Short sleep duration is associated with high energy and total lipid intake in obese women: a pilot study / A curta duração do sono está associada ao elevado consumo energético e de lipídios totais em mulheres com obesidade: um estudo piloto

ABSTRACT Objective To evaluate the influence of self-reported sleep duration on ghrelin secretion and nutritional indicators in obese women. Methods This is an observational study, including 36 adult women with obesity. Sleep duration was reported while completing the general questionnaire. Dietary, laboratory, anthropometric, and body composition indicators, and resting metabolic rate, were evaluated. For statistical analysis, sleep duration data were grouped into tertiles: less than six (first tertile); equal to or above six; and less than eight (second tertile); equal to or greater than eight hours of sleep per day (third tertile). The indicators were compared for the different ranges of the sleep duration. Results There was no significant difference when comparing anthropometric, laboratory, and energy expenditure indicators between sleep tertiles. However, women with shorter sleep duration (less than 6 hours per day) had a higher mean caloric intake, compared with the tertile of eight hours or more of sleep per day. For total lipid intake, the mean consumption was higher in the first tertile (up to six hours a day). Conclusion Sleeping less than six hours a day led to an increase in energy and lipid intake in obese women. However, it did not change the plasma ghrelin concentration.

RESUMO Objetivo Avaliar a influência da duração de sono autorrelatada na secreção de grelina e indicadores nutricionais na obesidade. Métodos Trata-se de um estudo observacional, incluindo 36 mulheres adultas com obesidade. A duração do sono foi relatada durante o preenchimento do questionário de dados gerais. Foram avaliados indicadores dietéticos, laboratoriais, antropométricos e de composição corporal, além da taxa metabólica de repouso. Para análise estatística, os dados de duração de sono foram agrupados em tercis, sendo menor do que seis (primeiro tercil), igual ou acima seis e menor do que oito (segundo tercil), igual ou maior do que oito horas de sono por dia (terceiro tercil). Os indicadores supracitados foram comparados entre as diferentes faixas dos tercis de duração de sono. Resultados Não houve diferença significativa ao comparar os indicadores antropométricos, laboratoriais e do gasto de energia, entre os tercis de sono. Porém, mulheres com menor tempo de duração do sono (menos de 6 horas por dia) apresentaram maior média da ingestão calórica, comparado com o tercil de oito horas ou mais de sono por dia. Para a ingestão de lipídios totais, a média de consumo foi maior no primeiro tercil (até seis horas por dia). Conclusão Dormir menos do que seis horas por dia levou ao aumento na ingestão energética e de lipídios em mulheres com obesidade, porém, não alterou a concentração de grelina plasmática.

Índice metabólico pediátrico en adolescentes venezolanos / Pediatric metabolic index in Venezuelan adolescents

Introducción. El índice metabólico pediátrico (IMP) constituye un índice específico para cada sexo y edad, propuesto para predecir alteraciones cardiometabólicas en esa población. El objetivo del presente estudio fue evaluar el IMP en adolescentes según la agrupación de factores de riesgo cardiovascular (FRCV) y su relación con indicadores de adiposidad, dislipidemia, estrés oxidativo, inflamación, resistencia a la insulina e hipertensión en adolescentes. Metodología. El estudio fue descriptivo, correlacional y transversal en 80 adolescentes. Se determinó la glicemia, perfil lipídico, insulina, PCR ultrasensible, IL-6, TNF-α, 8-isoprostano y LDL oxidada, y se calculó el índice HOMA-IR. Se midió el peso, talla y circunferencia de cintura, y se determinó el índice de masa corporal, el de conicidad, la relación cintura/talla y luego se determinó el IMP. También, se determinó la presión arterial, la actividad física y el hábito tabáquico. Resultados. Quienes presentaron tres o más FRCV, mostraron valores de IMP superiores a los que presentaron menos factores de riesgo (p<0,001). Además, el IMP se correlacionó con indicadores de adiposidad, presión arterial, componentes del perfil lipídico, marcadores de estrés oxidativo y el HOMA-IR. Conclusión. El IMP se incrementó a medida que lo hizo la agrupación de FRCV, y el mismo se relacionó con la mayoría de los indicadores estudiados, a excepción de los marcadores de inflamación y los niveles de glucosa. Adicionalmente, el IMP resultó ser un indicador de fácil determinación y aplicación, el cual puede corroborar o complementar los hallazgos clínicos que pudieran detectarse mediante el uso de indicadores antropométricos de uso cotidiano en la práctica médica

Introduction. The pediatric metabolic index (PMI) is a specific index according to sex and age to predict cardiometabolic alterations in this population. The objective of this study was to assess the PMI in adolescents according to grouped cardiovascular risk factors (CVRF) and its relationship with indicators of adiposity, dyslipidemia, oxidative stress, inflammation, insulin resistance and hypertension in adolescents. Methodology. The study was descriptive, correlational and cross-sectional in 80 adolescents. Glycemia, lipid profile, insulin, ultrasensitive PCR, IL-6, TNF-α, 8-isoprostane and oxidized LDL were determined, and the HOMA-IR index was calculated. The weight, height and waist circumference were measured, and the body mass index, conicity index, waist/height ratio were determined and then the PMI was calculated. Blood pressure, physical activity and smoking levels were also determined. Results. Those who presented three or more CVRF showed higher PMI values than those who presented less risk factors (p<0.001). In addition, the PMI correlated with indicators of adiposity, blood pressure, lipid profile components, oxidative stress markers and HOMA-IR. Conclusion. The PMI increased as the group of CVRF did, and it was related to the majority of the indicators studied, except for the markers of inflammation and glucose levels. Additionally, the PMI turned out to be an indicator of easy determination and application, which can corroborate or complement the clinical findings that could be detected through the use of anthropometric indicators of daily use in medical practice.

