Biochemical and hormonal changes in childhood obesity - Free Essay Example

The prevalence of chronic or non communicable disease is escalating much more rapidly in developing countries than in industrialized countries. According to World Health Organization (WHO) estimates, by the 2020, non communicable diseases will account for approximately three quarter of all deaths in the developing countries (WHO. Global Strategy for non communicable disease prevention, 1997). In this regard, a potential emerging public health issue for the developing countries may be increasing incidence of childhood obesity with associated complications, which in turn is likely to create public health burden for poorer nations in the near future (Freedman et al, 2001). Lower to middle income nations face the double burden of having both malnourished and over nourished population, with most overweight and obese children being concentrated in urban areas. Rapid urbanization is associated with unhealthy lifestyle or New World Syndrome. In addition, in such communities, childhood obesity is still considered a sign of healthiness and high social class. There is no universal consensus on a cut off points for defining overweight and obesity in children and adolescents, usually, for clinical practice and epidemiological studies, child overweight and obesity are assessed by means of indicators based on weight and height measurements, such as weight for height measures or body mass index (weight (kg)/height (m2))(WHO. Report series no.847, 1995).The US Centers for Disease Control and Prevention (CDC) defines obese as being at or above 95th percentile of body mass index for age (Kuczmarsk RJ et al, 2000). History of obesity is both interesting and gives details of its progression. Obesity is an age-old health condition. Through out the history of obesity, its reputation varies from appreciation and opposite among cultures and in time. Ancient Egyptians are said to consider obesity as disease. Perhaps the most famous and earliest evidence of obesity is the Venus figurines, Statuettes of an obese female torso that probably had a major role in rituals. Ancient China has also been aware of obesity and dangers that come with it. They always were a believer of prevention as a key to longevity. The Aztecs believed that obesity was supernatural, an affliction of the gods. Hippocrates, the father of medicines was aware of sudden deaths being more common among obese men than lean ones as stated in his writings. In certain cultures and areas where food is scarce and poverty is prevalent, is viewed as symbol of wealth and social status. To date, an African tribe purposely plumps up a bride to pre pare her for child bearing. Before a wedding can be set, a slim bride is pampered to gain weight until she reaches the suitable weight. Through out the history of obesity, the publics view and status of obesity changed considerably in the 1900s. It was regarded as unfashionable by the French designer, Paul Poi ret who designed skin-revealing clothes for women. About the same time, the incidence of obesity began to increase and become wide spread. Later in 1940s, Metropolitan life insurance published a chart of ideal weight for various heights. They also advocated that weight gain parallel to age is unhealthy. The government and medical society become more hands-on with obesity by imitating campaign against it. This was preceded by a study of risk factors for cardiovascular disease revealing obesity in the high ranks. Since then various diets and exercise programs have emerged. In 1996, the Body Mass Index (BMI) was published. This statistical calculation and index determined that a person is obese or not. At this time ,obesity incidence have soared, led by children and adolescent obesity, tripling in just a few short years, greater than any number in the history of obesity. This increase in the incidence of childhood obesity with associated cardiovascular risks, type 2 diabetes mellitus and stroke is supported by a considerable body of evidence. The prevalence of overweight and obesity in childhood and adolescents has been increasing throughout much of the developed and developing world for the past few decades. It has become increasingly clear that excess adiposity in childhood predisposes individual not only to increased risk of adiposity and its sequaele as adults (Freedman et al, 2001), but also to increased risk of multiple chronic diseases in childhood and adolescence (Rosen bloom et al, 1999). Though mechanism not clearly delineated, excess body weight and adiposity is associated with type 2 diabetes mellitus and its complications, cardiovascular disease risk factors, non alcoholic fatty liver disease and asthma in youth. Childhood Obesity 1930 1972 Risk factors for coronary heart disease (CHD) such as hypertension, dyslipidemia, impaired glucose tolerance and vascular abnormalities were present in overweight children. CHD is likely to be increased in overweight children when they become adults as a result of established risk factors. This study investigated whether excess weight in childhood was associated with CHD in adulthood among a very large cohort of persons born in Denmark in 1930 through 1972. They underwent mandatory annual health examination at public or private schools in Copenhagen. Each child was examined by school doctors or nurses and was assigned a health card bearing childs name, date of birth, birth weight reported by parents. 10,235 men and 4,318 women, for whom childhood BMI data were available, received a diagnosis of CHD or died of CHD as adults. The risk of CHD event, a non fatal event, and a fatal event among adults was positively associated with BMI at 7-13 years of age for boys and 10 to 13 years of ag e as girls. The associations were linear for each age and risk increased across the entire BMI distribution. Childhood Obesity 1930 1972 Risk factors for coronary heart disease (CHD) such as hypertension, dyslipidemia, impaired glucose tolerance and vascular abnormalities were present in overweight children. CHD is likely to be increased in overweight children when they become adults as a result of established risk factors. This study investigated whether excess weight in childhood was associated with CHD in adulthood among a very large cohort of persons born in Denmark in 1930 through 1972. They underwent mandatory annual health examination at public or private schools in Copenhagen. Each child was examined by school doctors or nurses and was assigned a health card bearing childs name, date of birth, birth weight reported by parents. 10,235 men and 4,318 women, for whom childhood BMI data were available, received a diagnosis of CHD or died of CHD as adults. The risk of CHD event, a non fatal event, and a fatal event among adults was positively associated with BMI at 7-13 years of age for boys and 10 to 13 years of ag e as girls. The associations were linear for each age and risk increased across the entire BMI distribution. Childhood Obesity and Economic Growth 1930-1983 Childhood obesity was related to the economic growth during the 50 years of economic growth in the industrialized world especially in Denmark. Annual measurements of height and weight were available for all children born between 1930 and 1983 attending primary schools in Copenhagen Municipality. 