La falacia de los niños gordos anémicos / The fallacy of the fat anemic child

Fundamento: los estudios sugieren la presencia de deficiencia de hierro en niños obesos, lo que conduciría a una mayor incidencia de anemia en este grupo. Objetivo: evaluar la prevalencia de anemia entre niños con sobrepeso y obesidad de dos niveles socioeconómicos y dos regiones diferentes en Brasil. Métodos: se obtuvieron datos de hemoglobina y antropometría de 598 niños y adolescentes con sobrepeso y obesidad de dos servicios especializados en la atención de estos niños. Resultados: la prevalencia global de anemia fue del 5,8% y el nivel medio de hemoglobina fue de 13,2 mg / dL, sin diferencia estadística para los dos indicadores según sobrepeso u obesidad y grupo de edad. Sin embargo, la hemoglobina media fue mayor entre los varones y, en el servicio con atención prestada a una población de menor nivel socioeconómico, la prevalencia de anemia fue mayor. Conclusión: la prevalencia de anemia encontrada en niños y adolescentes con sobrepeso y obesidad fue bastante baja, siendo mayor en la población más pobre. Para los niños y adolescentes con sobrepeso, la anemia parece estar más relacionada con el nivel socioeconómico que con la presencia de exceso de peso.

Background: studies suggest the presence of iron deficiency among obese children, which would lead to a higher incidence of anemia in this group. Aim: to assess the prevalence of anemia among overweight and obese children from two socioeconomic levels and two different regions in Brazil. Methods: hemoglobin and anthropometric data on 598 overweight and obese children and adolescents were obtained from two services specialized in the care of these children. Results: the overall prevalence of anemia was 5.8% and mean hemoglobin level was 13.2 mg/dL, with no statistical difference for the two indicators according to overweight or obesity and age group. However, the mean hemoglobin was higher among boys and, in the service with care provided to a population of lower socioeconomic status, the prevalence of anemia was higher. Conclusion: the prevalence of anemia found among overweight and obese children and adolescents was quite low, being higher in the poorest population. For overweight children and adolescents, anemia seems to be more related to socioeconomic status than to the presence of excess weight.

[Values of Body Mass Index and Chest CT Features in the Assessment of Chronic Obstructive Pulmonary Disease].

Objective To investigate the clinical values of nutritional status and chest CT phenotypes in the assessment of chronic obstructive pulmonary disease(COPD). Methods A total of 256 patients with stable COPD were enrolled from Peking Union Medical College Hospital and Civil Aviation General Hospital from June 2017 to June 2018.Demographic data,height,weight,smoking history,and number of exacerbations were collected.Pulmonary function tests and COPD assessment test(CAT)questionnaire-based survey were performed.The correlations of Goddard score with pulmonary function,CAT score,and number of exacerbations were analyzed.The clinical features of COPD patients with different body mass index(BMI)grades and CT phenotype were analyzed. Results The forced expiratory volume in one second as percentage of predicted value(FEV1%pred)was significantly higher in normal body mass group(t=-2.701,P=0.0080),overweight group(t=-3.506,P=0.001),and obese group(t=-4.323,P=0.000)than in low body mass group and was significantly higher in obese group than in normal body mass group(t=-3.096,P=0.002).The forced vital capacity as percentage of predicted value(FVC%pred)of normal body mass group(t=-3.081,P=0.002)and overweight group(t=-2.766,P=0.006)were significantly higher than that of low body mass group.The forced expiratory volume in one second(FEV1)/forced vital capacity(FVC)was significantly higher in overweight group than in normal body mass group(t=-3.702,P=0.001)and significantly higher in obese group than in low body mass group(t=-4.742,P=0.000),normal body mass group(t=-5.785,P=0.000),and overweight group(t=-2.984,P=0.003).In addition,the carbon monoxide diffusing capacity as percentage of predicted value(DLco%pred)was significantly higher in overweight group than in underweight(t=-3.042,P=0.003)and normal body mass groups(t=-3.128,P=0.002)and significantly higher in obese group than in underweight group(t=-4.742,P=0.000)and normal body mass group(t=-5.785,P=0.000).The Goddard scores of overweight(Z=4.535,P=0.000)and obese groups(Z=5.422,P=0.000)were significantly lower than that of normal body mass group.Partial correlation analysis showed that Goddard score was negatively correlated with FEV1/FVC(r =-0.230,P = 0.022)and DLco%pred(r =-0.531,P = 0.000)and positively correlated with CAT score(r = 0.244,P = 0.021).BMI of phenotype E(t=3.467,P=0.001)and M(t=3.031,P=0.003),FEV1/FVC of phenotype E(t=2.484,P=0.015)and M(t=2.969,P=0.004)as well as DLco%pred of phenotype E(t=4.928,P=0.000)and M(t=2.489,P=0.0163)were significantly lower than those of phenotype A.Patients with phenotype M had worse FEV1%pred,FVC%pred,residual volume/total lung capacity and number of acute exacerbations than patients with phenotypes A and E,but the differences were not statistically significant(all P >0.05). Conclusions The nutritional status is closely related to lung function,severity of emphysema,and number of exacerbations in COPD patients.Chest CT phenotype is clinically valuable in the assessment of COPD.

