Interdisciplinary Therapy Improves the Mediators of Inflammation and Cardiovascular Risk in Adolescents with Obesity.

Obesity is associated with inflammation and an increased risk of cardiovascular disease and premature mortality, as well as a range of other conditions. Obesity is a growing global problem, not only in adults, but also in children and adolescents. Therefore, the present study aimed to assess the effects of a one-year interdisciplinary intervention on the cardiometabolic and inflammatory profiles of adolescents with obesity. Twenty-two adolescents completed the intervention, which included clinical, nutritional, psychological and physical exercise counselling. Body composition, and metabolic, inflammatory, and cardiovascular risk biomarkers were analyzed before and after one year of intervention. Visceral and subcutaneous fat were determined ultrasonographically. The homeostasis model assessment of insulin resistance (HOMA-IR) and the quantitative insulin sensitivity check index (QUICKI) equation were used to estimate insulin resistance and insulin sensitivity, respectively. A reduction in body mass, adiposity, glucose, and insulin and an improved lipid profile were observed after the therapy. Hyperleptinemia was reduced from 77.3% to 36.4%. Plasminogen activator inhibitor-1 (PAI-1), intercellular adhesion molecule 1 (ICAM-1), leptin, the leptin/adiponectin ratio, and the adiponectin/leptin ratio were also significantly improved. Metabolic changes were associated with a reduction in visceral fat and waist circumference, and adiponectin and the leptin/adiponectin ratio were associated with HOMA-IR. The interdisciplinary therapy promoted improvements in hyperleptinemia and metabolic, inflammatory, and cardiovascular biomarkers.

Effect of transcranial direct current stimulation on homeostatic and hedonic appetite control and mood states in women presenting premenstrual syndrome across menstrual cycle phases.

PURPOSE: This study investigated the acute effect of anodal transcranial direct current stimulation (a-tDCS) over the left dorsolateral prefrontal cortex (DLPFC) on appetite, energy intake, food preferences, and mood states in the luteal and follicular phases of the menstrual cycle in women presenting premenstrual syndrome. METHODS: Sixteen women (26.5 ± 5.2 years; 1.63 ± 0.1 m; 64.2 ± 12.8 kg; body mass index 24.0 ± 5.0 kg/m2; body fat 27.6 ± 7.5%) with the eumenorrheic menstrual cycle were submitted to a-tDCS and sham-tDCS conditions over their follicular and luteal phases. At pre - and post-tDCS, hunger and desire to eat something tasty, (analogic visual scale), the profile of mood states (POMS), and the psychological components of food preferences (Leeds Food Preference Questionnaire-BR) were assessed. Participants recorded their food intake for the rest of the day using a diary log. RESULTS: There was a trend towards main effect of condition for decreased implicit wanting for low-fat savory food after a-tDCS but not sham-tDCS regardless of menstrual cycle phase (p = 0.062). There was no effect for self-reported hunger, desire to eat, energy and macronutrient intake, and on other components of food preferences (explicit liking and wanting for low- and high-fat savory and sweet foods, implicit wanting for low- and high-fat sweet and high-fat savory food); as well as for mood states. CONCLUSIONS: Although no significant effects of a-tDCS were found, the present investigation provides relevant perspectives for future studies.

Front-of-package nutrition labeling as a driver for healthier food choices: Lessons learned and future perspectives.

This work aims to provide a comprehensive overview of the use of front-of-package nutritional labeling (FOPL), identify and characterize the major existing FOPL systems, examine the impact of FOPL systems on consumer behavior, and discuss future perspectives. The searched databases were PubMed, Scopus, and Web of Science, and papers in English, Portuguese, Spanish, and French were considered. The integrative review method was used, comprising 68 papers. The FOPL system from more than 47 countries from North America, South America, Africa, Europe, Australia, and Asia was included in this study. The two main ways to characterize FOPL are the level of interpretation and the type of information provided. Interpretive schemes (such as warning labels, multiple traffic lights, and Nutri-Score) appear to lead to better consumer understanding and support healthier food purchases. However, due to the differences among the results and the specificity of the contexts in which they are used, it is impossible to define one FOPL interpretation scheme superior to the others. Some potential factors that influence the effectiveness of FOPL on consumer attitudes have been identified, such as food taste, as a major intrinsic factor. Extrinsic factors, such as price, food category, cultural diversity, politics, and economics, were also relevant. The lack of availability of similar alternatives, lack of understanding of the importance of FOPL, and lower levels of income and education were also some cognitive and social aspects impairing FOPL effectiveness. Prospects for the United States, Europe, Brazil, Colombia, and Argentina were discussed.

