, which included 398 "educated" patients, and a "non-trained" group, which included 242 "non-educated" patients.

[Subclinical hypothyroidism and quality of life of women aged 50 or more with hypercholesterolemia: results of the HYOGA study].

Aim: Subclinical hypothyroidism (SCHT) is defined by the combination of an increased TSH level and a normal free thyroxin concentration. The aim of this survey is the description of the prevalence, the symptoms and the quality of life in SCHT diagnosed in a group of hypercholesterolemic women.

Methods: A total of 1610 female patients aged 50 or more with hypercholesterolemia (total cholesterol between 240 and 400mg/dl, receiving or not a lipid-lowering treatment) were enrolled by 347 general practitioners (GPs).

Isolated microcytic anemia disclosing a unicentric Castleman disease: The interleukin-6/hepcidin pathway?

Castleman disease (CD) is a rare lymphoproliferative disorder of uncertain origin. Anemia is commonly reported and is related to an inflammatory mechanism. Occasionally an autoimmune hemolytic anemia appears as the leading clinical feature.

Low-density lipoprotein apheresis in children with familial hypercholesterolemia: follow-up to 21 years.

Twenty-seven patients (14 girls, 13 boys) affected by familial hypercholesterolemia who had begun low-density lipoprotein (LDL) apheresis treatment before the age of 15 were studied. The median age at diagnosis was 4 years and the blood LDL cholesterol level was 704 +/- 163 mg/dL. Screening was performed for homozygous or double heterozygous mutations of the LDL cholesterol receptor gene and mutations were found in 24 of the patients.

Reference range of serum calcitonin levels in humans: influence of calcitonin assays, sex, age, and cigarette smoking.

Objective: The objective of this study was to re-evaluate the adult C(T) reference values determined by five different immunoassays and by introducing criteria for selecting control subjects.

Design: A prospective multicenter study.

Patients: Three hundred and seventy-five clinically euthyroid subjects.

Effect of low-fat, fermented milk enriched with plant sterols on serum lipid profile and oxidative stress in moderate hypercholesterolemia.

Background: Plant sterol (PS)-enriched foods have been shown to reduce plasma LDL-cholesterol concentrations. In most studies, however, PSs were incorporated into food products of high fat content.

Objective: We examined the effect of daily consumption of PS-supplemented low-fat fermented milk (FM) on the plasma lipid profile and on systemic oxidative stress in hypercholesterolemic subjects.

[Do we still have glucocorticoid-induced adrenal insufficiency?].

Adrenal insufficiency (AI) induced by glucocorticoids was first described more than 50 years ago in patients undergoing surgical stress. Although considered the most frequent cause of AI, the true incidence of this complication of glucocorticoid treatment remains unknown. No factors are known to predict AI after glucocorticoid treatment.

Diet and physical activity profiles in French preadolescents.

Dietary patterns have been identified in adults, but less is known about children and adolescents. For the first time, we have investigated lifestyle patterns combining diet and physical activity in 12-year-old French preadolescents and examined their association with sociodemographic factors. Physical activity, sedentary activities and dietary habits were assessed by questionnaires given to 2724 students in 2001.

Plasma fatty acid composition is associated with the metabolic syndrome and low-grade inflammation in overweight adolescents.

Background: Together with adiposity, plasma fatty acid (FA) composition can modulate the development of the metabolic syndrome (MS).

Objective: Our aim was to investigate the relations of FA composition in plasma phospholipids and cholesterol esters (CEs) with weight status, MS, and inflammation in adolescents.

Design: Plasma FA composition was measured by gas-liquid chromatography in 120 (60 normal-weight and 60 overweight) 12-y-old adolescents.

Food-cobalamin malabsorption in elderly patients: clinical manifestations and treatment.

Purpose: Approximately 15% of people aged more than 60 years old have a cobalamin (vitamin B12) deficiency, mainly in relation with food-cobalamin malabsorption (FCM). To date, no study has documented this disorder in the elderly. There is also little information on clinical consequences.

Interactions between traditional regional determinants and socio-economic status on dietary patterns in a sample of French men.

The aim of the present study was to assess the respective contributions of regional and socio-economic factors to dietary pattern. We used the data from the final MONICA (MONItoring of trends and determinants in Cardiovascular disease) population survey conducted in the three French centres in 1995-7 among a representative sample of 976 men aged 45-64 years. Dietary intake was assessed using a 3-d record method.

Free thyroxine measured with equilibrium dialysis and nine immunoassays decreases in late pregnancy.

We measured free thyroxine in sera from 29 women in the ninth month of pregnancy. We used the reference method, equilibrium dialysis, and nine immunoassays. The bias between immunoassay and dialysis results was insignificant or modest.