Hypothalamic Networks in Adolescents With Excess Weight: Stress-Related Connectivity and Associations With Emotional Eating.

OBJECTIVE: Adolescents with excess weight are particularly sensitive to stress, which may contribute to the presence of emotional eating behaviors. It is proposed that this may be due to alterations in the connectivity between hypothalamic networks and regions of the "emotional nervous system," involved in the regulation of energy balance and stress processing. However, this remains to be clarified in adolescents with excess weight. METHOD: We investigated whole-brain differences in the functional connectivity of the medial and lateral hypothalamus (MH and LH) between adolescents with excess weight (EW, n = 53; mean age = 14.64 years, SD = 1.78) and normal weight (NW, n = 51; mean age = 15.29 years, SD = 1.75) using seed-based resting-state analyses. Then, in a subset of 22 adolescents with EW (mean age = 15.75 years, SD = 1.70) and 32 with NW (mean age = 15.27, SD = 2.03), we explored for group interactions between the MH/LH networks and stress response in the Trier Social Stress Task (TSST) and emotional eating, assessed with the Dutch Eating Behavior Questionnaire (DEB-Q). RESULTS: Compared to NW, EW showed higher functional connectivity in the LH-orbitofrontal cortex, ventral striatum, anterior insula, and in the MH-middle temporal cortex networks. EW also showed lower connectivity in the LH-cerebellum, and in the MH-middle prefrontal, pre-, and postcentral gyri networks. In EW, higher connectivity of the LH-nucleus accumbens and LH-midbrain networks were associated with stress response. Higher connectivity in the LH-midbrain was also associated with a greater presence of emotional eating behaviors in EW. CONCLUSION: Adolescents with EW showed functional connectivity alterations within both MH/LH networks. Alterations in the LH network were linked with higher levels of stress response and emotional-driven eating patterns.

Improved assessment of arterial stiffness using corrected cardio-ankle vascular index (CAVI0) in overweight adolescents with white-coat and essential hypertension.