Exploring the pathways from the power of food to food cravings in a sample of Brazilian young adults.

The present study has three main objectives: a) to analyse, for the first time, the factor structure of the Control of Eating Questionnaire (CoEQ) in a Brazilian sample; b) to explore, through in-depth interviews, motivators and consequences of food cravings among participants with high scores on the CoEQ; and c) to analyse whether and how the power of food is related to food cravings. The study involved 335 young adults aged 18-30 years, balanced for sex. The CoEQ and the Power of Food Scale (PFS) were used in an online survey. The CoEQ and PFS were subjected to confirmatory factor analysis. Semi-structured interviews were also conducted with a subsample (n = 20) with high CoEQ scores. The Socratic questioning method was used for the interviews. The interviews were transcribed and analysed according to thematic content analysis. The PFS and the CoEQ showed adequate factor structure with reliable factors. The results of the qualitative analysis showed that both food availability and seeking relief from stressors serve as motives for food cravings. Concern for health and weight gain were cited as consequences of cravings, as was seeking distraction to cope with these cravings. It was found that the PFS aggregate factor was a significant influencing factor for craving control (ß = 0.604; p < 0.001), craving for savoury (ß = 0.382; p < 0.001), craving for sweet (ß = 0.414; p < 0.001) and positive mood (ß = -0.198; p < 0.001). The findings suggest that the relationship between food cravings and the power of food is significant in today's obesogenic environment.

The Psychological Impact of the Widespread Availability of Palatable Foods Predicts Uncontrolled and Emotional Eating in Adults.

This study aimed to investigate the role of the psychological impact of environments rich in palatable foods on three aspects of eating behavior: cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). The hypotheses were as follows: (a) The psychological impact (i.e., motivation to eat) of an environment rich in palatable foods will positively predict CR, UE, and EE; (b) dieting will predict CR, UE, and EE; and (c) CR, UE, and EE will positively predict body mass index (BMI). This study had a cross-sectional design in which data were collected online from 413 subjects. The psychological impact of food-rich environments (food available, food present, and food tasted) was assessed using the Power of Food Scale (PFS), and CR, UE, and EE were assessed using the Three-Factor Eating Questionnaire (TFEQ-R18). Both instruments were tested for confirmatory factor analysis. The relationship between constructs was measured using partial least-square structural equation modeling (PLS-SEM). "Food available" positively predicted all TFEQ-R18 factors (p < 0.01). "Food present" positively predicted UE (p < 0.001) and EE (p = 0.01). People currently on a diet showed higher levels of CR (p < 0.001) and EE (p = 0.02). UE and EE positively predicted BMI. Thus, CR, UE, and EE were positively predicted by the motivation to consume palatable foods in varying proximity, suggesting that the presence of food and, more importantly, its general availability may be important determinants of eating behavior, particularly UE and EE. Health strategies should consider the influence of the food environment to prevent and better manage impairments in eating behavior. Sex differences suggest that special attention should be paid to women. Furthermore, dieting was associated with higher levels of EE, which in turn was associated with higher BMI. Weight loss interventions should consider this vulnerability.

Motivation to consume palatable foods as a predictor of body image dissatisfaction: Using the Power of Food Scale in a Brazilian sample.