Avaliação do gasto energético de repouso em pacientes com doença hepática gordurosa não alcoólica / Evaluation of rest energy expenditure in patients with non alcoholic fatty liver disease

ABSTRACT BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is currently considered a global public health problem, with changes in lifestyle being the effective way to treat the disease. To date, there is no recommended standard of assessment to determine the resting energy expenditure (REE) of patients with NAFLD, so that dietary therapy can be properly guided. OBJECTIVE: To evaluate the REE of patients with NAFLD through indirect calorimetry and compare with different predictive formulas of REE and with REE by electrical bioimpedance analysis (BIA). Assess body composition through BIA, with NAFLD staging and the presence of comorbidities. METHODS: They were evaluated in patients with NAFLD over 18 years of age treated at the Gastroenterology outpatient clinic of a tertiary level hospital in southern Brazil. NAFLD staging was performed using liver biopsy or a non-invasive method. Weight, height and body mass index (BMI) were determined in all patients. The short version of the International Physical Activity Questionnaire was used to assess physical activity. Comorbidities as arterial hypertension, diabetes mellitus and dyslipidemia were evaluated. To estimate energy expenditure at rest, Harris-Benedict, Jeor Mifflin-St, World Health Organization and Schofield formulas were used. BIA was used to assess resting metabolic rate (RMR) and body mass, and to measure RMR, indirect calorimetry was also used. Associations between categorical variables were tested with Pearson's χ2 test and between groups with McNemar's test. The level of significance assumed was 5%. The degree of agreement between the REE measurement methods was assessed using the Blan-Altman test. RESULTS: A total of 67 patients were evaluated, 70.5% male, with a mean age of 59 years and a mean BMI of 33.08 kg/m2 ±5.13. The average RMR per CI was 1,753 kcal ±614.58. When comparing the RMR estimate by different formulas with indirect calorimetry, only the Jeor Mifflin-St formula showed a statistically significant difference (P=0.0001), with a difference of +318.49 kcal. BIA and Harris Benedict's formula presented values closer to CI, 1,658 and 1,845 kcal respectively. CONCLUSION: We suggest that the Jeor Mifflin-St formula should not be used to estimate the RMR in patients with NAFLD. In the absence of indirect calorimetry, some alternatives can be used safely in this population, such as BIA and the predictive formulas of Harris Benedict, Schofield and the World Health Organization.

RESUMO CONTEXTO: A doença hepática gordurosa não alcoólica (DHGNA) é considerada, atualmente, um problema de saúde pública global, sendo a mudança no estilo de vida a forma efetiva de tratar a doença. Até o momento não há um padrão de avaliação recomendado para determinar o gasto energético de repouso (GER) de pacientes com DHGNA, para que se possa nortear adequadamente a conduta dietoterápica. OBJETIVO: Avaliar o GER de pacientes com DHGNA através da calorimetria indireta (CI) e comparar com diferentes fórmulas preditivas do GER e com GER através da bioimpedância elétrica (BIA). Avaliar a composição corporal através da BIA, com o estadiamento da DHGNA e com a presença de comorbidades. MÉTODOS: Foram avaliados em pacientes com DHGNA maiores de 18 anos de idade atendidos no ambulatório de Gastroenterologia de um Hospital de nível terciário do Sul do Brasil. O estadiamento da DHGNA foi realizado através de biópsia hepática ou método não invasivo. Peso, altura e índice de massa corporal (IMC) foram determinados em todos os pacientes. Para avaliação da atividade física foi utilizada a versão curta do International Physical Activity Questionnaire. Foram avaliadas as comorbidades hipertensão arterial, diabetes mellitus e dislipidemia. Para a estimativa do gasto energético de repouso utilizou-se as fórmulas de Harris-Benedict, de Jeor Mifflin-St, da Organização Mundial de Saúde e de Schofield. A BIA foi utilizada para avaliação do GER e da massa corporal, e para aferição do GER também se utilizou a CI. Associações entre variáveis categóricas foram testadas com teste χ2 de Pearson e entre grupos com teste de McNemar. O nível de significância assumido foi de 5%. O grau de concordância entre os métodos de mensuração do GER foi aferido pelo teste de Blan-Altman. RESULTADOS: Foram avaliados 67 pacientes, sendo 70,5% do sexo masculino, com média de idade de 59 anos e média de IMC 33,08 kg/m2 ±5,13. O GER médio por CI foi de 1.753 kcal ±614,58. Ao comparar a estimativa do GER por diferentes fórmulas com a calorimetria indireta, apenas a fórmula de Jeor Mifflin-St apresentou diferença estatisticamente significativa (P=0,0001), com uma diferença de +318,49 kcal. A BIA e a fórmula de Harris Benedict apresentaram valores mais próximos à CI, 1.658 e 1.845 kcal respectivamente. CONCLUSÃO: Sugerimos que a fórmula de Jeor Mifflin-St não deva ser utilizada para estimativa do GER em pacientes com DHGNA. Na ausência da CI algumas alternativas podem ser utilizadas com segurança nesta população, como a BIA e as fórmulas preditivas de Harris Benedict, de Schofield e da Organização Mundial de Saúde.

Estado nutricional y gasto energético basal de pacientes chilenos con síndrome de down / Nutritional status and basal energy expenditure of chilean patients with down syndrome

Introducción: se ha reportado una alta prevalencia de malnutrición por exceso en pacientes con Síndrome de Down (SD), tanto en niños, como en adolescentes y adultos. Evaluar correctamente el gasto energético basal (GEB) en estos pacientes, es un aspecto crítico del control de peso, que ha sido escasamente explorado. Objetivo: evaluar el estado nutricional y el GEB mediante calorimetría indirecta y dos ecuaciones predictivas, en pacientes con SD de Concepción, Chile. Materiales y método: estudio descriptivo y transversal en 6 pacientes con SD: 2 niños y 4 mujeres adultas. Se midieron el peso y la talla y se calcularon el índice peso/edad (niños) y el índice de masa corporal (adultos). La determinación del GEB, se realizó mediante calorimetría indirecta y utilizando dos ecuaciones predictivas: Harris & Benedict y FAO/OMS (1985). Los resultados se expresaron como medianas y rangos, y la comparación de los valores del GEB, se realizó a través de la prueba de Wilcoxon (α= 0,05). Resultados: se encontró que el 50% de los pacientes presentó sobrepeso. No se encontraron diferencias estadísticamente significativas entre el GEB calculado por las ecuaciones predictivas, y el obtenido por calorimetría indirecta. Conclusión: en el grupo de pacientes con SD evaluados, se podría estimar la GEB a través de las ecuaciones predictivas (Harris & Benedict y FAO/OMS, 1985), dada su concordancia con los valores obtenidos por calorimetría indirecta, lo que puede ser muy útil en la práctica clínica, permitiendo la elaboración de planes de alimentación adecuados para estos pacientes(AU)