Arterial stiffness is a marker of vascular damage. Although adiposity increases cardiovascular risk, the relationship between paediatric overweight and arterial stiffness is unclear. The study aimed to evaluate the simultaneous effect of hypertension and overweight on arterial stiffness using cardio-ankle vascular index (CAVI) and related novel, theoretically blood pressure (BP)-independent, index CAVI0. CAVI and CAVI0 were measured in 140 adolescent boys (16.0 ± 1.9 years) divided into age-matched groups: normal-weight normotensives, overweight normotensives, overweight white-coat hypertensives, and overweight essential hypertensives. Overweight normotensives had significantly lower CAVI and CAVI0 compared to normal-weight normotensives (4.81 ± 0.64 vs. 5.33 ± 0.66, p < .01; 7.10 ± 0.99 vs. 7.81 ± 1.00, p < .01, respectively). CAVI and CAVI0 in overweight essential hypertensives showed no significant difference compared to normal-weight normotensives and were significantly higher compared to overweight normotensives (5.32 ± 0.77 vs. 4.81 ± 0.64, p < .01; 7.77 ± 1.19 vs. 7.10 ± 0.99, p < .01, respectively). CAVI, but not CAVI0, was associated positively with diastolic pressure (0.022 mmHg-1, p = .002) and negatively with pulse pressure (-0.022 mmHg-1, p = .001), and it was significantly higher in overweight white-coat hypertensives compared to overweight normotensives (5.20 ± 0.63 vs. 4.81 ± 0.64, p < .05). The lowering effect of overweight on arterial stiffness indexed by CAVI and CAVI0 in hypertensive adolescents seems to counterbalance the early arteriosclerotic effect of essential hypertension. The increase in CAVI, but not CAVI0, in overweight white-coat hypertensives could be attributable to residual BP dependence of CAVI, which is not present in CAVI0. Under certain conditions, CAVI0 may offer a clinically relevant improved assessment of arterial stiffness superior to CAVI.

Assessing resting energy expenditure in overweight and obese adolescents in a clinical setting: validity of a handheld indirect calorimeter.

BACKGROUND: Accurately determining energy requirements is key for nutritional management of pediatric obesity. Recently, a portable handheld indirect calorimeter, MedGem (MG) has become available to measure resting energy expenditure (REE). Our work aims to determine the clinical validity and usefulness of MG to measure REE in overweight and obese adolescents. METHODS: Thirty-nine overweight and obese adolescents (16 male (M): 23 female (F), 15.2 ± 1.9 y, BMI percentile: 98.6 ± 2.2%) and 15 normal weight adolescents (7M: 8F, age 15.2 ± 2.0 y, BMI percentile: 39.2 ± 20.9%) participated. REE was measured with both MG and standard indirect calorimeter (VMax) in random order. RESULTS: MG REE (1,600 ± 372 kcal/d) was lower than VMax REE (1,727 ± 327 kcal/) in the overweight and obese adolescents. Bland Altman analysis (MG -VMax) showed a mean bias of -127 kcal/d (95% CI = -72 to -182 kcal/d, P < 0.001), and a proportional bias existed such that lower measured REE by VMax was underestimated by MG, and higher measured REE by VMax were overestimated by MG. CONCLUSION: MG systematically underestimates REE in the overweight and adolescent population, thus the MG portable indirect calorimeter is not recommended for routine use. Considering that it is a systematic underestimation of REE, MG may be clinically acceptable, only if used with caution.

Socio-economic position as an intervention against overweight and obesity in children: a systematic review and meta-analysis.

Studies that investigated the association between socio-economic position (SEP) and obesity in children suggest inconsistent results. The aim of this study is to summarize and quantify the current evidence on SEP and risks of overweight and obesity in children aged 0-15 years. Relevant studies published between 1990 to Sep 4, 2014 were searched in Medline, Web of Science, Embase, and the Cochrane Database of Systematic Reviews. Risk estimates from individual studies were pooled using random-effects models, according to lowest vs the highest SEP category. A total of 62 articles were included in the meta-analysis. The odds of both overweight risk and obesity risk were higher in the children with lowest SEP than in those with highest SEP (OR, 1.10, 95% CI: 1.03-1.17, and OR, 1.41, 95% CI: 1.29-1.55, respectively). Sub-group analyses showed that the inverse relationships between SEP and childhood overweight and obesity were only found in high-income countries and in more economic developed areas. In conclusion, our study suggests that children with lower SEP had higher risks of overweight and obesity, and the increased risks were independent of the income levels of countries.

Whey protein isolate decreases murine stomach weight and intestinal length and alters the expression of Wnt signalling-associated genes.

