The effect of a multidisciplinary intervention program on hepatic adiposity in overweight-obese children: protocol of the EFIGRO study.

BACKGROUND: Non-alcoholic fatty liver disease is the most frequent liver abnormality observed in overweight or obese children and is strongly associated with metabolic syndrome and insulin resistance. OBJECTIVES: (i) To evaluate the effect of a 22-week multidisciplinary intervention program on hepatic fat fraction in overweight or obese children and (ii) to examine the effect of the intervention on cardiometabolic risk factors, self-esteem and well-being. METHODS: A total of 160 children, 9-11 years, will be recruited by pediatricians and randomly assigned to control (N = 80) or intervention (N = 80) groups. The control group will receive a family-based lifestyle and psycho-educational program (2 days/month), while the intervention group will attend the same lifestyle education and psycho-educational program plus the exercise program (3 days/week). The duration of training sessions will be 90 min of exercise, including warm-up, moderate to vigorous aerobic activities, and strength exercises. The primary outcome is the change in hepatic fat fraction (magnetic resonance imaging, MRI). Secondary outcomes include cardiometabolic risk factors such as total adiposity (dual Xray absorptiometry), visceral adiposity (MRI), functional peak aerobic capacity (cardiopulmonary exercise testing), blood pressure, muscular fitness, speed­agility, and fasting blood insulin, glucose, C-reactive protein, alanine aminotransferase, aspartate aminotransferase, gamma glutamyltransferase, lipid profile and psychological measurements (questionnaires). All the measurements will be evaluated at baseline prior to randomization and after the intervention. DISCUSSION: This study will provide insight in the efficacy of a multidisciplinary intervention program including healthy lifestyle education, psycho-education and supervised exercise to reduce hepatic fat and cardiometabolic risk in overweight children.

Association of circulating visfatin concentrations with insulin resistance and low-grade inflammation after dietary energy restriction in Spanish obese non-diabetic women: role of body composition changes.

BACKGROUND AND AIMS: To assess the influence of body composition changes on circulating serum visfatin after following 12 weeks of energy restricted diet intervention. We also examined the possible role of visfatin in glucose metabolism and in obesity-associated low-grade inflammation. METHODS AND RESULTS: A total of 78 obese (BMI 34.0 ± 2.8 kg/m²) women aged 36.7±7 y volunteered to participate in the study. We measured by DXA body fat mass (FM) and lean mass (LM). Fasting serum visfatin, glucose, insulin, adiponectin, leptin, IL-1ß, IL-6, IL-8, TNF-α and CRP concentrations were analyzed before and after the intervention and HOMA and QUIKI indexes were calculated. Mean weight loss 7.7 ± 3.0 kg and HOMA decreased in 24 ± 35%. Serum visfatin concentration change was negatively associated with LM difference (P < 0.05), whereas no significant relationship was observed with FM changes after energy restricted diet intervention. Changes in circulating serum visfatin levels were significantly and inversely associated with HOMA-IR (P < 0.01) and positively with QUICKI index (P < 0.02) after energy restricted diet intervention, regardless of achieved body weight loss. We did not find any significant association between changes in visfatin levels and IL-1ß, IL-6, IL-8, TNF-α and CRP levels after dietary intervention (all P > 0.2). CONCLUSION: Circulating visfatin concentration is associated with sensitivity improvement achieved after energy restricted diet intervention induced weight loss. Furthermore, LM changes could be an influencing factor on visfatin concentrations and consequently, on the improvement of insulin sensitivity after weight loss in obese non-diabetic women. Our findings did not provide any evidence for a role of visfatin increase on low-grade inflammation after weight loss.

Preliminary findings on the role of PLIN1 polymorphisms on body composition and energy metabolism response to energy restriction in obese women.

