Textbook of Obesity E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1685

Veröffentlichungsjahr: 2012

Beschreibung

Textbook of Obesity is designed to cover all of the essential elements concerning the etiology, prevention and treatment of obesity suitable for students in nutrition, dietetics and health science courses. Providing core knowledge for students is an essential and urgent requirement to ensure that those graduating will be properly equipped to deal with the high prevalence of overweight and obesity, currently affecting almost two-thirds of the population of the USA and with prevalence in much of the rest of the world rapidly catching up.

This landmark text is organized into 5 parts comprising 27 chapters, each carefully written in a user-friendly style by experts in the area. Part I helps the reader to understand the scope and complexity of the problem of obesity. Part II focuses on obesity etiology. Part III examines the health consequences of obesity for both children and adults. Part IV discusses the challenge of assessing obesity in humans and offers insights into community factors that influence the risk of obesity. Finally, Part V dedicates 13 chapters to a discussion of a wide variety of obesity prevention and treatment interventions that are currently in use.

Textbook of Obesity is an essential purchase for students and the many health professionals dealing with obesity on a day-to-day basis. A dedicated companion website features an extensive bank of questions and answers for readers to test their understanding, and all of the book's illustrations for instructors to download: www.wiley.com/go/akabas/obesity

Leseprobe

Table of Contents

Cover

Companion website: Textbook of Obesity

Title page

Copyright page

Contributors

Editors

Foreword

Acknowledgments

Glossary

Introduction

The excitement of discovery

Part I: Understanding the Scope

Introduction

1 Epidemiology, etiology, and consequences of obesity

Introduction

Definitions and assessment

Surveying obesity prevalence

Consequences of obesity and overweight

The etiology of obesity

Conclusion

2 Cultural attitudes and biases toward obese persons

Introduction

Sources and settings of obesity stigmatization

Consequences of weight bias

Coping with weight stigma

Causes of weight bias

Changing weight bias

Conclusions and future research directions

3 The application of public health lessons to stemming the obesity epidemic

Introduction

Public health lessons learned

The search for success

Fomenting health-related social change

Applying the Framework Convention on Tobacco Control to obesity

An organizing framework for public health interventions

The need for research and evaluation

Concluding principles and issues

4 Psychodynamic approaches to the treatment of obesity

Introduction

Sex differences and obesity

Psychological understanding of obesity

Theoretical and treatment approaches

Conclusion

Part II: Etiology

Introduction

5 Genetic contributions to the development of obesity

An introduction to the genetics of obesity

Basic genetic terms

How do we study the genetics of obesity?

Designs of human studies

Findings for the genetic component of obesity

Contributions from the environment

Specific genes

The “new” genetics

Novel approaches to genomic studies

Conclusions

Acknowledgements

6 Hidden persuaders: environmental contributors to obesity

The missing environment

Why do environmental cues make us overeat?

Are we aware of the consumption norms that have led us to overeat?

How the food environment encourages mindless eating

How the eating environment stimulates consumption

Conclusions

7 White adipose tissue as a dynamic organ

Introduction

The anatomy of adipose tissue

The physiology of adipose tissue

The pathophysiology of adipose tissue

Summary

8 Appetite and body weight regulation

Basic concepts

A simplified regulatory model

Long-term weight regulatory signals

Higher-order CNS systems involved in energy homeostasis

Short-term feeding control signals

Brain nutrient sensing

Adipose tissue influences

Characteristics of the weight regulatory system

9 Eating behaviors in obesity: the role of appetite

Introduction

Appetitive characteristics and weight

The origins of obesogenic appetitive characteristics

Implications for clinical practice

10 The relation of pregnancy and lactation to obesity development in the mother and child

Pregnancy

Lactation

Summary

Part III: Health Consequences

Introduction

11 Effect of obesity on development and health in childhood

Introduction to childhood obesity

Measurement and definition issues unique to children

Biological outcomes

Social outcomes

Cognitive and psychological outcomes

12 Impact of obesity during adulthood on chronic disease: diabetes, hypertension, metabolic syndrome, cardiovascular disease, and cancer

