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Article ; Online: A higher proportion of small adipocytes is associated with increased visceral and ectopic lipid accumulation during weight gain in response to overfeeding in men.

White, Ursula / Beyl, Robbie A / Ravussin, Eric

International journal of obesity (2005)

2022 Volume 46, Issue 8, Page(s) 1560–1563

Abstract: Background: Adipose tissue (AT) expansion occurs by hypertrophy (increase in size) and hyperplasia (increase in number) of adipocytes. The AT expandability hypothesis postulates that impaired subcutaneous AT expansion leads to ectopic fat accretion, ... ...

Abstract	Background: Adipose tissue (AT) expansion occurs by hypertrophy (increase in size) and hyperplasia (increase in number) of adipocytes. The AT expandability hypothesis postulates that impaired subcutaneous AT expansion leads to ectopic fat accretion, contributing to impaired metabolic health. The role of adipogenesis as a contributing factor is debatable. Subjects/methods: In the present analysis, we assess changes in adipocyte size distribution in relation to changes in ectopic fat accretion in response to 8-weeks of overfeeding in 22 men (28 ± 5.4 years; BMI 25.5 ± 2.3 kg/m Results: Participants gained 6.7 ± 2.1 kg. The percentage of small adipocytes (p = 0.03) and the peak diameter of large adipocytes (p = 0.01) increased after overfeeding. At baseline, the percentage of small adipocytes was positively correlated with % body fat (p = 0.03), SAT mass (p = 0.01), VAT mass (p = 0.02), VAT:TAT (p = 0.05), and IHL (p = 0.09; trend). The relative (percent) change in small adipocytes was positively associated with the increase in whole-body fat (p = 0.001), VAT mass (p = 0.0003), VAT:TAT (p = 0.01), and IHL (p = 0.007) in response to overfeeding. Conclusions: These findings, surprisingly, indicate that during substantial weight gain, an increase in small adipocytes (suggesting hyperplastic expansion) is associated with impaired (not improved) metabolic health outcomes, specifically visceral and ectopic fat accumulation. Clinical trial registration: ClinicalTrials.gov Identifier- NCT01672632.
MeSH term(s)	Adipocytes/metabolism ; Adult ; Humans ; Insulin Resistance/physiology ; Intra-Abdominal Fat/metabolism ; Lipids ; Male ; Obesity/metabolism ; Weight Gain/physiology
Chemical Substances	Lipids
Language	English
Publishing date	2022-05-23
Publishing country	England
Document type	Clinical Study ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	752409-2
ISSN	1476-5497 ; 0307-0565
ISSN (online)	1476-5497
ISSN	0307-0565
DOI	10.1038/s41366-022-01150-y
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Article ; Online: Longitudinal Impact of Vision Impairment on Concern About Falling in People With Age-Related Macular Degeneration.

White, Ursula E / Black, Alex A / Delbaere, Kim / Wood, Joanne M

Translational vision science & technology

2022 Volume 11, Issue 1, Page(s) 34

Abstract: Purpose: To explore the longitudinal impact of central vision loss on concern about falling (CF), over a 12-month period, in people with age-related macular degeneration (AMD).: Methods: Participants included 60 community-dwelling older people (age, ... ...

