Clinically Effective Molecules of Natural Origin for Obesity Prevention or Treatment.

The prevalence and incidence of obesity and the comorbidities linked to it are increasing worldwide. Current therapies for obesity and associated pathologies have proven to cause a broad number of adverse effects, and often, they are overpriced or not affordable for all patients. Among the alternatives currently available, natural bioactive compounds stand out. These are frequently contained in pharmaceutical presentations, nutraceutical products, supplements, or functional foods. The clinical evidence for these molecules is increasingly solid, among which epigallocatechin-3-gallate, ellagic acid, resveratrol, berberine, anthocyanins, probiotics, carotenoids, curcumin, silymarin, hydroxy citric acid, and α-lipoic acid stand out. The molecular mechanisms and signaling pathways of these molecules have been shown to interact with the endocrine, nervous, and gastroenteric systems. They can regulate the expression of multiple genes and proteins involved in starvation-satiety processes, activate the brown adipose tissue, decrease lipogenesis and inflammation, increase lipolysis, and improve insulin sensitivity. This review provides a comprehensive view of nature-based therapeutic options to address the increasing prevalence of obesity. It offers a valuable perspective for future research and subsequent clinical practice, addressing everything from the molecular, genetic, and physiological bases to the clinical study of bioactive compounds.

Participatory intervention to improve nutrition and physical activity of school-age children in Mexico.

Obesity is one of the major public health problems of the 21st century, affecting every country in the world. In Mexico, the prevalence of overweight and obesity in children (5 to 11 years) was 35.5%. Childhood obesity is a chronic disease itself; and is associated with other chronic conditions. OBJECTIVE: To assess the effect and feasibility of a participatory intervention to improve nutrition and physical activity within the school environment in children in public elementary schools in Mexico. METHODS: The present study is a cluster trial. The intervention focused on; changes in food offered, training the schools' food service staff, promoting water consumption and physical activity at the community level, implementing healthy spaces inside the school, improving the quality of physical education within schools, among others. The main outcomes will focus on rate of weight gain, time devoted to physical activity, sedentary behaviors, diet quality and response feeding behaviors. We also will assess the time and personnel involved in the intervention development, maintenance, and dissemination. CONCLUSION: Findings from this trial will generate new translational knowledge in Mexico; if the results are positive, this participatory intervention could serve as a basis for designing multidimensional interventions that could be scaled up at the national level.

Development of alternatives to estimate resting metabolic rate from anthropometric variables in paralympic swimmers.

The resting metabolic rate (RMR) is one of the most representative components of total daily energy expenditure (TDEE). Multiple equations have been developed to estimate RMR, but none have been described for Para-Athletes. This study aimed to; i) develop and validate new RMR estimation models from anthropometric variables; and ii) explore the level of agreement between the RMR determined by indirect calorimetry (IC) and the developed models, as well as a selection of existent estimation models in Para-Athletes. Fifteen young Paralympic swimmers (age, 18.7±6.5 years) underwent assessments of RMR by IC and anthropometric batteries. Four RMR estimation models (M1-M4) were developed. The anthropometric variables which explained most of the variance were biacromial breadth (M3-37%), stature (M1-45%; M2-49%), and estimated stature from half arm span (M4-24%). However, the neck girth corrected by the submandibular skinfold entered in all four models. The 95% limits of agreement between IC and M3 equation (best performance model) ranged from -142.02 to 172.39 kcal×day-1 (bias 15.19 kcal×day-1). Concerning the commonly used equations, Harris & Benedict equation was the most consistent when compared to IC. The results of this study suggest four novel RMR equations that may assist in the estimation of energy requirements in elite Para-Athletes.

Percentile Reference Values for the Neck Circumference of Mexican Children.

