The purpose of this study was to investigate the prevalence and present food intake and morbidity patterns of obesity in men (n = 162) and women (n = 286) 15 to 80 years of age. Data were collected in a community-based longitudinal study from 1983 to 1985 in a semi-rural Egyptian village. Degree of obesity was estimated using body mass index (BMI) and a derived measure of adiposity from principal components analysis of several anthropometric variables. BMI was significantly correlated with other available measures of adiposity, lean mass and age and uncorrelated with height. Derived measures of adiposity were related to all other measures of relative weight and adiposity in both sexes and related to age in women. Within agricultural households, men were shorter and had higher adiposity levels, and women were taller than non-agricultural households. The presence of chronic disease was unrelated to BMI in men. However, chronic disease and respiratory difficulties occurred more often in overweight and obese women. There was no difference in the prevalence of acute illness for lean and normal weight compared to overweight and obese men. Skin problems occurred more often in overweight and obese women. There was a risk of low pregnancy weight gain across the range of BMI. Obese women produced heavier infants than normal weight or overweight women; overweight women produce heavier infants than leaner women. Infant birthweight was predicted by prepregnancy BMI or adiposity level, pregnancy weight gain and height. For men, animal products contributed to the higher intakes of fat, vitamin A and zinc in overweight and obese, and fats and oils contributed to higher vitamin E intakes. For women, bread contributed to higher intakes of dietary fiber and lower intakes of calcium in overweight and obese.

Title page, contents and abstract only. The complete thesis in print form is available from the University of Adelaide Library. / The overall objective of the studies that comprise this thesis is to compare the effect of various dietary proteins and carbohydrates on acute postprandial changes in appetite sensations, ad libitum energy intake and associated regulatory hormones in overweight/obese adults. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1289323 / Thesis (Ph.D.) -- University of Adelaide, School of Molecular and Biomedical Science, 2007

Title page, contents and abstract only. The complete thesis in print form is available from the University of Adelaide Library. / The overall objective of the studies that comprise this thesis is to compare the effect of various dietary proteins and carbohydrates on acute postprandial changes in appetite sensations, ad libitum energy intake and associated regulatory hormones in overweight/obese adults. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1289323 / Thesis (Ph.D.) -- University of Adelaide, School of Molecular and Biomedical Science, 2007

Thesis (MPH.) --University of Limpopo, 2018 / Background: Obesity and physical inactivity have been reported as the major contributing factors to non-communicable diseases and a public health problem worldwide. According to World health organization the global prevalence of obesity has increased more than doubled between 1980 and 2014. Many healthcare professionals fail to achieve sufficient levels of physical activity and most of them display poor dietary habits. The study conducted in South Africa among health care professionals in urban hospital in Gauteng province confirmed that 20% of them developed at least one NCD of which the contributing factors are obesity and physical inactivity. The aim of the study was to determine the prevalence of obesity and level of physical activity among health care professional in rural hospitals in Sekhukhune district, Limpopo province, South Africa. Methods: A quantitative descriptive study was conducted on 400 HCPs. The global questionnaire was closed ended. GPAQ was used for physical activity and anthropometric measurements were taken for BMI. A stratified random sampling method was used to sample HCPs. Data was analysed using SPSS version 23.0. Results: Most participants were females (71%), majority were between 30-39 years of age (46.3%), the highest category were nurses (77.8%), most of them their job title were assistants (44.5) and blacks (99.3%). The results revealed that 40.8% of HCPs were obese and 30.3% were overweight. Majority of (79.3%) were not engaging on work vigorous PA, however were engaging on work moderate PA. Also (60.5%) were not engaging on leisure vigorous PA, though 55.5% were engaging on leisure moderate PA. Majority (88.3%) had high sedentary (sitting) time. (35.50%) engaged in high activity of walking from one place to the other. In conclusion: There is a need for regular health promotion programmes among health care professionals with regard to obesity and importance of physical activity. The hospitals need to be equipped with onsite fitness centre that will be accessible to all HCPs. Physical activities support groups need to be established such as aerobics classes and fun run. Policies that guide participation in physical activities need to be drawn and be implemented accordingly in health sector, so as to promote healthy living habits. Key words: Obesity, Overweight, Level of physical activity, Health care professionals

Background: Obesity-associated metabolic complications display sexual dimorphism and can be impacted by cytokines. We previously showed that interleukin-10 (IL-10) was upregulated in white adipose tissue (WAT) of obese women with type 2 diabetes (T2D). Whether this pertains to men is unknown. The aim of this study was to compare the impact of obesity and T2D on WAT IL- 10 levels in men versus women. Methods: Plasma and subcutaneous WAT biopsies were obtained from 108 metabolically well-characterized individuals. WAT IL10 expression/secretion and WAT-resident IL-10-secreting macrophage number were measured. Circulating sex hormone levels were correlated toWAT IL10 expression in 22 individuals and sex hormone effects on macrophage IL10 expression were investigated in vitro. Results: Obese women with T2D showed increased IL10 expression/secretion and IL-10-secreting WAT macrophage number compared to other female groups. This difference was absent in men. Non-obese women and men with T2D showed similar IL-10 levels compared to healthy controls, indicating that T2D alone does not regulate IL-10. Although WAT IL10 expression correlated with serum estrone (E1) concentrations, recombinant E1 did not affect macrophage IL10 expression in vitro. Conclusion: WAT IL-10 levels are higher in women with obesity and T2D, but not in men and this effect is primarily attributed to obesity per se. This is less likely to be driven by circulating sex hormones. We propose that the WAT IL-10 might exert protective effects in obesity-associated chronic inflammation in women which could be one of the contributing factors for the decreased morbidity observed in women during obesity than men.

