Prevalence of class-I, class-II and class-III obesity in Australian adults between 1995 and 2011-12

OBJECTIVE: To compare the prevalence of class-I, II and III obesity in Australian adults between 1995, 2007-08 and 2011-12. METHODS: Prevalence data for adults (aged 18+ years) were sourced from customised data from the nationally representative National Nutrition Survey (1995), the National Health Survey (2007-08), and the Australian Health Survey (2011-12) conducted by the Australian Bureau of Statistics. Obesity classifications were based on measured height and weight (class-I body mass index: 30.0-34.9kg/m(2), class-II: 35.0-39.9kg/m(2) and class-III: ≥40.0kg/m(2)). Severe obesity was defined as class-II or class-III obesity. RESULTS: Between 1995 and 2011-12, the prevalence of obesity (all classes combined) increased from 19.1% to 27.2%. During this 17 year period, relative increases in class I, II and III obesity were 1.3, 1.7 and 2.2-fold respectively. In 2011-12, the prevalence of class I, II and III obesity was 19.4, 5.9 and 2.0 per cent respectively in men, and 16.1, 6.9 and 4.2 per cent respectively in women. One in every ten people was severely obese, increasing from one in twenty in 1995, and women were disproportionally represented in this population. Obesity prevalence increased with increasing levels of area-level socioeconomic disadvantage, particularly for the more severely obese classes. Severe obesity affected 6.2% and 13.4% in the least and most disadvantaged quintiles respectively. CONCLUSION: Over the last two decades, there have been substantial increases in the prevalence of obesity, particularly the more severe levels of obesity. This study highlights high risk groups who warrant targeted weight gain prevention interventions.

Interaction of exercise and diet on GLUT-4 protein and gene expression in type I and type II rat skeletal muscle

We determined the interaction of exercise and diet on glucose transporter (GLUT-4) protein and mRNA expression in type I (soleus) and type II [extensor digitorum longus (EDL)] skeletal muscle. Forty-eight Sprague Dawley rats were randomly assigned to one of two dietary conditions: high-fat (FAT, n =24) or high-carbohydrate (CHO, n =24). Animals in each dietary condition were allocated to one of two groups: control (NT, n =8) or a group that performed 8 weeks of treadmill running (4 sessions week^–1 of 1000 m @ 28 m min^–1 , RUN, n =16). Eight trained rats were killed after their final exercise bout for determination of GLUT-4 protein and mRNA expression: the remainder were killed 48 h after their last session for measurement of muscle glycogen and triacylglycerol concentration. GLUT-4 protein expression in NT rats was similar in both muscles after 8 weeks of either diet. However, there was a main effect of training such that GLUT-4 protein was increased in the soleus of rats fed with either diet (P < 0.05) and in the EDL in animals fed with CHO (P < 0.05). There was a significant diet–training interaction on GLUT-4 mRNA, such that expression was increased in both the soleus (100% ↑P < 0.05) and EDL (142% ↑P < 0.01) in CHO-fed animals. Trained rats fed with FAT decreased mRNA expression in the EDL (↓ 45%, P < 0.05) but not the soleus (↓ 14%, NS). We conclude that exercise training in CHO-fed rats increased both GLUT-4 protein and mRNA expression in type I and type II skeletal muscle. Despite lower GLUT-4 mRNA in muscles from fat-fed animals, exercise-induced increases in GLUT-4 protein were largely preserved, suggesting that control of GLUT-4 protein and gene expression are modified independently by exercise and diet.