Diabetes mellitus

Hypertension

Risk factor clustering

Conclusion

Part IV: Assessment

Introduction

13 Measurement of human body composition to assess obesity

Introduction to body composition assessment

Anthropometry

Two-compartment measurement approaches

Three- and four-compartment measurement approaches

Five-level, theoretical model

Imaging techniques

Spectroscopy

Measurement methods most applicable in clinical and research settings

Conclusion

14 Assessment of obesity risk in the community

Introduction

Definition of community

The burden of obesity in communities

Methods of community assessment

Novel approaches to community assessment

Summary

Acknowledgment

Part V: Prevention and Intervention Approaches and Settings

Introduction

15 Behavioral approaches to the treatment of obesity

Introduction

The promise and challenge of behavioral treatment: short- and long-term effectiveness

Principles and structure of behavioral treatment

Components of behavioral treatment

Dietary components of behavioral treatment

Physical activity components of behavioral treatment

Improving weight loss maintenance

Conclusion

16 Non-dieting approaches to the treatment of obesity

Assumptions

Non-dieting programs: goals and methods

Empirical support

A critical view

Conclusion

Acknowledgments

17 Dietary intervention approaches to the treatment of obesity

Introduction

Energy balance basics

Diet strategies

Categorizing diets

The diets

Conclusions

18 Pharmacological approaches to the treatment of obesity

Introduction

Energy balance equation and targets of drugs

Principles for using obesity medications

Selecting patients suitable for using medications for weight management

Benefits of modest weight loss

Drugs used

Drugs approved by the FDA for long-term treatment of overweight

Drugs approved by the FDA for Short-term treatment of overweight

Drugs approved by the FDA for a use other than obesity

Drugs with phase III clinical trials, but not approved by the FDA

Conclusions

19 Surgical treatment of severe obesity: patient selection and screening, surgical options, and nutritional management

Introduction

Patient selection

Preoperative assessment

Surgical options and outcomes

Nutritional management and follow-up

Conclusion

20 Metabolic consequences of weight reduction

Evidence that body weight is regulated

Energy homeostasis following weight reduction

Energy intake

Implications for the management of weight reduction

Summary

21 The role of physical activity in weight loss and weight loss maintenance

Introduction

Relationship between physical activity and weight change

Difference between activity and exercise

Effect of physical activity on weight

Measurement of physical activity

Methods and theories to initiate and maintain physical activity among overweight and obese

Diversity issues in physical activity and weight loss: underserved populations

Summary, recommendations, and conclusion

22 The challenge of weight loss maintenance: successful losers

Defining weight loss maintenance

Prevalence of weight loss maintenance

Maintenance of weight loss after behavioral programs

Health impact of modest weight loss

Why is maintenance so difficult?

Research on successful weight loss maintainers—The National Weight Control Registry

Research testing strategies for weight loss maintenance

Summary and conclusions

Acknowledgment

23 Treatment of obesity in the primary care setting

Introduction: Why primary caregivers rarely treat obesity

Assessment

Evaluation

Management

Conclusion

24 Worksite health promotion for obesity prevention

Introduction and background

Worksite interventions: evidence of the need for health promotion

Health promotion opportunity for worksites: guidelines for development and implementation of worksite wellness programs

Summary and conclusions

25 Treatment of overweight and obesity in children

Intervention: Selecting weight management approaches

Evidence for specific approaches to modify behavior

The practice of specific approaches to modify behaviors

Useful approaches for health providers, families, and children

Special approaches for overweight and obese children and adolescents

Conclusion—putting weight management into perspective

26 School-based interventions for overweight and obesity prevention

Introduction

Overview of school-based obesity prevention programs

An innovative approach based on inquiry-based science education—choice, control and change

Conclusion

27 Preventing childhood obesity: It Takes a Nation

Introduction

The case for prevention as a national priority

The complexity of prevention

Settings for prevention: It Takes a Nation

Obesity prevention in rural areas

Gaps in the data and research needs

Summary and conclusion

Index

Companion website: Textbook of Obesity

This book is accompanied by a companion website:

www.wiley.com/go/akabas/obesity

The website includes:

• Extensive bank of Questions and Answers

• All figures from the book for downloading

• Note-taking outline for each chapter

• Webliography

This edition first published 2012 © 2012 by John Wiley & Sons, Ltd.

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Library of Congress Cataloging-in-Publication Data

Textbook of obesity : biological, psychological, and cultural influences / editors, Sharon R. Akabas, Sally Ann Lederman, Barbara J. Moore.

p. ; cm.

 Includes bibliographical references and index.

