Glossary of Terms

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Abdominal fat: Fat (adipose tissue) that is centrally distributed between the thorax and pelvis and that induces greater health risk.

Absolute risk: The observed or calculated probability of an event in a population under study, as contrasted with the relative risk.

Aerobic exercise: A type of physical activity that includes walking, jogging, running, and dancing. Aerobic training improves the efficiency of the aerobic energy-producing systems that can improve cardiorespiratory endurance.

Age-adjusted: Summary measures of rates of morbidity or mortality in a population using statistical procedures to remove the effect of age differences in populations that are being compared. Age is probably the most important and the most common variable in determining the risk of morbidity and mortality.

Anorexiant: A drug, process, or event that leads to anorexia.

Anthropometric measurements: Measurements of human body height, weight, and size of component parts, including skinfold measurement. Used to study and compare the relative proportions under normal and abnormal conditions.

Atherogenic: Causing the formation of plaque in the lining of the arteries.

Behavior therapy: Behavior therapy constitutes those strategies, based on learning principles such as reinforcement, that provide tools for overcoming barriers to compliance with dietary therapy and/or increased physical activity.

Biliopancreatic diversion: A surgical procedure for weight loss that combines a modest amount of gastric restriction with intestinal malabsorption.

BMI: Body mass index; the body weight in kilograms divided by the height in meters squared (wt/ht2) used as a practical marker to assess obesity; often referred to as the Quetelet Index. An indicator of optimal weight for health and different from lean mass or percent body fat calculations because it only considers height and weight.

Body composition: The ratio of lean body mass (structural and functional elements in cells, body water, muscle, bone, heart, liver, kidneys, etc.) to body fat (essential and storage) mass. Essential fat is necessary for normal physiological functioning (e.g., nerve conduction). Storage fat constitutes the body's fat reserves, the part that people try to lose.

BRL 26830A: An atypical B adrenoreceptor agonist drug that in obese rodents showed an increased metabolic rate and caused a reduction in weight by decreasing body lipid content. It is not approved as a weight loss drug by FDA.

Carbohydrates: A nutrient that supplies 4 calories/gram. They may be simple or complex. Simple carbohydrates are called sugars, and complex carbohydrates are called starch and fiber (cellulose). An organic compound—containing carbon, hydrogen, and oxygen—that is formed by photosynthesis in plants. Carbohydrates are heat producing and are classified as monosaccha-rides, disaccharides, or polysaccharides.

Cardiovascular disease (CVD): Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure).

Central fat distribution: The waist circumference is an index of body fat distribution. Increasing waist circumference is accompanied by increasing frequencies of overt type 2 diabetes, dyslipidemia, hypertension, coronary heart disease, stroke, and early mortality. In the body fat patterns called android type (apple shaped) fat is deposited around the waist and upper abdominal area and appears most often in men. Abdominal body fat is thought to be associated with a rapid mobilization of fatty acids rather than resulting from other fat depots, although it remains a point of contention. If abdominal fat is indeed more active than other fat depots, it would then provide a mechanism by which we could explain (in part) the increase in blood lipid and glucose levels. The latter have been clearly associated with an increased risk for cardiovascular disease hypertension and type 2 diabetes mellitus. The gynoid type (pear-shaped) of body fat is usually seen in women. The fat is deposited around the hips, thighs, and buttocks, and presumably is used as energy reserve during pregnancy and lactation.

Cholecystectomy: Surgical removal of the gallbladder and gallstones, if present.

Cholecystitis: Inflammation of the gallbladder, caused primarily by gallstones. Gallbladder disease occurs most often in obese women older than 40 years of age.

Cholesterol: A soft, waxy substance manufactured by the body and used in the production of hormones, bile acid, and vitamin D and present in all parts of the body, including the nervous system, muscle, skin, liver, intestines, and heart. Blood cholesterol circulates in the bloodstream. Dietary cholesterol is found in foods of animal origin.

Cimetidine: A weight loss drug that is thought to work by suppression of gastric acid or suppression of hunger by blocking histamine H2 receptors. It is not approved by the FDA.

Cognitive behavior therapy: A system of psychotherapy based on the premise that distorted or dysfunctional thinking, which influences a person's mood or behavior, is common to all psychosocial problems. The focus of therapy is to identify the distorted thinking and to replace it with more rational, adaptive thoughts and beliefs.

Cognitive rehearsal: A technique used in cognitive behavior therapy. In a weight loss program, for example, individuals first imagine the situation that is causing temptation (such as eating a high fat food), describe the thoughts and feelings that accompany the imagined situation, and make positive self-statements about the situation (e.g., "I am feeling good about choosing a low calorie drink rather than the high fat cheese."). Then the next step is to follow the positive self-statement with an adaptive behavior (such as walking away from the buffet line to chat with a friend). Finally, individuals are encouraged to reward themselves for doing well in a difficult situation, with either positive statements or material rewards, or both. The idea is to rehearse one's thoughts and behaviors prior to experiencing the potentially difficult situation, and to be armed with healthy adaptive responses.

Cognitive restructuring: A method of identifying and replacing fear-promoting, irrational beliefs with more realistic and functional ones.

Comorbidity: Two or more diseases or conditions existing together in an individual.

Computed tomography (CT) scans: A radiographic technique for direct visualization and quantification of fat that offers high image contrast and clear separation of fat from other soft tissues. CT can estimate total body adipose tissue volume and identify regional, subcutaneous, visceral, and other adipose tissue depots. Radiation exposure, expense, and unavailability restrict the epidemiologic use of CT.

Confounding: Extraneous variables resulting in outcome effects that obscure or exaggerate the "true" effect of an intervention.

Coronary heart disease (CHD): A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results.

Cue avoidance: A stimulus control technique often used in weight loss programs in which individuals are asked to reduce their exposure to certain food cues by making a variety of changes in their habits. The rationale is to make it easier on oneself and reduce temptation by reducing contact with food cues. For example, coming home from work and feeling tired is a time when many people reach for the high fat foods if they are available. By not having the high fat foods within reach, one can avoid eating them.

Dexfenfluramine: A serotonin agonist drug used to treat obesity. FDA approval has been withdrawn.

Diabetes: A complex disorder of carbohydrate, fat, and protein metabolism that is primarily a result of relative or complete lack of insulin secretion by the beta cells of the pancreas or a result of defects of the insulin receptors.

Diastolic blood pressure: The minimum pressure that remains within the artery when the heart is at rest.

Diethylproprion: An appetite suppressant prescribed in the treatment of obesity.

Dopamine: A catecholamine neurotransmitter that is found primarily in the basal ganglia of the central nervous system. Major functions include the peripheral inhibition and excitation of certain muscles; cardiac excitation; and metabolic, endocrine and central nervous system actions.

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