Investigations of the I Ching : II. Reliability and validity studies

In six studies on the I Ching - an ancient Chinese system of divination - successful predictions of first- and second-hexagrams (i.e., hexagram hitting) based on pre-selections of corresponding descriptor-pairs have ranged from chance, to significantly above chance. No significant effect below chance has ever been found. Hexagram hitting has been predicted by measures such as paranormal belief, time perspective, and meaningfulness. Storm (2008a) found a near-significant aggregate hexagram hit rate of 27%. Though these results are encouraging, there has been no assessment of the reliability and validity of the main test instrument used in the I Ching studies, the Hexagram Descriptor Form (HDF). To test the validity of the HDF, three control methods were tested against the experimental method. Taking first- and second-hexagram hit rates together, three out of 22 tests on the experimental method (14%) were significant or near-significant. Three significant or near-significant outcomes out of 66 control tests (4.5%) were attributed to chance. Inter-rater reliability was tested using two I Ching experts who judged the 64 descriptor-pairs of the HDF for suitability against their corresponding hexagram readings. The correlation between judges' ratings was not significant (the mean rating ranged between 60% and 82%). Using the pooled data of six studies, the HDF was tested for possible selection and outcome biases. A selection bias was found, but no outcome biases were found. The I Ching and the HDF were considered suitable for parapsychological research.

The interplay of secondary Te···N, Te···O, Te···I and I···I interactions, Te···π contacts and π-stacking in the supramolecular structures of [{2-(4-nitrobenzylideneamino)-5-methyl}phenyl](4-methoxyphenyl)tellurium dihalides

The unsymmetrical1y substituted diorganotellurium dihalides [2-(4,4'-N0₂C₆H₄CHNC₆H₃Me]RTeX₂ (R = 4-MeOC₆H₄, X = Cl,
1a; Br, 1b; I, 1c; R =4-MeC₆H₄ ; X = Cl, 2; R =C₆H₅, X = Cl, 3) were prepared in good yields and characterized by solution and solid-state ¹²⁵Te NMR spectroscopy, IR spectroscopy and X-ray crystallography. In the solid-state, molecular structures of 1a and 1c possess scarcely observed 1,4-type intramolecular Te&middot;&middot;&middot;N secondary interaction. Crystal packing of these compounds show an unusually rich diversity of intermolecular secondary, Te&middot;&middot; &middot;0, Te&middot; .. \ and 1&middot;&middot;&middot;1 interactions, Te&middot;&middot; &middot;&pi; contacts as well as extensive
&pi;-stacking of the organic substituents.

Urban–rural comparison of weight status among women and children living in socioeconomically disadvantaged neighbourhoods

Objective: To compare the weight status of women and children living in socioeconomically disadvantaged rural and urban neighbourhoods in Victoria.

Design, setting and participants: Cross-sectional study of data collected between August 2007 and July 2008 as part of the Resilience for Eating and Activity Despite Inequality (READI) study. Women aged 18–45 years living in 40 rural and 40 urban socioeconomically disadvantaged Victorian areas were surveyed by postal questionnaire. Data from a subset of their children aged 5–12 years were also analysed. Weight and height were self-reported for women and measured for children.

Main outcome measures: Women’s weight status based on body mass index (BMI): underweight; healthy; overweight; or obese Class I, II or III; children’s weight status based on International Obesity Taskforce BMI cut-off points.

Results: Of 11 940 women randomly selected, 4934 (41%) replied to a postal invitation to participate. After exclusions for various reasons, data were available on 3879 women and 636 of their children. Twenty-four per cent of urban and 26% of rural women were classified as overweight; a further 19% of urban and 23% of rural women were classified as obese. Twenty per cent of both urban and rural children were classified as overweight; a further 10% of urban and rural children were classified as obese. In crude analyses, rural women had higher odds of Class I and II obesity (odds ratio [OR], 1.34 and 1.72, respectively) compared with urban women. After adjusting for sociodemographic factors (age, number of children, country of birth, education level, employment status and marital status), there was no difference between urban and rural women in odds of overweight or obesity Class I, II or III. No significant urban–rural difference in odds of overweight/obesity was evident among children.

Conclusions: The higher prevalence of obesity in rural women compared with urban women was largely explained by individual-level sociodemographic factors, such as age, number of children, country of birth, education level, employment status and marital status. This suggests that higher obesity levels among women in rural areas may be attributable to the sociodemographic composition of these areas.