165,389 boys and 163,609 girls from the age of 7 through 13 years were included in this study. After computerization SBMI (kg/m2) were calculated and the prevalence of overweight and obesity according to international age and genderà ¢Ã¢â€š ¬Ã¢â‚¬Å"specific criteria. Economics growth was indicated by the Gross National Product and the overall consumption per capita, adjusted for inflation. Prevalence of overweight and obesity among Danish children rose in phases, which were not paralleled by trends in economic growth. The microeconomics growth indicators seem inappropriate as proxies for the environmental exposures that have elicited the obesity epidemic. Childhood obesity and television viewing Children spend a substantial portion of their lives watching television (TV). Investigators have hypothesized that TV viewing causes obesity by one or more than three mechanisms: Displacement of physical activity. Increased calorie consumption while watching or caused by the effects of advertising. Reduced resting metabolism. The relationship between TV viewing and obesity has been examined in a relatively large number of cross sectional epidemiological but few longitudinal studies. Many of them have found relatively weak, positive association or mixed results. Many experimental studies have found that reducing TV viewing may help to reduce the risk of obesity. One school based experimental study was designed specifically to test directly the casual relationship between TV viewing behaviors and body fatness. The results of this randomized controlled trial provide evidence that TV viewing is a cause of increased body fatness and that reducing the TV viewing is a promising strategy for preventing childhood obesity (Robinson; 2001). The objective of another study (Utter J et al, 2006), was to explore how time spent watching television (TV) is associated with the dietary behavior of New Zealand children and young adolescents. Total number of participants was 3275 children aged 5-17 years. The findings suggest that longer duration of TV watching (thus more frequent exposure to advertising) influences the frequency of consumption of soft drinks, some sweets and snacks and some fast foods among children and young adolescents. Efforts to control the time spent watching TV may result in better dietary habits and weight control for children and adolescents. Childhood Obesity US- A decade of progress, 1990-1999 Current data suggest that 20% of US children are overweight .An analysis of the secular trends suggest that 20% of US children are overweight, and a clear up ward trend in body weight in children of 0.2 Kg between 1973 and 1994. In addition, childhood obesity is more prevalent among minority sub groups such as African Americans. Obesity that begins early in life persists into adulthood and increases the risk of obesity related conditions later in life. There has been tremendous increase in the number of studies examining the etiology and health effects of obesity in children (Goran MI, 1990-1999).1980 (boys 0.2% girls 0.5%) and 1997 (boys 1.2%, girls 2.0%). Ten years trends of childhood obesity in Israel 1990-2000 Cross sectional data was collected from 13284 second and fifth class school; children between 1990-2000. Prevalence of obesity was determined using Israeli and US reference values. BMI values at 95th percentile increased overtime in all ages and sex categories. Between 1990 and 2000, 95th centile values were increased by 12.7%and 11.8% among second grade boys and girls respectively. Among fifth graders in 2000, 10.7% of boys and 11.1% of girls exceeded the 1990 BMI reference values. The proportion of obese children increased over time using both Israeli and US reference values (Huerta Michael et al, 2008). Netherlands. Overweight, Obesity in 2003: V.1980-97. Data on 90,071 children, aged 4-16 years were routinely collected by 11 Community Heath Services during 2002-2004. International cut -off points for BMI to determine overweight and obesity. On average, 14.5% of boys and 17.5% of the girls were overweight (including obesity), which is a substantial increase since 1980 (boys 3.9% and girls 6.9%) and 1997 (boys 9.7% and girls 13%). Similarly 2.6% of the boys and 3.3% 0f the girls aged 4-16 years were obese, which is much higher than in 1980 (boys 0.2% and girls 0.5%) and 1997 (boys 1.2% and girls 2.0%), (KatjaVan Den Husk, 2007). Obesity trends in US. 2003-2006 Height and weight measurements were obtained from 8164 children and adolescents as apart of the 2003-2004 and 2005-2006 National Health and Nutrition Examination Survey (NHANES). Because no statistically significant differences in the prevalence of high BMI for age were found between the estimates for 2003-2004 and 2005-2006, data for four years were combined to provide more stable estimates for the most recent time period. Over all, in 2003-2006, 11.3% of children and adolescents aged 2 through years were at or above 97th percentile of the 2000 BMI- for- age growth charts, 16.3% were at or above 95th percentile. Prevalence estimates vary by age and by racial/ethnic group. Analysis of the trends in high BMI for age showed no statistically significant trend over the four time periods (1999-2000, 2001-2002, 2003-2004, and 2005-2006) for either boys or girls (Cynthia l.Ogden et al, 2008). 11-March 2005. Public Release Date: Consensus on Childhood Obesity, Recommends classification as disease A common statement on childhood obesity was published to day in the journal of Chemical Endocrinology and Metabolism (one of the journals of Endocrine Society). The consensus statement reflects the conclusions from an international summit held in Israel last year (2004) and includes a controversial recommendation to classify obesity as a disease. This decision was based upon the available research on the diagnosis, prevalence, causes (including endocrine disorders), risks, prevention and treatment of childhood obesity. Pediatric obesity is now recognized as a major health problem all over the world. Researcher have found that children who are obese have a higher risks adult obesity, which is strongly associated with many serious medical complications that impair quality of life and lead to additional increased risks. The statement also noted the prevalence of overweight/obesity among children 6-11 years (in the US) doubled between the years 1980-2000. By classifying obesity as legiti mate disease, public funding and in user sreimbursement for obesity treatment becomes legalized (consensus on childhood obesity, 2005). Serious health risks will likely to begin to appear in obese children and adolescents as they grow older. These may include diabetes mellitus, metabolic syndrome, hyperandrogenism, heart disease, hypertension, respiratory factors, and sleep disorders. Obese children are also at greater risk of anxiety and depression. It also recommended a number of measures that can be implemented by parents; schools, health providers and government and regulatory agencies to help to prevent the onset of childhood obesity Endocrine Regulation of Energy Metabolism Adipocytokines and Obesity The mechanism underlying obesity was further explained by the discovery of adipocytokines, the role of peripheral thyroid hormones (T4, T3), thyroid stimulating hormone and insulin the regulation of energy metabolism. The levels of some of the adipocytokines were shown to be related to visceral obesity, type 2 diabetes mellitus and coronary artery disease. Plasma levels of all the adipocytokines increase with the obesity except adiponectin (Yuji Matsuzawa et al, 2003). Recent studies point out to the adipose tissue as a highly active organ secreting a range of hormones, Leptin, Adiponectin, and Resistin. They are considered to take part in the regulation of energy metabolism. Leptin, Adiponectin and Resistin are produced by the adipose tissue. Leptin and Adiponectin are insulin sensitizing while Resistin increase the insulin resistance. Leptin The notion that genetic abnormalities contribute to obesity gained important support with the identification of the Ob gene and its protein product in 1994 (Zhangy et al, 1996). The Ob gene termed Leptin from the Greek Leptos, meaning thin, is produced in adipose tissue and is thought to act as an afferent satiety signal in a feed back loop that affects the appetite and satiety centre in the hypothalamus of brain. The ultimate effect of this loop is to regulate body-fat mass. In human, as noted by Considine et al, 1996; caloric restriction reduces leptin concentrations and Ob mRNA levels in adipose tissue, and refeeding increases these levels. One fundamental mechanism of obesity is insensitivity to the action of Leptin, presumably in the hypothalamus. The Leptins primary physiological function is to provide a signal to suppress body fat by decreasing food intake or increasing energy expenditure. Serum leptin concentrations change more during weight loss than during weight gain (Rose nbaum M et al, 1997). Adiponectin Adiponectin or Adipo Q, an adipocyte specific secreted protein with roles in glucose and lipid homeostasis (Insulin stimulates the secretion of adiponectin). Circulating adiponectin concentrations are high 500-30,000  µg/l (5-30mg/ml) accounting for 0.01% of total plasma proteins (Berget et al, 2002). Adiponectin was discovered in the mid 1990s by four different groups of researchers (Hu E et al, 1996). Adiponectin has various biological functions including insulin sensitizing (Hotta K et al, 2000), antiatherogenic (Yamauchi T et al, 2003), anti-inflammatory (Ouchi N et al, 2003), antiangiogenic and anti tumor functions (Brakenhielm E et al, 2004). Adiponectin acts through Adiponectin receptors, Adipo R1 and Adipo R2. Adipo R1 is mostly expressed in skeletal muscles and Adipo R2 is abundant in liver. These receptors are also expressed by the pancreatic ÃÆ'Ã… ¸ cells (Kharroubi et al, 2003), macrophages and atherosclerotic lesions (Chinetti et al, 2004) as well as in brain (Yamauchi et al, 2003). Circulating Adiponectin levels display diurnal variation with a nocturnal decline and maximum levels in the late morning (Gavrila et al, 2003). Adiponectin is also found in breast milk, which in turn is implicated in childhood obesity prevention (Savino et al, 2008). Among the various adipocytokines, adiponectin, which is an abundant circulating protein (247 amino acids) synthesized purely in adipose tissue, appears to play a very important role in carbohydrates, lipid metabolism and vascular biology. Adiponectin appears to be a major modulator of insulin action and its levels are reduced in type 2 diabetes mellitus, which could contribute to peripheral insulin resistance in this condition. It has significant insulin sensitizing as well as anti inflammatory properties that include suppression of macrophage phagocytosis and TNF-a secretion and blockage of monocytes adhesion to endothelial cells in vitro. Although further investigations are required, Adiponectin administration, as well as regulation of the pathway controlling its production, represents a promising target for managing obesity, hyperlipidemia, insulin resistance, type 2 diabetes mellitus, and vascular inflammation (Manju Chandran et al, 2003). Resistin Human resistin is 108 amino acids prepeptide and is cleaved before its secretion from the Adipose tissue. Resistin circulates in the blood as dimeric protein consisting of 92 amino acids polypeptides that are linked by a disulfide bridge. Holcomb et al, 2000 first described the gene family and its tissue specific distribution. Originally described as lung specific, is also produced by the adipose tissue and peripheral blood monocytes. It is also present in dividing epithelia of the intestine. Resistin increase blood glucose and insulin concentration in the mice and impairs hypoglycemic response to insulin infusion. In addition, anti resistin antibodies decrease blood glucose and insulin sensitivity in obese mice (Ukkalo O, 2002). The physiological role of resistin in human remains controversial. There more resistin protein in obese than lean individuals, with a significant positive correlation between resistin and BMI. BMI is a significant predictor of insulin resistance, but resisti n adjusted for BMI is not. These data demonstrate that resistin protein is present in human adipose tissue and blood and that there is significantly more resistin in serum of obese individuals. Serum resistin is not a significant predictor of insulin resistance in human (Youn et al, 2003, Rear R and Donnelly R, 2004). Tumor Necrosis Factor-a It will be unreasonable not to mention the Tumor Necrosis Factor a and its role in vascular inflammation related to atherosclerosis especially in obesity. It is a cytokine involved in systemic inflammation and is a member of a group of cytokines that stimulate the acute phase reaction. The primary role of TNF is in the regulation of immune cells. TNF is able to induce apoptotic cell death, to induce inflammation and to inhibit tumourgenesis and viral replication. Dysregulation and, in particular, over production of TNF have been implicated in a variety of human diseases, as well as cancer (Locksley et al, 2001). The theory of antitumoural response of the immune system in vivo was recognized by the physician William B in 1968. Dr A Granger reported a cytotoxic factor produced by lymphocytes and named it Lymphotoxin (Kalli WB and Granger GA, 1968). Dr L Loyal old, in 1975 reported another cytotoxic factor produced by macrophages and named it Tumor Necrosis Factor (TNF) (Cars well et al, 1975). Interleukin à ¢Ã¢â€š ¬Ã¢â‚¬Å" 6 (IL-6) Chronic inflammation is linked to endothelial dysfunction, atherosclerosis, and insulin resistance (Fernandez-Real JM and Ricart W, 2003 and Fernandez-Real JM, Ricart W, 2005). Plasma concentrations of proinflammatory cytokines, such as interleukin (IL) 18, IL-6, and tumor necrosis factor (TNF)-a, and of several other inflammatory markers are increased in patients with ischemic heart disease (Fernandez-Real JM and Ricart W, 2003, Ridker PM et al, 2002, Engstrom G et al, 2004, Ridker PM et al, 1997, Pradham AD et al, 2002). Circulating cytokines also are elevated in type 2 diabetes, obesity, and insulin resistance syndrome and play a central role in the pathogenesis of these disorders (Fernandez-Real JM and Ricart W, 2003). IL-6 is a mediator of the inflammatory response, and it is linked to dyslipidemia, type 2 diabetes, and risk of myocardial infarction (Fernandez-Real JM and Ricart W, 2003, Ridker PM et al, 2000, Esteve E et al, 2005, Yudkin JS et al, 2000). IL-6 is secreted by a variety of different cell types, including lymphoid and endothelial cells, fibroblasts, skeletal muscle, and adipose tissue. Circulating IL-6 levels correlate with obesity and insulin resistance and may predict the development of type 2 diabetes mellitus (Yudkin JS et al, 2000, Pradhan AD et al, 2001, Akira S et al, 1993, Mohamed-Ali V et al, 1997). Endothelial dysfunction is regarded as a causal factor in the development of atherosclerosis (Hansson GK, 2005). It is one of the earliest abnormalities that can be detected in people at risk for cardiovascular events, and it is linked to insulin resistance and type 2 diabetes (Steinberg HO and Baron AD, 2002, Natali A et al, 2006). Cytokines have an important role in the endothelial injury induced by inflammation. The vascular endothelium is involved in the inflammatory response to atherosclerosis (Hansson GK, 2005, Steinberg HO and Baron AD, 2002, Natali A et al, 2006, Widlansky ME et al, 2003), and changes in endothelium function could underlie the association between cardiovascular disease and inflammation. Obesity Related Insulin Resistance: Definition and Pathogenesis Insulin resistance is a state in which a given amount of insulin produces a subnormal biological response (Kahn CR, 1978). In particular, it is characterized by a decrease in the ability of insulin to stimulate the use of glucose by muscles and adipose tissue and to suppress hepatic glucose production and output (Matthaei et al, 2000). Furthermore, it accounts a resistance to insulin action on protein and lipid metabolism and on vascular endothelial function and genes expression (Bajaj M and Defronzo RA, 2003). Several defects in the insulin signaling cascade have been implicated in the pathogenesis of insulin resistance, Insulin resistance is believed to have both genetic and environmental factors implicated in its etiology (Matthaei et al, 2000 and Liu et al, 2004). The genetic component seems to be polygenic in nature, and several genes have been suggested as potential candidates (Matthaei et al, 2000). However, several other factors can influence insulin sensitivity, such as obesity, ethnicity, gender, perinatal factors, puberty, sedentary lifestyle and diet (Liu et al, 2004). The Role of Fatty Acids and Adipocytokines Obesity represents the major risk factor for the development of insulin resistance in children and adolescents (Caprio S, 2002), and insulin resistance/hyperinsulinemia is believed to be an important link between obesity and the associated metabolic abnormalities and cardiovascular risk (Weiss R and Kaufman FR, 2008). Approximately, 55% of the variance in insulin sensitivity in children can be explained by total adiposity, after adjusting for other confounders, such as age, gender, ethnicity and pubertal stage (Caprio S, 2002). Obese children have hyperinsulinemia and peripheral insulin resistance with an ~40% lower insulin-stimulated glucose metabolism than non-obese children (Caprio S et al, 19996). Adipose