Thesis (PhD (Biomedical Sciences. Medical Physiology))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: In recent years there has been an increase in obesity and diabetes mellitus (DM). These conditions have for a long time been associated with infertility. Obesity is characterized by high levels of circulating leptin and cytokines as well as insulin resistance. Type I DM is associated with low or no insulin whereas, Type II DM is characterised by insulin resistance. As the prevalence of obesity and DM continues to rise, it is likely that the incidence of infertility associated with these pathological conditions will likewise increase. The effects of insulin and leptin on male reproductive function have been reported on the endocrine and spermatogenesis level, but their effects on cellular level of human ejaculated spermatozoa are yet to be elucidated. This study presents data on the role of insulin and leptin on human ejaculated spermatozoa and their interaction with cytokines and nitric oxide. In the first part of the study, we established the suitable concentrations of glucose, insulin and leptin that could be administered to human spermatozoa in vitro. Glucose concentration of 5.6 mM was chosen as the suitable concentration to be administered to human spermatozoa because it has previously been reported in the literature; furthermore, it is within the range of the physiological glucose levels found in the blood of fasting humans. Insulin and leptin concentrations of 10 μIU and 10 nmol were chosen respectively because they gave much improved sperm function and this was within the range of insulin and leptin levels previously measured in human ejaculated spermatozoa. This was followed by investigating the signalling pathway of insulin and its beneficial effects on human spermatozoa function. Endogenous insulin secretion from human ejaculated spermatozoa was blocked by nifedipine and its receptor tyrosine phosphorylation effects were inhibited by erbstatin while phosphatidylinositol 3-kinase (PI3K) phosphorylation activity was inhibited by wortmannin. Exogenous insulin administration significantly increased human sperm motility parameters as well as the sperm ability to acrosome react. The inhibition of endogenous insulin release from spermatozoa as well as the inhibition of the insulin receptor substrate (IRS) tyrosine phosphorylation significantly decreased motility parameters and the ability of spermatozoa to acrosome react. The study also investigated the effects of insulin and leptin on human sperm motility, viability, acrosome reaction and nitric oxide (NO) production. Both insulin and leptin significantly increased sperm motility parameters, acrosome reaction and NO production. The NO production induced by insulin and leptin was via PI3K signalling as evidenced by a reduction in NO levels when PI3K activity was inhibited by wortmannin. To investigate whether insulin and leptin could improve motility parameters of asthernozoospermic and teratozoospermic spermatozoa, the spermatozoa were separated into two fractions by means of a double density gradient technique. The gradient system was able to separate spermatozoa into high morphologically abnormal and less motile spermatozoa similar to that of asthernozoospermic and teratozoospermic patients as well as a more motile fraction. Insulin and leptin significantly increased the motility parameters of spermatozoa from the immature and less motile fraction. The fourth part of the study was aimed at investigating the effects of the cytokines, tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6), on human sperm motility, viability, acrosome reaction and NO production. The study shows that TNF-α and IL-6 significantly reduced motility parameters and acrosome reaction in a dose4 and time-dependent manner. These cytokines were also shown to significantly increase NO production from human spermatozoa. The decreased motility parameters induced by these cytokines could be attributed to their ability to induce