ISBN 978-0-470-65588-7 (hardback : alk. paper)

ISBN 978-1-118-31838-6 (epub)

ISBN 978-1-118-31840-9 (mobi)

 I. Akabas, Sharon R. II. Lederman, Sally Ann III. Moore, Barbara J., 1947–

 [DNLM: 1. Obesity. WD 210]

 616.3'98–dc23

2011035230

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Contributors

Editors

Sharon R. Akabas, PhD, Director, MS Program, Associate Director of Educational Initiatives, Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York City, NY, USA

Sally Ann Lederman, PhD, Special Lecturer, Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York City, NY, USA

Barbara J. Moore, PhD, President and CEO, Shape Up America!, Clyde Park, MT, USA

Contributors

Jeanine B. Albu, MD, Associate Director, Endocrinology Fellowship Training Program, Division of Endocrinology and Metabolism, St. Luke’s Roosevelt Hospital Center, New York City, NY, USA

David B. Allison, PhD, Professor of Biostatistics, Department of Biostatistics, School of Public Health University of Alabama at Birmingham, AL, USA

Georgina Ankra-Badu, Whitehaven, Cumbria, United Kingdom

Louis J. Aronne, MD, Clinical Professor of Medicine at Weill Cornell Medical College, Director, Weill Cornell’s Comprehensive Weight Control Program, New York City, NY, USA

Jamile A. Ashmore, PhD, Director, Behavioral Medicine Center, Plano, TX, USA

Ninia Baehr, MA, RN, Department of Health and Human Development, Montana State University, Bozeman, MT, USA

Tesfaye M. Baye, PhD, Assistant Professor, Divison of Asthma Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

Leora Benson, MS, Research Technician, New York Obesity Research Center, St. Luke’s-Roosevelt Hospital & Institute of Human Nutrition, Columbia University, New York City, NY, USA

Bonnie Bernstein, PhD, Adjunct Professor, Teachers College, Columbia University, New York City, NY, USA

Marc Bessler, MD, Professor of Clinical Surgery, Chief, Division of Minimal Access/Bariatric Surgery, Department of Surgery, College of Physicians and Surgeons, Columbia University, New York City, NY, USA

Steven N. Blair, PED, Professor, Department of Exercise Science and Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

George A. Bray, MD, Boyd Professor, Chief, Division of Clinical Obesity and Metabolism, Pennington Biomedical Research Center, Baton Rouge, LA, USA

Meghan L. Butryn, PhD, Research Assistant Professor, Department of Psychology, Drexel University, Philadelphia, PA, USA

Angela Calabrese-Barton, PhD, Professor, Department of Teacher Education, Michigan State University. East Lansing, MI, USA

Susan Carnell, PhD, Research Fellow, PhD New York Obesity Research Center, St. Luke’s-Roosevelt Hospital & Institute of Human Nutrition, Columbia University, New York City, NY, USA

Vicki L. Clark, PhD, Post-Doctoral Fellow, Department of Psychology, Drexel University, Philadelphia, PA, USA

Maria C. Coletta, PhD, Post-Doctoral Fellow, Department of Psychology, Drexel University, Philadelphia, PA, USA

Isobel R. Contento, PhD, Mary Swartz Rose Professor of Nutrition and Education, and Coordinator, Program in Nutrition, Department of Health and Behavior Studies, Teachers College, Columbia University, New York City, NY, USA

Issa Coulibaly, PhD, Post-Doctoral Fellow, Department of Biostatistics, Section on Statistical Genetics, University of Alabama at Birmingham, AL, USA

Sharron Dalton, PhD, RD, Professor, Department of Nutrition, Food Studies, and Public Health Steinhardt School of Culture, Education, and Human Development, New York University, New York City, NY, USA

Daniel Davis, DO, Chief of Bariatric Surgery, Department of Surgery, Stamford Hospital, Stamford, CT, USA

Nichola Davis, MD, MS, Assistant Professor, Department of Medicine, Albert Einstein College of Medicine of Yeshiva University, and Montefiore Medical Center, Bronx, NY, USA

Mary DiGiorgi, MS, MPH, Columbia University Center for Metabolic and Weight Loss Surgery, New York Presbyterian Hospital, New York City, NY, USA

Michael Eriksen, ScD, Professor and Director, Institute of Public Health, Georgia State University, Atlanta, GA, USA

Anthony W. Ferrante Jr. MD, PhD, Dorothy & Daniel Silberberg Assistant Professor of Medicine, Department of Medicine, Naomi Berrie Diabetes Center, Columbia University, New York City, NY, USA