tissue seems to play a key role in the pathogenesis of insulin resistance through several released metabolites, hormones and adipocytokines that can affect different steps in insulin action (Matsuzawa Y, 2005) (Fig. 1). Adipocytes produce non-esterified fatty acids, which inhibit carbohydrate metabolism via substrate competition and impaired intracellular insulin signaling (Matsuzawa Y, 2005, Griffin ME et al 1999 and Randle PJ, 1998). In children, as in adults, several adipocytokines have been related to adiposity indexes as well as to insulin resistance. Adiponectin is one of the most common cytokines produced by adipose tissue, with an important insulin sensitizing effect associated with anti-atherogenetic properties (Despres JP, 2006 and Gil-Campos M et al, 2004). Whereas obesity is generally associated with an increased release of metabolites by adipose tissue, levels of Adiponectin are inversely related to adiposity (Matsuzawa Y, 2005). Therefore, reduced levels of this adipocytokine have been implicated in the pathogenesis of insulin resistance and metabolic syndrome (Matsuzawa Y, 2005). Decreased levels of Adiponectin have been detected across tertiles of insulin resistance in children and adolescents (Weiss R et al, 2004), where it is a good predictor of insulin sensitivity, independently of adiposity (Lee S et al, 2006). Adipose tissue also produces tumour necrosis factor-a, an inflammatory factor, which can alter insulin action at different levels in the intracellular pathway (Matsuzawa Y, 2005). Interleukin-6 (IL-6) is ano ther inflammatory cytokine released by adipose tissue and its levels are increased in obesity (Matsuzawa Y, 2005). IL-6 stimulates the hepatic production of C-reactive protein and this can explain the state of inflammation associated with obesity, and could mediate, at least partially, obesity-related insulin resistance (Matsuzawa Y, 2005). Data based mainly on animal studies also suggest that increased levels of resistin, another molecule produced by adipose tissue, could impair insulin sensitivity (Matsuzawa Y, 2005). The close relationship between Leptin levels and insulin resistance in children has also been suggested by the data (Chu NF et al, 2000). Serum levels of retinol-binding protein 4 (RBP4) correlate with insulin resistance in subjects with obesity as well as in those with impaired glucose tolerance (IGT) or type 2 diabetes mellitus, therefore suggesting that it could be useful in assessing insulin resistance and the associated risk for complications (Graham TE et al, 2006). Serum RBP4 is independently related to obesity as well as to components of the metabolic syndrome in normal weight and overweight children (Aeberli I et al, 2007). Diet composition in obese children might be an additional factor promoting and/or worsening insulin resistance. Animal and human studies suggest that a high energy intake as well as a diet rich in fat and carbohydrates and low in fiber could increase the risk of developing insulin resistance (Canete R et al, 2007). The Role of Fat Distribution An altered partitioning of fat between subcutaneous and visceral or ectopic sites has been associated with insulin resistance (Weiss R and Kaufman FR, 2008). Visceral fat has a better correlation with insulin sensitivity than subcutaneous or total body fat (Caprio S et al, 1995), in both obese adults and children. Visceral fat has higher lipolytic activity compared with subcutaneous fat, therefore a greater amount of free fatty acids and glycerol gain entry or carried out to the liver (Matthaei et al, 2000). Visceral fat in girls is directly correlated to the glucose-stimulated insulin levels and inversely correlated with insulin sensitivity and the rate of glucose uptake. No correlation was found between abdominal subcutaneous fat (Caprio S et al, 1995). Ectopic deposition of fat in the liver or muscle can also be responsible for insulin resistance in obese subjects, as the accumulation of fat in these sites impairs insulin signaling, with a reduced glucose uptake in the muscle and a decreased insulin-mediated suppression of hepatic glucose production (Weiss R and Kaufman FR, 2008). Intramyocellular lipid (IMCL) accumulation has been shown as a factor related to decreased insulin sensitivity (Jacob S et al, 1999 and Thamer C et al, 2003). Obese insulin sensitive children and adolescents present lower levels of visceral fat and IMCL when compared with obese insulin resistant children (Weiss R et al, 2005). Accumulation of fat in the liver has also been associated with insulin resistance, independently of adiposity (Kelley DE et al, 2003). It has also been suggested that deposits of fat around blood vessels can produce several cytokines and therefore contribute to the development of insulin resistance, through a so-called vasocrine effect (Yudkin JS et al, 2005). Insulin Resistance and Associated Complications Insulin resistance in obesity is strictly related to the development of hypertension (Marcovecchio ML et al, 2006 and Cruz ML et al, 2002), dyslipidemia (Howard BV and Howard WJ, 1994), impaired glucose tolerance (IGT) (Sinha R et al, 2002), hepatic steatosis (DAdamo E et al, 2008), as well as to the combination of these factors, also known as metabolic syndrome (Eckel RH et al, 2005). Furthermore, insulin resistance is associated with systemic inflammation, endothelial dysfunction, early atherosclerosis and disordered fibrinolysis (Dan Dona P et al, 2002). It is alarming that these metabolic and cardiovascular complications are already found in obese children and adolescents (Dietz WH, 2004). The presence of these alterations in prepubertal children is then particularly worrying, as insulin resistance and related complications might be further exacerbated by the influence of puberty, due to the physiological decrease in insulin sensitivity associated with normal pubertal development (Caprio S et al, 1989). Insulin resistance in childhood can track in adult life (Sinaiko AR et al, 2006). Insulin resistance at the age of 13 years predicts insulin resistance at age 19 years, independently of BMI, and is also associated with cardiovascular risk in adulthood (Sinaiko AR et al, 2006). The fundamental role of insulin resistance in human disease was already recognized in 1988 by Reaven (Reaven GM, 1988) who emphasized its role in the development of a grouping of metabolic abnormalities, which he defined as syndrome X. Later studies strengthened the concept of insulin resistance as a key component of the metabolic syndrome, a cluster of impaired glucose tolerance (IGT), dyslipidemia, hypertension, hyperinsulinemia, associated with an increased risk of type 2 diabetes mellitus and cardiovascular disease (Eckel RH et al, 2005). Insulin resistance represents a serious and common complication of obesity during childhood and adolescence. A timely diagnosis and an appropriated prevention and treatment of obesity and insulin resistance are required in order to reduce the associated risk of metabolic and cardiovascular complications. Childhood Obesity at Present While children and adolescents in many developing countries are experiencing dramatic increase in the rates of overweight (obese), youths in the United States are the heaviest in the world. The National Health and Nutrition Examination Surveys (NHANES), a series of cross-sectional examinations conducted on nationally representative samples in the US between 1971 (NHANES I) and the present day, have documented a marked increase in the prevalence of overweight among children of all race/ethnic groups. With overweight in youth defined as having a BMI95th percentile for age and sex (Himes JH and Dietz WH, 1994, Kuczmarski RJ and Flegal KM, 2000, Ogden CL et al, 1997), the prevalence among white children increased from 5% to 12%, among black children from 6% to 18% and among Mexican-American children from 8% to 21% from 1971 to 2002 (Freedman DS et al, 2006, Hedley AA et al, 2004, Ogden CL et al, 2006). The upward trend in rate of overweight does not appear to be abating as the NHANES 20 03-2004 data indicate a 1.1% increase over the 1999-2002 data in the overall rate for youth in the US (Ogden CL et al, 2006). While it is generally accepted that the highest rates among youth occur in the most industrialized countries, almost all regions of