The role of environmental pollutants in body composition: Systematic review and meta-analysis.

The effects of environmental pollution are associated with higher rates of mortality, morbidity, and years of life lost. It is known that these produce alterations in the human body, including changes in body composition. Research has focused on the association between contaminants and BMI through cross-sectional studies. The objective of this study was to synthesize the evidence for the association of pollutants on different measures of body composition. The PECOS strategy was defined, in which "P": participants of any age, sex, or ethnicity, "E": a higher level of environmental pollution, "C": a lower level of environmental pollution, "O": body composition measurements and "S": longitudinal studies. Studies from the following databases were included: MEDLINE, EMBASE, SciELO, LILACS, Scopus, Web of Science, SPORTDiscus, and gray literature from inception to January 2023.3069 studies were identified, 18 were included in the systematic review, and 13 in the meta-analysis. These studies included 8.563 people, 47 environmental contaminants, and 16 measures of body composition. The meta-analysis by subgroup found that the association between dioxins, furans, PCBs, and waist circumference was ß = 1.0 (95% CI: 0.85 to 1.16; I2: 95%), and the sum of four skinfolds ß = 1.02 (95% CI: 0.88 to 1.16; I2: 24%). The association between pesticides and waist circumference was ß = 1.00 (95% CI: 0.68 to 1.32; I2: 98%), and the fat mass was ß = 0.99 (95% CI: 0.17 to 1.81; I2: 94%). Pollutants, especially endocrine-disrupting chemicals, among which dioxins, furans, PCBs, and pesticides, are associated with changes in body composition, mainly with waist circumference and the sum of four skinfolds.

Brazilian instrument for assessing of eating disorders in children and adolescents / Instrumento brasileño para la evaluación de los trastornos alimentarios en niños y adolescentes

Objective: This study aimed to develop the Brazilian instrument for assessing eating disorders in children and adolescents and test its psychometric quality using item response theory (IRT). Design: Cross-sectional study. Participants: Participants aged between five and twelve years old of both sexes. Main measures: IRT logistic model of two parameters was used to evaluate the item's severity and discrimination and test information curve of symptoms of eating disorders’ latent trait symptoms. Content validity and reliability were also assessed. The IRT evaluation suggested that the instrument contained items that performed differently concerning severity, discrimination, and test information curve presented good accuracy. Results: There was agreement on the clarity of language (83.3%) and theoretical relevance (91.7%), indicating good content validity. The value of the Cronbach's Alpha was 0.63 (95% confidence interval), and the result of the Spearman–Brown test was 0.65. Conclusion: These results indicate good performance of the screening tool in assessing the level of eating disorders in children and adolescents.(AU)

Objetivo: Este estudio tuvo como objetivo desarrollar un instrumento brasileño para la evaluación de los trastornos alimentarios en niños y adolescentes, y testar el análisis psicométrico utilizando la teoría de respuesta al ítem (TRI). Diseño: Estudio observacional, transversal. Participantes: Individuos de ambos sexos entre los 5 y 12 años de edad. Mediciones principales: Se utilizó el modelo logístico TRI de 2 parámetros para evaluar la gravedad y la discriminación del ítem, y probar la curva características del test (CCT) de los síntomas del rasgo latente de los trastornos alimentarios. También se evaluaron la validez de contenido y la confiabilidad. Resultado: La evaluación TRI sugirió que el instrumento contenía ítems que funcionaban de manera diferente en cuanto a severidad, discriminación y la CCT presentando una buena precisión. Hubo concordancia en la claridad del lenguaje (83,3%) y en la relevancia teórica (91,7%), indicando buena validez de contenido. El valor del alfa de Cronbach fue de 0,63 (intervalo de confianza del 95%) y el resultado de la prueba de Spearman-Brown fue de 0,65. Conclusión: Estos resultados indican un buen desempeño de la herramienta de detección en la evaluación del nivel de los trastornos alimentarios en niños y adolescentes.(AU)

Influence of Massive Weight Loss on the Perception of Facial Age: The Facial Age Perceptions Cohort.