Abstract	Purpose: To explore the longitudinal impact of central vision loss on concern about falling (CF), over a 12-month period, in people with age-related macular degeneration (AMD). Methods: Participants included 60 community-dwelling older people (age, 79.7 ± 6.4 years) with central vision impairment due to AMD. Binocular high-contrast visual acuity, contrast sensitivity, and visual fields were assessed at baseline and at 12 months. CF was assessed at both time points using the Falls Efficacy Scale-International (FES-I). Sensorimotor function (sit to stand, knee extension, postural sway, and walking speed) and neuropsychological function (reaction time, symptoms of anxiety and depression) were also assessed at both time points using validated instruments. Falls data were collected using monthly diaries during the 12 months. Results: CF increased by a small but significant amount over the 12-month follow-up (2.1 units; P = 0.01), with increasing prevalence of high levels of CF (FES-I score ≥ 23), from 48% at baseline to 65% at 12 months. Linear mixed models showed that reduced contrast sensitivity was significantly associated with increased concern about falling (P = 0.004), whereas declines in both visual acuity and contrast sensitivity during the follow-up period were associated with increases in CF over the 12-month follow-up (P = 0.041 and P = 0.054, respectively), independent of age, gender, falls history, or number of comorbidities. Conclusions: Higher levels of CF are common in older people with AMD, and levels increase over time; this increase is associated with declines in both visual acuity and contrast sensitivity. These findings highlight the need for regular assessment of both visual acuity and contrast sensitivity to identify those at greatest risk of developing higher CF. Translational relevance: Routine assessment of visual acuity and contrast sensitivity in older people with AMD will assist in identifying those at risk of developing high CF.
MeSH term(s)	Accidental Falls ; Aged ; Aged, 80 and over ; Contrast Sensitivity ; Humans ; Macular Degeneration/complications ; Macular Degeneration/diagnosis ; Macular Degeneration/epidemiology ; Scotoma/complications ; Visual Acuity ; Visual Fields
Language	English
Publishing date	2022-01-25
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2674602-5
ISSN	2164-2591 ; 2164-2591
ISSN (online)	2164-2591
ISSN	2164-2591
DOI	10.1167/tvst.11.1.34
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Article: Adipose tissue expansion in obesity, health, and disease.

White, Ursula

Frontiers in cell and developmental biology

2023 Volume 11, Page(s) 1188844

Abstract: White adipose tissue (WAT) expands under physiological conditions via an increase in adipocyte size ...

Abstract	White adipose tissue (WAT) expands under physiological conditions via an increase in adipocyte size (hypertrophy) and/or number (hyperplasia; adipogenesis), and the ability of WAT to expand to accommodate energy demands is a significant determinant of metabolic health status. Obesity is associated with impaired WAT expansion and remodeling, which results in the deposition of lipids to other non-adipose organs, leading to metabolic derangements. Although increased hyperplasia has been implicated as a cornerstone in promoting healthy WAT expansion, recent developments suggest that the role of adipogenesis as a contributing factor in the transition from impaired subcutaneous WAT expansion to impaired metabolic health remains up for debate. This mini-review will summarize recent developments and highlight emerging concepts on the features of WAT expansion and turnover, and the significance in obesity, health, and disease.
Language	English
Publishing date	2023-04-26
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2737824-X
ISSN	2296-634X
ISSN	2296-634X
DOI	10.3389/fcell.2023.1188844
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Article ; Online: Assessing DNP impact using program evaluations to capture healthcare system change.

Pritham, Ursula A / White, Patricia

The Nurse practitioner

2016 Volume 41, Issue 4, Page(s) 44–53

Abstract: The doctor of nursing practice (DNP) degree was formalized in 2004. Data evaluating the impact of DNP-prepared nurses on individual patient care, population health, and healthcare system outcomes are limited. This article demonstrates how the DNP ... ...

Abstract	The doctor of nursing practice (DNP) degree was formalized in 2004. Data evaluating the impact of DNP-prepared nurses on individual patient care, population health, and healthcare system outcomes are limited. This article demonstrates how the DNP Essentials can be used to frame DNP program evaluation data.
MeSH term(s)	Delivery of Health Care/organization & administration ; Education, Nursing, Graduate ; Humans ; Nurse Practitioners/education ; Nursing Education Research ; Nursing Evaluation Research
Language	English
Publishing date	2016-04-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	604085-8
ISSN	1538-8662 ; 0361-1817
ISSN (online)	1538-8662
ISSN	0361-1817
DOI	10.1097/01.NPR.0000481509.24736.c8
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Article ; Online: Determinants of concern about falling in adults with age-related macular degeneration.

White, Ursula E / Black, Alex A / Delbaere, Kim / Wood, Joanne M

Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)

2020 Volume 41, Issue 2, Page(s) 245–254

Abstract: Purpose: To investigate the prevalence and level of concern about falling (CF) among older people with vision impairment due to age-related macular degeneration (AMD) compared to a visually normal control group, and to identify determinants of CF for ... ...