The Power of Food Scale (PFS) is a questionnaire for self-assessing the motivation to consume palatable foods, especially in environments where food is abundant and constantly available. This study aimed to a) assess the factorial structure of the PFS in a Brazilian sample and b) examine the relationship between the power of food and body image dissatisfaction and BMI. The PFS and Body Shape Questionnaire (BSQ) were applied to a sample of 300 adults. Data were analysed using confirmatory factor analysis. Composite reliability (CR) was used to verify factor reliability. A partial least squares structural equation model was used to verify the effect of the PFS score on body image dissatisfaction. The PFS had an adequate factorial structure in this Brazilian sample, showing three well-defined factors: food available (CR = 0.91), food tasted (CR = 0.84), and food present (CR = 0.87). The BSQ showed one reliable factor (CR = 0.97). The power of the food aggregate factor significantly predicted body mass index (ß = 0.16; p = .01) and body image dissatisfaction (ß = 0.46; p < .001). The effect size was small for body mass index (f2 = 0.02) and medium for body image dissatisfaction (f2 = 0.26). The food present factor also had a slightly higher average among the three PFS factors. Women had higher PFS scores than men. Understanding the role that this motivation plays in physical and psychological outcomes such as body dissatisfaction can contribute to developing treatment strategies and support health professionals' performance in clinical settings.

Are Dietitians With Obesity Perceived as Competent and Warm? Applying the Stereotype Content Model to Weight Stigma in Brazil.

The aim of this study was to understand how dietitians' body size influences perceived competence and warmth, based on the Stereotype Content Model (SCM). Online data were collected from 1,039 Brazilians, who were either laypeople, registered dietitians, or nutrition students. Participants rated the competence and warmth dimensions of three dietitians who differed in sex, body weight, and age. Participants also indicated how likelythey would consult or recommend each dietitian for nutritional advice, and indicated their attitudes toward people with obesity (PWO) [using The Antifat Attitudes Test (AFAT)]. Laypeople attributed less competence and warmth to all profiles compared to dietitians and students (p < 0.001). Three clusters occupied the SCM warmth-by-competence space. However, the clusters were different among groups (laypeople, dietitians, and students). For lay participants, the woman without overweight, the older woman, and the older man were located in the high competence/medium warmth cluster. Meanwhile, the woman with obesity was located in the medium competence/high warmth cluster. The dietitians and students map found the woman with obesity and the older woman in a high competence and warmth cluster. In general, the woman with obesity, the man without obesity, and the older man can be classified as ambivalent stereotypes, the woman being perceived as more warm than competent and the men more competent than warm. Participants with high AFAT scores were less likely to consult or recommend to a family member a dietitian with obesity. This study contributes to identifying ambivalent stereotypes for dietitians. Dietitians with obesity can be seen as warm but less competent. Also, although less intense than laypeople, dietitians, and students exhibited weight stigma. These findings can foster important discussions about weight stigma and emphasize the need to increase population awareness about the causes of obesity.

A dataset of food choice motives among adults consumers in Brazil: The use of Food Choice Questionnaire.

The Food Choice Questionnaire (FCQ) was applied to assess the motivations for daily food choices and associated factors in a Brazilian sample. Data were collected from January to July 2019 from 525 individuals over 18 years old recruited face-to-face in different places (e.g., university, public squares, health posts), using a convenient, intentional, and reasoned sampling. In addition to the FCQ, socioeconomic data were collected from printed questionnaires. Answers were given using a seven-point scale, ranging from (1) strongly disagree to (7) strongly agree. After Confirmatory factor analysis led to the rejection of the original FCQ structure, exploratory factor analysis was performed. Eight factors were extracted and named: nutritional composition, mood, health, sensory appeal, price, preparation convenience, familiarity, and purchase convenience. Other analyses were performed and led to a previously published discussion about food choice criteria hierarchy and associated factors. Researchers and practitioners can further use data from this survey in science and practice. These data can be useful for product development, nutritional counseling, and public health policies development. Furthermore, the FCQ is a widely used instrument, and comparisons between results obtained in different samples can bring meaningful contributions to the study of consumer behavior.

Do Registered Dietitians, Nutrition Students, and Laypeople Perceive Individuals with Obesity Differently?

