Dietary macronutrient regulation of acyl and desacyl ghrelin concentrations in children with Prader-Willi syndrome (PWS).

BACKGROUND: The effects of dietary macronutrients on orexigenic and anorexigenic hormones in children are poorly understood. OBJECTIVE: To explore effects of varying dietary macronutrients on appetite-regulating hormones [acyl ghrelin (AG) and desacyl ghrelin (DAG), glucagon-like peptide 1 (GLP-1), peptide tyrosine tyrosine (PYY) and insulin] in children with PWS and healthy children (HC). DESIGN: Randomized, cross-over experiments compared two test diets [high protein-low carbohydrate (HP-LC) and high protein-low fat (HP-LF)] to a STANDARD meal (55% carbohydrate, 30% fat, 15% protein). Experiment 1 included ten children with PWS (median age 6.63 years; BMI z 1.05); experiment 2 had seven HC (median age 12.54 years; BMI z 0.95). Blood samples were collected at baseline and at 60-minute intervals for 4 hours. Independent linear mixed models were adjusted for age, sex and BMI z-score. RESULTS: Fasting and post-prandial AG and DAG concentrations are elevated in PWS children; the ratio of AG/DAG is normal. Food consumption reduced AG and DAG concentrations in both PWS and HC. GLP-1 levels were higher in PWS after the HP-LC and HP-LF meals than the STANDARD meal (P = .02-0.04). The fasting proinsulin to insulin ratio (0.08 vs 0.05) was higher in children with PWS (P = .05) than in HC. Average appetite scores in HC declined after all three meals (P = .02) but were lower after the HP-LC and HP-LF meals than the STANDARD meal. CONCLUSION: Altered processing of proinsulin and increased GLP-1 secretion in children with PWS after a high protein meal intake might enhance satiety and reduce energy intake.

Prevalence and Risk Factors of Anemia in Patients After Bariatric Surgery in Qassim Region, King Fahad Specialist Hospital.

Introduction There is a high prevalence of obesity among the Saudi population. Anemia due to iron deficiency or an inflammatory state is often associated with obesity. Multiple nutritional deficiencies are associated with bariatric surgeries, with anemia being one of the commonest causes. Aim This study aimed to evaluate the prevalence of anemia after bariatric surgery among patients in the Qassim Region, Saudi Arabia. Patients and methods This retrospective cohort study was conducted at King Fahad Specialist Hospital Al-Qassim (Buraydah), Saudi Arabia. We reviewed data from patients' records who underwent bariatric surgeries from January 2018 to January 2021. By using a structured data collection form, we collected data such as demographic variables, surgery perioperative-related data, postoperative complications and interventions, type of transfusion required after surgery, postoperative medications and/or supplements and duration, and blood count indices. Results Of the 520 patients who underwent bariatric surgery, 61% were females, and 31.7% were aged between 26 to 35 years old. The most prominent type of bariatric surgery was sleeve gastrectomy (97.1%). The prevalence of anemia among patients who underwent bariatric surgery was 28.1%. Independent risk factors for anemia were female gender, microcytic red blood cells, and low normal hematocrit and hemoglobin (Hgb) levels. It is interesting to know that sleeve gastrectomy and elevated BMI levels are considered to be the protective factors for developing anemia postoperatively. Conclusion There was a high prevalence of anemia among bariatric patients postoperatively. Female gender with decreasing hematocrit and hemoglobin levels after the surgery might be more at the receiving end for developing anemia than the other patients. Further longitudinal studies are needed to establish the prevalence and risk factors for developing anemia among bariatric surgery patients.

Patterns of Skin Diseases in Qassim Province, Saudi Arabia.

Objective Dermatological complaints are one of the most common reasons to see a physician. Identifying the incidence and prevalence of different skin conditions is essential to improve health outcomes. Only a few studies regarding the pattern of skin diseases have been conducted in Saudi Arabia, especially in the Qassim region. This study aims to identify, evaluate, and compare the pattern of skin conditions in the Qassim region regarding age and sex, and to compare the results with previous studies. Methods A retrospective record-based study included all Saudi patients who attended the dermatology clinics at Qassim University Medical City, for 12 months, from 2021/08/26 to 2022/07/1. Data were collected from the electronic medical records. Results The study included 2775 Saudi patients comprising 1654 (59.6%) females and 1121 (40.4%%) males, with a male-to-female ratio of 1: 1.475. Around 75% of patients were between 15 and 34 years of age. The top most common diagnoses were pilosebaceous disorders (49.2%), with acne vulgaris being the predominant condition, followed by hair disorders (15.6%), dermatitis (9.2%), pigmentary disorders (7.2%), infections (3.9%), and papulosquamous disorders (3%). The prevalence of dermatological conditions was significantly higher in females than males for pilosebaceous disorders (P=.01) and hair disorders (P=.02). Conclusion There is a changing trend in the prevalence of skin disorders in the Qassim province of Saudi Arabia. Pilosebaceous disorders are being diagnosed more frequently compared to previous years and females visit dermatology clinics more than males. Due to its hospital-based setting, this study only gives a rough estimate of the pattern of skin diseases, and extensive epidemiological studies are needed to estimate the prevalence accurately.