Abstract	Purpose: To investigate the prevalence and level of concern about falling (CF) among older people with vision impairment due to age-related macular degeneration (AMD) compared to a visually normal control group, and to identify determinants of CF for the AMD group. Methods: Participants included 133 older people: 77 with AMD (mean age = 80.5 ± 6.2 years), and 56 controls (mean age = 75.4 ± 5.3 years). Binocular visual acuity, contrast sensitivity and visual fields were measured, and CF was assessed using the Falls Efficacy Scale - International (FES-I). Data were also collected for sensorimotor function (postural sway, sit-to-stand, knee extensions, walking speed, proprioception), and neuropsychological function (reaction time, symptoms of anxiety and depression) using validated tests and scales. Results: Concern about falling scores were higher for AMD participants compared to control participants (mean ± S.D. 24.6 ± 8.0 vs 21.6 ± 5.7, p = 0.02, respectively), although these findings failed to reach significance when adjusted for age (p = 0.16). Among AMD participants, multivariable models showed that greater CF was associated with reduced contrast sensitivity (p = 0.02), slower sit-to-stand times (p < 0.001) and higher anxiety scores (p < 0.001); these factors explained 40% of the variance in CF (p < 0.01). Conclusion: Levels of CF in older people with AMD were not found to be elevated by their disease status alone, but rather by the extent of vision loss. Levels of CF in those with AMD were associated with various visual, sensorimotor and neuropsychological factors. These findings will assist clinicians in identifying those at greatest risk of developing high CF and inform the design of future intervention programmes for this population.
MeSH term(s)	Accidental Falls/statistics & numerical data ; Age Factors ; Aged ; Aged, 80 and over ; Cognition/physiology ; Contrast Sensitivity/physiology ; Female ; Humans ; Incidence ; Macular Degeneration/complications ; Macular Degeneration/diagnosis ; Macular Degeneration/physiopathology ; Male ; New South Wales/epidemiology ; Vision, Binocular/physiology ; Vision, Low/diagnosis ; Vision, Low/epidemiology ; Vision, Low/etiology ; Visual Acuity ; Visual Fields/physiology ; Walking
Language	English
Publishing date	2020-12-25
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	604564-9
ISSN	1475-1313 ; 0275-5408
ISSN (online)	1475-1313
ISSN	0275-5408
DOI	10.1111/opo.12777
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Article ; Online: The Effects of Alcohol Consumption on Cardiometabolic Health Outcomes Following Weight Loss in Premenopausal Women with Obesity: A Pilot Randomized Controlled Trial.

Apolzan, John W / Beyl, Robbie A / Martin, Corby K / Greenway, Frank L / White, Ursula

International journal of environmental research and public health

2020 Volume 17, Issue 15

Abstract: Alcohol (i.e., ethanol) is consumed regularly by much of the adult population; yet, the health effects associated with its use are not well-characterized. Clinical interventions to investigate the effects of moderate alcohol consumption on metabolic ... ...

Abstract	Alcohol (i.e., ethanol) is consumed regularly by much of the adult population; yet, the health effects associated with its use are not well-characterized. Clinical interventions to investigate the effects of moderate alcohol consumption on metabolic outcomes, including adiposity and cardiovascular risk factors, are limited and have yielded conflicting data. In addition, no study has reported the effects of routine alcohol intake during weight loss in a controlled feeding trial. We present the first randomized controlled pilot trial to investigate the effects of moderate alcohol consumption on metabolic outcomes during weight loss in women with obesity. Both groups consumed 30% energy restricted diets and were randomized to either an ethanol-free control (CTL) group or a group (EtOH) that consumed 35 g ethanol daily for eight weeks. Our findings demonstrate that, despite similar weight loss, the decrease in mean arterial pressure was attenuated in the EtOH group, relative to the CTL group (
MeSH term(s)	Alcohol Drinking ; Cardiovascular Diseases/prevention & control ; Female ; Humans ; Obesity ; Outcome Assessment, Health Care ; Pilot Projects ; Weight Loss
Language	English
Publishing date	2020-07-23
Publishing country	Switzerland
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph17155302
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Article: Resistant Starch Has No Effect on Appetite and Food Intake in Individuals with Prediabetes