Introduction: a high prevalence of malnutrition due to overweight and obesity has been reported in patients with Down Syndrome (DS), in children, adolescents and adults. A correct evaluation of the basal energy expenditure (BEE) in these patients is a critical aspect of weight control; however, this aspect has not been thoroughly studied. Objective: to evaluate the nutritional status and BEE using indirect calorimetry and two predictive equations in patients with DS from Concepción, Chile. Materials and methods: a descriptive and cross-sectional study was carried out in 6 patients with DS: 2 boys and 4 adult women. Weight and height were measured, and the weight/age index (children) and the body mass index (adults) were calculated. The determination of the BEE was carried out by indirect calorimetry and using two predictive equations: Harris & Benedict and FAO/WHO (1985). The results were expressed as means, standard deviations, medians and ranges, and the comparison of the BEE values was performed using the Wilcoxon test (α = 0.05). Results: 50% of the patients were overweight. No statistically significant differences were found between the BEE calculated by the predictive equations, and that obtained by indirect calorimetry. Conclusion: In the group of patients with DS evaluated, BEE could be estimated through the predictive equations (Harris & Benedict and FAO/ WHO, 1985), given its agreement with the values obtained by indirect calorimetry, which can be very useful in clinical practice, allowing the elaboration of adequate feeding plans for these patients(AU)

The Effect of Continuous Positive Airway Pressure on Basal Metabolism Rate in Patients with Severe Obstructive Sleep Apnoea Syndrome

ABSTRACT Objective: To assess the effect of the continuous positive airway pressure (CPAP) treatment on basal metabolism rate (BMR) in patients with severe obstructive sleep apnoea syndrome (OSAS). Methods: Demographic characteristics, body mass index (BMI), apnoea-hypopnoea index (AHI) and smoking history of the patients were recorded. Basal metabolism rate was measured via indirect calorimetry in the morning following nights of polysomnography and CPAP titration. Basal metabolism rate, oxygen consumption (VO2) and carbon dioxide output (VCO2) levels were compared before and after CPAP administration. Results: A total of 25 patients with a mean age of 51.4 ± 13.7 years were included in the study: 6 (24%) female and 19 (76%) male. A significant reduction in the BMR (p = 0.049), VO2 (p = 0.042) and VCO2 (p = 0.008) values were observed after a single night administration of CPAP as compared to before treatment. Furthermore, it was detected that this reduction provided by CPAP treatment was more significant in current smokers, patients with AHI > 60 and BMI ≥ 30. Conclusion: It is suggested that there is a correlation between BMR and the severity of OSAS, and it is possible to provide a significant reduction in BMR with single night administration of CPAP depending on the patient's smoking history, degree of obesity and disease severity.

Lactate: a biological marker of physical activity in colombian weightlifting athletes / Lactato: um marcador biológico da atividade física em atletas colombianos de halterofilismo / Lactato: un marcador biológico de la actividad física en atletas colombianos de halterofilia

ABSTRACT Introduction Blood biomarkers are measurable metabolic products that allow objective monitoring of the training process, and their analysis provides an opportunity to improve athletic performance. Objective To evaluate blood lactate concentrations in a group of the Valle League weightlifting athletes as a tool to determine the effects of training and its direct relationship to performance during competition. Methods This is an observational cross-sectional study. Lactate levels of 32 weightlifting athletes belonging to the Valle Weightlifting League were evaluated. Blood samples were taken from the ear lobe to quantify the lactate concentration, using a Scout Lactate analyzer. Samples were taken before and after a high intensity training section consisting of four maximum repetition (MR) sports gestures, in which 5 series and 15 repetitions were performed for each sports gesture, with a rest period of 40 seconds between each exercise. The software program SPSS, version 25, was used to determine the lactate concentrations. Results An average lactate concentration 22.46 mg/dL was obtained for the athletes at rest, and an average of 98.30 mg/dL in the final lactate concentration, after high intensity exercise. Significant differences were found between the initial and final lactate concentrations. Conclusion Lactate concentration increases with physical activity; it varies from one individual to another; and it can be used as a biomarker of intensity of physical activity in the field of sports. Level of evidence; II type of study: Prognostic Studies Investigating the Effect of a Patient Characteristic on a disease outcome.

RESUMO Introdução Os biomarcadores sanguíneos são produtos metabólicos mensuráveis que permitem a monitorização objetiva do processo de treino, e sua análise é uma oportunidade para melhorar o desempenho atlético. Objetivos Avaliar as concentrações de lactato no sangue de um grupo de atletas de halterofilismo da Liga Valle como ferramenta para determinar os efeitos do treino e sua relação direta com o desempenho durante a competição. Métodos Este é um estudo transversal e observacional. Foram avaliados os níveis de lactato em 32 atletas da Liga de Halterofilismo Valle. A amostra de sangue foi retirada do lóbulo da orelha com o intuito de quantificar a concentração de lactato com o analisador Scout Lactate. As amostras foram colhidas antes e depois de uma seção de treino de alta intensidade, que consistiu em quatro gestos esportivos de repetição máxima (RM), nos quais foram realizadas 5 séries e 15 repetições para cada gesto esportivo, com um período de repouso de 40 segundos entre cada exercício. O software SPSS, versão 25 foi usado para determinar as concentrações de lactato. Resultados A concentração média de lactato nos atletas em repouso foi 22,46 mg/dl e a concentração média final foi de 98,30 mg/dl depois de exercício de alta intensidade. Foram encontradas diferenças significativas ao comparar a concentração inicial com a concentração final de lactato. Conclusões A concentração de lactato aumenta com a realização da atividade física, é variável de um indivíduo para outro e pode ser usada como biomarcador de intensidade da atividade física na área dos esportes. Nível de Evidência II; Estudos prognósticos - Investigação do efeito de característica de um paciente sobre o desfecho da doença.

RESUMEN Introducción Los biomarcadores sanguíneos son productos metabólicos mensurables que permiten la monitorización objetiva del proceso de entrenamiento, y su análisis es una oportunidad para mejorar el desempeño atlético. Objetivos Evaluar las concentraciones de lactato en la sangre de un grupo de atletas de halterofilia de la Liga Valle como herramienta para determinar los efectos del entrenamiento y su relación directa con el desempeño durante la competición. Métodos Este es un estudio transversal y observacional. Fueron evaluados los niveles de lactato en 32 atletas de la Liga de Halterofilia Valle. La muestra de sangre fue retirada del lóbulo de la oreja con el objetivo de cuantificar la concentración de lactato con el analizador Scout Lactate. Las muestras fueron tomadas antes y después de una sección de entrenamiento de alta intensidad, que consistió en cuatro gestos deportivos de repetición máxima (RM), en los que se realizaron 5 series y 15 repeticiones para cada gesto deportivo, con un período de descanso de 40 segundos entre cada ejercicio. El software SPSS versión 25 fue usado para determinar las concentraciones de lactato. Resultados La concentración promedio de lactato en los atletas en reposo fue 22,46 mg/dl y la concentración promedio final fue de 98,30 mg/dl después del ejercicio de alta intensidad. Fueron encontradas diferencias significativas al comparar la concentración inicial con la concentración final de lactato. Conclusiones La concentración de lactato aumenta con la realización de actividad física, es variable de un individuo para otro, y puede ser usada como biomarcador de intensidad de la actividad física en el área de los deportes. Nivel de evidencia II; Estudios pronósticos - Investigación del efecto de característica de un paciente sobre el resultado de la enfermedad