The present study examined the underlying mechanisms by which whey protein isolate (WPI) affects energy balance. C57BL/6J mice were fed a diet containing 10% energy from fat, 70% energy from carbohydrate (35% energy from sucrose) and 20% energy from casein or WPI for 15 weeks. Mice fed with WPI had reduced weight gain, cumulative energy intake and dark-phase VO2 compared with casein-fed mice (P< 0.05); however, WPI intake had no significant effects on body composition, meal size/number, water intake or RER. Plasma levels of insulin, TAG, leptin, glucose and glucagon-like peptide 1 remained unchanged. Notably, the intake of WPI reduced stomach weight and both length and weight of the small intestine (P< 0.05). WPI intake reduced the gastric expression of Wingless/int-1 5a (Wnt5a) (P< 0.01) and frizzled 4 (Fzd4) (P< 0.01), with no change in the expression of receptor tyrosine kinase-like orphan receptor 2 (Ror2) and LDL receptor-related protein 5 (Lrp5). In the ileum, WPI increased the mRNA expression of Wnt5a (P< 0.01) and caused a trend towards an increase in the expression of Fzd4 (P= 0.094), with no change in the expression of Ror2 and Lrp5. These genes were unresponsive in the duodenum. Among the nutrient-responsive genes, WPI specifically reduced ileal mRNA expression of peptide YY (P< 0.01) and fatty acid transporter protein 4 (P< 0.05), and decreased duodenal mRNA expression of the insulin receptor (P= 0.05), with a trend towards a decreased expression of Na-glucose co-transporter 1 (P= 0.07). The effects of WPI on gastrointestinal Wnt signalling may explain how this protein affects gastrointestinal structure and function and, in turn, energy intake and balance.

Effect of rye bread enriched with tomato pomace on fat absorption and lipid metabolism in rats fed a high-fat diet.

BACKGROUND: Tomato pomace (TP), obtained as a residue of tomato processing, was used to enrich rye bread (RB). The sensory profile of this functional bread (RB+TP) was characterised, and its fat absorption and lipid metabolism properties in high-fat-fed rats were studied. RESULTS: Intake of the HF diet containing RB, RB+TP, or TP alone increased faecal energy and fat excretion, but did not affect animal growth or visceral fat weight. Both RB and RB+TP diminished the negative impact of the HF diet, lowering the atherogenic index of plasma (AIP) and the total liver lipid contents by 31.6% and 24%, respectively. The experimental diets had no effect on liver S-adenosylhomocysteine (SAH) concentrations or on the S-adenosylmethionine (SAM) to SAH ratio, though the lowest SAM levels were observed in the HF+TP group. No significant differences were detected in blood homocysteine, triglycerides, glucose or insulin levels. CONCLUSIONS: Although RB+TP incorporated into a HF diet may lead to a decrease in AIP and total liver lipid content, this effect does not depend on the components of TP, but rather on the RB ingredients. However, pure TP, in the doses used in this study, may potentially play a role in the energy balance via faecal loss of lipids.

Assessment of DNA damage using comet assay in middle-aged overweight/obese subjects after following a hypocaloric diet supplemented with cocoa extract.

UNLABELLED: Nutrient excess and unbalanced diets can result in overproduction of reactive oxygen species (ROS), which are associated with oxidative stress. Cocoa extract contains antioxidants that inhibit the harmful effects of ROS. This trial analysed the effect of cocoa extract consumption integrated as a bioactive compound into ready-to-eat meals, on oxidative stress at the level of DNA in overweight/obese subjects. Fifty volunteers [57.26(5.24) years, 30.59(2.33)kg/m(2)] participated in a 4-week double-blind, randomised, placebo-controlled parallel nutritional intervention. Half of the volunteers received meals supplemented with 1.4 g/day cocoa extract, while the other half received control meals, both within a 15% energy restriction diet. Lymphocytes were isolated and endogenous strand breaks, oxidised bases and resistance to H2O2-induced damage were measured by the comet assay. The intake of ready-to-eat meals supplemented with cocoa extract did not show relevant changes in the oxidative status of DNA. However, in the cocoa group, oxidised bases negatively correlated with methyl epicatechin-O-sulphate (r = -0.76; P = -0.007) and epicatechin sulphate (r = -0.61; P = -0.046). When volunteers of both groups were analysed together, a marginal decrease (P = 0.072) in oxidised bases was observed, which attributed to weight loss. Subjects who started the intervention with higher levels of damage showed a greater reduction in oxidised bases after 4 weeks (P = 0.040) compared to those who had lower baseline levels. In conclusion, even if 1.4 g of cocoa supplementation for 4 weeks did not show notable changes in terms of antioxidant status of DNA, the energy restriction showed a slightly decrease in oxidised bases and this was seen to a greater extent in subjects who started the intervention with higher levels of damage. On the other hand, the inverse associations found between oxidised bases and some cocoa-derived metabolites suggest that a protective effect might be seen in a longer period of time or in subjects with higher baseline DNA damage. TRIAL REGISTRATION: www.clinicaltrials.gov (NCT01596309).