(1) Background: Obesity is associated with significant social consequences, and individuals with obesity are regularly affected by weight-related stigmatization experiences. This study compares antifat attitudes among registered dietitians (RD), nutrition students, and laypeople and assesses which factors related to the perceived causes of obesity influence these attitudes. (2) Methods: An online survey was conducted in Brazil with RD (n = 336), nutrition students (n = 300), and laypeople (n = 403) with questionnaires assessing antifat attitudes and perceived causes of obesity. (3) Results: All groups presented low antifat attitudes. Minor differences in antifat attitudes were found among the three groups. Compared to RDs and nutrition students, laypeople presented higher Weight Control/Blame scores, but with a small effect size (η2 = 0.01). Weight bias was predicted by age, sex, and body mass index. External, social, and financial factors were not perceived to be very important in the development of obesity by RD and students. (4) Conclusions: Since slight differences were seen among RD and students compared to laypeople, and some perceptions of the causes of obesity indicate a stigmatized view. It is essential to place a greater focus on educating and updating these health professionals and students about weight stigma and its consequences for the mental and physical health of individuals.

Perceptions of risk and benefit of different foods consumed in Brazil and the optimism about chronic diseases.

This study aimed to assess consumers' perceptions about the impact of consumption of different foods on health and body weight, as well as to identify risk perceptions about food-related chronic diseases. Face-to-face questionnaires were conducted with 525 Brazilians. Individuals were asked about their perception of risks associated with the consumption of 50 food items on health and bodyweight. The unrealistic optimism was measured by asking participants about their risk and the risk of another person with similar body and health conditions of developing diabetes mellitus (DM), systemic arterial hypertension (SAH), and gaining 3 to 10 kg in the next 12 months. According to the principal component analysis, biased perception of food healthiness and weight gain was observed. Some UPF were perceived as healthy (e.g., gelatin, cereal bars, cream cracker), indicating a false healthy stereotype. Regarding the bodyweight effect, some typical Brazilian staple foods, such as rice, pasta, bread, and potatoes, were considered fattening foods. Optimistic bias was found for DM, SAH, and weight gain, and perceived control over health correlated negatively to risk perception of all hazards. Some motives for food choice and perceptions about foods affected the risk perception about chronic disease. Consumers with higher income, highly educated, and without children perceive higher health benefits in food than risks. These results indicate that health campaigns must be unbiased, clarifying the level of food processing and health effects, especially for the food stereotyped as healthy and fattening.

Factors Underlying Food Choice Motives in a Brazilian Sample: The Association with Socioeconomic Factors and Risk Perceptions about Chronic Diseases.

This study aimed to evaluate the food choice motives in a sample in Brazil and to identify how socioeconomic characteristics and risk perceptions about chronic diseases and weight gain affect these motives. The Food Choice Questionnaire (FCQ) is an instrument to analyze the motivations for food choice. The FCQ was completed by 525 adult individuals in Brazil. The participants were asked about their perceived risk of gaining weight, developing diabetes, and hypertension. Confirmatory factor analysis led to the rejection of the original FCQ structure, and, after exploratory factor analysis, 30 items of the FCQ were maintained in eight factors: Nutritional Composition, Preparation Convenience, Purchase Convenience, Mood, Sensory Appeal, Health, Price, and Familiarity. Sensory Appeal and Familiarity were, respectively, the most and the least important factors involved in food choices in this sample. A high education level, high income, age, and female sex positively affected FCQ factors (except for the Price factor). On the basis of FCQ scores, we defined five clusters: Health Driven, Practicality Concerned, Shape Concerned, Food Concerned, and Cooking Enthusiasts. In general, individuals were optimistic regarding the risk of developing diabetes, hypertension, and gaining weight, especially those from the Shape Concerned cluster. The differences in food choice motives presented here reinforce the existence of different niches of food consumption. Different types of products can attract specific target groups at the time of choice.

Adiposity and binge eating are related to liking and wanting for food in Brazil: A cultural adaptation of the Leeds food preference questionnaire.