Agreement between equations-estimated resting metabolic rate and indirect calorimetry-estimated resting metabolic rate in low-income obese women

ABSTRACT Objectives Indirect calorimetry is established as a gold standard to determine the resting metabolic rate (RMR), however, its clinical use is limited, especially in low-income settings. Thus, the use of predictive equations appear as an alternative to estimate the RMR, but its precision is debatable, especially in obese individuals and in populations without specifically developed equations. To evaluate the agreement between the RMR estimated by equations and by indirect calorimetry in low-income obese women. Subjects and methods A cross-sectional study with adult and obese women, which estimated the RMR by indirect calorimetry and compared with 13 predictive equations using the concordance correlation coefficient, root mean square error (RMSE) and Bland-Altman methods. The maximum allowed differences were predefined as 10%. Results No equation presented its confidence intervals for the Bland-Altman limits of agreement inside the predefined acceptable range. The Harris-Benedict equation achieved better agreement (bias of 2.9% and RMSE of 274.3kcal) whereas the Henry-Rees equation achieved better precision (42.3% of the sample within the 10% maximum allowed difference). Conclusion None of the studied equations satisfactorily estimated the RMR estimated by indirect calorimetry. In the absence of specific equations for this population, the use of the Harris-Benedict and Henry-Rees equations could be considered.

Comparison of bioelectrical impedance analysis and air displacement plethysmography / Comparación de análisis de impedancia bioeléctrica y pletismografía de desplazamiento de aire

The measurement of body composition has become an important component in the diagnosis of health, physical conditioning and nutritional status. The aim of this study was to compare two methods of detecting body composition, bioelectrical impedance and air displacement plethysmography for athletes and non-athletes. Specifically, we compared the parameters as fat mass, fat free mass and the value of basal metabolic rate. A sample size of 52 men (age 26.2 ± 5.4 years) that included a group of mixed martial arts (MMA) fighters (n = 31, age 27.2 ± 5.5 years) and a group of the non-athletes (n =21, age 24.6 ± 5.1 years). Both groups were measured by bioelectrical impedance and air displacement plethysmography. Significant differences in % body fat (p<0.05) and fat-free mass (p<0.05) were noted between bioelectrical impedance and air displacement plethysmography of non-athletes, but there were no significant differences for athletes. Furthermore, there was a significant difference (p<0.001) of basal metabolic rate between bioelectrical impedance and air displacement plethysmography, but the correlation with fat free mass was very strong for both methods. Therefore, the use of bioelectrical impedance and air displacement plethysmography may be useful for detecting changes in body composition, but their accuracy is controversial and for this reason we recommend using only one method and not combining them.

La medición de la composición corporal se ha convertido en un componente importante en el diagnóstico de la salud, el acondicionamiento físico y el estado nutricional. El objetivo de este estudio fue comparar dos métodos para detectar la composición corporal, la impedancia bioeléctrica y la pletismografía de desplazamiento de aire para atletas y no atletas. Específicamente, comparamos los parámetros como masa grasa, masa libre de grasa y el valor de la tasa metabólica basal. Un tamaño de muestra de 52 hombres (edad 26,2 ± 5,4 años) de un grupo de luchadores de artes marciales mixtas (MMA) (n = 31, edad 27,2 ± 5,5 años) y un grupo de no deportistas (n = 21, edad 24,6 ± 5,1 años). Ambos grupos se midieron por impedancia bioeléctrica y pletismografía de desplazamiento de aire. Se observaron diferencias significativas en el porcentaje de grasa corporal (p<0,05) y la masa libre de grasa (p<0,05) entre la impedancia bioeléctrica y la pletismografía de desplazamiento de aire de los no deportistas, sin embargo no hubo diferencias significativas en los atletas. Además, se observó una diferencia significativa (p<0,001) de la tasa metabólica basal entre la impedancia bioeléctrica y la pletismografía de desplazamiento de aire, pero la correlación con la masa libre de grasa fue importante para ambos métodos. Por lo tanto, el uso de la pletismografía de impedancia bioeléctrica y desplazamiento de aire puede ser útil para detectar cambios en la composición corporal, pero su precisión es controvertida por lo que recomendamos usar solo un método y no una combinación de ambos.

Basal metabolic rate in Brazilian patients with type 2 diabetes: comparison between measured and estimated values

ABSTRACT Objectives: The aims of this study are to investigate which of the seven selected predictive equation for estimating basal metabolic rate (BMR) is the best alternative to indirect calorimetry (IC) and to evaluate the dietary energy intake in patients with type 2 diabetes. Subjects and methods: Twenty-one patients with type 2 diabetes participated in this diagnostic test study. Clinical and laboratorial variables were evaluated as well as body composition by absorptiometry dual X-ray emission (DXA) and BMR measured by IC and estimated by prediction equations. Dietary intake was evaluated by a quantitative food frequency questionnaire. Data were analyzed using Bland-Altman plots, paired t-tests, and Pearson's correlation coefficients. Results: Patients were 62 (48-70) years old, have had diabetes for 8 (2-36) yeas, and 52.4% were females. The mean body composition comprised a fat-free mass of 49.8 ± 9.4 kg and a fat mass of 28.3 ± 7.2 kg. The energy intake was 2134.3 ± 730.2 kcal/day and the BMR by IC was 1745 ± 315 kcal/day. There was a wide variation in the accuracy of BMR values predicted by equations when compared to IC BMR measurement. Harris-Benedict, Oxford, FAO/WHO/UNO equations produced the smallest differences to IC, with a general bias of < 8%. The FAO/WHO/UNO equation provided the best BMR prediction in comparison to measured BMR. Conclusion: In patients with type 2 diabetes, the equation of the FAO/WHO/UNO was the one closest to the BMR values as measured by IC.

Effect of physical exercise on cardiometabolic parameters in post-menopause: an integrative review / Efeito do exercício físico nos parâmetros cardiometabólicos na pós-menopausa: revisão integrativa

Abstract Objective: To identify the evidence available in literature which relates the practice of physical exercise to improvements in the cardiovascular and metabolic parameters of postmenopausal women. Method: A search was performed of works published between 2008 and 2018 included in the MEDLINE, BDENF, IBCS and LILACS databases. Of the 792 studies identified, 23 met the inclusion criteria. Results: Following analysis, the studies were separated into three categories. In the first category it was observed that physical exercise improved lipid metabolism, reduced abdominal circumference and promoted weight loss. The second category revealed that physical exercise reduced systolic blood pressure, prevented the development of arterial hypertension and reduced the release of sympathomimetic hormones. In the third category the studies indicated that physical exercise elevated the antioxidant mediators and reversed the oxidative stress involved in the inflammatory reactions present in cardiovascular diseases. Conclusion: The studies confirm the beneficial effects of physical exercise on the metabolic and cardiovascular parameters of postmenopausal women.