Impact of body composition during weight change on resting energy expenditure and homeostasis model assessment index in overweight nonsmoking adults.

BACKGROUND: Weight change affects resting energy expenditure (REE) and metabolic risk factors. The impact of changes in individual body components on metabolism is unclear. OBJECTIVE: We investigated changes in detailed body composition to assess their impacts on REE and insulin resistance. DESIGN: Eighty-three healthy subjects [body mass index (BMI; in kg/m²) range: 20.2-46.8; 50% obese] were investigated at 2 occasions with weight changes between -11.2 and +6.5 kg (follow-up periods between 23.5 and 43.5 mo). Detailed body composition was measured by using the 4-component model and whole-body magnetic resonance imaging. REE, plasma thyroid hormone concentrations, and insulin resistance were measured by using standard methods. RESULTS: Weight loss was associated with decreases in fat mass (FM) and fat-free mass (FFM) by 72.0% and 28.0%, respectively. A total of 87.9% of weight gain was attributed to FM. With weight loss, sizes of skeletal muscle, kidneys, heart, and all fat depots decreased. With weight gain, skeletal muscle, liver, kidney masses, and several adipose tissue depots increased except for visceral adipose tissue (VAT). After adjustments for FM and FFM, REE decreased with weight loss (by 0.22 MJ/d) and increased with weight gain (by 0.11 MJ/d). In a multiple stepwise regression analysis, changes in skeletal muscle, plasma triiodothyronine, and kidney masses explained 34.9%, 5.3%, and 4.5%, respectively, of the variance in changes in REE. A reduction in subcutaneous adipose tissue rather than VAT was associated with the improvement of insulin sensitivity with weight loss. Weight gain had no effect on insulin resistance. CONCLUSION: Beyond a 2-compartment model, detailed changes in organ and tissue masses further add to explain changes in REE and insulin resistance.

Lower energy expenditure predicts long-term increases in weight and fat mass.

CONTEXT: The relevance of the contribution of energy expenditure (EE) and substrate oxidation to weight change has not been fully confirmed. OBJECTIVE: The objective of the study was to determine whether metabolic parameters measured in a whole room indirect calorimeter are predictive of long-term body weight change. SETTING: The study was conducted at a clinical research unit in Phoenix, Arizona, from 1985 to 2005. PARTICIPANTS: A total of 612 healthy subjects (384 males and 228 females; aged 29.5 ± 8.1 years; body mass index 33.0 ± 8.7 kg/m(2); percent body fat 30.9 ± 9.6%), including 422 Native Americans and 190 whites. Follow-up data were available for 292 Native Americans with a median follow-up time of 6.7 years (interquartile range 3.9-10.5). MAIN OUTCOME MEASURES: Twenty-four-hour EE, sleeping metabolic rate, daily (fed) and sleeping (fasting) respiratory quotient, and carbohydrate and fat oxidation rates were measured during a 24-hour respiratory chamber. Body composition was assessed by underwater weighing or dual-energy x-ray absorptiometry. RESULTS: After accounting for demographic and body composition measures, the remaining variance of 24-hour EE was inversely related to the rate of weight change (ρ = -0.158, P = .007) and fat mass change (ρ = -0.179, P = .012), such that 100 kcal below the expected 24-hour EE corresponded to 0.2 kg/y weight gain, of which 0.1 kg/y was fat mass. Deviations from the predicted values of the sleeping metabolic rate (ρ = -0.121, P = .039) and fed respiratory quotient (ρ = 0.119, P = .042) were also associated with future weight change, whereas the fat oxidation rate was inversely associated with weight change in men (ρ = -0.174, P = .024) but not in women (ρ = 0.018, P = .853). CONCLUSIONS: Measures of energy expenditure and substrate oxidation are predictors of long-term weight change, indicating a small but significant role for reduced metabolic rate in weight gain.