excessive NO production. It is not yet clear how they inhibit spermatozoa to undergo the acrosome reaction. The fifth part of the study was to investigate the expression and localization of glucose transporter 8 (GLUT8) in human spermatozoa. This study shows that GLUT8 is constitutively expressed and located in the midpiece region of the human spermatozoa. The study also showed that stimulating spermatozoa with insulin led to an increase in GLUT8 expression as well as translocation to the acrosomal region. In the last part of the study we wanted to investigate why the increase in NO generation by spermatozoa due to insulin and leptin stimulation is accompanied with increased sperm function whereas NO increased due to TNF-α and IL-6 stimulation is accompanied with decreased sperm function. We observed that TNF-α and IL-6 not only increased NO production but also ROS production. This study speculates that the decrease in sperm motility and acrosome reaction when TNF-α and IL-6 were administered was due to the concomitant high increase in NO and ROS they induced. In conclusion, this study has established in vitro beneficial effects of insulin and leptin in normozoospermic and asthernozoospermic human sperm function. These hormones influence sperm function via the PI3K signalling pathway in two ways. Firstly, by increasing GLUT8 expression and translocation thereby possibly increasing glucose uptake and metabolism and secondly, by increasing NO production. The study has also established that TNF-α and IL-6 have detrimental effects on human spermatozoa in a dose and time dependent manner. These effects are mediated via their ability to stimulate both NO and ROS production in human spermatozoa. This study reports that GLUT8 is expressed in the midpiece region of human spermatozoa and that insulin stimulation upgrades its expression and leads to its translocation to the acrosomal region. / AFRIKAANSE OPSOMMING: Oor die afgelope jare was daar `n toename in obesiteit en diabetes mellitus (DM). Hierdie toestande word reeds vir ’n geruime tyd geassosieer met onvrugbaarheid. Obesiteit word gekenmerk deur verhoogde sirkulerende vlakke van leptiene en sitokiene sowel as insulien weerstandigheid. Tipe I DM word geassosieer met lae of geen insulien terwyl Tipe II DM gekenmerk word deur insulien weerstandigheid. Soos wat die voorkoms van obesiteit en DM toeneem, is dit waarskynlik dat die insidensie van onvrugbaarheid wat met hierdie patologiese toestande geassosieer word, gevolglik ook sal toeneem. Die effek van insulien en leptien op die manlike voortplantingsfunksie is alreeds aangetoon op endokriene en spermatogenese vlak, maar hul effekte op sellulêre vlak van menslike geëjakuleerde spermatosoë is nog onduidelik. Die studie vertoon data oor die rol van insulien en leptien op die menslike geëjakuleerde spermatosoë en hul interaksie met sitokiene en stikstofoksied (NO). In die eerste gedeelte van die studie, het ons ’n toepaslike konsentrasie van insulien en leptien bepaal wat aan menslike spermatosoë in vitro toegedien kan word. Glukose konsentrasies van 5,6 mM is bepaal as die gepaste konsentrasie om aan menslike spermatosoë toe te dien, omdat dit beter resultate tot gevolg het; verder is dit vergelykbaar met fisiologiese glukose vlakke in die bloed van `n vastende persoon. Insulien en leptien konsentrasies is op 10 μIU en 10 nm onderskeidelik vasgestel, aangesien dit tot beter resultate gelei het, en omdat dit vergelykbaar was met insulien en leptien vlakke wat reeds voorheen in menslike geëjakuleerde spermatosoë gemeet is. Dit was gevolg deur `n ondersoek na die insulien seintransduksie pad en sy voordelige effekte op menslike spermatosoë funksie. Endogene insulien afskeiding deur menslike geëjakuleerde spermatosoë was deur nifedipien geïnhibeer en sy reseptor tirosien fosforilasie effekte was deur erbstatin geïnhibeer terwyl fosfatidielinositol 3-kinase (PI3K) fosforilasie deur wortmannin geïnhibeer is. Eksogene insulien toediening het menslike sperm-motiliteit parameters