Resumo Objetivo: Identificar as evidências disponíveis na literatura que relacionam a prática do exercício físico com a melhora dos parâmetros cardiovasculares e metabólicos em mulheres na pós-menopausa. Método: Foi realizada busca nas bases de dados MEDLINE, BDENF, IBCS e LILACS de trabalhos publicados entre 2008 a 2018. Dos 792 estudos identificados, 23 preencheram os critérios de inclusão. Resultados: A análise dos estudos permitiu a separação em três categorias. Na primeira categoria foi observado que o exercício físico melhorou o metabolismo lipídico, reduziu a circunferência abdominal e promoveu perda de peso. A segunda categoria evidenciou que o exercício físico reduziu a pressão arterial sistólica, preveniu o desenvolvimento de hipertensão arterial e reduziu liberação de hormônios simpatomiméticos. Na terceira categoria os estudos indicaram que o exercício físico eleva os mediadores antioxidantes e reverte o stress oxidativo envolvido nas reações inflamatórias presentes em doenças cardiovasculares. Conclusão: Os estudos afirmam efeitos benéficos do exercício físico sobre os parâmetros metabólicos e cardiovasculares de mulheres na pós-menopausa.

Energy expenditure, growth, and nutritional therapy in appropriate and small for gestational age preterm infants / Gasto energético, crescimento e terapia nutricional em recém-nascidos pré-termo adequados e pequenos para idade gestacional

Abstract Objective: To evaluate the resting energy expenditure, growth, and quantity of energy and macronutrients intake in a group of preterm newborns. Methods: The cohort study was performed with appropriate and small for gestational age preterm infants (birth weight lower than 1500 g or gestational age < 32 weeks). Resting energy expenditure was measured using indirect calorimetry on the 7th, 14th, 21st, and 28th days of life, and at discharge. Length, head circumference and body weight were assessed weekly. Nutritional therapy was calculated during the hospital stay and the information for each type of food was recorded in software that calculates the total amount of energy and macronutrients. Results: 61 preterm infants were followed; 43 appropriate and 18 small for gestational age infants. There was no statistical difference for resting energy expenditure between the groups, and it increased from the first to the fourth week of life (appropriate: 26.3% and small: 21.8%). Energy intake in the first two weeks of life was well below the energy requirement. Conclusion: Considering that the results demonstrate high energy expenditure during the first weeks of life, there is an evident need to provide the best quality of nutrition for each child in the first weeks of life so that preterm infants with or without intrauterine growth restriction can achieve their maximum potential for growth and development.

Resumo Objetivo: Avaliar o gasto energético de repouso, o crescimento e a quantidade ofertada de energia e macronutrientes em um grupo de recém-nascidos pré-termo. Método: Foi feito estudo de coorte com recém-nascidos pré-termo adequados e pequenos para a idade gestacional (peso de nascimento inferior a 1.500 gramas ou idade gestacional < 32 semanas). O gasto energético foi avaliado com a calorimetria indireta nos dias 7°, 14°, 21°, 28° dias de vida e alta hospitalar. Medidas do comprimento, perímetro cefálico e peso corporal foram avaliadas semanalmente. A terapia nutricional foi calculada durante a internação do recém-nascido e as informações de cada tipo de alimentação foram registradas em um software que calcula a quantidade total de energia e macronutrientes. Resultados: Foram acompanhados 61 recém-nascidos, sendo 43 adequados e 18 pequenos para idade gestacional. O gasto energético de repouso não apresentou diferença estatística entre os grupos e aumentou entre a primeira e quarta semana de vida (adequados: 26,3% e pequenos: 21,8%). O aporte energético nas duas primeiras semanas de vida mostrou-se bem abaixo do requerimento energético mensurado pela calorimetria. Conclusão: Considerando os resultados que demonstram um gasto energético alto ao longo das primeiras semanas de vida, fica evidente a necessidade de fornecer ao recém-nascido pré-termo um melhor aporte energético já nas primeiras semanas de vida, para que os neonatos com ou sem restrição intrauterina possam atingir o seu potencial máximo de crescimento e desenvolvimento.

Indice cardiometabólico como predictor de factores de riesgo cardiovascular en adolescentes / Cardiometabolic index as a predictor of cardiovascular risk factors in adolescents / Índice cardiometabólico como preditor de fatores de risco cardiovascular em adolescentes

RESUMEN Objetivo Evaluar la capacidad del Índice Cardiometabólico (ICM) para predecir alteraciones en las concentraciones en ayuno de glucosa, dislipidemia e hipertensión en adolescentes. Métodos El estudio fue descriptivo, correlacional y transversal. Se evaluaron 278 adolescentes de entre 12 y 15 años. Se determinó las concentraciones de glicemia, triglicéridos, HDL-c y se calculó el índice TG/HDL-c. Se midió el peso, talla y circunferencia de cintura y se determinó el Índice de Masa Corporal, el de conicidad y la relación cintura talla (Rel. CC-T). El producto de la Rel. CC-T y TG/HDL-C constituyó el índice cardiometabólico (ICM). Se determinó la presión arterial. Resultados El área bajo la curva ROC del ICM como predictor de dislipidemia, hipertensión (HTA) y glucosa alterada en ayunas (GAA) fue de 0,777 (IC 95%=0,712-0,842), 0,710 (IC 95%=0,559-0,853) y 0,564 (IC 95%=0,447-0,682), respectivamente. Conclusión En la muestra estudiada el ICM mostró capacidad de predecir dislipidemia e HTA, pero no para GAA.(AU)

ABSTRACT Objective To evaluate the ability of the Cardiometabolic Index (CMI) to predict alterations in fasting glucose concentrations, dyslipidemia and hypertension in adolescents. Materials and Methods Descriptive, correlational and cross-sectional study. 278 adolescents aged between 12 and 15 years were evaluated. Serum glucose, triglycerides and HDL-C were determined and the TG/HD-C ratio was estimated. Weight, height and waist circumference were measured and body mass index, conicity index and waist-to-height ratio (WHtR) were determined. The product of WHtR and TG/HDL-C was the Cardiometabolic Index (CMI). Blood pressure was determined. Results The area under the ROC curve of the CMI as a predictor of dyslipidemia, hypertension (AHT) and impaired fasting glucose (IFG) was 0.777 (CI 95% = 0.712 to 0.842), 0.710 (CI 95% = 0.559 to 0.853) and 0.564 (CI 95% = 0.447 to 0.682), respectively. Conclusion In the studied sample, CMI showed ability to predict dyslipidemia and hypertension, but not IFG.(AU)