the world experience some degree of overweight, with sub-Saharan Africa being the most notable exception (Lobstein T et al, 2004). Regardless of differences in global prevalence estimates, multiple surveys have identified particular regions as being of primary concern for excess weight: the Middle East, North Africa and the Americas, including Mexico (Hedley AA et al, 2004, Ogden CL et al, 2006, Lobstein T et al, 2004, de Onis M and Blossner M, 2000, Martorell R et al, 2000, Rivera-Dommarco J et al, 1999, del RÃÆ' ­o-Navarro BE et al, 2004). Among older children in Mexico, 6-11 years of age, the prevalence of overweight was quite high at 8.8% at the national level in 1999, with regional differences ranging from 5.5% in the south to 12.7% in the north (Rivera-Dommarco J et al, 1999). Childhood Obesity 6-11 years, the Present Study, 2005-2008. Background: Childhood obesity is a global epidemic involving both developed and developing countries. It is a stare of over-nutrition with long term complications such as dyslipidemia, hypertension, and coronary artery disease and type-2 diabetes. Underweight is the result of under nutrition leading to reduction in growth and development of every body organ especially the Central Nervous System. Long term under-nutrition causes failure in linear growth (height) of the child. Growth is further retarded by the repeated attacks of respiratory infections, diarrhea and anemia as a result of reduced immunity. Methods: This study was carried out eight primary schools of Dera Ismail Khan (Private, semi government organizations, and welfare foundations) having mixed population with some of the wards belonging to high socioeconomic group. Thorough clinical examination excluded those suffering from chronic heath problems. Height and weight of each one was taken body mass index of determined according to Quatelets index. Body mass index number was plotted on the CDCs age and gender specific growth charts 2-20 years for BMI-for age percentile and body mass status (underweight, normal weight, overweight/at the risk of overweight and obese/overweight. Results: 1338 school going children (6-11years) were examined with 865 (67.75%) boys and 471(35.25%) as girls. 13.39%, 72.15%, 8.83% and 5.61% as underweight, normal weight, overweight and obese respectively. Percentage of underweight was higher in girls (25%) than boys (13.22). Percentage of obesity was higher (5.17%) in boys than girls (1.39%). Conclusion: Awareness about balanced diet, improvement in the level of education and socioeconomic conditions, easy access to health facilities and prevention of the gender discrimination, are the remedial measures to be taken to redress the situation.

Poverty Can Be Defined As The State Of Being Inferior...

Final Paper 50% please write your 3-4 page paper below. Please include your name, date, etc. on this page. Include your topic as well. Hope Stokes Mrs. Dunham Economics Per 4 12 Dec 2016 Inevitableness of Poverty Poverty can be defined as the state of being inferior in quality or, the more popular definition, poor. If examined closely poverty can be found everywhere, in every nation, every city and society. To the world, poverty seems inevitable, however what if it s not? What if? Doubt may fill any sane person at this moment, however through research and several economist poverty has been deemed as avoidable. To avoid poverty, the causes of poverty must first be examined one by one and solved theretofore poverty can be avoided and eliminated. Poverty can be avoided through human will, the right government policies, and a the avoidance of young rash decisions. The American government, for example is one that from sole experience I know do focus their attention on poverty so much, that the presidential debates and elections almost always included the issue of poverty. Even with the national spotlight on poverty the question remains, how come poverty still exists? The answer lies within the way the government tries to fix poverty which has failed to work. The government policies and politicians the people The politicians appointed often do very minuscule things in order to actually make a vast change, on the other hand many argue it takes years to actually haveShow MoreRelatedPoverty in the United States755 Words   |  4 PagesPoverty in the United States is getting in inferior quality every day and nothing is being done about it. Many people who want to help the poor, but no one knows exactly how to help them. A primary reason for people not taking action is because of lack of information that is provided about issues on poverty. 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As Mark Bittman stated in his article â€Å"Why We’re Fasting† â€Å"This is a moral issue; the budget is a moral document.† Poverty can be improved if more emphasis is added to helpingRead MorePhilippine Contemporary Problems and Issues1511 Words   |  7 PagesPhilippine Contemporary Problems and Issues POVERTY - The state of being extremely poor. - The state of being inferior in quality or insufficient in amount. Causes of Poverty 1. Rapid Population Growth As the Philippines has financially limited resources and a high poverty rate, the rapid increase in population has become a problem because there is already insufficient resources to support the population, which leaves much fewer resources to improve the economy. From 2003 to 2006,Read MoreAnnotated Bibliography On Obedience And Authority Essay1358 Words   |  6 Pagesculture, between all groups of people, in all types of countries, and under all forms of government, however menial, it is as ingrained as is smiling or frowning. People have long been uncomfortable when they feel lack of purpose or a meaning; it can be a hopeless life when one thinks they are a random, purposeless dot in a bunch of chaos. So, when people are united under an authority and they are given orders, no matter how bizarre or unethical, their authority has given them a purpose and a meaningRead MoreSpecial Education in Classrooms Across America Essay708 Words   |  3 Pagesupon their unique needs based on a documented disability. Student disabilities often involve mental, physical, emotional and behavioral issues that makes instruction a challenge. The Individuals with Disabilities Education Act (IDEA) governs how states and public agencies provide early intervention, special education and related services to more than 6.5 million eligible infants, toddlers, children and youth with disabilities. (Building the legacy: IDEA 2004) This law provides guidelines forRead MoreCultural Bias And Health Care Disparity1528 Words   |  7 PagesCultural Bias and Health Care Disparity: Introduction: Cultures, social, ethnicity, English proficiency are factors that my significantly affect the quality of healthcare. Patient’s perspective, values, beliefs and behavior are highly influenced by the sociocultural background pf the patient (1-5). These factors can affect dealing with patient’s symptoms, seeking care, pain toleration, care adherence, preventive measure, and health care expectations. There is a clear evidence that links Clinician-patientRead MoreRacial Discrimination : The Act Of Making Or Perceiving A Difference1705 Words   |  7 Pagescolor impact the quality of your work or the fortitude your resolve? It may seem that the answer to that question is quite clear, nonetheless, 32,309 cases of race/color discrimination were reported in fascial year 2016 (EEOC, 2017.) 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What Are Teen Fashion Magazines - 820 Words