Prevalence of Gastroesophageal Reflux Symptoms Post Sleeve Gastrectomy in Al-Qassim Region.

BACKGROUND AND AIMS: After sleeve gastrectomy, heartburn sensation and regurgitation are frequent postoperative consequences. This study aimed to determine the prevalence and severity of heartburn sensation and regurgitation symptoms among patients who underwent sleeve gastrectomy, as well as the relationship between demographic variables and the presence and severity of these symptoms. METHODOLOGY: This cross-sectional study included 290 patients who underwent sleeve gastrectomy in the Al-Qassim region, Saudi Arabia. Patients were asked to complete a questionnaire that assessed the presence and severity of heartburn and regurgitation symptoms. Demographic data, including age, gender, smoking status, and the date of bariatric surgery, were also collected. RESULTS: The results showed that heartburn and regurgitation were common symptoms among patients who underwent sleeve gastrectomy, with 78% and 73.9% of patients reporting these symptoms, respectively. 11.5% of patients who experienced severe symptoms of regurgitation, and 6.4% of patients with severe heartburn reported serious symptoms that affected their lives by causing an inability to perform daily activities. Age and the date of bariatric surgery were significant factors associated with heartburn and regurgitation symptoms. Patients aged 25-35 years reported the highest prevalence of heartburn symptoms, and the more recent surgery; dated less than one year ago had the highest prevalence of heartburn symptoms. CONCLUSION: Patients who have sleeve gastrectomy frequently experience heartburn and regurgitation, which can have a substantial influence on their quality of life. Routine evaluation and treatment of heartburn and regurgitation symptoms should be an integral component of postoperative care. Younger patients and those who undergo surgery in the early postoperative period may be at a greater risk for developing heartburn and regurgitation symptoms, necessitating more active measures to treat these symptoms.

Serum Asprosin Concentrations in Children with Prader-Willi Syndrome: Correlations with Metabolic Parameters.

Children with Prader-Willi syndrome (PWS) are characterized by severe obesity. Asprosin is a newly discovered protein hormone produced by the white adipose tissue and is correlated with insulin resistance. The aim of our study was to describe the concentrations of serum asprosin in children with PWS compared to those with overweight/obesity and normal weight, and to explore the postprandial change in asprosin concentrations in participants with PWS and BMI-z matched controls. We enrolled 52 children, 23 with PWS, 8 with overweight/obesity, and 21 with normal weight. Fasting levels of asprosin, glucose, and insulin were collected in all children, and postprandial asprosin and fasting levels of acyl ghrelin (AG) and leptin were also determined in a subsample of participants. There were no significant differences among groups in fasting levels of asprosin, glucose, insulin, and HOMA-IR. Fasting serum asprosin and 1-h post-meal serum asprosin did not differ in children with PWS nor in BMI-z matched controls. Fasting asprosin showed an adjusted positive correlation with glucose in children with obesity (r = 0.93, p = 0.007) but not in children with PWS nor children with normal weight. Circulating asprosin might be a predictor of early alterations in glucose metabolism in children with obesity. More research is needed to further explain the association between asprosin, food intake, metabolism, and obesity in PWS.

Effect of High-Protein Diet on Postprandial Energy Expenditure in Children with Prader-Willi Syndrome: A Pilot and Feasibility Study.