RESUMO Objetivo Avaliar a capacidade do Índice Cardiometabólico (ICM) de predizer alterações nas concentrações de glicose em jejum, dislipidemia e hipertensão em adolescentes. Métodos O estudo foi descritivo, correlacional e transversal. Foram avaliados 278 adolescentes entre 12 e 15 anos. As concentrações de glicemia, triglicerídeos, HDL-c foram determinadas e o índice TG / HDL-c foi calculado. Peso, altura e circunferência da cintura foram medidos e o Índice de Massa Corporal, o índice de conicidade e a relação cintura-comprimento (Rel. CC-T) foram determinados. O produto do Rel. CC-T e TG / HDL-C constituiu o índice cardiometabólico (ICM). A pressão arterial foi determinada. Resultados A área sob a curva ICM ROC como um preditor de dislipidemia, hipertensão (HT) e glicemia de jejum alterada (GAA) foi 0,777 (IC 95% = 0,712-0,842), 0,710 (IC 95% = 0,559-0,853) e 0,564 (IC 95% = 0,447-0,682), respectivamente. Conclusão Na amostra estudada, o ICM apresentou capacidade de predizer dislipidemia e TH, mas não para GAA.(AU)

Índice metabólico en mayas: asociación con hipercolesterolemia en pacientes con diabetes tipo 2 / Metabolic index in Mayas: association with hypercholesterolemia in patients with type 2 diabetes / Índice metabólico em Mayas: associação com hipercolesterolemia em pacientes com diabetes tipo 2

El objetivo del presente estudio fue evaluar la asociación entre el índice metabólico, una medida indirecta de resistencia a la insulina, y la hipercolesterolemia en población indígena maya con diabetes tipo 2 (DT2). Se incluyeron un total de 77 pacientes indígenas mayas con diagnóstico previo de DT2. Las variables bioquímicas se analizaron por métodos fotométricos estandarizados y se calculó el índice metabólico (GB x TG/HDL-C2). Se encontró en la muestra total una correlación entre el índice metabólico y los niveles de: glucosa basal (GB) (r=0,333, p=0,001), A1c (r=0,331, p=0,003), CT (r=0,255, p=0,026), TG (r=0,762, p=1,29x10-15), HDL-C (r= -0,735, p=4,2x10-14); mientras que no existió correlación con las concentraciones de LDL-C (r=0,120, p=0,300). La asociación entre el índice metabólico e hipercolesterolemia (B=1,590, p=0,041, Exp(B)=4,901 e I.C=1,066-22,544) fue independiente de la edad, género, IMC, tiempo de evolución de DT2 y de los niveles de A1c. El trabajo presenta evidencia de la asociación entre el índice metabólico y la hipercolesterolemia, y propone el potencial uso del índice metabólico como medida indirecta de riesgo aterogénico en población indígena maya con DT2.

It is already known that combination of insulin resistance (IR) and compensatory hyperinsulinemia increases the risk of hypertension, and atherogenic dyslipidemia. These changes increase the risk of cardiovascular disease. With that in mind, the aim of the present study was to evaluate the association between elevated metabolic index, an indirect measure of insulin resistance, and hypercholesterolemia in an indigenous Mayan population with type 2 diabetes (T2D). A total of 77 indigenous Mayan patients with a previous diagnosis of T2D were included. Biochemical variables were measured by standardized photometric methods and the metabolic index (GB x TG/HDL-C2) was calculated. A correlation between the metabolic index and the levels of GB (r=0.333, p=0.001), A1c (r=0.331, p=0.003), CT (r=0.255, p=0.026), TG (r=0.762, p=1.29x10-15), HDL-C (r=-0.735, p=4.2x10-14) was found; while there was no correlation with LDL-C concentrations (r=0.120, p=0.300). The association between the metabolic index and hypercholesterolemia (B=1.590, p=0.041, Exp(B)=4.901 and I.C=1.066-22.544) was independent of A1c levels, age, gender, BMI and evolution time of DT2. The study presents evidence of the association between the metabolic index and hypercholesterolemia, and proposes the potential use of the metabolic index as an indirect measure of atherogenic risk in an indigenous Mayan population with T2D.

O objetivo do presente estudo foi avaliar a associação entre a taxa metabólica, uma medida indireta de resistência à insulina e a hipercolesterolemia na população indígena maia com diabetes tipo 2 (DT2). Foram incluídos 77 pacientes indígenas maias com diagnóstico prévio de DT2. As variáveis bioquímicas foram medidas através de métodos fotométricos padronizados e foi calculado o índice metabólico (GB x TG/HDL-C2). Uma correlação entre o índice metabólico e os níveis de glicose basal (GB) (r=0,333, p=0,001), A1c (r=0,331, p=0,003), CT (r=0,255, p=0,026), TG (r=0,762, p=1,29x10-15), HDL-C (r=-0,735, p=4,2x10-14) foi encontrada na amostra total; enquanto que não houve correlação com as concentrações de LDL-C (r=0,120, p=0,300). A associação entre o índice metabólico e a hipercolesterolemia (B=1,590, p=0,041, Exp(B)=4,901 e I.C=1,066-22,544) foi independente da idade, sexo, IMC, tempo de evolução de DT2 e dos níveis de A1c. O trabalho apresenta evidência da associação entre o índice metabólico e a hipercolesterolemia, e propõe o potencial uso do índice metabólico como medida indireta do risco aterogênico na população indígena maia com DT2.

Normative values of some morphometric variables for Kosovo Albanian population aged 06 - >70 years old / Valores normativos de algunas variables morfométricas para la población albanesa de Kosovo de edades comprendidas entre los 6 y los 70 años

The purpose of this study was to find out normative values of the Body Height, Body Weight, Body Mass Index and Basal Metabolic Rate, as well as to study, observe and to clarify the dynamics of physical growth and changes. Four anthropometric variables were measured in 94825 male Albanian entities from Kosovo aged 06->70 years old, during the period 2007-2016. The same variables were measured in 409 sportsmen from Kosovo. The obtained data were analysed through Descriptive Parameters (arithmetic mean, maximum, minimum and standard deviation) and Correlation Analysis. Gained results indicate average to high Body Height of measured male Kosovo Albanians (50.6 % of entities = 1700-1799 mm; 38.2 % = 1800-1899 mm). The smaller entity with body height 1015 mm belongs to age-group of 6 years old, while the higher entity with 2015 mm belongs to the age group of 19 years old. The correlation coefficient between Body Height and Body Weight shows its higher values in two phases of intensive body growth (0.71- 0.76) and in the decrease phase of the body morphometry (0.57-0.65). Kosovo Albanian sportsmen aged 17-25 years with average Body Height=1847.75 mm and Body Weight=75.87 kg belongs to group of higher people with ideal body weight.