The Leeds Food Preference Questionnaire (LFPQ) measures separable psychological components of food reward (Liking and Wanting). In this study a cultural adaptation of the LFPQ for a Brazilian population (LFPQ-BR) was examined by comparing liking and wanting scores in fasted and fed states and their association with adiposity and disturbed eating. A culturally adapted food picture database was validated by an online questionnaire completed by 162 individuals. Cluster analysis verified if the foods were accurately perceived in terms of sweetness, fat and calorie content. Subsequently, 48 male (N = 21) and female (N = 27) adults with mean Body Mass Index 26.6 (0.9) kg/m2, and mean age 32.8 (1.4) years, were evaluated by the LFPQ-BR before and after a fixed test meal. The Binge Eating Scale was used to measure binge eating symptoms. There was a decrease in explicit liking, implicit wanting, and explicit wanting scores for food in general in the fed condition. The implicit and explicit wanting and explicit liking scores for high-and-low fat savoury food decreased and for high-and-low fat sweet foods increased to a greater extent after the savoury test meal. Body Mass Index was found to predict implicit wanting for high fat relative to low fat foods. Binge eating symptoms predicted high fat sweet explicit liking and explicit wanting in the fed condition. Finally, high fat sweet preference was found to be sex-related as females had greater implicit wanting for high fat sweet foods in fasted and fed states. The results presented here indicate that the LFPQ-BR is a useful instrument for the evaluation of liking and wanting for food in Brazil.

Relationship between adiponectin and leptin on osteocalcin in obese adolescents during weight loss therapy.

OBJECTIVES: Obesity is a multifactorial disease characterized by the presence of the pro-inflammatory state associated with the development of many comorbidities, including bone turnover marker alterations. This study aimed to investigate the role of the inflammatory state on bone turnover markers in obese adolescents undergoing interdisciplinary weight loss treatment for one year. SUBJECTS AND METHODS: Thirty four post-pubescent obese adolescents with primary obesity, a body mass index (BMI) greater than > 95th percentile of the CDC reference growth charts, participated in the present investigation. Measurements of body composition, bone turnover markers, inflammatory biomarkers and visceral and subcutaneous fat were taken. Adolescents were submitted to one year of interdisciplinary treatment (clinical approach, physical exercise, physiotherapy intervention, nutritional and psychological counseling). RESULTS: Reduction in body mass, body fat mass, visceral and subcutaneous fat, as well as, an increase in the body lean mass and bone mineral content was observed. An improvement in inflammatory markers was seen with an increase in adiponectin, adiponectin/leptin ratio and inteleukin-15. Moreover, a positive correlation between the adiponectin/leptin ratio and osteocalcin was demonstrated. Further, both lean and body fat mass were predictors of osteocalcin. Negative associations between leptin with osteocalcin, adiponectin with Beta CTX-collagen, and visceral fat with adiponectin were observed. CONCLUSIONS: It is possible to conclude that the inflammatory state can negatively influence the bone turnover markers in obese adolescents. In addition, the interdisciplinary weight loss treatment improved the inflammatory state and body composition in obese adolescents. Therefore, the present findings should be considered in clinical practice.

Relationship between adiponectin and leptin on osteocalcin in obese adolescents during weight loss therapy

ABSTRACT Objectives: Obesity is a multifactorial disease characterized by the presence of the pro-inflammatory state associated with the development of many comorbidities, including bone turnover marker alterations. This study aimed to investigate the role of the inflammatory state on bone turnover markers in obese adolescents undergoing interdisciplinary weight loss treatment for one year. Subjects and methods: Thirty four post-pubescent obese adolescents with primary obesity, a body mass index (BMI) greater than > 95th percentile of the CDC reference growth charts, participated in the present investigation. Measurements of body composition, bone turnover markers, inflammatory biomarkers and visceral and subcutaneous fat were taken. Adolescents were submitted to one year of interdisciplinary treatment (clinical approach, physical exercise, physiotherapy intervention, nutritional and psychological counseling). Results: Reduction in body mass, body fat mass, visceral and subcutaneous fat, as well as, an increase in the body lean mass and bone mineral content was observed. An improvement in inflammatory markers was seen with an increase in adiponectin, adiponectin/leptin ratio and inteleukin-15. Moreover, a positive correlation between the adiponectin/leptin ratio and osteocalcin was demonstrated. Further, both lean and body fat mass were predictors of osteocalcin. Negative associations between leptin with osteocalcin, adiponectin with Beta CTX-collagen, and visceral fat with adiponectin were observed. Conclusions: It is possible to conclude that the inflammatory state can negatively influence the bone turnover markers in obese adolescents. In addition, the interdisciplinary weight loss treatment improved the inflammatory state and body composition in obese adolescents. Therefore, the present findings should be considered in clinical practice.

LEPR polymorphism may affect energy balance during weight loss among Brazilians obese adolescents.

