RESUMEN
AIMS: The present paper outlines the results of analyses carried out on the content of tablets sold as ecstasy, collected in the Netherlands by the Drugs Information Monitoring System (DIMS) from January 1993 to December 2008. METHODS: During a period of 16 years, the DIMS analysed the content of 33 006 tablets sold as ecstasy that were handed in by numerous individual (potential) substance users. The DIMS results were compared with the results from various seized tablets to determine whether the DIMS is a monitor of the ecstasy consumer market. RESULTS: The DIMS system appears to be a market monitor that gives an accurate reflection of what is actually available on the hidden Dutch ecstasy market. During 16 years of monitoring, the purity [tablets containing only 3,4-methylenedioxymethamphetamine (MDMA)] was lowest around 1997. During this time-period many tablets contained other substances in addition to or instead of MDMA [e.g. 3,4-methylene-dioxyamphetamine (MDA), 3,4-methylene-dioxyethylamphetamine (MDEA) and N-methyl-a-(1,3-benzodixol-5-yl)-2-butamine (MBDB), amphetamine and caffeine]. From 1998 to 2008, the number of high-dose tablets (> or =106 mg MDMA per tablet) gradually increased. The same holds true for the proportion of tablets that contained only MDMA, reaching the highest levels in 2000 and 2004. After 2004, the purity of ecstasy tablets decreased again, caused mainly by a growing proportion of tablets containing meta-chlorophenylpiperazine (mCPP). CONCLUSIONS: The DIMS results provide valuable qualitative information on the content of ecstasy tablets in the Netherlands, and its changes throughout the years. Moreover, the results were used for national and international risk assessments and important warning and prevention activities.
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Contaminación de Medicamentos/estadística & datos numéricos , Alucinógenos/química , N-Metil-3,4-metilenodioxianfetamina/química , Humanos , Países Bajos , Comprimidos , Factores de TiempoRESUMEN
AIMS: To report on trends in the content and adulterants present in street cocaine (powder) in the Netherlands and to describe the associated health hazards. DESIGN AND PARTICIPANTS: Drug consumers handed in samples of cocaine powder from 1999 to 2007 for analysis. Reports were compiled of users' experiences with the samples received. MEASUREMENTS AND ANALYSIS: Linear regression analysis was used to assess the trend in adulterated cocaine powder across the study period, and comparison of reported adverse effects of adulterated with those of unadulterated cocaine by Fisher's exact test. FINDINGS: There has been a statistically significant upward trend in the occurrence of adulterated cocaine powder over the years. Adulterated cocaine was associated more frequently with reported adverse effects than unadulterated cocaine. Phenacetin, hydroxyzine and diltiazem appeared to be three adulterants contributing to these adverse effects. CONCLUSIONS: An increase in adulterants was detected in the analysed cocaine powder between 1999 and 2007. This increase is associated with relatively more adverse effects with cocaine use. The cardiac and hallucinatory effects that were reported more frequently are not understood clearly. Adverse effects are likely to be due to several factors, including interactions of adulterants with cocaine and the route of administration.