White, Ursula / Peterson, Courtney M / Beyl, Robbie A / Martin, Corby K / Ravussin, Eric

Academy of Nutrition and Dietetics Journal of the Academy of Nutrition and Dietetics. 2020 Jan. 24,

2020

Abstract: Type 2 resistant starch (RS2) has been shown to improve metabolic health outcomes and may increase satiety and suppress appetite and food intake in humans.This study assessed whether 12 weeks of daily RS2 supplementation could influence appetite ... ...

Abstract	Type 2 resistant starch (RS2) has been shown to improve metabolic health outcomes and may increase satiety and suppress appetite and food intake in humans.This study assessed whether 12 weeks of daily RS2 supplementation could influence appetite perception, food intake, and appetite-related gut hormones in adults with prediabetes, relative to the control (CTL) group.The study was a randomized controlled trial and analysis of secondary study end points.Sixty-eight adults (body mass index ≥27) aged 35 to 75 years with prediabetes were enrolled in the study at Pennington Biomedical Research Center (2012 to 2016). Fifty-nine subjects were included in the analysis.Participants were randomized to consume 45 g/day of high-amylose maize (RS2) or an isocaloric amount of the rapidly digestible starch amylopectin (CTL) for 12 weeks.Subjective appetite measures were assessed via visual analogue scale and the Eating Inventory; appetite-related gut hormones (glucagon-like peptide 1, peptide YY, and ghrelin) were measured during a standard mixed-meal test; and energy and macronutrient intake were assessed by a laboratory food intake (buffet) test, the Remote Food Photography Method, and SmartIntake app.Data were analyzed using linear mixed models, adjusting for treatment group and time as fixed effects, with a significance level of α=.05.RS2 had no effect on subjective measures of appetite, as assessed by visual analogue scale (P>0.05) and the Eating Inventory (P≥0.24), relative to the CTL group. There were no effects of RS2 supplementation on appetite-related gut hormones, including glucagon-like peptide 1 (P=0.61), peptide YY (P=0.34), and both total (P=0.26) and active (P=0.47) ghrelin compared with the CTL. RS2 had no effect on total energy (P=0.30), carbohydrate (P=0.11), protein (P=0.64), or fat (P=0.37) consumption in response to a buffet meal test, relative to the CTL. In addition, total energy (P=0.40), carbohydrate (P=0.15), protein (P=0.46), and fat (P=0.53) intake, as quantified by the Remote Food Photography Method, were also unaffected by RS2, relative to the CTL.RS2 supplementation did not increase satiety or reduce appetite and food intake in adults with prediabetes.
Keywords	adults ; amylopectin ; appetite ; biomedical research ; body mass index ; corn ; digestive system ; energy ; food intake ; ghrelin ; glucagon-like peptide 1 ; inventories ; linear models ; peptide YY ; photography ; randomized clinical trials ; resistant starch ; satiety
Language	English
Dates of publication	2020-0124
Publishing place	Elsevier Inc.
Document type	Article
Note	Pre-press version
ZDB-ID	2646718-5
ISSN	2212-2672
ISSN	2212-2672
DOI	10.1016/j.jand.2020.01.017
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Adipose depot-specific effects of 16 weeks of pioglitazone on in vivo adipogenesis in women with obesity: a randomised controlled trial.

White, Ursula / Fitch, Mark D / Beyl, Robbie A / Hellerstein, Marc K / Ravussin, Eric

Diabetologia

2020 Volume 64, Issue 1, Page(s) 159–167

Abstract: ... women with obesity (20 black; 21 white; 29 ± 6 years; BMI 32.0 ± 1.7 kg/m: Results: After the 16 week ...