OBJECTIVE: Leptin is an adipokine released mainly by adipose tissue, with many functions including regulation of energy balance. However, little is known about the effect of LEPR polymorphism on orexigenic and anorexigenic neuropeptides. Thus, the aim of the present study is to verify the influence of LEPR polymorphism (rs2767485) on serum orexigenic (NPY, MCH and AgRP) and anorexigenic (Leptin and α-MSH) neuropeptides levels among obese adolescents submitted to 1year of multicomponent weight loss therapy. METHODS: Seventy-six adolescents with obesity were enrolled in 1year of weight loss therapy including clinical, nutritional, psychological and exercise-related. Blood samples were collected to analyze neuropeptides (NPY, MCH, AgRP and leptin) and LEPR genotyping. Visceral fat was measured by ultrasound and body composition was measured by plethysmography. The parameters were measured at baseline and after one year. Adolescents were grouped according to genotype (TT or CT+CC group). Effect of the weight loss therapy was analyzed through ANOVA and Wilcox, according to normality. Statistic value was set at <0.05. RESULTS: C-allele carriers have the orexigenic neuropeptides (NPY, AgRP and MCH) levels statistically higher when compared with TT group, at baseline. Furthermore, TT group seems to respond better to the therapy by a greater delta on BMI. Indeed, the data suggest a concomitant increased of AgRP levels in CT+CC genotypes, after weight loss therapy. CONCLUSION: Both groups responded to the weight loss intervention, however wildtypes (TT) appear to respond to the intervention most optimally with C carries, where post intervention reduction in BMI was significantly greater in wildtypes. The leptin receptor polymorphism seems to affect neuroendocrine regulation of energy balance among adolescents with obesity.

Waist circumference as a marker for screening nonalcoholic fatty liver disease in obese adolescents / Circunferência da cintura como marcador para triagem de doença hepática gordurosa não alcoólica em adolescentes obesos

To assess the relationship between the degree of waist circumference (WC) and nonalcoholic fatty liver disease (NAFLD) in obese adolescents of both genders, analyzed according to quartiles of WC. Methods: Cross-sectional study that involved 247 obese adolescents aged 12–19 years. Mean values of the nutritional parameters and serum analyses were compared with the groups using the independent t-test. Pearson correlation coefficient was used to determine the relationship of the parameters studied. Chi-square test for trend was used to determine the relationship between the prevalence of the NAFLD and WC quartile by gender. Results: NAFLD were presented in 60% of the study participants. Obese adolescents in the 3rd and 4th quartiles of WC presented higher prevalence of NAFLD when compared with that in the 1st quartile in both genders. The NAFLD patients had significantly higher values for body weight, BMI (body mass index), BAZ-score (BMI-for-age z-scores), total fat (% and kg), WC, visceral fat, insulin, insulin resistance index (HOMA-IR), aspartate aminotransferase and alanine aminotransferase, when compared with non-NAFLD obese adolescents. Conclusions: In conclusion, the results presented here suggest that an increase in WC can reliably predict the risk of NAFLD in obese adolescents. This is a low cost and easy-to-use tool that can help in screening in adolescents.

Avaliar a associação entre o grau de circunferência da cintura (CC) e doença hepática gordurosa não alcoólica (DHGNA) em adolescentes obesos de ambos os sexos, avaliados de acordo com quartis de CC. Métodos: Estudo transversal que envolveu 247 adolescentes obesos entre 12 a 19 anos. Os valores médios dos parâmetros nutricionais e as analises séricas foram comparados com o teste t independente. O coeficiente de correlação de Pearson foi usado para determinar a relação entre os parâmetros estudados. O teste do qui-quadrado de tendência foi usado para determinar a relação entre a prevalência da DHGNA e quartil da CC por sexo. Resultados: DHGNA estava presente em 60% dos participantes do estudo. Adolescentes obesos nos quartis 3 e 4 de CC apresentaram maior prevalência de DHGNA quando comparados com aqueles no primeiro quartil em ambos os sexos. Os pacientes com DHGNA tinham valores significativamente mais elevados de peso corporal, IMC (índice de massa corporal), IMC/I (IMC para idade) z-escore, gordura total (% e kg), CC, gordura visceral, insulina, índice de resistência à insulina (HOMA-IR), aspartato aminotransferase e alanina aminotransferase quando comparados com adolescentes obesos sem DHGNA. Conclusões: Os resultados aqui apresentados sugerem que um aumento da CC pode predizer com segurança o risco de DHGNA em adolescentes obesos. Essa é uma ferramenta de baixo custo e fácil de usar que pode ajudar na triagem de adolescentes.