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Cocaína/química , Contaminación de Medicamentos , Cocaína Crack/química , Contaminación de Medicamentos/estadística & datos numéricos , Drogas Ilícitas/química , Países Bajos , Análisis de RegresiónRESUMEN
BACKGROUND: Genetic variation in the perilipin (PLIN) gene may play a role in the etiology and treatment of obesity. OBJECTIVE: To examine different polymorphisms in the PLIN gene in relation to body-weight regulation. METHODS: 118 subjects followed a 6 wk VLCD, followed by 1 year weight maintenance. Body-weight (BW), body composition, leptin concentration, and polymorphisms of the PLIN gene: PLIN1:rs2289487, PLIN4:rs894160, PLIN6:rs1052700, PLIN5:rs2304795 and PLIN7:rs 2304796 were determined. RESULTS: BW loss during VLCD was 7.0+/-3.1 kg (p<0.05), and BW regain was 3.7+/-1.4 kg (p<0.05), including changes in body mass index (BMI), waist-circumference, body-composition and leptin concentrations (p<0.05). Linkage disequilibria were observed between PLIN1 and PLIN4: D' >0.9, r2=0.72; PLIN5 and PLIN7: D' >0.9, r2=0.85. In men, body weight, BMI, waist circumference, body fat, leptin concentrations were significantly lower for the haplotype of PLIN1 (C-alleles) and PLIN4 (A-alleles). In women weight loss and loss of fat mass were larger for the haplotype of PLIN1 (C-alleles) and PLIN4 (A-alleles). For PLIN6 genotypes body weight and body fat were lower for homozygotes of the minor allele (T/T) in the men; in the women leptin concentrations were lower. The haplotype of PLIN5 and PLIN7 consisting of A/G and G/G of PLIN5 and A/A of PLIN7 showed a reduction in FM: 5.9+/-0.6 kg vs 3.1+/-0.4 kg, % body fat: 5.5+/-0.6% vs 2.2+/-0.2%, and leptin: 20.5+/-10.8 ng/ml vs 12.9+/-6.7 ng/ml over time in the women (p<0.05). CONCLUSION: Since the haplotype of the minor alleles PLIN1-4, PLIN5-7 and PLIN6, was related to body-weight regulation at a lower level of body-weight in the men as well in the women we conclude that the PLIN1-4, 6, and 5-7 locus appears as a genetic influencer of obesity risk in humans.
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Composición Corporal/genética , Leptina/sangre , Obesidad/genética , Fosfoproteínas/genética , Pérdida de Peso/genética , Adulto , Composición Corporal/fisiología , Peso Corporal/genética , Proteínas Portadoras , Femenino , Estudios de Seguimiento , Predisposición Genética a la Enfermedad , Humanos , Masculino , Persona de Mediana Edad , Perilipina-1 , Factores de Riesgo , Pérdida de Peso/fisiologíaRESUMEN
OBJECTIVE: To find factors associated with successful weight maintenance (WM) in overweight and obese subjects after a very low-calorie diet (VLCD). RESEARCH METHODS AND PROCEDURES: Subjects (133) followed a VLCD (2.1 MJ/d) for 6 weeks in a free-living situation. Of these, 103 subjects (age, 49.6 +/- 9.7 years; BMI, 30.9 +/- 3.8 kg/m(2)) completed the following 2-year WM period. Body weight (BW), body composition, leptin concentration, attitude toward eating, and physical activity were determined right before (t0) and after (t1) the VLCD, after 3 months (t2), after 1 year (t3), after 1.5 years (t4), and after 2 years (t5). RESULTS: BW loss during VLCD was 7.2 +/- 3.1 kg. After 2 years, follow-up BW regain was 69.0 +/- 98.4%. After 2 years of WM, 13 subjects were successful (<10% BW regain), and 90 were unsuccessful (>10% BW regain). At baseline, these groups were significantly different in BMI (33.7 +/- 4.7 vs. 30.5 +/- 3.5 kg/m(2), respectively; p < 0.05) and fat mass (38.3 +/- 9.8 vs. 32.1 +/- 8.3 kg, p < 0.05). Successful subjects increased their dietary restraint significantly more during the whole study period (dietary restraint score, -4.9 +/- 4.4 vs. -2.1 +/- 3.8). Furthermore, %BW regain was associated with the amount of percentage body fat lost during VLCD, which indicates that the more fat lost, the better the WM, suggesting a fat free mass-sparing effect. DISCUSSION: Characteristics such as the ability to increase dietary restraint and maintain this high level of restraint, fat free mass sparing, and a relatively high baseline BMI and fat mass were associated with successful long-term WM (<10% regain after 2 years).
