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1 Ford ES, Giles WH, Dietz WH: Prevalence of the metabolic syndrome among US adults: findings from the Third National Health and Nutrition Examination Survey. JAMA 2002;287: 356-359.

2 Grundy SM, Brewer HB Jr, Cleeman JI, et al: Definition of metabolic syndrome: report of the National Heart, Lung and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 2004;109:433-438.

3 Anderson JL, Horne BD, Jones HU, et al: Which features of the metabolic syndrome predict the prevalence and clinical outcomes of angiographic coronary artery disease? Cardiology 2004;101:185-193.

4 Solymoss BC, Boruassa MG, Campeau L, et al: Effect of increasing metabolic syndrome score on atherosclerotic risk profile and coronary artery disease angiographic severity. Am J Cardiol 2004;93:159-164.

5 Lakka HM, Laaksonen DE, Lakka TA, et al: The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002;288:2709-2716.

6 Isomaa B, Almgren P, Tuomi T, et al: Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001;24:683-689.

7 Weiss R, Dziura J, Burgert TS, et al: Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004;350:2362-2374.

8 Cook S, Weitzman M, Auinger P, et al: Prevalence of a metabolic syndrome phenotype in adolescents: findings from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med 2003;157:821-827.

9 De Ferranti SD, Gauvreau K, Ludwig DS, et al: Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation 2004;110:2494-2497.

10 Grundy SM, Hansen B, Smith SC Jr, et al: Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association conference on scientific issues related to management. Circulation 2004;109:551-556.

11 Knowler WC, Barrett-Connor E, Fowler SE, et al, Diabetes Prevention Program Research Group: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393-403.

12 Haffner S, Temprosa M, Crandall J, et al, Diabetes Prevention Program Research Group: Intensive lifestyle intervention or metformin on inflammation and coagulation in participants with impaired glucose tolerance. Diabetes 2005;54:1566-1572.

13 Tuomilehto J, Lindstrom J, Eriksson JG, et al: Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001;344: 1343-1350.

14 Orchard TJ, Temprosa M, Goldberg R, et al: The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the diabetes prevention program randomized trial. Ann Intern Med 2005;142:611-619.

15 Ryan DH, Espeland MA, Foster GD, et al, Look AHEAD Research Group: Look AHEAD (Action for Health in Diabetes): design and methods for a clinical trial of weight loss for the prevention of cardiovascular disease in type 2 diabetes. Control Clin Trials 2003;24:610-628.

16 Foreyt JP: Need for lifestyle intervention: how to begin. Am J Cardiol 2005;96:11E-14E.

17 Steer RA, Cavalieri TA, Leonard DM, Beck AT: Use of the Beck depression inventory for primary care to screen for major depression disorders. Gen Hosp Psychiatry 1999;21:106-111.

18 Krauss RM, Eckel RH, Howard B, et al: AHA dietary guidelines: revision 2000: a statement for healthcare professionals from the Nutrition Committee of the American Heart Association. Circulation 2000;102:2284-2299.

19 Foreyt JP, Pendleton VR: Management of obesity. Prim Care Rep 2000;6:19-30.

20 Foster GD, Wadden TA, Vogt RA, Brewer G: What is a reasonable weight loss? Patients' expectations and evaluations of obesity treatment. J Consult Clin Psychol 1997;65:79-85.

21 Baker RC, Kirschenbaum DS: Self-monitoring may be necessary for successful weight control. Behav Ther 1993;24:377-394.

22 Wing RR, Hamman RF, Bray GA, et al, Diabetes Prevention Program Research Group: Achieving weight and activity goals among diabetes prevention program lifestyle participants. Obes Res 2004;12:1426-1434.

23 Foreyt JP, Goodrick GK: Attributes of successful approaches to weight loss and control. Appl Prev Psychol 1994;3:209-215.

24 Foreyt JP, Poston WS 2nd: What is the role of cognitive-behavior therapy in patient management? Obes Res 1998;6(suppl 1):18S-22S.

25 Poston WS 2nd, Foreyt JP: Successful management of the obese patient. Am Fam Physician 2000;61:3615-3622.

26 Wadden TA, Foster GD, Wang J, et al: Clinical correlates of short and long-term weight loss. Am J Clin Nutr 1922;56:274-278.

27 Pritchett AM, Foreyt JP, Mann DL: Treatment of the metabolic syndrome: the impact of lifestyle modification. Curr Atheroscler Rep 2005;7:95-102.


Dr. Slama: I have two points to make. One I don't know if it is a joke or a philosophical question, and the second one is much more serious. My first point is that if you say that 20 years from now 100% of the people will be fat, then what will be the definition of normal? Will we be normal, or will they be abnormal? Do we say that elephants are too fat? So 20 years from now we will all be normal. My serious question is that I read in the newspaper that for the first time in the history the increase in life expectancy is leveling off and even now slightly decreasing. Might it be that we are now paying the price for our very recent lifestyle?

Dr. Foreyt: I will answer your second question first. That came out of a paper just published by Olshansky et al. [1] in the New England Journal of Medicine. What they did was take all the data and show that this extended life expectancy is starting to level off, and they think now it is going to start decreasing because of obesity. They particularly show data, especially in children who are developing adult risk factors earlier and earlier, that this generation of children will die before their parents do. So according to Olshansky et al. this extending lifestyle is ending. Regarding your first point about 100% of Americans being obese or overweight by 2040; as you know obesity itself is excess body fat not weight. So the body mass index doesn't fit for everybody, but the average man in the United States has about 20% body fat, the average woman has about 25% body fat. With a body mass index of 30 a woman has about 37% body fat, and a man has about 25% body fat. So that equates very well if we look at body fat in men and women and look at that with respect to when this is going to happen, and it looks as though it is going to happen by 2040 in all of us in the United States, but all the other countries are catching up quickly. That curve is not starting to level off yet in any of the countries. The International Obesity Task Force data show that the lines are going up in all countries. I have not yet seen a country where it is leveling off or going down; not pessimistic, realistic.

Dr. Eshki: I want to make a recommendation. When looking at diseases in the past century, we see that the major killers, such as heart disease, cancer, stroke, and diabetes, are on the rise. Yet there is a lot of money being spent on research and health care. Looking at the preceding theory which focuses on the predisposing, reinforcing and enabling factors, I see the enabling factors as a major player when fighting this battle. Health professionals and the public seem to be fighting this battle alone. The government and industrial sectors seem to be watching this battle take place and don't seem to know that their intervention would make a difference. For instance, in Saudi Arabia there is a city called Medina where the governor issued a law banning smoking there. Furthermore, there are billboards in the streets around the city which are intended to educate the public about the dangers of smoking. As a result of this in the past 2 years health professionals have witnessed a dramatic reduction in the prevalence of lung cancer. So do you think the other two sectors should join the battle or should we continue to spend more money and lives, and hope for a happy ending?

Dr. Foreyt: That is a great question and it is being debated over and over; at every meeting I go to that is the major focus of the meeting. I think it has to do with personal responsibility. There is a role for communities, a role for local governments, and there is a role for the federal government. What that role should be is being debated now. But ultimately it has got to do with each individual; we all have to play a part.


1 Olshansky SJ, Passaro DJ, Hershow RC, et al: A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 2005;352:1138-1145.

Bantle JP, Slama G (eds): Nutritional Management of Diabetes Mellitus and Dysmetabolic Syndrome. Nestlé Nutr Workshop Ser Clin Perform Program, vol 11, pp 207-218, Nestec Ltd., Vevey/S. Karger AG, Basel, © 2006.

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