[Waist circumference as a marker for screening nonalcoholic fatty liver disease in obese adolescents]. / Circunferência da cintura como marcador para triagem de doença hepática gordurosa não alcoólica em adolescentes obesos.

OBJECTIVE: To assess the relationship between the degree of waist circumference (WC) and nonalcoholic fatty liver disease (NAFLD) in obese adolescents of both genders, analyzed according to quartiles of WC. METHODS: Cross-sectional study that involved 247 obese adolescents aged 12-19 years. Mean values of the nutritional parameters and serum analyses were compared with the groups using the independent t-test. Pearson correlation coefficient was used to determine the relationship of the parameters studied. Chi-square test for trend was used to determine the relationship between the prevalence of the NAFLD and WC quartile by gender. RESULTS: NAFLD were presented in 60% of the study participants. Obese adolescents in the 3rd and 4th quartiles of WC presented higher prevalence of NAFLD when compared with that in the 1st quartile in both genders. The NAFLD patients had significantly higher values for body weight, BMI (body mass index), BAZ-score (BMI-for-age z-scores), total fat (% and kg), WC, visceral fat, insulin, insulin resistance index (HOMA-IR), aspartate aminotransferase and alanine aminotransferase, when compared with non-NAFLD obese adolescents. CONCLUSIONS: The results presented here suggest that an increase in WC can reliably predict the risk of NAFLD in obese adolescents. This is a low cost and easy-to-use tool that can help in screening in adolescents.

Is there a role for leptin in the reduction of depression symptoms during weight loss therapy in obese adolescent girls and boys?

Several studies have sought to clarify the association between adolescent obesity and psychological distress. Recently, a biological link between leptin resistance and depression has been proposed. The aim of the present study was to examine changes in leptin concentrations as a potential predictor of reduced depression symptoms in obese adolescents during long-term interdisciplinary weight loss therapy. Seventy-five obese adolescents (age: 16.28±2.37 years; BMI: 35.65±4.64 kg/m2) engaged in a long-term interdisciplinary therapy for weight loss. They were evaluated at baseline and after 1 year of treatment for body composition, serum analyses and depression symptomatology. After therapy, body mass BMI, fat mass (% and kg), waist circumference, visceral, subcutaneous and visceral/subcutaneous fat and depression symptoms decreased and lean mass (%) increased significantly. There was an improvement in inflammatory profiles with a significant reduction in leptin and increase in adiponectin. Regression analyses showed that decreased leptin predicted amelioration in depression symptoms independent of age, gender and changes in visceral fat, body mass, fat mass (%) and leptin/adiponectin ratio. These associations appear stronger in girls than boys. The attenuation of hyperleptinemia appears to play an important role in the association between weight loss and depression, particularly in obese girls.

Interdisciplinary lifestyle therapy improves binge eating symptoms and body image dissatisfaction in Brazilian obese adults.

INTRODUCTION: Obesity is related to numerous negative consequences for physical and mental health. It is often associated with the presence of binge eating disorder, body image dissatisfaction, and general psychopathology. OBJECTIVE: To assess the effects of an interdisciplinary lifestyle therapy on binge eating symptoms, depression, anxiety, body dissatisfaction, and quality of life in obese adults. METHODS: A total of 49 obese adults (body mass index = 37.35±5.82 kg/m²; age = 44.14±10.00 years) participated in a weight-loss program for 6 months. Symptoms suggestive of binge eating, body dissatisfaction, depression, anxiety, and quality of life were measured using self-reported questionnaires. Food intake was assessed using a 3-day dietary record. Data were analyzed using analysis of variance (ANOVA). RESULTS: ANOVA results showed a reduction in binge eating symptoms and in body dissatisfaction results. Depression and anxiety symptoms also decreased, and an increase was observed in quality of life scores. After therapy, a significant improvement was observed in dietary patterns, as well as significant weight loss. A positive correlation was found between variation of anxiety symptoms and lipid intake. Binge eating symptoms were associated with anxiety symptoms and body image dissatisfaction, and body image dissatisfaction correlated positively with anxiety symptoms in males only. In females, a positive correlation was observed between depression and binge eating symptoms. CONCLUSION: The interdisciplinary therapy was effective in promoting positive physical and psychological changes and in improving the quality of life of obese adults.