The aim of the present study was to investigate the association of PLIN1 11482G>A (rs894160) and PLIN1 13041A>G (rs2304795) polymorphisms with body composition, energy and substrate metabolism, and the metabolic response to a 12-week energy-restricted diet in obese women. The study comprised a total of seventy-eight obese (BMI 34·0 (SD 2·8) kg/m(2)) women (age 36·7 (SD 7) years). We measured weight, height and waist circumference before and after a 12-week controlled energy-restricted diet intervention. Body fat mass and lean mass were measured by dual-energy X-ray absorptiometry. RMR and lipid oxidation rate were measured by indirect calorimetry. We also analysed fasting plasma glucose, insulin, cholesterol and leptin. Women carrying the 11482A allele had a lower reduction in waist circumference than non-A allele carriers (3·2 (SD 0·5) v. 4·6 (SD 0·6) %, respectively, P = 0·047; P for gene-diet interaction = 0·064). Moreover, women with the 11482A allele had a higher decrease in lipid oxidation rate than non-A allele carriers (58·9 (SD 6·7) v. 31·3 (SD 8·2) %, respectively, P = 0·012; P for gene-diet interaction = 0·004). There was no interaction effect between the 13041A>G polymorphism and diet-induced changes on the outcome variables (all P>0·1). These results confirm and extend previous findings suggesting that the PLIN1 11482G>A polymorphism plays a modulating role on diet-induced changes in body fat and energy metabolism in obese women.

Efecto de un agua rica en fibra y L-carnitina como adyuvante en una terapia de control de peso, sobre medidas antropométricas en pacientes con sobrepeso / Effect of a fiber and L-carnitina-enriched mineral water as adjuvant of a weight-control therapy on overweight patients

El sobrepeso y la obesidad son trastornos metabólicos caracterizados por una excesiva acumulación de energía en forma de grasa en el organismo, que conlleva un aumento del peso corporal con respecto al valor esperado según sexo, talla y edad y que están ligados a un gran número de patologías como diabetes tipo 2, dislipemia, hipertensión arterial, etc. En los últimos años la incidencia de estos trastornos ha aumentado de manera alarmante, llegando a ser, en España, del 50% en el año 2000 según los datos de la SEEDO. La relación directa entre la obesidad y el incremento del riesgo enfermedad hace que el consumidor demande tratamientos y productos, ya sean complementos alimenticios o fármacos, que le permitan superar esa situación y mejorar tanto su aspecto físico como su estado de salud, por lo que resulta de gran interés el desarrollo y evaluación de productos que junto con una modificación en la dieta y estilo de vida ayuden a conseguir una disminución en el IMC y una mejora en parámetros asociados al sobrepeso y obesidad. El objetivo de este estudio fue evaluar el efecto de uno de estos productos, un agua enriquecida con fibra y L-carnitina, como adyuvante en una terapia de control de peso. Se llevó a cabo un estudio aleatorizado, doble ciego, controlado con placebo en el que participaron 40 sujetos, hombres y mujeres, con sobrepeso a los que se les indicó el seguimiento de una dieta hipocalórica durante 56 días, complementada, en 20 de los voluntarios con la ingesta de 1 litro de Vitalis Elegante, mientras que en los otros 20 se complementó con la ingesta de 1 litro de agua. Se llevaron a cabo determinaciones de peso, IMC y medidas antropométricas. Ambos tratamientos resultaron eficaces en la reducción de diversas medidas antropométricas relacionadas con el sobrepeso, no encontrándose diferencias estadísticamente significativas entre ambos tratamientos en la evolución de ninguno de los parámetros estudiados, aunque sí se encontraron algunos resultados reseñables. Sólo el grupo que tomó Vitalis Elegante como adyuvante de su terapia de control de peso fue capaz de reducir de manera estadísticamente significativa el perímetro de cintura y el pliegue tricipital respecto a los valores iniciales, lo que no ocurrió en el grupo que al que se le administró placebo como adyuvante. Teniendo en cuenta estos datos, Vitalis Elegante podría contribuir a la mejora de las estrategias de control de peso que se utilizan en la actualidad (AU)