Teen fashion magazines, such as Vogue and Seventeen, feature slender models that increase women’s desire to be thin (Cohen, 2006). A study done by Bradley University found that 3 minutes spent looking at a fashion magazine caused 70% of women to feel depressed, guilty, and shameful (Bradley University, 2016). Bradley University’s research also attributes magazines for causing many eating disorders and negative body image in women. The university’s research states that the images in these magazines are becoming societal norms in the eyes of teenage readers. Young readers are accepting of magazines that promote a positive perception of one’s body. Researchers created an activity that assigned a group of students the three following readings: chapter 11 of Wood (2009), Bissell and Zhou (2004), and Harrison (2000). The activity given to the students was to design a new teen fashion magazine that includes healthy body images instead of false images that many magazines feature. The magazines the students created were different from those that are sold because their magazines focused on self-love instead of being a specific body type. (Malachowski; Myers, 2013, p. 34-35). These students demonstrated how magazines don’t have to only feature content that is centered around one type of beauty and extols its unattainability. The inclusion of the students in the activity also reveals that young readers are willing to read positive magazines different from the usual, trendy fashionShow MoreRelatedVogue Magazine : The World s Top Most Influential Fashion Magazine1475 Words   |  6 Pages1. Introduction Vogue magazine is the world’s top most influential fashion magazine in the world. How did a magazine like this become so popular and worldwide famous. Vogue magazine was found in 1892 by Arthur Turnure. When it was first founded the idea for vogue was not about high fashion it was about celebrating the ceremonial side of life it had sections for art and literature. It included social affairs and sports targeted for men as well as women. Now, since Anna Wintour became editor in chiefRead MoreThe Medias Influence on Teenagers on What They Watch, Read, and Listen 705 Words   |  3 Pages The ages thirteen through nineteen have been influenced by many things through the media. TV programs, movies, advertising, magazines, and the web. These medias are more used by teenagers than any other group. Teenagers are very difficult to figure out what they watch, or read, or listen. It’s different, but all together it’s mostly the same. The TV programs have a lot of stereotypes towards teenagers. Girls think they can’t do things that guys do. There are programs out there that showRead MoreThe Effects Of Advertising On The Fashion Industry1621 Words   |  7 PagesThe misleading body image advertised on the cover of Fashion Magazines such as Vogue and Teen Vogue, create a prejudice among women in the United States that motivates individuals to believe that there is only one body type that is beautiful and successful in society. This harmful advertising has a causal relationship with the increase in eating disorders and depression seen in young women (Kilbourne, 2000). Because Magazines are a powerful marketing tool; this type of advertising leads to a culturalRead MoreTeenage Magazine Essay984 Words   |  4 Pagespounds before the Holidays? Or maybe you want to learn â€Å"new kissing tricksâ€Å", that are guaranteed to be guy approved. Those are just some of the catchy titles you may find on the co vers of different magazines. 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Instead of being alive and healthyRead MoreEssay about Teen Magazines Negative Influence on the Teenage Society1063 Words   |  5 Pagesâ€Å"hottest† teen magazines on the market; Allure, Cosmopolitan, Seventeen, and Teen Vogue are a few at the top. As I flip through the magazine this holiday season I see pages of clothes that only the rich can afford, pictures of half-naked people draped over each other, articles about horoscopes and editorials talking about which teen star is the sexiest. Fashion, makeup, men, sex, celebrities, and exercising are the most popular topics I see as I peruse these magazines. These popular magazines take noRead More Female Beauty in America Essay1243 Words   |  5 Pagesattractive because of who they are rathe r than what they look like. Today’s society is progressing into one of refinement – a move that is currently influencing the youth of America. Mischa Barton and Kate Hudson, two well-known celebrities, are now part of the new face of America. They are both A-List stars on the cover of two popular magazines. Neither Mischa nor Kate is portrayed in a tasteless fashion. They represent the essence of what a real woman is. Mischa, for example, is dressedRead MoreHow Celebrity Fashion Affects Teens Self Image785 Words   |  4 Pagesbecome mainstream role models for teens as their images and lifestyles are normally advertised across television, movies, magazines, and all throughout pop culture. Teens that try to emulate their favorite celebrities may select good or bad role models that can be positive or negative for them (www.child.net). Problems with teens linked to celebrities include teen behaviors resulting in celebrity influence and self esteem and body image issues for teens. Celebrity fashion also plays a role in the behaviorRead MoreThe Media s Influence On Women1659 Words   |  7 Pages1950s around the time Marilyn Monroe was living, models were curvier. Everyone desired Marilyn Monroe’s hourglass figure, but now the hourglass figure is no longer in. The 20th century fashion world is obsessed with the idea of being thin. Models are dying because they are trying to reach that â€Å"perfection† that the fashion industry wants them to be. Self-starvation to achieve a thin physique has resulted in the common occurrence of anorexia nervosa within the model world. Anorexia nervosa has affectedRead MorePhotoshop should be banned for models1535 Words   |  7 Pagesnot only the fashion industry but any industry related to print media nowadays. Retouching pictures has not blossomed due to technology, we can trace it back to 1500’s when the period of high renaissance art was fading away a new form of art was emerging known as Mannerism which applauded the modified physic of the subjects over the regular ones(1). Setting impossible standards, models are made to look like v irtual perceptions and nothing like their own selves. Being in the fashion industry, models

Seated Bodhisattva Avalokitesvara ( Guanyin ) - 982 Words

The group of objects chosen for this paper comes from the collection of the Saint Louis Art Museum. The title of both pieces is called Seated Bodhisattva Avalokitesvara (Guanyin). Both these pieces which are statues were sculpted in china. The earliest statue was made during the Tang dynasty. While, the later statue was made during the Northern Song dynasty. These statues were chosen because the same deity is depicted and were made in a similar geographic and cultural location. This allows for the comparison of the different styles between the 2 periods. The statue made during the Northern Song dynasty depicts the Bodhisattva Avalokitesvara sitting in a pose called the relaxed pose or easy pose. This statue also depicts the Bodhisattva adorned in lavish silk garments while a jeweled crown sits atop his head. The statue is carved from wood and painted with gesso, pigments, and gilding. The statue made during the Tang Dynasty depicts the Bodhisattva sitting in the easy pose as well. It also depicts the Bodhisattva in flowing robes while wearing a string of jewels. These 2 statues depict the Buddhist deity whose name is Bodhisattva Avalokitesvara. The other names for this deity is Guanyin Bodhisattva, and the goddess of mercy. This deity is worshipped by all schools of Buddhism, but is mostly associated with Mahayana Buddhism, which is a school of Buddhism which states that anyone can become a Buddha with practice. The purpose of Bodhisattvas is to guide those seeking to

The Movie Perks Of Being A Wallflower - 2368 Words