The aim of this study was to explore the feasibility of measuring a postprandial increase in energy expenditure (ΔEE) using a state-of-the-art whole-body calorimetry unit (WBCU) in children and youth with Prader-Willi syndrome (PWS). Five participants (aged 10-25 y) received both a standard and a high-protein diet in a random order (crossover design). Resting energy expenditure, postprandial ΔEE 6 h after intake of a standard [15% of total energy (TE)] and a high-protein (30% TE) meal, and respiratory exchange ratio (RER) were measured in a WBCU. No differences were observed in ΔEE comparing the 2 meals. Mean RER was lower following the high-protein meal (0.80 ± 0.01) compared with the standard meal (0.87 ± 0.02) (P = 0.009). Despite the high participant burden, it was feasible to conduct this metabolic test in children and youth with PWS. This study paves the way for further studies targeting EE in this patient population.

Energy Metabolism Profile in Individuals with Prader-Willi Syndrome and Implications for Clinical Management: A Systematic Review.

Prader-Willi syndrome (PWS) is a rare genetic disorder associated with excessive weight gain. Hyperphagia associated with PWS may result in higher energy intake, but alterations in energy expenditure may also contribute to energy imbalance. The purpose of this critical literature review is to determine the presence of alterations in energy expenditure in individuals with PWS. Ten studies that measured total energy expenditure (TEE), resting energy expenditure (REE), sleep energy expenditure (SEE), activity energy expenditure (AEE), and diet induced thermogenesis (DIT) were included in this review. The studies provided evidence that absolute TEE, REE, SEE, and AEE are lower in individuals with PWS than in age-, sex-, and body mass index-matched individuals without the syndrome. Alterations in lean body mass and lower physical activity amounts appear to be responsible for the lower energy expenditure in PWS rather than metabolic differences. Regardless of the underlying mechanism for lower TEE, the estimation of energy requirements with the use of equations derived for the general population would result in weight gain in individuals with PWS. The determination of energy requirements for weight management in individuals with PWS requires a more comprehensive understanding of energy metabolism. Future studies should aim to comprehensively profile all specific components of energy expenditure in individuals with PWS with the use of appropriately matched controls and gold standard methods to measure energy metabolism and body composition. One component of energy expenditure that is yet to be explored in detail in PWS is DIT. A reduced DIT (despite differences in fat free mass), secondary to hormonal dysregulation, may be present in PWS individuals, leading to a reduced overall energy expenditure. Further research exploring DIT in PWS needs to be conducted. Dietary energy recommendations for weight management in PWS have not yet been clearly established.

Combination effects of wild rice and phytosterols on prevention of atherosclerosis in LDL receptor knockout mice.

Dietary modifications including healthy eating constitute one of the first line strategies for prevention and treatment of atherosclerotic cardiovascular diseases (CVD), including atherosclerosis. In this study, we assessed anti-atherogenic effects of a combination of wild rice and phytosterols in low-density lipoprotein receptor knockout (LDL-r-KO) mice. Male LDL-r-KO mice were divided into four groups and fed with: (1) control diet; (2) the control diet containing 60% (w/w) wild rice; (3) the control diet containing 2% (w/w) phytosterols; or (4) the control diet containing both wild rice and phytosterols for 20weeks. All diets were supplemented with 0.06% (w/w) dietary cholesterol. Blood samples, hearts, and feces were collected and used for biochemical and histological examination. Consumption of 60% (w/w) wild rice in combination with 2% (w/w) phytosterols significantly reduced the size and severity of atherosclerotic lesions in the aortic roots as compared to those in the control group. This effect was associated with significant reductions in plasma total, LDL and VLDL cholesterol concentrations as well as an increase in fecal cholesterol excretion. In conclusion, the dietary combination of wild rice and phytosterols prevents atherogenesis in this animal model. Further investigations are needed to understand mechanisms of action and potential clinical outcome of such dietary intervention.

Nutritional constituents and health benefits of wild rice (Zizania spp.).

Wild rice (Zizania spp.) seems to have originated in North America and then dispersed into Eastern Asia and other parts of the world. Nutritional analysis shows that wild rice is rich in minerals, vitamins, protein, starch, dietary fiber, and various antioxidant phytochemicals, while it is low in fat. Wild rice has been recognized as a whole grain by the US Food and Drug Administration; in the North American marketplace it is currently sold as and considered to be a health-promoting food. Recent scientific studies have revealed antioxidant and lipid-lowering properties of wild rice, while others have documented cardiovascular benefits associated with the long-term consumption of wild rice in experimental settings. The present review article summarizes various features of wild rice and its cultivation, including its plantation, harvest, nutritional composition, and biological properties. While evidence for the cardiovascular benefits of wild rice consumption is accumulating, additional studies are warranted to determine the clinical benefits of regular consumption of wild rice.