Overweight and obesity are metabolic disorders characterized by an excessive energy accumulation in the organism in the form of fat, which leads to an increase in body weight according to sex, age and height. These disorders are usually linked to different pathologies, such as diabetes, dyslipemia, hypertension, etc. In last years, the incidence of these disorders has reached 50 % of adult population in Spain, according to SEEDO data. This relationship between obesity and the increase of pathology risk has caused an increase in consumer’s demand of products or drugs that allow them to overcome this situation and improve not only their appearance but their health. In that context is interesting the development of products that, together with a modification in diet and life style, allow getting a decrease in BMI and an improvement in parameters associated to overweight and obesity. The aim of this study was to evaluate the effect of a fiber and L-carnitine enriched mineral water as adjuvant of a weight control therapy in overweight patients. A double-blind, placebo-controlled, randomized clinical trial was carried out, in which 40 overweight persons were enrolled. They were indicated to follow a hypocaloric diet during 56 days, supplemented, in one group, with 1liter per day of Vitalis Elegante, while the other group was supplemented with 1 liter per day of placebo. During the intervention weight, BMI and anthropometric measures were determined. Both, Vitalis Elegante and placebo were effective in the reduction of several measures related to overweight, not having found statistically significant differences between them as regards to evolution of parameters during the treatment. However, we found some interesting results. Only the group supplemented with Vitalis Elegante was able to decrease the waist perimeter and the tricipital fold in comparison with basal values, what did not happen in the group supplemented with placebo. Taken together, these data show that Vitalis Elegante could contribute to the improvement of weight control used at the moment (AU)

Up-regulation of a thermogenesis-related gene (UCP1) and down-regulation of PPARgamma and aP2 genes in adipose tissue: possible features of the antiobesity effects of a beta3-adrenergic agonist.

A number of experiments have demonstrated the antiobesity effects of beta(3)-adrenergic receptor stimulation by promoting thermogenesis and/or lipolysis. While many studies have been performed in order to develop beta(3)-adrenergic agonists as a novel strategy in the management of obesity, more information is needed about the mechanisms involved in thermogenesis and the actions of these drugs on adipocyte differentiation. To address this, the possible thermogenic and antiadipogenic properties of Tertatolol, a beta(3)-adrenergic agonist, in a diet-induced obesity model has been tested. Animals fed on a high-fat diet gained more weight and fat mass as compared with control and high-fat fed animals treated with Tertatolol. A RT-PCR was carried out in white adipose tissue specific genes involved in thermogenesis such as uncoupling proteins (UCPs) and adipogenesis such as peroxisome proliferator-activated receptor (PPARgamma2), retinoid receptors (RXRalpha/RARalpha), and fatty acid binding protein (aP2). Levels of UCP1 mRNA were augmented in the Tertatolol-treated group as compared to non-treated high-fat fed animals, while the beta(3)-adrenergic agonist treatment significantly decreased the expression levels of aP2 and transcription factors such as PPARgamma2 and the ratio RXRalpha/RARalpha as compared to obese rats. Altogether these data suggest that the antiobesity effects of beta(3)-adrenergic agonists are not limited to the promotion of thermogenesis and/or lipolysis and support the implication that these beta(3)-adrenergic agonists also affect fat deposition by impairing adipogenesis in white adipose tissue (WAT).

UCP2 muscle gene transfer modifies mitochondrial membrane potential.

OBJECTIVE: The aim of this work was to evaluate the effect of uncoupling protein 2 (UCP2) muscle gene transfer on mitochondrial activity. DESIGN: Five week-old male Wistar rats received an intramuscular injection of plasmid pXU1 containing UCP2 cDNA in the right tibialis anterior muscles. Left tibialis anterior muscles were injected with vehicle as control. Ten days after DNA injection, tibialis anterior muscles were dissected and muscle mitochondria isolated and analyzed. RESULTS: There were two mitochondrial populations in the muscle after UCP2 gene transfer, one of low fluorescence and complexity and the other, showing high fluorescence and complexity. UCP2 gene transfer resulted in a 3.6 fold increase in muscle UCP2 protein levels compared to control muscles assessed by Western blotting. Furthermore, a significant reduction in mitochondria membrane potential assessed by spectrofluorometry and flow cytometry was observed. The mitochondria membrane potential reduction might account for a decrease in fluorescence of the low fluorescence mitochondrial subpopulation. CONCLUSION: It has been demonstrated that UCP2 muscle gene transfer in vivo is associated with a lower mitochondria membrane potential. Our results suggest the potential involvement of UCP2 in uncoupling respiration. International Journal of Obesity (2001) 25, 68-74