Gary D. Foster, PhD, Professor, Medicine and Public Health, Director, Center for Obesity Research and Education, Temple University School of Medicine, Philadelphia, PA, USA

I. J. Frame, MS, MD/PhD Candidate Albert Einstein College of Medicine, Bronx, NY, USA

Georita Frierson, PhD, Department of Psychology, Southern Methodist University, Dallas, Texas, USA

Dympna Gallagher, EdD, Associate Professor of Nutritional Medicine, Department of Medicine St. Luke’s-Roosevelt Hospital the Institute of Human Nutrition, Columbia University, Director, Human Body Composition Core Laboratory, Associate Director, New York Obesity Nutrition Research Center, New York City, NY, USA

James O. Hill, PhD, Professor of Pediatrics and Medicine, Director, Center for Human Nutrition, Director, Colorado Nutrition Obesity Research Center (NORC), University of Colorado School of Medicine, Denver, CO, USA

Carmen R. Isasi, MD, PhD, Assistant Professor, Department of Epidemiology & Population Health, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY, USA

Wahida Karmally, DrPH, RD, CDE, CLS, Director of Nutrition, Irving Institute for Clinical and Translational Research, Columbia University, New York City, NY, USA

Pamela A. Koch, EdD, Executive Director of the Center for Food & Environment, Program in Nutrition, Department of Health and Behavior Studies, Teachers College, Columbia University, New York City, NY, USA

Aliki Kosteli MS, PhD, Post-Doctoral Fellow, Department of Medicine, Naomi Berrie Diabetes Center, Institute of Human Nutrition, Columbia University, New York City, NY, USA

Janet D. Latner, PhD, Associate Professor, Department of Psychology, University of Hawaii at Manoa, Honolulu, HI, USA

Rodney Lyn, PhD, Assistant Professor, Institute of Public Health, Georgia State University, Atlanta, GA, USA

Edward Mandelbaum, LCSW, Manhattan Institute for Psychoanalysis, New York City, NY, USA

Barbara J. Moore, PhD, President and CEO, Shape Up America!, Clyde Park, MT, USA

Melissa A. Napolitano, PhD, Associate Professor, Kinesiology and Public Health, Temple University School of Medicine, Philadelphia, Pa, USA

Cathy A. Nonas, MS, RD, Director of the Physical Activity and Nutrition Program, New York City Department of Health and Mental Hygiene, New York City, NY, USA

Xavier Pi-Sunyer, MD, MPH, Professor of Medicine, Columbia University College of Physicians and Surgeons, Chief, Division of Endocrinology, Diabetes and Nutrition, St. Luke’s-Roosevelt Hospital, Director, New York Obesity Research Center, St. Luke’s-Roosevelt Hospital, New York City, NY, USA

Rebecca M. Puhl, PhD, Director of Research, Rudd Center for Food Policy & Obesity, Yale University, New Haven, CT, USA

Nancy L. Restuccia, MS, RD, CDN, Bariatric Dietician, Columbia University Center for Metabolic and Weight Loss Surgery, New York Presbyterian Hospital, New York City, NY, USA

Karen Reznik Dolins, EdD, RD, Adjunct Associate Professor, Teachers College, Columbia University, Sports Dietitian, Columbia University Athletics, New York City, NY, USA

Michael Rosenbaum, MD, Professor, Clinical Pediatrics and Medicine, Associate Program Director, General Clinical Research Center, College of Physicians & Surgeons, Columbia University, New York City, NY, USA

Beth Schrope, MD, PhD, Assistant Surgery, Department of Surgery, College of Physicians and Surgeons, Columbia University, New York City, NY, USA

Daniel Shriner, PhD, Research Fellow, Center for Research on Genomics and Global Health, The National Institutes for Health (NIH), Bethesda, MD, USA

Albert J. Stunkard, MD, Professor, Department of Psychiatry, Founder, Founded the Center for Weight and Eating Disorders. University of Pennsylvania, Philadelphia, PA, USA

Judy Townsend, PA-C, Weill Cornell’s Comprehensive Weight Control Program, New York City, NY, USA

Megan Tubman, MS, RD, Nutritionist, Fresh Start Nutrition Studio, LLC, New York City, NY, USA

Akuenzunkpa Ude, MD, Department of Surgery, New York University, Bellevue Hospital, New York City, NY, USA