Abstract	Aims/hypothesis: In vitro and rodent studies suggest that pioglitazone, a thiazolidinedione, can promote adipogenesis in adipose tissue (AT); however, there is a lack of in vivo studies in humans to support these findings. The objectives of this randomised, placebo-controlled, parallel-arm trial were to test if pioglitazone stimulates in vivo adipogenesis in the subcutaneous adipose tissue depots and if these measures were related to metabolic health outcomes in women with obesity. Methods: Forty-one healthy women with obesity (20 black; 21 white; 29 ± 6 years; BMI 32.0 ± 1.7 kg/m Results: After the 16 week intervention, there was a significant decrease in visceral fat (VAT:total abdominal AT [as a %]; p = 0.002) and an increase in the Matsuda index (i.e. improved insulin sensitivity; p = 0.04) in the pioglitazone group relative to the placebo group. A significant increase in the formation of new adipocytes was observed in the scFEM (Δ = 3.3 ± 1.6%; p = 0.04) but not the scABD depot (Δ = 2.0 ± 2.1%; p = 0.32) in the pioglitazone group relative to the placebo group. No serious adverse events were reported. Conclusions/interpretation: Pioglitazone may elicit distinct differences in in vivo adipogenesis in subcutaneous adipose depots in women with obesity, with increased rates in the protective scFEM. Trial registration ClinicalTrials.gov NCT01748994 Funding This study was funded by R01DK090607, P30DK072476, and R03DK112006 from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health. U54 GM104940 from the National Institute of General Medical Sciences of the National Institutes of Health. The Robert C. and Veronica Atkins Foundation. Graphical abstract.
MeSH term(s)	Abdominal Fat/drug effects ; Abdominal Fat/pathology ; Adipocytes/pathology ; Adipogenesis/drug effects ; Adult ; Biopsy ; Blacks ; Body Composition ; Double-Blind Method ; Female ; Humans ; Hypoglycemic Agents ; Intra-Abdominal Fat/drug effects ; Intra-Abdominal Fat/pathology ; Obesity/metabolism ; Obesity/pathology ; Pioglitazone/administration & dosage ; Placebos ; Subcutaneous Fat/drug effects ; Subcutaneous Fat/pathology ; Waist-Hip Ratio ; Whites
Chemical Substances	Hypoglycemic Agents ; Placebos ; Pioglitazone (X4OV71U42S)
Language	English
Publishing date	2020-10-01
Publishing country	Germany
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1694-9
ISSN	1432-0428 ; 0012-186X
ISSN (online)	1432-0428
ISSN	0012-186X
DOI	10.1007/s00125-020-05281-7
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Article ; Online: The Effects of Alcohol Consumption on Cardiometabolic Health Outcomes Following Weight Loss in Premenopausal Women with Obesity

John W. Apolzan / Robbie A. Beyl / Corby K. Martin / Frank L. Greenway / Ursula White

International Journal of Environmental Research and Public Health, Vol 17, Iss 5302, p

A Pilot Randomized Controlled Trial

2020 Volume 5302

Abstract	Alcohol (i.e., ethanol) is consumed regularly by much of the adult population; yet, the health effects associated with its use are not well-characterized. Clinical interventions to investigate the effects of moderate alcohol consumption on metabolic outcomes, including adiposity and cardiovascular risk factors, are limited and have yielded conflicting data. In addition, no study has reported the effects of routine alcohol intake during weight loss in a controlled feeding trial. We present the first randomized controlled pilot trial to investigate the effects of moderate alcohol consumption on metabolic outcomes during weight loss in women with obesity. Both groups consumed 30% energy restricted diets and were randomized to either an ethanol-free control (CTL) group or a group (EtOH) that consumed 35 g ethanol daily for eight weeks. Our findings demonstrate that, despite similar weight loss, the decrease in mean arterial pressure was attenuated in the EtOH group, relative to the CTL group ( p = 0.02). In addition, decreases in other outcomes, including visceral adipose tissue ( p = 0.23), circulating lipids (triglycerides ( p = 0.11) and cholesterol ( p = 0.11)), and uric acid ( p = 0.07) tended to be attenuated with alcohol consumption. These pilot data provide potential evidence that moderate alcohol consumption may mitigate the beneficial effects of weight loss and support the need for larger Randomized Controlled Trials (RCTs) to better investigate the metabolic effects of moderate alcohol intake in humans.
Keywords	ethanol ; alcohol ; weight loss ; body weight ; obesity ; triglycerides ; Medicine ; R
Language	English
Publishing date	2020-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Resistant Starch Has No Effect on Appetite and Food Intake in Individuals with Prediabetes.