Neck circumference was studied for the first time in a pediatric population in 2010. Since then, various countries have proposed cutoff values to identify overweight, obesity, and metabolic syndrome. However, no reference values have been established for the Mexican child population. The aim of this study is to provide percentile reference values for the neck circumference of Mexican schoolchildren. Only normal-weight schoolchildren aged 6-11 years were included. Percentiles and growth charts were constructed based on the "Generalized Additive Model for Location, Scale and Shape" (GAMLSS). A total of 1059 schoolchildren (52.9% female) was evaluated. Weight, height, and BMI values were higher for males; however, this difference was not statistically significant. The 50th percentile for females was 24.6 cm at six years old and 28.25 cm at 11 years old, and for males, it was 25.75 cm and 28.76 cm, respectively. Both males and females displayed a pronounced increase in neck circumference between 10 and 11 years of age. The greatest variability was found in the 11-year-old group, with an increase of 5.5 cm for males and 5.4 cm for females. This study presents the first reference values for neck circumference for a Mexican child population.

Neck circumference as an indicator of elevated central adiposity in children.

OBJECTIVE: We aimed to study the correlation between neck circumference (NC) and anthropometric adiposity indicators, and to determine cut-off points of NC for both sexes to identify elevated central adiposity in schoolchildren in western Mexico. DESIGN: Cross-sectional study. SETTING: Rural settings in western México.ParticipantsChildren from a convenience sample of six schools in Acatlán, Jalisco, Mexico (n 1802). RESULTS: NC showed a strong positive correlation with all anthropometric adiposity indicators in both sexes, which were notably higher in boys regardless of age. Noteworthy, waist circumference displayed the highest significant correlation when analysed by both age and sex. As age increased, NC cut-off points to identify elevated central adiposity ranged from 25·7 to 30·1 cm for girls and from 27·5 to 31·7 cm for boys. CONCLUSIONS: NC could be used as a simple, inexpensive and non-invasive indicator for central obesity assessment in Mexican schoolchildren.

Precisión diagnóstica del pliegue submandibular, perímetro de cintura mínima e índice cintura mínima-estatura, como indicadores de sobrepeso y obesidad por adiposidad en población infantil / Diagnostic precision of the submandibular skinfold, minimum waist circumference and minimum waist to height ratio, as adipose overweight and obesity indicators in children

Introducción: La obesidad es una enfermedad caracterizada por el exceso de tejido adiposo en el cuerpo y es considerada uno de los problemas de salud pública más importantes del siglo 21, particularmente en la edad infantil. Uno de los métodos más utilizados para su diagnóstico es el Índice de masa corporal, sin embargo, este no identifica eficazmente la adiposidad. Otras dimensiones antropométricas más allá del peso, la talla y la relación entre ellas, pueden constituir una alternativa para identificar y valorar el exceso de peso y adiposidad en población infantil. Este estudio busca evaluar la precisión diagnostica del pliegue submandibular, el perímetro de cintura mínima y el índice cintura mínima-estatura, como indicadores de sobrepeso y obesidad por exceso de adiposidad en población infantil. Métodos: Se evaluaron 6 variables antropométricas (peso, estatura, perímetro de cintura mínima [PCM], pliegue tricipital [PT], pliegue subescapular [PSE] y pliegue submandibular o submentoniano [PSM]), en 1,858 niños de 6 a 11 años de edad. Se calculó el IMC para la edad con las referencias de la Organización Mundial de la Salud y se estimó adiposidad con referencias latinoamericanas y españolas. Se creó un estándar a partir de ambas referencias con el cual se realizaron correlaciones y pruebas de sensibilidad y especificidad para generar puntos de corte para las 3 variables propuestas. Resultados: De acuerdo a la variable creada, 15.8 % de la población general presentó sobrepeso con adiposidad moderada, mientras que 12.2 % presentó obesidad con adiposidad elevada, para una prevalencia combinada de 28.0 %. Las tres variables estudiadas se correlacionan significativamente (<0.001) con el IMC y el pliegue tricipital (como indicador de adiposidad). El área bajo la curva de las curvas ROC osciló entre 0.835 a 0.993 para pliegue submandibular, 0.942 a 0.993 para perímetro de cintura mínima y entre 0.909 a 0.991 para índice cintura mínima-estatura. Así mismo, la sensibilidad y la especificidad más bajas se encontraron en pliegue sumbandibular para mujeres de 11 años (70.6%) y para mujeres de 9 años (79.8%) respectivamente. Discusión: Se observó que tanto el perímetro de cintura mínima, como el índice cintura mínima-estatura fueron significativamente mayores en los niños, mientras que los pliegues tricipital y subescapular lo fueron en las niñas (p<0.001). Lo anterior puede atribuirse al diferencial de composición corporal entre ambos sexos. La mayor asociación del índice de masa corporal se presentó con el perímetro de cintura mínima (niñas, r= 0.926; niños, r= 0.924), mientras que la del pliegue submandibular se presentó con el pliegue tricipital (niños, p= 0.857; niñas, r= 0.821). Como estándar para analizar la sensibilidad y especificidad, se creó una variable para agrupar a sujetos que presentaran simultáneamente: a) sobrepeso y adiposidad moderada; y, b) obesidad y adiposidad elevada. Esto nos permite no solo diagnosticar exceso de peso sino concomitantemente adiposidad. Conclusiones: Las tres variables propuestas identifican eficaz y paralelamente exceso de peso y exceso de adiposidad tanto en niños como en niñas de 6 a 11 años de edad, por lo que pueden ser utilizadas como una alternativa al índice de masa corporal y aquellos pliegues cutáneos que requieren una evaluación más invasiva. Así mismo, su facilidad de aplicación en campo, las presenta como instrumentos elegibles, alternativos o complementarios para la vigilancia epidemiológica (AU)