Assessment and prediction of thoracic gas volume in pregnant women: an evaluation in relation to body composition assessment using air displacement plethysmography.

Assessment of body fat (BF) in pregnant women is important when investigating the relationship between maternal nutrition and offspring health. Convenient and accurate body composition methods applicable during pregnancy are therefore needed. Air displacement plethysmography, as applied in Bod Pod, represents such a method since it can assess body volume (BV) which, in combination with body weight, can be used to calculate body density and body composition. However, BV must be corrected for the thoracic gas volume (TGV) of the subject. In non-pregnant women, TGV may be predicted using equations, based on height and age. It is unknown, however, whether these equations are valid during pregnancy. Thus, we measured the TGV of women in gestational week 32 (n 27) by means of plethysmography and predicted their TGV using equations established for non-pregnant women. Body weight and BV of the women was measured using Bod Pod. Predicted TGV was significantly (P = 0·033) higher than measured TGV by 6 % on average. Calculations in hypothetical women showed that this overestimation tended to be more pronounced in women with small TGV than in women with large TGV. The overestimation of TGV resulted in a small but significant (P = 0·043) overestimation of BF, equivalent to only 0·5 % BF, on average. A Bland-Altman analysis showed that the limits of agreement were narrow (from -1·9 to 2·9 % BF). Thus, although predicted TGV was biased and too high, the effect on BF was marginal and probably unimportant in many situations.

Weight change in a commercial web-based weight loss program and its association with website use: cohort study.

BACKGROUND: There is a paucity of information in the scientific literature on the effectiveness of commercial weight loss programs, including Web-based programs. The potential of Web-based weight loss programs has been acknowledged, but their ability to achieve significant weight loss has not been proven. OBJECTIVE: The objectives were to evaluate the weight change achieved within a large cohort of individuals enrolled in a commercial Web-based weight loss program for 12 or 52 weeks and to describe participants' program use in relation to weight change. METHOD: Participants enrolled in an Australian commercial Web-based weight loss program from August 15, 2007, through May 31, 2008. Self-reported weekly weight records were used to determine weight change after 12- and 52-week subscriptions. The primary analysis estimated weight change using generalized linear mixed models (GLMMs) for all participants who subscribed for 12 weeks and also for those who subscribed for 52 weeks. A sensitivity analysis was conducted using the last observation carried forward (LOCF) method. Website use (ie, the number of days participants logged on, made food or exercise entries to the Web-based diary, or posted to the discussion forum) was described from program enrollment to 12 and 52 weeks, and differences in website use by percentage weight change category were tested using Kruskal-Wallis test for equality of populations. RESULTS: Participants (n = 9599) had a mean (standard deviation [SD]) age of 35.7 (9.5) years and were predominantly female (86% or 8279/9599) and obese (61% or 5866/9599). Results from the primary GLMM analysis including all enrollees found the mean percentage weight change was -6.2% among 12-week subscribers (n = 6943) and -6.9% among 52-week subscribers (n = 2656). Sensitivity analysis using LOCF revealed an average weight change of -3.0% and -3.5% after 12 and 52 weeks respectively. The use of all website features increased significantly (P < .01) as percentage weight change improved. CONCLUSIONS: The weight loss achieved by 12- and 52-week subscribers of a commercial Web-based weight loss program is likely to be in the range of the primary and sensitivity analysis results. While this suggests that, on average, clinically important weight loss may be achieved, further research is required to evaluate the efficacy of this commercial Web-based weight loss program prospectively using objective measures. The potential association between greater website use and increased weight loss also requires further evaluation, as strategies to improve participants' use of Web-based program features may be required.