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Composición Corporal , Peso Corporal , Ingestión de Alimentos/fisiología , Ejercicio Físico , Pérdida de Peso/fisiología , Adulto , Actitud , Dieta , Ingestión de Alimentos/psicología , Estudios de Seguimiento , Humanos , Leptina/sangre , Persona de Mediana Edad , Países Bajos , Encuestas y Cuestionarios , Factores de TiempoRESUMEN
BACKGROUND: To improve the effective prevention and treatment of obesity, it is important to focus on body weight (BW) development and its determinants during childhood. OBJECTIVE: The aim of the present study was to investigate the effects of early development, parental and genetic variables, and behavioral determinants on overweight at 12 y. DESIGN: In a Dutch cohort of 105 children, anthropometric measurements were conducted from birth until age 7 y. At age 12 y, anthropometric measurements were obtained again, as were measurements of body composition, leptin concentration, 3 polymorphisms, and physical activity, and the Three-Factor Eating Questionnaire was conducted. In addition, parental body mass indexes (BMIs, in kg/m2) and Three-Factor Eating Questionnaire scores were determined. RESULTS: The children's mean (+/-SD) BMI at 12 y was 19.0 +/- 2.6, and 15.2% were classified as overweight. From the first year of life, BMI tracked significantly with BMI at age 12 y (r = 0.24, P < 0.05). Linear regression analyses showed that a rapid increase in BW during the first year of life, a high BMI of the father, and a high dietary restraint score of the mother were significantly associated with overweight at age 12 y (P < 0.05). No significant genetic relation was observed. In addition, overweight was positively associated with dietary restraint of the child, and percentage body fat was negatively associated with the child's activity score (P < 0.05). CONCLUSIONS: In this homogeneous cohort of normal-weight to moderately overweight children, tracking of BMI during childhood took place from the first year of life. Overweight at age 12 y was predicted by an early rapid increase in BW and parental influences. Overweight during childhood may be maintained or even promoted by a high dietary restraint score and low physical activity.
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Obesidad/prevención & control , Sobrepeso , Composición Corporal , Índice de Masa Corporal , Niño , Preescolar , Estudios de Cohortes , Conducta Alimentaria , Femenino , Genotipo , Humanos , Lactante , Recién Nacido , Leptina/sangre , Modelos Lineales , Masculino , Actividad Motora , Países Bajos/epidemiología , Obesidad/epidemiología , Obesidad/etiología , Sobrepeso/genética , Padres , Esfuerzo Físico , Polimorfismo Genético , Valor Predictivo de las Pruebas , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
We assessed the effect of ingestion of green tea (GT) extract along with a low-energy diet (LED) on resting energy expenditure (REE), substrate oxidation and body weight as GT has been shown to increase energy expenditure and fat oxidation in the short term in both animals and people. Forty-six overweight women (BMI 27.6 (sd 1.8) kg/m2) were fed in energy balance from day 1 to day 3, followed by a LED with GT (1125 mg tea catechins +225 mg caffeine/d) or placebo (PLAC) from day 4 to day 87. Caffeine intake was standardised to 300 mg/d. Energy expenditure was measured on days 4 and 32. Reductions in weight (4.19 (sd 2.0) kg PLAC, 4.21 (sd 2.7) kg GT), BMI, waist:hip ratio, fat mass and fat-free mass were not statistically different between treatments. REE as a function of fat-free mass and fat mass was significantly reduced over 32 d in the PLAC group (P<0.05) but not in the GT group. Dietary restraint increased over time (P<0.001) in both groups, whereas disinhibition and general hunger decreased (P<0.05). The GT group became more hungry over time and less thirsty, and showed increased prospective food consumption compared with PLAC (P<0.05). Taken together, the ingestion of GT along with a LED had no additional benefit for any measures of body weight or body composition. Although the decrease in REE as a function of fat-free mass and fat mass was not significant with GT treatment, whereas it was with PLAC treatment, no significant effect of treatment over time was seen, suggesting that a robust limitation of REE reduction during a LED was not achieved by GT.