Interdisciplinary lifestyle therapy improves binge eating symptoms and body image dissatisfaction in Brazilian obese adults / Terapia interdisciplinar de mudança do estilo de vida melhora sintomas de compulsão alimentar e insatisfação com a imagem corporal em adultos obesos brasileiros

INTRODUCTION: Obesity is related to numerous negative consequences for physical and mental health. It is often associated with the presence of binge eating disorder, body image dissatisfaction, and general psychopathology. OBJECTIVE: To assess the effects of an interdisciplinary lifestyle therapy on binge eating symptoms, depression, anxiety, body dissatisfaction, and quality of life in obese adults. METHODS: A total of 49 obese adults (body mass index = 37.35±5.82 kg/m²; age = 44.14±10.00 years) participated in a weight-loss program for 6 months. Symptoms suggestive of binge eating, body dissatisfaction, depression, anxiety, and quality of life were measured using self-reported questionnaires. Food intake was assessed using a 3-day dietary record. Data were analyzed using analysis of variance (ANOVA). RESULTS: ANOVA results showed a reduction in binge eating symptoms and in body dissatisfaction results. Depression and anxiety symptoms also decreased, and an increase was observed in quality of life scores. After therapy, a significant improvement was observed in dietary patterns, as well as significant weight loss. A positive correlation was found between variation of anxiety symptoms and lipid intake. Binge eating symptoms were associated with anxiety symptoms and body image dissatisfaction, and body image dissatisfaction correlated positively with anxiety symptoms in males only. In females, a positive correlation was observed between depression and binge eating symptoms. CONCLUSION: The interdisciplinary therapy was effective in promoting positive physical and psychological changes and in improving the quality of life of obese adults (AU)

INTRODUÇÃO: A obesidade se relaciona com inúmeras consequências negativas para a saúde física e mental. Está frequentemente associada com transtorno da compulsão alimentar periódica, insatisfação com a imagem corporal e psicopatologia geral. OBJETIVO: Avaliar os efeitos de uma terapia interdisciplinar de mudança do estilo de vida sobre sintomas de compulsão alimentar, depressão, ansiedade, insatisfação com a imagem corporal e qualidade de vida em adultos obesos. MÉTODOS: Um total de 49 adultos obesos (índice de massa corporal = 37.35±5.82 kg/m²; idade = 44.14±10.00 anos) participaram de um programa de redução de peso por 6 meses. Sintomas de compulsão alimentar, insatisfação com a imagem corporal, depressão, ansiedade e qualidade de vida foram avaliados por meio de questionários autoaplicáveis. O consumo alimentar foi avaliado utilizando-se um registro alimentar de 3 dias. Os dados foram analisados utilizando análise de variância (ANOVA). RESULTADOS: Os resultados da ANOVA mostraram uma redução nos sintomas de compulsão alimentar e na insatisfação com a imagem corporal. Os sintomas de depressão e ansiedade também diminuíram, e foi observado um aumento nos escores de qualidade de vida. Após a terapia, foi verificada melhora significativa no perfil nutricional, assim como significativa redução de peso. Foi observada uma correlação positiva entre a variação dos sintomas de ansiedade e o consumo de lipídios. Sintomas de compulsão alimentar apresentaram associação com sintomas de ansiedade e insatisfação com a imagem corporal, e a insatisfação com a imagem corporal se correlacionou positivamente com os sintomas de ansiedade nos homens. Nas mulheres, foi observada uma correlação positiva entre sintomas de depressão e de compulsão alimentar. CONCLUSÃO: A terapia interdisciplinar foi eficaz na promoção de mudanças físicas e psicológicas e proporcionou uma melhor qualidade de vida em adultos obesos (AU)