Increasing body weight and risk of limitations in activities of daily living: a systematic review and meta-analysis

This study examined the relationship between normal weight, overweight and obesity class I and II+, and the risk of disability, which is defined as impairment in activities of daily living (ADL). Systematic searching of the literature identified eight cross-sectional studies and four longitudinal studies that were comparable for meta-analysis. An additional four cross-sectional studies and one longitudinal study were included for qualitative review. Results from the meta-analysis of cross-sectional studies revealed a graded increase in the risk of ADL limitations from overweight (1.04, 95% confidence interval [CI] 1.00-1.08), class I obesity (1.16, 95% CI 1.11-1.21) and class II+ obesity (1.76, 95% CI 1.28-2.41), relative to normal weight. Meta-analyses of longitudinal studies revealed a similar graded relationship; however, the magnitude of this relationship was slightly greater for all body mass index categories. Qualitative analysis of studies that met the inclusion criteria but were not compatible for meta-analysis supported the pooled results. No studies identified met all of the pre-defined quality criteria, and subgroup analysis was inhibited due to insufficient comparable studies. We conclude that increasing body weight increases the risk of disability in a graded manner, but also emphasize the need for additional studies using contemporary longitudinal cohorts with large numbers of obese class III individuals, a range of ages and with measured height and weight, and incident ADL questions.

Dietary regulation of fat oxidative gene expression in different skeletal musle fiber types

Objective: To determine the effect of a high-fat diet on the expression of genes important for fat oxidation, the protein abundance of the transcription factors peroxisome proliferator-activated receptor (PPAR) isoforms α and γ, and selected enzyme activities in type I and II skeletal muscle. Research Methods and Procedures: Sprague-Dawley rats consumed either a high-fat (HF: 78% energy, <i>ni> = 8) or high-carbohydrate (64% energy, <i>ni> = 8) diet for 8 weeks while remaining sedentary. Results: The expression of genes important for fat oxidation tended to increase in both type I (soleus) and type II (extensor digitorum longus) fiber types after an HF dietary intervention. However, the expression of muscle type carnitine palmitoyltransferase I was not increased in extensor digitorum longus. Analysis of the gene expression of both peroxisome proliferator-activated receptor-γ coactivator and forkhead transcription factor O1 demonstrated no alteration in response to the HF diet. Similarly, PPARα and PPARγ protein levels were also not altered by the HF diet. Discussion: An HF diet increased the expression of an array of genes involved in lipid metabolism, with only subtle differences evident in the response within differing skeletal muscle fiber types. Despite changes in gene expression, there were no effects of diet on peroxisome proliferator-activated receptor-gamma coactivator and forkhead transcription factor O1 mRNA and the protein abundance of PPARα and PPARγ.

Effects of alternative dietary lipid sources on performance, tissues chemical composition, mitochondrial fatty acid oxidation capabilities, and sensory characteristics in brown trout (Salmo trutta L.)

The efficiency of five dietary lipid sources (fish oil as control—C; canola oil—CO; poultry fat—PF; pork lard—PL; and oleine oil—OO) were evaluated in juvenile brown trout (58.4±0.7 g) in an experiment conducted over 70 days at 14.6±0.4 °C. The best growth was observed in fish fed the C diet whereas the PL diet fed fish had the best feed utilization. Significant differences in carcass and muscle proximate composition, but not in liver, were noted among fish fed the different dietary treatments. The fatty acid composition of muscle largely reflected that of the diets, while total cholesterol was not affected. The atherogenicity and the thrombogenicity qualities of the trout flesh were modified by the lipid sources. Sensory analysis did not show any significant differences among the cooked fillets with respect to dietary treatments, while in uncooked products, some significant differences were observed. The carnitine palmitoyltransferase I and II (CPT-I and CPT-II) activities of liver and white muscle were assayed for a better understanding of the potential β-oxidation capability of the different dietary lipid sources. The hepatic, but not white muscle CPT-I and CPT-II activities were affected by dietary treatments. This study showed that alternative lipid sources could be used effectively for oil coating extruded diets for brown trout.

Can Australain general practitioners tackle chidhood overweight/obesity? Methods and processes from the LEAP (live, eat, and play) randomized controlled trial

Background: General practitioners (GPs) could make an important contribution to management of childhood overweight. However, there are no efficacy data to support this, and the feasibility of this approach is unknown.