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Metabolismo Basal/fisiología , Dieta , Obesidad/fisiopatología , Té , Pérdida de Peso/fisiología , Tejido Adiposo/fisiopatología , Adulto , Apetito/fisiología , Presión Sanguínea/fisiología , Índice de Masa Corporal , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Persona de Mediana Edad , Oxidación-Reducción , Extractos Vegetales/administración & dosificación , Encuestas y Cuestionarios , Factores de TiempoRESUMEN
BACKGROUND: Genetic variation in the peroxisome proliferator-activated receptor gamma2 (PPARgamma2), glucocorticoid receptor (GRL), and ciliary neurotrophic factor (CNTF) genes may play a role in the etiology of obesity. OBJECTIVE: We examined biological, psychological, and genetic determinants associated with weight maintenance (WM) after weight loss. DESIGN: Subjects (n = 120) followed a 6-wk diet and then a 1-y period of WM. Body weight (BW), body composition, leptin concentration, attitude toward eating (measured with the Three-Factor Eating Questionnaire), physical activity, and the polymorphisms of the PPARgamma2, GRL, and CNTF genes were measured. RESULTS: BW loss was 7.0 +/- 3.1 kg. After 1 y, 21 subjects showed successful WM (<10% regain); 99 were unsuccessful (> or =10% regain). Compared with unsuccessful subjects, successful subjects had a higher increase in dietary restraint over time (4.8 +/- 5.0 and 1.8 +/- 3.9, respectively; P < 0.01) but significantly less sensation of general hunger (-4.0 +/- 4.9 and -1.2 +/- 2.7, respectively; P < 0.05). Successful subjects had a significantly different frequency distribution for the PPARgamma2 (P = 0.05) and GRL (P < 0.05) genes than did unsuccessful subjects. The more successful genotypes showed a higher baseline body mass index and waist circumference (PPARgamma2), a greater decrease in disinhibition of dietary restraint (GRL), and less sensation of hunger (GRL). The G/G genotype (GRL) was an independent predictor of successful WM. CONCLUSION: The different genotypes of the PPARgamma2 and GRL genes contribute to WM, either directly (GRL) or indirectly (PPARgamma2 and GRL) via baseline body mass index and waist circumference, and to changes in Three-Factor Eating Questionnaire scores.
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Factor Neurotrófico Ciliar/genética , Ingestión de Alimentos/genética , Obesidad/etiología , PPAR gamma/genética , Polimorfismo Genético , Receptores de Glucocorticoides/genética , Adulto , Anciano , Actitud Frente a la Salud , Composición Corporal/fisiología , Restricción Calórica , Factor Neurotrófico Ciliar/fisiología , Dieta Reductora , Ingestión de Alimentos/fisiología , Ingestión de Alimentos/psicología , Ejercicio Físico/fisiología , Femenino , Genotipo , Humanos , Hambre/fisiología , Leptina/sangre , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Obesidad/dietoterapia , Obesidad/genética , Obesidad/psicología , PPAR gamma/fisiología , Cooperación del Paciente , Receptores de Glucocorticoides/fisiología , Encuestas y Cuestionarios , Pérdida de Peso/genética , Pérdida de Peso/fisiologíaRESUMEN
OBJECTIVE: The purpose of this study was to evaluate available variables of a long-term weight maintenance study to investigate possible factors predisposing to weight regain after a period of weight loss. RESEARCH METHODS AND PROCEDURES: The Maastricht Weight Maintenance Study is an ongoing longitudinal study of healthy men and women (29 men and 62 women; 18 to 65 years of age; BMI = 30.2 +/- 3.1 kg/m(2)). A variety of parameters were measured before and after a very-low-energy diet and after a follow-up of at least 2 years. RESULTS: Mean weight loss was 7.9 +/- 3.6 kg, and percent weight regain was 113.8 +/- 98.1%. Percent BMI regain was negatively associated with an increase in dietary restraint (r = -0.47, p < 0.05). Percent weight regain was negatively correlated with baseline resting metabolic rate (r = -0.38, p = 0.01) and baseline fat mass (r = -0.24, p = 0.05) and positively correlated with the magnitude of change in body weight (BW) expressed as maximum amplitude of BW (r = 0.21, p < 0.05). In addition, amplitude of BW was positively correlated with the frequency of dieting (r = 0.57, p < 0.01). DISCUSSION: The best predictors for weight maintenance after weight loss were an increase in dietary restraint during weight loss, a high baseline resting metabolic rate, a relatively high baseline fat mass favoring a fat-free mass-sparing effect during weight loss, a rather stable BW, and a low frequency of dieting. Therefore, BW maintenance after BW loss seems to be a multifactorial issue, including mechanisms that regulate an individuals' energy expenditure, body composition, and eating behavior in such a way that energy homeostasis is maintained.