The movie â€Å"Perks of Being a Wallflower† is about a young teenage boy, name Charlie and his many struggles that he’s faced with as he enters his freshman year of High School. The movie, while at times entertaining, addresses many issues that many teenagers go through in early and late adolescent years. Bullying, sexual identity, substance abuse, romantic relationships, loss, high risk behaviors, sexual abuse, and suicide are topics that are addressed in this fascinating movie. The movie is a coming of age story that describes a difficult time for many teenagers who struggle to find themselves and their identity in society. Watching this movie, I was reminded of my own high school experience and could identify with the struggles and challenges that Charlie and his friends faced throughout their teenage years. The main character Charlie, is a young teenager who is shy, socially awkward, and an introvert who is ready to begin his freshman year of high school. Cha rlie struggles with his new transition from middle to high school, and he is uncertain what to expect as he prepares to enter this new life event. His social circle is minimal to non-existent while he is dealing with the suicide of his best friend earlier in the year. In addition, he also seems to struggle with the loss of his aunt who was killed in a car accident when he was a young boy. While he does appear to have good family support with his mother, father, older brother and sister. He also appears toShow MoreRelatedAnalysis Of The Movie Perks Of Being A Wallflower 1698 Words   |  7 PagesThe movie â€Å"Perks of Being a Wallflower is a bout an young teenage boy, name Charlie and his many struggles that he is faced with as he enters his freshman year of High School. The movie, while at times entertaining, addresses many issues that many teenagers go through in early and late adolescent years. Bullying, sexual identity, substance abuse, romantic relationships, loss, hi gh risk behaviors, sexual abuse, and suicide are topics that are addressed in this fascinating movie. The movie a comingRead MoreThe Perks of Being a Wallflower Compare and Contrast Essay808 Words   |  4 PagesThe Perks of being a Wallflower Compare and Contrast The book and the movie for The Perks of Being a Wallflower are extremely different, and I believe that the movie is much better than the book. The book is written much differently than the movie. There are lots of scenes that are in the book but not in the movie and that are in the movie not the book. The movie focuses less on the bigger, depressing topics than the book does. The characters in the movie are also much different than theyRead MoreThe Perks Of Being A Wallflower1401 Words   |  6 PagesI chose to do my Abnormal Psychology paper over The Perks of Being a Wallflower. I heard about this movie a couple of years ago and I never had time to watch it until recently. I did have a difficult time diagnosing what disorder I thought the main character had, but it turned out to actually be a learning opportunity for myself. This assignment did give me the opportunity to watch the movie differently than I have examined a movie before. What I mean is, for this assignment, I had to examine inRead MoreThe Perks Of Being A Wallflower870 Words   |  4 Pagesthe scientific study of being behavior in human groups (Schaefer). There are very many examples of sociology in the movie The Perks of Being a Wallflower, but I view alienation, deviance, and gender roles to be the most prominent. This movie is about the struggles of a teenage boy named Charlie’s freshman year of high school. Charlie is seen as a social outcast and he just barely makes it through the year with the help of his best friends Sam and Patrick. 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The Perks of Being a Wallflower was banned because parent complained about the books decpetion of homosexualtiy, sex, masturbation, and the use of alcohol and drugs. Elizabeth Thompson stated â€Å" 2. The Perks of Being a Wallflower is the only controversial book thatRead MoreThe Perks of Being a Wallflower: Image of the Self Essay2952 Words   |  12 Pagesï » ¿ THE PERKS OF BEING A WALLFLOWER Czarina Ann B. Baptisma Hum St 25 Ma’am Odal-Devora October 18, 2013 INTRODUCTION Stephen Chbosky’s The Perks of Being a Wallflower is a coming-of-age novel about a 15-year-old boy, Charlie, who is unable to repress any emotions. The novel was first released on 1999 by MTV Books. It has quietly sold nearly half a million copies.1 Stephen Chbosky was born on January 25, 1970 and raised in Pittsburgh, Pennsylvania. He grewRead MorePerks of Being a Wallflower Context Analysis1813 Words   |  8 PagesThe Perks of Being a Wallï ¬â€šower: Context Analysis Paper ! Stephen Chbosky, a 29 year-old ï ¬ lm director and screenwriter published his ï ¬ rst semi-autobiographical novel in 1991, The Perks of Being a Wallï ¬â€šower. He later directed the movie in 2011 and released it in October 2012. The central theme of the story revolves around the struggle to understand the terrible things that inevitably happen to those we love and to ourselves. It unfolds through a series of letters written by the main character, CharlieRead MoreThe 2012 Film The Perks of Being a Wallflower1233 Words   |  5 PagesThe 2012 film The Perks of Being a Wallflower, directed by Stephen Chbosky, is a modern classic that captures the highs and downs of growing up. It is a moving film about first love, fear, hope, and unforgettable friend s. The Perks of Being a Wallflower is a great media text to convey the meaning of groups and leaders, technology in everyday life, and the affects on my own media profile. Logan Lerman stars as Charlie, the introverted and naà ¯ve high school freshman. Charlie is already counting downRead MoreHigh School And Social Hierarchy1246 Words   |  5 Pagesa sense of belongingness and security. Although there are positive aspects of cliques, there is a correlation between cliques and social pressure. Some clique members deal with the anxiety of constantly trying to impress their peers or the fear of being kicked out of the group while those who are outcasts may face bullying and feelings such as loneliness and depression. Either way, links have been found between certain coping mechanisms pertaining to the social pressure adolescents face. For example

Research Paper on the Effects of Mass Media on the Perfect Body Image Free Essays

How can you determine what body image should be? The desire for the perfect body has been prevalent throughout society for a vast majority of time. What makes teenage girls feel the need to strive for this â€Å"perfect body†? Some have asked, â€Å"†¦a rapidly growing body of research addresses the question of whether body perfect ideals in the mass media are a core risk factor for negative body image, particularly in women† (Dittmar, Helga) My hypothesis is â€Å"Does the media influence adolescent girl’s weight concerns and their perceptions of body weight and shape? The media in many aspects controls the way that people see themselves and the way they do things. So with teenagers striving to look like what they see in the media some of them go through drastic means to achieve these looks. We will write a custom essay sample on Research Paper on the Effects of Mass Media on the Perfect Body Image or any similar topic only for you Order Now â€Å"The role of mass media influences and parental marital status in the onset of eating disorders. In particular, teenagers tend to be the main target of trying to look like this image. † (Irala-Estevez, Martinez-Gonzalez, Lahortiga, Alonso, Cervera, Gual) Eating disorders is a major medical problem that most teens face. Among girls, eating disorders symptoms were directly affected by sociocultural influences, in particular media influences†(Rodgers, Paxton, Chabrol). If the media keeps influencing how teenagers see themselves it can not only damage their life but their families. The Health Information Network as done research on diets has shown â€Å"Anorexia is the Number one killer of teenage girls and in total more than 90% of those with eating disorders are adolescent young women.In many girls, the problems appear to set in from a very early age and is caused by peer pressure and exposure to media advertising† Does media have a major influence in the way teens look at themselves? â€Å"Media causes body dissatisfactions since they are the ones who define this perfect body. † ( Furnham, Greaves) I will test whether different outlets of media from T. V advertisements and shows, magazines, and street ads have a strong influence on how teenage girls look at themselves.Also to what measures will they go to, to achieve the perfect body that they see in the media. In this ever changing society the perfect body has had many different definitions. â€Å"This ideal standard of beauty is conveyed to individuals via a number of sources including fami ly, peers and the mass media. † (Hargreaves) There has been other research down to measure the influence media has on the perception of the perfect body image. A study was done by psychologists with individuals from Fiji where there was little edia influence. Their results showed that, â€Å"Key indicators of disordered eating were significantly