BACKGROUND: Knowledge is scarce about the role of massive weight loss in facial age perception. The aim of this study was to verify whether there is a change in the perception of facial age when comparing people with morbid obesity before surgery and 1 year after the procedure. METHODS: Patients with morbid obesity have been analyzed, through a prospective cohort, before and 1 year after undergoing bariatric surgery. Seven plastic surgeons estimated the age of each subject. RESULTS: Seventy patients participated. Five patients were excluded because of the exclusion criteria. There was no drop-off among the subjects participating in this cohort. Before surgery, the mean facial age perception was 40.8 years; after surgery, mean facial age perception was 43.7 years (95 percent CI, 0.58 to 2.95; p = 0.004). Men older than 40 years, with a preoperative body mass index between 40 and 49.9 kg/m, weight greater than 127.65 kg before surgery, and percentage of excess weight lost greater than 75.13 percent demonstrated greater perceived facial aging. CONCLUSION: Massive weight loss appears to produce facial aging. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Doença hepática não-alcoólica gordurosa e risco de cirrose / Nonalcoholic fatty liver disease andrisk of cirrhosis

objetivos: destacar a doença hepática gordurosa não-alcoólica, seus diversos graus e suas possíveis conseqüências (cirrose e hepatocarcinoma) como uma comorbidez freqüentemente não diagnosticada da obesidade.Fonte de dados: os artigos selecionados para esta revisão foram obtidos em pesquisa no PUBMED. Os principais critérios de seleção foram publicações avaliadas por pares e autores de destaque na área de obesidade e hepatologia.Síntese dos dados: artigos recentes confirmam a relação entre obesidade e doença hepática gordurosa não-alcoólica. É de interesse a possível progressão da esteatose para cirrose e carcinoma hepatocelular.Conclusões: a obesidade mórbida está associada à doença hepática gordurosa não-alcoólica que, por sua vez, determina risco de cirrose e de carcinoma hepatocelular.

Aims: To highlight the non-alcoolic fatty liver disease, its different severities and possible consequences ? cirrhosis and hepatocellular carcinoma ? as an often underdiagnosed co-morbidity of obesity.Source of data: The review was based on a search in PUbMED. main criteria was peer-reviewed journals and well-known authors in the area of obesity and liver disease.Summary of the findings: Recent papers support the association of obesity with non-alcoolic fatty liver disease. It is of interest the possible progression of the steatosis process to cirrhosis and liver carcinoma.Conclusion: Morbid obesity is associated to non-alcoholic fatty liver disease, which, in turn, determines risk of cirrhosis and liver carcinoma.

Behavior of type 2 diabetes mellitus in morbid obese patients submitted to gastric bypass.

INTRODUCTION: Surgical treatment of obesity has not only resulted in weight loss, but also the control of associated diseases in the postoperative period. The aim of this study was to determine the post-op response of type 2 diabetes mellitus (DM2) to gastric bypass. METHODS: A historical cohort study was performed involving all the diabetic, morbid obese patients who underwent gastric bypass during the period of May 2000 to October 2006 at the Centro da Obesidade Mórbida. Patient records were reviewed with regard to sex, age, anthropometric measurements, glycemia, glycosylated hemoglobin, pre-op insulin, and DM2 outcome. RESULTS: A total of 125 diabetic, morbid obese patients were operated; they had a mean age of 42.6 +/- 9.7 years and body mass index of 49 +/- 8.3 kg/m2. Of these patients, 63 (50.4%) required medication for control of DM2, and the rest managed only with diet. Of these 63 patients, 43 (68.2%) achieved control of DM2 and were discharged without the need for antidiabetic medication, and 20 (31.7%) were discharged still on medication. One month after surgery, seven more patients discontinued medication for DM2, and 18 months after surgery, 97.6% of the patients showed control of DM2. CONCLUSION: Gastric bypass is effective in controlling DM2 in morbid obese patients.