Meredith Urban-Skuro, MS, RD, Bariatric Dietician Columbia University Center for Metabolic and Weight Loss Surgery, New York Presbyterian Hospital and Valley Hospital, New York City, NY, USA

Ileana Vargas, MD, Assistant Clinical Professor of Pediatrics, Department of Pediatrics, Morgan Stanley Children’s Hospital of New York Presbyterian and Naomi Berrie Diabetes Center, New York City, NY, USA

Joseph R. Vasselli, PhD, Associate Research Scientist, Department of Medicine, St. Luke’s-Roosevelt Hospital Center and The Institute of Human Nutrition, Columbia University, New York City, NY, USA

Brian Wansink, PhD, John S. Dyson Professor of Marketing, Department of Applied Economics and Management, Director, Cornell Food and Brand Lab, Cornell University, Ithaca, NY, USA

Jane Wardle, PhD, Professor in Clinical Psychology and Director of the Health Behaviour Unit Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology & Public Health, University College London, London, United Kingdom

Rena R. Wing, PhD, Professor, Department of Psychiatry & Human Behavior, Director, Weight Control and Diabetes, Research Center, Brown Medical School, Brown University, Providence, RI, USA

Judith Wylie-Rosett, RD, EdD, Professor, Department of Epidemiology & Population Health, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY, USA

Jung-Eun Yim, PhD, Research Professor, Research Institute of Clinical Nutrition, Kyung Hee University, Seoul, Korea

Foreword

While I served as U.S. Surgeon General from 1981 to 1989, the data from the National Health and Nutrition Examination Survey (NHANES) and the Behavioral Risk Factor Surveillance System (BRFSS) documented a surge in obesity prevalence in America. The data spurred me to found the nonprofit organization, Shape Up America! in 1994, to raise awareness of obesity as a health issue. The prevalence of obesity has continued to climb with upsurges documented in adults and children in all walks of life, with the problem more severe among America’s poor and uninsured.

Progress in raising awareness of obesity as a health issue has certainly been made, but there has been little progress in stemming the epidemic. We now have nearly 75 million Americans categorized as “obese” and more than 17 million are categorized as “severely obese.” Of greatest concern, an estimated 12 million children are obese with 2.5 million severely obese.

Now we are learning that the offspring of obese and severely obese parents are at greater risk of obesity, introducing a new understanding of the way the obesity epidemic is self-propagating through epigenetic pathways. With so many millions of Americans of childbearing potential entering pregnancy and parenthood in the obese condition, this represents a deepening of the crisis.

A broadly increased understanding of the many causes and consequences of obesity is urgently needed. The field has made remarkable strides enlightening us about the endocrine function of fat cells and how leptin—a protein synthesized by fat cells—crosses the blood-brain barrier to mediate the communication between body fat depots and regulatory centers in the brain that influence appetite and energy balance. But much more work needs to be done, particularly to develop effective prevention and treatment approaches.

The publishing world is highly competitive and up to now, a comprehensive textbook such as this one did not exist. The editors and authors of this volume have labored for more than 3 years to create a textbook suitable for college level students and those who are beginning their graduate education. Their goal was to attract bright new minds to the field of obesity to help us devise innovative research, invent new medical devices, discover new therapeutic agents for treatment, and develop public health solutions to help us stop and reverse the epidemic. I am proud to support their effort as I share their hope that making information about the complex nature of obesity more accessible to students will increase the likelihood of finding urgently needed answers to these highly perplexing problems.

Now I am calling upon you, the reader, to help us move the field forward and make America a healthier place to live, learn, work and play. There is no doubt that it takes a nation to stem obesity and regardless of your chosen career path, we call upon you to be a part of the solution.

C. Everett Koop, MD, ScD

13th U. S. Surgeon General and

Founder of Shape Up America!

Hanover, NH

November 2011

Acknowledgments

The volume editors would like to acknowledge the important contributions of Institute of Human Nutrition students Oluwatosin Akintola, John Buza, Shaun Darrah, Sarah Goldsberry, Sheena Harris, Erin Paxson, and Jordan Sill who helped at critical stages of completion of this text.