more prevalent following exposure. Narrative data revealed subjects’ interest in weight loss as a means of modeling themselves after television characters. † (Becker) After being exposed to American TV shows there was a huge change in body image. Not only with T. V shows but as well as magazines have a great influence on body perception. One researcher as shown the relationship between magazines and body image, from the Department of Medicine from Harvard Medical School they concluded â€Å"There was a positive linear association between the frequency of reading women’s magazines and the prevalence of having dieted to lose weight because of a magazine article, initiating an exercise program because of a magazine article, wanting to lose weight because of pictures in magazines, and feeling that pictures in magazines influence their idea of the perfect body shape. With my research, this type of study would hard to replicate because it’s impractical to find a somewhere in the United States that has no or little media influence. The ideal woman and man portrayed in the media practically do not exist.It sets up images that fool viewers and readers to think that there are actually people that look like models. â€Å"The average American woman weighs 140 pounds and is 5’4† tall, reports Eating D isorders and Prevention, Inc. In contrast, the typical model is 5’11† and weighs 117 pounds. That makes the model thinner than 98 percent of American women. (Strahan) This makes young people have enormous pressures and when they can’t measure up to this image prevailed by the media, their self-esteem suffers. So in my research I will test girls from the ages of 13-19 from high school and college. I will give them surveys that will ask how much media they are exposed to. With questions that see if they are watching TV shows like 90210, or Melrose Place and magazines such as Seventeen, and Cosmopolitan. Then the girls can then be split into two groups; Group 1 with the girls that are exposed to little forms of media, and Group 2 with girls that are exposed to many forms of media.They then will be given another survey that will ask how much they weigh, how they see themselves, and what type of body image they desire. Body-image is being measured by the â€Å"conceptualized as a multidimensional construct that represents how individuals think, feel, and behave with regard to their own physical attributes† (Morrison , Kalin) If Group1, the group with little exposure to media, has a normal body perception and doesn’t desire a skinnier body image in contrast to Group 2. Where Group 2, the group an immense exposure to media, has poor body perceptions and desires a skinner body.The conclusion then can be made that the amount of media exposure has an influence on body image and perception. There are many challenges that can come up during research on the â€Å"perfect body† image. Some teenage girls might show a change in how they view themselves during the course of the experiment. But it may not be because of media influence but maybe their peers influenced them or their culture demands for a certain body image. â€Å"Both peers and popular culture, independent of each other, exert influence on girls’ weight control beliefs and behaviors. (Field, Camargo, Taylor, Berkey, Colditz) If we come to the conclusion that media indeed has a great influence on body perception; how are we going to try to fix the damage media causes on many individuals? Why not media? â€Å"Social activism and social marketing approaches are suggested as methods for fighting negative media messages. The media itself is one potential vehicle for communicating productive, accurate, and deglamorized messages about eating and shape-related disorders. † (Thompson, Heinberg) If media has such a great influence on creating negative body image, we can use media to create a positive body image.With media showing normal body image it might help teenage girls feel less pressured to desire an unhealthy body image. Therefore, over time it will become clearer as to whether actions will be taken against the media in order to end teenagers from trying to achieve the perfect body. Teenagers need to see that being different is good and the media is only brainwashing them to be like everyone else. Hopefully with more research done to show the great effects media has on teen’s body perception and the measures they go to, to obtain that perfect body image.Media will stop putting out such a negative body image, and more of a natural, average body image. How to cite Research Paper on the Effects of Mass Media on the Perfect Body Image, Essays

Love and Fate in Eugene Onegin free essay sample

In Alexander Pushkin’s novel Eugene Onegin stanza’s nineteen and twenty in Chapter two illustrate the connection between love and fate that is present throughout the novel. These stanzas come shortly after Eugene and Lensky become friends. Lensky is in love with a woman, Olga, whom he has known since childhood and he continuously expresses to Eugene his blissful adoration for her. These stanzas illuminate to the reader that love and fate are intertwined concepts and that Lensky’s and Eugene’s fates will be intertwined as well. Passionate love is only experienced by poets according to the speaker, because â€Å"they’re fated to. (20) Since Lensky is a poet, he finds love and passion with Olga, while Eugene is â€Å"one whom love had left forsaken. † Poets may be fated to find passionate love since they explore emotions in their work and concentrate more on what is vitally significant in life, as opposed to others, like Eugene. We will write a custom essay sample on Love and Fate in Eugene Onegin or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Pushkin’s narrator states at the end of stanza nineteen, regarding feelings, that â€Å"to us they’re hardly new. † Here he is identifying himself and the narrator as poets as well, in order to explain their irregular behavior and sporadic manner of speaking and thinking. Poets are fated to love, which is an irrational emotion; therefore poets act irrational and irregular. When the narrator describes Eugene â€Å"gravely† (19) listening to Lensky, he is speaking with a patronizing tone. Eugene is not interested in anything and everything has lost its appeal to him, therefore when he listens to Lensky, he is only humoring him. Eugene is apathetic and skeptical and as a result he believes Lensky is naive and that one day Lensky will realize the folly of his ways. The narrator states through Eugene’s thoughts in stanza fifteen that Lensky’s â€Å"blissful, brief infection† will soon pass â€Å"without my [Eugene’s] knife. † However Eugene will only be able to humor Lensky for so long, before he whether maliciously or innocuously intervenes. Eugene’s eventual intervention reiterates the idea of fate, which can be foreshadowed. Stanzas nineteen and twenty foreshadow events to come. Given that Lensky only knows â€Å"one constant source of dreaming,† (20) Olga, he will do anything to protect their love. Eugene’s indifferent attitude towards love and life in eneral, which is touched upon in stanza nineteen, lead him to confront Lensky by dancing and flirting with Olga. Lensky’s soul is â€Å"aflame with virgin fire† (20) for his beloved and Eugene’s betrayal ignites a fire from the flame in Lensky and prompts him to act irrationally and challenge Eugene to a duel. Eugene tests Lensky’s and Olga’s relationship even though he said in stanza fifteen he did not want to interfere with Lensky’s view of life and love; he constantly listened to ideas and emotions he found irrational and tiresome, therefore he wanted to observe how real these emotions and ideas were. Stanzas nineteen and twenty are significant to a central concept of love and fate that is prevalent throughout the novel. Lensky’s and Eugene’s lives are intertwined because of fate, however each one experiences love differently because of fate. Lensky experiences passionate love, because he is a poet, which leads to his death. Lensky’s death is caused by Eugene’s indifference and cynacism towards love. Eugene at first dismisses love and then he experiences unrequited love, when Tatiana rejects him. Both of these characters where shaped by their attitudes regarding love and because of love their fates were intertwined.