El objetivo de este estudio fue conocer los valores normales de la altura, el peso, el índice de masa corporal y la tasa metabólica basal, así como estudiar, observar y aclarar la dinámica del crecimiento y los cambios físicos. Se midieron cuatro variables antropométricas en 94825 personas albanesas de Kosovo de edades comprendidas entre los 6 y los 70 años, durante el período 2007-2016. Las mismas variables se midieron en 409 deportistas de Kosovo. Los datos obtenidos fueron analizados a través de parámetros descriptivos (media aritmética, máxima, mínima y desviación estándar) y análisis de correlación. Los resultados obtenidos indican una altura promedio de los varones albaneses de Kosovo (50,6 % de los grupos = 1700- 1799 mm, 38,2 % = 1800-1899 mm). El grupo menor con una altura corporal de 1015 mm pertenece al grupo etario de 6 años, mientras que el grupo superior con 2015 mm pertenece al grupo de edad de 19 años. El coeficiente de correlación entre la altura del cuerpo y el peso corporal muestra sus valores más altos en dos fases de crecimiento corporal intensivo (0,71-0,76) y en la fase de disminución de la morfometría corporal (0,57-0,65). Los deportistas albaneses de Kosovo de entre 17 y 25 años con una estatura corporal promedio = 1847,75 mm y un peso corporal = 75,87 kg pertenecen al grupo de personas más altas con un peso corporal ideal.

Determinación del índice de masa corporal y tasa metabólica basal en estudiantes de medicina de la Escuela Superior Politécnica de Chimborazo (ESPOCH) / Determination of body mass index and basal metabolic rate in medical students of la Escuela Superior Politécnica de Chimborazo (ESPOCH)

Introducción: El sobrepeso y la obesidad están estrechamente ligados al consumo de calorías y constituyen un factor de riesgo importante en el desarrollo de enfermedades crónicas. Es importante controlar el consumo de calorías para que no sea excesivo y armonice con las necesidades del organismo. Objetivo: Determinar la prevalencia de sobrepeso y obesidad a través del cálculo del índice de masa corporal (IMC) y tasa metabólica basal (TMB) en estudiantes de medicina de tercer semestre de la ESPOCH. Determinar si el aporte energético de los estudiantes se ajusta a lo recomendado según su género, edad y actividad física. Metodología: Se tomó medidas antropométricas y recolectó datos demográficos en una muestra de estudiantes de tercer semestre de medicina de la ESPOCH (n = 69). Se calculó el IMC y TMB. Se recolectó datos de aporte energético de dos estudiantes, un hombre y una mujer. Resultados: Según el IMC, en el 10.1 % (n = 7) se observó sobrepeso tipo I y en el 7.3 % (n = 5) sobrepeso tipo II. El promedio del IMC y tasa metabólica basal fue mayor en los hombres en comparación con las mujeres (IMC: 23.1 Kg/m² vs. 22.0 Kg/m²; TMB: 1689.7 vs. 1431.2). El aporte de calorías en los dos estudiantes estuvo a corde a lo recomendado para su edad, peso y talla. Conclusiones: La prevalencia de sobrepeso en la muestra de estudiantes fue del 17.4 %. No se observaron personas con obesidad. El aporte calórico en los dos individuos analizados estuvo acorde a su TMB.

Introduction: Overweight and obesity are closely related to the consumption of calories and constitute an important risk factor for the development of chronic diseases. It is important to control the consumption of calories for it does not become excessive and is consistent with the needs of the organism. Objective: Determine the prevalence of overweight and obesity by determining body mass index (BMI) alongside basal metabolic rate (BMR) in medical students of third semester of the ESPOCH. Determine wether their energy intake is consistent with that recomended according their age, gender and physical activity. Methodology: We measured anthropometric dimentions and collected demographic data from a sample of medical students of third semester of the ESPOCH (n = 69 ). We calculated BMI and BMR. We collected data about calory intake of two students, one male and one female. Results: According to the BMI, in 10.1 % (n = 7) we observed overweight type I and in 7.3 % (n = 5) overweight type II. BMI and BMR average was higher among males in comparison to females (BMI: 23.1 Kg/m² vs. 22.0 Kg/m²; BMR: 1689.7 vs. 1431.2). Calory intake in both estudents was consistent with that recomended for their age, weight and height. Conclusions: The prevalence of overweight in the sample was 17.4 %. We did not identify students with obesity. Calory intake in both subjects was in accordance with their BMR.

Comparison between resting metabolic rate and indirect calorimetry in postmenopausal women / Comparação de equações preditivas de taxa metabólica de repouso com calorimetria indireta em mulheres pós-menopáusicas

ABSTRACT Objective To compare resting metabolic rate values determined by indirect calorimetry with values estimated using different predictive equations in lean and overweight postmenopausal women. Methods Twenty-four women, who had stopped menstruating for at least two years, were subjected to anthropometric measurements and indirect calorimetry after 12-hour overnight fasting to determine, mathematically and experimentally, resting metabolic rate values. Results There was no difference in the indirect calorimetry values between the groups evaluated. Difference values of resting metabolic rate were obtained with all equations used. For the lean women, there was no difference between the values obtained by indirect calorimetry and those estimated using the equations proposed by Food and Agricultural Organization, Fredix, Lazzer, and Schofield. However, in the overweight group, the resting metabolic rate values estimated using the Institute of Medicine, Berstein and Owen equations were different from those obtained by indirect calorimetry. Conclusion This study suggests that differences in body composition in postmenopausal women influence the accuracy of predictive equations, demonstrating the need for more accurate estimation methods for resting metabolic rate in postmenopausal women with different body compositions.