Sharon R. Akabas, Barbara J. Moore and Sally Ann Lederman

A major theme of this book is to understand the complexity of the factors that underlie energy balance and weight, with the goal of understanding the overweight or obese person. Understanding is an attribute I have had modeled for me my whole life, by my parents, Eli and Rebecca Freedman, and my siblings, Karen Jimmerson, Jay Freedman, Barry Freedman, Beth Rosen, Jayne Quinn, Judy Fask, and Barbara Freedman. This modeling has been continued in my own family by my husband, Myles, and children, Sam, Leor, and Reuben. I am grateful to all of them for their love, humor, support, and patience during this arduous process.

Sharon R. Akabas

I would like to thank Sharon R. Akabas for giving me the opportunity to collaborate on this book and other exciting projects, enabling me to work with two smart and dear friends, while learning things of great interest and importance, both from the work itself and from the two of them.

Sally Ann Lederman

I would like to extend special thanks to my husband, Denis Prager, for his patience and support during the years of bringing this project to fruition. He is my toughest critic and best editor. I also wish to thank my postdoctoral and lifelong professional mentor, Dr Judith S. Stern, for her staunch commitment to clear communication and for instilling a similar commitment in her students.

Barbara J. Moore

Sharon Akabas and Barbara Moore would like to jointly acknowledge Sally Ann Lederman. She is always willing to serve as a very thoughtful sounding board and is extremely generous with her time. Over the years she has been one of our toughest and most valuable critics. Without her unflagging ability to stay on task, solve problems, and get the job done this book would not exist.

Glossary

α-melanocyte-stimulating hormone(s); alpha-MSH

A set of peptide hormones secreted by the anterior pituitary gland. In the brain, release increases appetite.

2003 Rotterdam criteria

Criteria used to define PCOS established during a conference of experts who met in Rotterdam in May 2003 and indicate that PCOS can be diagnosed (once certain other conditions are excluded) when two of three conditions are present: infrequent or no ovulation, indications of hyperandrogenism, or polycystic ovaries. These criteria expand the definition of PCOS established by an April 1990 expert conference sponsored by NIH.

95% confidence interval

An estimate, determined from the standard error, of the range of values for a given variable that would include the true mean 95% of the time. It is used to indicate the reliability of the estimate of the mean provided by a particular sample. Greater sample sizes reduce the range of the confidence interval, making the estimate of the mean more reliable.

acanthosis nigricans

A darkening and thickening of the skin usually seen at the nape of the neck and in areas where opposing skin surfaces can touch and rub, such as in the groin, underarms, and beneath pendulous breasts; associated with insulin resistance.

accelerometers

An instrument for measuring acceleration, used in some methods that determine energy expenditure. Initiation of movement in a part of the body involves an acceleration, which can be counted, if registered on the accelerometer. Complex models are used to convert these counts into calories expended, using a variety of estimates and assumptions.

activity thermogenesis

Energy expenditure above that used when at rest.

acute phase reactants

Proteins whose concentration in the plasma are changed significantly during inflammation.

ad libitum

An amount of food freely chosen by an individual; unrestricted food intake.

adaptive immune responses

An immune response dependent on action of antigen-specific lymphocytes. This response can result in lifelong protection from reinfection with the same antigen.

adipocyte

A connective tissue cell containing one or more fat droplets. The adipocyte is the defining cell type within adipose tissue; also known as “fat cell.”

adipogenesis

The formation of fat; fat cell proliferation.

adipokines

Any of a variety of compounds secreted by adipose tissue; some play important roles as signaling molecules in energy balance and metabolism.

adiponectin

An adipokine, a protein hormone secreted by adipose tissue. Has generally beneficial effects on insulin-sensitive tissues and the vascular system.

adjusted odds ratio

An odds ratio statistically adjusted for other factors that might affect the chance of the disease. See odds ratio.

adrenal hyperandrogenism

Excessive production of androgen hormones (testosterone, dehydroepiandosterone, etc.) by the adrenal glands.

adrenalectomy

Removal of the adrenal gland.

afferent centers

Areas of the brain that integrate signals from the body and send outgoing (efferent) messages via neural pathways to other parts of CNS and to other parts of the body.

agouti protein

A protein produced in the body (endogenous) that has a strong stimulating effect on appetite. It acts as an antagonist of the melanocortin receptors MC3R and MC4R.

air displacement plethysmography

A method for determining body volume. It consists of two connected chambers in one of which the subject is placed, the other being a reference chamber that contains pressure-measuring instruments. A flexible diaphragm is mounted in the common wall between the chambers. The ratio of the pressures in the two chambers as the diaphragm is moved is inversely related to the ratio of the air volumes within the chambers, allowing calculation of body volume.