Accuracy of direct segmental multi-frequency bioimpedance analysis in the assessment of total body and segmental body composition in middle-aged adult population.

BACKGROUND & AIMS: Body composition measurement is a valuable tool for assessing nutritional status and physical fitness in a variety of clinical settings. Although bioimpedance analysis (BIA) can easily assess body composition, its accuracy remains unclear. We examined the accuracy of direct segmental multi-frequency BIA technique (DSM-BIA) in assessing different body composition parameters, using dual energy X-ray absorptiometry (DEXA) as a reference standard. METHODS: A total of 484 middle-aged participants from the Leiden Longevity Study were recruited. Agreements between DSM-BIA and DEXA for total and segmental body composition quantification were assessed using intraclass correlation coefficients and Bland-Altman plots. RESULTS: Excellent agreements were observed between both techniques in whole body lean mass (ICC female = 0.95, ICC men = 0.96), fat mass (ICC female = 0.97, ICC male = 0.93) and percentage body fat (ICC female = 0.93, ICC male = 0.88) measurements. Similarly, Bland-Altman plots revealed narrow limits of agreements with small biases noted for the whole body lean mass quantification but relatively wider limits for fat mass and percentage body fat quantifications. In segmental lean muscle mass quantification, excellent agreements between methods were demonstrated for the upper limbs (ICC female≥0.91, ICC men≥0.87) and lower limbs (ICC female≥0.83, ICC male≥0.85), with good agreements shown for the trunk measurements (ICC female = 0.73, ICC male = 0.70). CONCLUSIONS: DSM-BIA is a valid tool for the assessments of total body and segmental body composition in the general middle-aged population, particularly for the quantification of body lean mass.

Obesidad en Argentina: epidemiología, morbimortalidad e impacto económico / Obesity in Argentina: epidemiology, morbimortality and economic impact

OBJETIVO: obtener conocimientos aplicables al diseño de estrategias de prevención, control y tratamiento de la obesidad y otros factores de riesgo cardiovascular (FRCV), para la toma de decisiones basadas en evidencia local y para optimizar el uso de recursos humanos y económicos en entidades de financiamiento de salud. MÉTODOS: estudio observacional y cuantitativo. Se verificaron: a) asociaciones entre obesidad y características demográficas y epidemiológicas; b) eventos fatales, costo por muerte prematura y Años de Vida Saludables Perdidos atribuibles al sobrepeso/obesidad. RESULTADOS: la prevalencia nacional de sobrepeso y obesidad fue de 34,8% y 14,8%, respectivamente, con edades entre 35 y 64 años. Un tercio de la población obesa presentó obesidad severa a muy severa. El 16,2% de los obesos y el 15,1% de las personas con sobrepeso tenían Necesidades Básicas Insatisfechas. El 40,4% de las personas con obesidad presentaron otros FRCV asociados, siendo la hipertensión arterial el más frecuente (48,1%). Las muertes atribuibles al sobrepeso/obesidad fueron 14.776, con lo cual se perdieron 596.704 Años de Vida Saludables atribuibles al exceso de peso y con un costo total por muerte prematurade AR$ 190,5 millones, del cual el 70% fue atribuible al sobrepeso. CONCLUSIONES: es necesario implementar estrategias efectivas de prevención y tratamiento del sobrepeso/obesidad para disminuir su alto costo económico y los Años de Vida Saludable perdidos por su causa.