White, Ursula / Peterson, Courtney M / Beyl, Robbie A / Martin, Corby K / Ravussin, Eric

Journal of the Academy of Nutrition and Dietetics

2020 Volume 120, Issue 6, Page(s) 1034–1041

Abstract: Background: Type 2 resistant starch (RS2) has been shown to improve metabolic health outcomes and may increase satiety and suppress appetite and food intake in humans.: Objective: This study assessed whether 12 weeks of daily RS2 supplementation ... ...

Abstract	Background: Type 2 resistant starch (RS2) has been shown to improve metabolic health outcomes and may increase satiety and suppress appetite and food intake in humans. Objective: This study assessed whether 12 weeks of daily RS2 supplementation could influence appetite perception, food intake, and appetite-related gut hormones in adults with prediabetes, relative to the control (CTL) group. Design: The study was a randomized controlled trial and analysis of secondary study end points. Participants/setting: Sixty-eight adults (body mass index ≥27) aged 35 to 75 years with prediabetes were enrolled in the study at Pennington Biomedical Research Center (2012 to 2016). Fifty-nine subjects were included in the analysis. Intervention: Participants were randomized to consume 45 g/day of high-amylose maize (RS2) or an isocaloric amount of the rapidly digestible starch amylopectin (CTL) for 12 weeks. Main outcome measures: Subjective appetite measures were assessed via visual analogue scale and the Eating Inventory; appetite-related gut hormones (glucagon-like peptide 1, peptide YY, and ghrelin) were measured during a standard mixed-meal test; and energy and macronutrient intake were assessed by a laboratory food intake (buffet) test, the Remote Food Photography Method, and SmartIntake app. Statistical analyses performed: Data were analyzed using linear mixed models, adjusting for treatment group and time as fixed effects, with a significance level of α=.05. Results: RS2 had no effect on subjective measures of appetite, as assessed by visual analogue scale (P>0.05) and the Eating Inventory (P≥0.24), relative to the CTL group. There were no effects of RS2 supplementation on appetite-related gut hormones, including glucagon-like peptide 1 (P=0.61), peptide YY (P=0.34), and both total (P=0.26) and active (P=0.47) ghrelin compared with the CTL. RS2 had no effect on total energy (P=0.30), carbohydrate (P=0.11), protein (P=0.64), or fat (P=0.37) consumption in response to a buffet meal test, relative to the CTL. In addition, total energy (P=0.40), carbohydrate (P=0.15), protein (P=0.46), and fat (P=0.53) intake, as quantified by the Remote Food Photography Method, were also unaffected by RS2, relative to the CTL. Conclusions: RS2 supplementation did not increase satiety or reduce appetite and food intake in adults with prediabetes.
MeSH term(s)	Adult ; Aged ; Amylose/administration & dosage ; Appetite/drug effects ; Appetite/physiology ; Body Mass Index ; Double-Blind Method ; Eating/drug effects ; Female ; Ghrelin/blood ; Glucagon-Like Peptide 1/blood ; Humans ; Male ; Middle Aged ; Peptide YY/blood ; Placebos ; Prediabetic State/physiopathology ; Resistant Starch/administration & dosage ; Satiation/drug effects ; Zea mays/chemistry
Chemical Substances	Ghrelin ; Placebos ; Resistant Starch ; Peptide YY (106388-42-5) ; Glucagon-Like Peptide 1 (89750-14-1) ; Amylose (9005-82-7)
Language	English
Publishing date	2020-04-09
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
ZDB-ID	2646718-5
ISSN	2212-2672
ISSN	2212-2672
DOI	10.1016/j.jand.2020.01.017
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