RESUMO Objetivo Comparar os valores de taxa metabólica de repouso determinados por calorimetria indireta com os valores obtidos utilizando diferentes equações preditivas em mulheres pós-menopausicas eutróficas e com sobrepeso. Métodos Vinte e quatro mulheres com pelo menos dois anos de menopausa foram submetidas à avaliações antropométricas e à calorimetria indireta após 12 horas de jejum para determinar, matematicamente e experimentalmente, a taxa metabólica de repouso. Resultados Os valores para calorimetria indireta não diferiram entre os grupos e a taxa metabólica de repouso predita por equações foi diferente para todas as equações usadas. Para o grupo de eutróficas, as equações que não foram estatisticamente diferentes da calorimetria indireta foram Food and Agricultural Organization, Fredix, Lazzer e Schofield. No entanto, apenas as equações Berstein e Owen foram significativamente diferentes comparadas com calorimetria indireta para o grupo sobrepeso. Conclusão O presente estudo sugere que diferenças na composição corporal em mulheres na pós-menopausa modificam a precisão de equações que predizem a taxa metabólica de repouso, demonstrando a necessidade de aprimorar métodos de estimação de taxa metabólica de repouso em mulheres pós-menopáusicas com diferentes composições corporais.

Body composition, resting energy expenditure and inflammatory markers: impact in users of depot medroxyprogesterone acetate after 12 months follow-up

ABSTRACT Objective The aim of this study was to evaluate for 12 months the changes of body weight using Depot Medroxyprogesterone Acetate (DMPA) and if these changes are related to inflammatory markers. Subjects and methods Twenty women of childbearing age who chose the DMPA, without previous use of this method, BMI < 30 kg/m2, and 17 women using IUD TCu 380A, participated in the study. At the baseline and after one year, changes in weight gain, body composition by the bioimpedance electric method, resting energy expenditure (REE) by the indirect calorimetry method, inflammatory markers and HOMA-IR were assessed. Results After 12 months of evaluation, we could observe a significant increase in the DMPA group in weight (3,01 kg) and BMI, while the IUD group’s only significant increase was observed in the BMI. Relative to REE there was an increase of basal metabolic rate (BMR) in both groups after one year. The sub-group DMPA that gained < 3 kg had increased significant weight, BMI and body surface (BS) with respiratory quotient (RQ) reduction, while the sub-group that gained ≥ 3 kg had a significant increase in weight, BMI, BS, fat-free mass, fat mass, BMR, Leptin, HOMA-IR and waist circumference, with RQ significantly reduced. Conclusion Our study found significant changes in weight, body composition and metabolic profile of the population studied in the first 12 months of contraceptive use. These changes mainly increased body weight, leptin levels and HOMA-IR which can contribute to the development of some chronic complications, including obesity, insulin resistance and diabetes mellitus.

Adiponectina: caracterização, ação metabólica e cardiovascular / Adiponectin: characterization, metabolic and cardiovascular action

Nas últimas duas décadas, o entendimento da biologia do tecido adiposo sofreu mudanças revolucionárias, passando de principal sítio de armazenamento energético a importante órgão endócrino responsável pela produçãoe secreção de proteínas, peptídeos e não peptídeos bioativos. Dentre as proteínas secretadas pelos adipócitos, aadiponectina (APN) é a mais abundante, apresentando ações fisiológicas importantes no sistema cardiovasculare endócrino, envolvendo a sensibilização da ação insulínica e regulação do metabolismo energético corporal, incluindo o coração. Esta revisão tem por objetivo descrever a ação da APN sobre o sistema cardiovascular. Foramincluídos artigos originais realizados com animais ou humanos. Consultadas as bases de dados Pubmed e Medlineentre os anos de 1994 e 2013. Não foram incluídos relatos de caso, estudos-piloto ou estudos de revisão. Utilizou-se como palavras-chave os descritores em ciências da saúde e MeSH específico para o Medline. Oscruzamentos realizados foram: Adiponectin AND Obesity, Adiponectin AND Metabolism e Adiponectin AND Cardiovascular Disease. Encontrados 303 artigos, excluídos 204 e selecionados 31 artigos que compuseram esteestudo. No contexto geral desta revisão a APN apresenta efeitos anti-inflamatórios e ateroprotetores no tecidovascular e ainda ação sensibilizadora para a insulina nos tecidos envolvidos nos metabolismos glicídico e lipídico. Assim, é considerado biomarcador importante para o desenvolvimento de doenças cardiovasculares.

In the last two decades, the understanding of adipose tissue biology underwent revolutionary changes, from a major energy storage site to an important endocrine organ responsible for the production and secretion of proteins, peptides and non-bioactive peptides. Among the proteins secreted by adipocytes, adiponectin (APN) is the most abundant, with important physiological actions in the cardiovascular and endocrine system, involving the sensitization of insulin action and regulation of body energy metabolism, including the heart. This review aims to describe the action of APN on the cardiovascular system. It includes original manuscripts with humans or animals. The databases PubMed and Medline, from years 1994 to 2013, were searched. Case reports, pilot studies or review studies have not been included. The health science descriptors and MeSH specific for Medline were used as keywords. The following cross searches were carried out: Adiponectin AND Obesity, Adiponectin AND Metabolism and Adiponectin AND Cardiovascular Disease. We found 303 manuscripts, excluded 204 and selected 31 manuscripts that were included this study. Inthe general context of this review, APN presents anti-inflammatory and ateroprotector effects in the vascular tissue and an insulin sensitizing action in tissues involved in glucose and lipid metabolism. It is thus considered an important biomarker for the developmentof cardiovascular diseases.

Impacto del Programa de manejo de la obesidad Bright Bodies aplicado a niños y adolescentes chilenos / Effects of the Bright Bodies Program in Chilean obese children

Background: Yale University’s Bright Bodies Program consists on a lifestyle intervention, in areas such as nutrition and exercise, while focusing on behavior modification and family support. Aim: To evaluate the impact of the Program in Chilean children and adolescents with obesity who participated in the Program during 8 months. Material and Methods: The weight management Program was carried out during 8 months and consisted in weekly sessions directed by dietitians or psychologists and exercise sessions twice per week in charge of physical education teachers. The family component was based on sessions for parents or caregivers to achieve the same goals of children activities. Results: Twenty eight obese children aged 9.5 ± 2 years completed the eight months of intervention. There was a significant 5% reduction of body mass index (BMI), a 15% reduction of BMI z score and a 2.9% reduction of waist circumference. Bioelectrical impedance showed a 9% reduction of percentage body fat and a 7% increase in lean body mass. Blood pressure, blood glucose, total and LDL cholesterol and triglycerides decreased significantly, without changes in HOMA-IR. The frequency of metabolic syndrome decreased from 36% at baseline to 18% at the end of the intervention. A 43% reduction in caloric intake and an improvement in physical condition was also observed. Conclusions: The Bright Bodies Program produced significant and positive changes on anthropometric and metabolic parameters in this group of children.