OBJECTIVE: To gain knowledge that may be applied to the design of strategies for the prevention, control and treatment of obesity and other cardiovascular risk factors (CVRFs), to promote their use for local evidence-based decision making and to optimize the use of human and economic resources in health financing entities. METHODS: Observational and quantitative study recording: a) associations between obesity and demographic/epidemiological characteristics; b) fatal events, cost of premature deaths and lost healthy life years due to overweight and obesity. RESULTS: National prevalence of overweight and obesity: 34.8% and14.8%, respectively; age range of the adult overweight/obesity population: 35-64 years; one third of the obese population presents severe to very severe obesity; unsatisfied basicneeds: 16.2% and 15.4% in obese and overweight people, respectively; presence of other associated CVRFs: 40.4% of obese people, being hypertension the most frequent one(48.1%); deaths due to overweight//obesity: 14.776; cost of premature deaths: $190.5 millions (70% due to overweight); lost healthy life years due to overweight: 596.704. CONCLUSION: Effective strategies for the prevention and treatment of overweight and obesity should be implemented to decrease the high socioeconomic costs and the lost healthy life years due to the disease.

Beneficial changes in energy expenditure and lipid profile after eccentric exercise in overweight and lean women.

The aim was to compare lean and overweight females in regard to the effects of eccentric exercise on muscle damage indices, resting energy expenditure (REE) and respiratory quotient (RQ) as well as blood lipid and lipoprotein profile. Lean and overweight females (deviated by their body mass index) performed an eccentric exercise session. Muscle damage, energy cost and lipid profile were assessed pre-exercise and up to 72 h post-exercise. After eccentric exercise (i) muscle damage indices were affected more in the overweight subjects compared with the lean subjects; (ii) the elevation of absolute and relative REE was larger and more prolonged in the overweight group compared with the lean group; (iii) after 24 h, RQ had significantly declined, with the overweight subjects exhibiting a larger reduction compared with the lean group; and (iv) the blood lipid profile was favorably modified, with the overweight group exhibiting more favorable responses compared with the lean group. The differences between the lean and the overweight subjects may be partly due to the fact that overweight individuals experienced greater muscle damage than lean individuals. Eccentric exercise may be a promising lifestyle factor to combat obesity and dyslipidemias.

[Obesity in schoolchildren from Merida, Venezuela: association with cardiovascular risk factors]. / Obesidad en escolares de Mérida, Venezuela: asociación con factores de riesgo cardiovascular.

OBJECTIVE: To investigate the prevalence of obesity and associated cardiovascular risk factors in schoolchildren in our city, given the influence of these factors on the development of atherosclerosis. METHODS: We studied a representative sample of second grade students composed of 370 children aged 7.82+/-0.62 years (47.8% girls and 52.2% boys); 52.4% were from public schools and 47.6% were from private schools. Surveys were performed and anthropometric measurements, blood pressure (BP) values and glucose and lipid profiles in capillary blood were determined. RESULTS: A total of 9.7% (36 schoolchildren) were obese and 13.8% were overweight. There were no differences according to sex or school system. Abdominal obesity was observed in 69.4% (p<0.0001), normal-high BP (90-97th percentile) in 27.8% (p<0.0001), dyslipidemia in 66.7% (p<0.05) and metabolic syndrome in 38.9% (p<0.0001) of the obese children compared with 1.3%, 5.1%, 48.9% and 0.4% of the children with normal weight, respectively. No association was found between fasting hyperglycemia and obesity. There were no cases of hypertension or diabetes mellitus. The risk (odds ratio) for normal-high BP, dyslipidemia, abdominal obesity and metabolic syndrome was 6.3, 2.2, 60.9, and 70.2 times higher in obese children than in non-obese children, respectively. A positive and significant correlation was found between waist circumference and body mass index with BP and the atherogenic indexes triglycerides/high-density lipoprotein cholesterol (HDL-C), total cholesterol/HDL-C and low-density lipoprotein cholesterol/HDL-C (p=0.0001). CONCLUSIONS: Compared with cities in other countries, the city of Mérida, Venezuela, has an intermediate prevalence of overweight and obesity in schoolchildren. The high frequency of cardiovascular risk factors in the obese and its positive correlation with adiposity highlights the need to implement population-based strategies for its prevention in childhood.