Introduction: Obesity is caused by the excess of adipose tissue in the body, and is considered one of the most important public health issues of the 21st century, particularly in childhood. One of the most used methods for obesity diagnosis is the body mass index, however, it is not an effective method to identify adiposity. Other anthropometric dimensions beyond weight, height and the relationship between them, may constitute an alternative to identify and assess obesity and adiposity in children. This study seeks to evaluate the diagnostic accuracy of submandibular skinfold, minimum waist circumference and minimum waist to height ratio, as markers of overweight and obesity due to excess adiposity in children. Methods: Six anthropometric variables (weight, height, minimum waist circumference [PCM], tricipital fold [PT], subscapular fold [PSE] and submandibular or submental depression [PSM]) were evaluated in 1,858 school-aged children (6 to 11 years). BMI for age was calculated based on the World Health Organization references. Adiposity was estimated with Latin American and Spanish references. A standard was created from both references to test all 3 proposed variables for association, sensibility and specificity tests to generate cutoff points. Results: According to the standard created, 15.8% of the study population was overweight with moderate adiposity, while 12.2% presented obesity with high adiposity, for a combined prevalence of 28.0%. All three variables studied were significantly correlated (<0.001) with the BMI and triceps skinfold (as an adiposity indicator). The area under the curve of the ROC curves ranged from 0.835 to 0.993 for submandibular skinfold, 0.942 to 0.993 for minimum waist circumference, and from 0.909 to 0.991 for minimum waist to height ratio. The lowest sensitivity and specificity were found in submandibular skinfold for 11-year-old girls (70.6%) and for 9-year-old girls (79.8%), respectively. Discussion: Both, minimum waist circumference and minimum waist to height ratio were significantly higher in boys, while triceps and subscapular skinfolds were in girls (p<0.001). This can be attributed to the different body composition characteristics between genders. The highest association of body mass index was observed with the minimum waist circumference (girls, r = 0.926; boys, r = 0.924), while submandibular skinfold presented the highest association with tricipital skinfold (boys, p = 0.857; girls, R = 0.821). As a standard to analyze sensitivity and specificity, a variable was created to group subjects who simultaneously presented: a) overweight with moderate adiposity; and, b) obesity with high adiposity. This allows not only to diagnose excess weight but, concomitantly, adiposity. Conclusion: All three proposed variables effectively identify excess weight and excess adiposity in both boys and girls from 6 to 11 years of age, so they can be used as an alternative to the body mass index and those skinfolds that require a more invasive evaluation. Also, because their application in the field is simple, could be eligible as alternatives for epidemiological surveillance (AU)