Objectives: To determine if GPs and families can be recruited to a randomized controlled trial (RCT), and if GPs can successfully deliver an intervention to families with overweight/obese 5- to 9-year-old children.

Methods: A convenience sample of 34 GPs from 29 family medical practices attended training sessions on management of childhood overweight. Practice staff trained in child anthropometry conducted a cross-sectional body mass index (BMI) survey of 5- to 9-year-old children attending these practices. The intervention focused on achievable goals in nutrition, physical activity and sedentary behaviour, and was delivered in four solution-focused behaviour change consultations over 12 weeks.

Results: General practitioners were recruited from across the sociodemographic spectrum. All attended at least two of the three education sessions and were retained throughout the trial. Practice staff weighed and measured 2112 children in the BMI survey, of whom 28% were overweight/obese (17.5% overweight, 10.5% obese), with children drawn from all sociodemographic quintiles. Of the eligible overweight/obese children, 163 (40%) were recruited and retained in the LEAP RCT; 96% of intervention families attended at least their first consultation.

Conclusions: Many families are willing to tackle childhood overweight with their GP. In addition, GPs and families can participate successfully in the careful trials that are needed to determine whether an individualized, family-based primary care approach is beneficial, harmful or ineffective.

David v. Goliath: the gay games, the Olympics, and the ownership of language

The Gay Games is firmly established on the contemporary global sports calendar, but is seldom canvassed in mainstream sports media, or considered a model for sports administrators. This is regrettable, as the Games’ ethos offers many clues into the relationships between individual and communal empowerment for homosexual and heterosexual participants alike, while providing a site of resistance against entrenched norms of elitism, nationalism, victory and record-breaking indicative of the modern Olympic movement. Credit for this inclusive ethos rests with the vision of inaugural Gay Games organiser Dr. Tom Waddell. Drawing on Games archives, this paper outlines Waddell’s vision, then discusses the impact of a protracted legal dispute instigated by the United States Olympic Committee in 1982 over the use of the term ‘Olympics’ in association with Gay Games I and II. Four United States Federal court rulings are examined, with particular reference to the contrasting hierarchy of private intellectual property and public civil rights considered under United States law of the time. Domestic and international legacies of the dispute are also briefly examined, focusing on the inherent tensions between the state-sanctioned protection of Olympic terminology, the ideals of free speech, the ownership of common sporting terms, and the potential discriminatory effects of selective trademark enforcement. The paper concludes with a brief discussion of how Waddell’s vision superseded each of these legal technicalities to ensure the Games continues to provide a viable model for inclusive and engaged participation for all people.

Obesity prevention and public health

More than 22 million children under five are now obese or overweight. Globally, an estimated 10% of school-aged children, between five and 17 years old, are overweight or obese, and the situation is getting worse. Although recognised clinically for some time as an important condition that increases risk of ill-health in affected individuals, it is only recently, that obesity has been recognised as a population-wide problem that requires preventive action. Obesity is a major contributor to diseases and disability, the associated health costs are enormous, obesity has already reached epidemic proportions in many countries, and incidence is continuing to increase in children and adults. Disturbingly the epidemic is not confined to developed countries, with many developing countries and those in transition affected. While recognised as a major population health problem, our understanding of the causes of the epidemic is poor, there has been relatively little population-based research that has focused on the prevention of unhealthy weight gain, and as a consequence knowledge regarding how and where best to intervene is limited. This book draws together the existing literature and expertise and with a view to helping set the agenda for public health action. The book is divided into three sections. Part 1 provides an overview of the context of the problem. It examines the epidemiology of obesity, the role of behavioural factors, socio-cultural factors and environmental factors in the obesity epidemic. Part 2 reviews interventions across a range of key settings and in different population groups - drawing on existing research that has aimed to increase physical activity, promote healthy eating and prevent obesity at a population level. Given how little research there is that has specifically examined the effectiveness of interventions aimed at preventing obesity per se, Part 3 explores potential opportunities to prevent obesity