betekenisvol laat toeneem asook die vermoë van sperme om die akrosoomreaksie te ondergaan. Die inhibisie van endogene insulien afskeiding deur spermatosoë sowel as die inhibisie van die insulien reseptor substraat (IRS) tirosien fosforilasie het die motiliteit parameters en die akrosoomreaksievermoë van spermatosoë verlaag. Die studie het ook die effekte van insulien en leptien op menslike sperm-motiliteit, -lewensvatbaarheid, -akrosoomreaksie en -NO produksie nagevors. Beide insulien en leptien het sperm-motiliteit parameters, -akrosoomreaksie en -NO produksie betekenisvol verhoog. NO produksie is deur insulien en leptien via PI3K seintransduksie geïnduseer, soos bewys deur die verlaging waargeneem in NO vlakke toe PI3K aktiwiteit deur wortmannin geïnhibeer was. Om vas te stel of insulien en leptien die motiliteit parameters van asthenozoospermiese en teratozoospermiese spermatosoë kon verbeter, het ons spermatosoë in twee fraksies met ’n dubbel digtheid gradiënt geskei. Die gradiënt sisteem was daartoe instaat om die spermatosoë in ’n onvolwasse, (morfologies abnormaal en minder motiel - soortgelyk aan dié van asthenozoospermiese en teratozoospermiese pasiënte), sowel as ’n volwasse meer motiele fraksie te skei. Insulien en leptien het die motiliteit parameters van spermatosoë van die onvolwasse en minder motiele fraksie verhoog. Die vierde gedeelte van die studie was daarop gemik om die effekte van die sitokiene tumor nekrose faktor alfa (TNF-α) en interleukin-6 (IL-6) op menslike sperm-motiliteit, -lewensvatbaarheid, -akrosoomreaksie en -NO produksie, te ondersoek. Die studie het getoon dat TNF-α en IL-6 motiliteit parameters en akrosoomreaksie in ’n tyd- en dosis-afhanklike wyse betekenisvol verlaag het. Hierdie sitokiene was ook in staat om NO produksie in menslike spermatosoë te verhoog. Die verlaging in motiliteit parameters wat deur hierdie sitokiene geïnduseer is, kan toegeskryf word aan hul vermoë om die produksie van oormatige hoeveelhede NO te stimuleer. Dit is nog nie duidelik hoe hulle die akrosoomreaksie in spermatosoë kan inhibeer nie. Die vyfde gedeelte van die studie het dit ten doel gehad om die uitdrukking en lokalisering van die glukose transporter 8 (GLUT8) in menslike spermatosoë te ondersoek. Hierdie studie kon aantoon dat GLUT8 konstitutief uitgedruk is en in die middelstuk van die menslike spermatosoë voorkom. Die studie bewys ook dat stimulering van die spermatosoë met insulien tot `n toename in GLUT8 uitdrukking sowel as translokasie na die akrosomale area, lei. In die finale gedeelte van die studie wou ons ondersoek waarom die toename in NO produksie in spermatosoë (as gevolg van insulien en leptien stimulasie) deur `n toename in spermfunksie gekenmerk word, terwyl die toename in NO produksie (as gevolg van TNF-α en IL-6 stimulasie) deur ’n afname in spermfunksie gekenmerk word. Ons het waargeneem dat TNF-α en IL-6 nie alleen NO produksie nie, maar ook reaktiewe suurstof spesies (ROS) produksie verhoog het. Ons vermoed dat die afname in sperm motiliteit en akrosoomreaksie met TNF-α en IL-6 toediening, die gevolg van die gelyktydige verhoging in NO en ROS was. In gevolgtrekking kan ons sê dat hierdie studie die voordelige in vitro effekte van insulien en leptien op asthenozoospermiese en teratozoospermiese menslike spermfunksie aangetoon het. Hierdie hormone beïnvloed spermfunksie via die PI3K seintransduksie pad op twee maniere. Eerstens, deur `n toename in GLUT8 uitdrukking en translokasie, met die gevolg dat glukose opname en metabolisme moontlik verhoog is, en tweedens, deur die toename in NO produksie. Die studie het ook vasgestel dat TNF-α en IL-6 nadelige effekte op menslike spermatosoë in `n dosis- en tyd-afhanklike wyse het. Hierdie effekte vind plaas a.g.v. hul vermoë om beide NO en ROS produksie in menslike spermatosoë te induseer. Die studie toon aan dat GLUT8 uitdrukking in die middelstuk van die menslike spermatosoon voorkom en dat insulien stimulasie GLUT8 uitdrukking opreguleer en tot translokasie na die akrosomale area lei.

Obesity is a major epidemic and is increasing in prevalence worldwide. The health problems and consequences of obesity include cardiovascular disease (CVD) risk factors, such as hypertension, hyperlipidemia, glucose intolerance and diabetes mellitus. Each of these abnormalities directly promotes atherosclerosis. More recently, visceral obesity has been shown to be independently associated with abnormalities of both the ventricular and vascular structure and function. The mechanisms by which they occur remain incompletely defined. Cardiovascular magnetic resonance imaging (CMR) offers several advantages for evaluation of cardiac structure and function in the obese. The high accuracy and reproducibility of the technique allows for detection of very small changes in ventricular volumes, mass, ejection fraction, and cardiac output with a relatively small sample size, as compared with echocardiography. In this thesis we investigated whether cardiovascular magnetic resonance imaging can better characterize possible cardiac abnormalities associated with obesity, in the absence of other confounding comorbidities. Obesity is associated with myocardial and vascular function, the extent of reversibility of these abnormalities with rapid acute weight loss remains uncertain. Therefore the first aim of the study was to (i) determine the relationship between obesity and left ventricular structure and function using magnetic resonance imaging, and (ii) the acute effects of rapid diet-induced weight loss on cardiac and vascular function in normal obese and obese diabetic men. Erectile dysfunction is related to cardiovascular risk factors such as obesity by an impairment of endothelial function. Therefore, symptoms of erectile dysfunction are probably to precede cardiovascular disease and events. The second aim of this study was to (i) determine the relationship between obesity and erectile function (EF), sexual desire (SD), lower urinary tract symptoms (LUTS) and quality of life (QOL) measures in obese males, and (ii) determine the effects of rapid diet-induced weight loss on EF, SD, LUTS and QOL measures in normal obese and obese diabetic men. In this group of men, obesity was associated with mild/moderate erectile dysfunction, and significant LUTS, which together with sexual desire improved following rapid diet induced weight loss, but was not directly related to the amount of weight loss or changes in measured metabolic state. Pericardial adipose tissue (PAT) covers 80% of the heart and constitutes 20% of its weight. PAT mass is related to the amount of abdominal fat and the risk of coronary atherosclerosis. Epicardial fat mass may be a sensitive indicator of cardiovascular risk. The third aim of this study was to (i) determine the relationship between obesity and PAT volume and (ii) effectively evaluate the impact of caloric restriction and associated weight reduction on epicardical fat volume via cardiac magnetic resonance imaging (CMR). This is the first study to show a reduction in PAT volume is associated with caloric restriction. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1352389 / Thesis (Ph.D.) - University of Adelaide, School of Medicine, 2009

Obesity is a major epidemic and is increasing in prevalence worldwide. The health problems and consequences of obesity include cardiovascular disease (CVD) risk factors, such as hypertension, hyperlipidemia, glucose intolerance and diabetes mellitus. Each of these abnormalities directly promotes atherosclerosis. More recently, visceral obesity has been shown to be independently associated with abnormalities of both the ventricular and vascular structure and function. The mechanisms by which they occur remain incompletely defined. Cardiovascular magnetic resonance imaging (CMR) offers several advantages for evaluation of cardiac structure and function in the obese. The high accuracy and reproducibility of the technique allows for detection of very small changes in ventricular volumes, mass, ejection fraction, and cardiac output with a relatively small sample size, as compared with echocardiography. In this thesis we investigated whether cardiovascular magnetic resonance imaging can better characterize possible cardiac abnormalities associated with obesity, in the absence of other confounding comorbidities. Obesity is associated with myocardial and vascular function, the extent of reversibility of these abnormalities with rapid acute weight loss remains uncertain. Therefore the first aim of the study was to (i) determine the relationship between obesity and left ventricular structure and function using magnetic resonance imaging, and (ii) the acute effects of rapid diet-induced weight loss on cardiac and vascular function in normal obese and obese diabetic men. Erectile dysfunction is related to cardiovascular risk factors such as obesity by an impairment of endothelial function. Therefore, symptoms of erectile dysfunction are probably to precede cardiovascular disease and events. The second aim of this study was to (i) determine the relationship between obesity and erectile function (EF), sexual desire (SD), lower urinary tract symptoms (LUTS) and quality of life (QOL) measures in obese males, and (ii) determine the effects of rapid diet-induced weight loss on EF, SD, LUTS and QOL measures in normal obese and obese diabetic men. In this group of men, obesity was associated with mild/moderate erectile dysfunction, and significant LUTS, which together with sexual desire improved following rapid diet induced weight loss, but was not directly related to the amount of weight loss or changes in measured metabolic state. Pericardial adipose tissue (PAT) covers 80% of the heart and constitutes 20% of its weight. PAT mass is related to the amount of abdominal fat and the risk of coronary atherosclerosis. Epicardial fat mass may be a sensitive indicator of cardiovascular risk. The third aim of this study was to (i) determine the relationship between obesity and PAT volume and (ii) effectively evaluate the impact of caloric restriction and associated weight reduction on epicardical fat volume via cardiac magnetic resonance imaging (CMR). This is the first study to show a reduction in PAT volume is associated with caloric restriction. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1352389 / Thesis (Ph.D.) - University of Adelaide, School of Medicine, 2009