Influence of polymorphisms in IRS1, IRS2, MC3R, and MC4R on metabolic and inflammatory status and food intake in Brazilian adults: An exploratory pilot study

Polymorphisms in genes of leptin-melanocortin and insulin pathways have been associated with obesity and type 2 diabetes. We hypothesized that polymorphisms in IRS1, IRS2, MC3R, and MC4R influence metabolic and inflammatory markers and food intake composition in Brazilian subjects. This exploratory pilot study included 358 adult subjects. Clinical, anthropometric, and laboratory data were obtained through interview and access to medical records. The variants IRS1 rs2943634 A˃C, IRS2 rs1865434 C>T, MC3R rs3746619 C>A, and MC4R rs17782313 T>C were analyzed by real-time polymerase chain reaction. Food intake composition was assessed in a group of subjects with obesity (n = 84) before and after a short-term nutritional counseling program (9 weeks). MC4R rs17782313 was associated with increased risk of obesity (P = .034). Multivariate linear regression analysis adjusted by covariates indicated associations of IRS2 rs1865434 with reduced low-density lipoprotein cholesterol and resistin, MC3R rs3746619 with high glycated hemoglobin, and IRS1 rs2943634 and MC4R rs17782313 with increased high-sensitivity C-reactive protein (P < .05). Energy intake and carbohydrate and total fat intakes were reduced after the diet-oriented program (P < .05). Multivariate linear regression analysis showed associations of IRS2 rs1865434 with high basal fiber intake, IRS1 rs2943634 with low postprogram carbohydrate intake, and MC4R rs17782313 with low postprogram total fat and saturated fatty acid intakes (P < .05). Although significant associations did not survive correction for multiple comparisons using the Benjamini-Hochberg method in this exploratory study, polymorphisms in IRS1, IRS2, MC3R, and MC4R influence metabolic and inflammatory status in Brazilian adults. IRS1 and MC4R variants may influence carbohydrate, total fat, and saturated fatty acid intakes in response to a diet-oriented program in subjects with obesity.

Influence of polymorphisms in IRS1, IRS2, MC3R, and MC4R on metabolic and inflammatory status and food intake in Brazilian adults: An exploratory pilot study.

Polymorphisms in genes of leptin-melanocortin and insulin pathways have been associated with obesity and type 2 diabetes. We hypothesized that polymorphisms in IRS1, IRS2, MC3R, and MC4R influence metabolic and inflammatory markers and food intake composition in Brazilian subjects. This exploratory pilot study included 358 adult subjects. Clinical, anthropometric, and laboratory data were obtained through interview and access to medical records. The variants IRS1 rs2943634 A˃C, IRS2 rs1865434 C>T, MC3R rs3746619 C>A, and MC4R rs17782313 T>C were analyzed by real-time polymerase chain reaction. Food intake composition was assessed in a group of subjects with obesity (n = 84) before and after a short-term nutritional counseling program (9 weeks). MC4R rs17782313 was associated with increased risk of obesity (P = .034). Multivariate linear regression analysis adjusted by covariates indicated associations of IRS2 rs1865434 with reduced low-density lipoprotein cholesterol and resistin, MC3R rs3746619 with high glycated hemoglobin, and IRS1 rs2943634 and MC4R rs17782313 with increased high-sensitivity C-reactive protein (P < .05). Energy intake and carbohydrate and total fat intakes were reduced after the diet-oriented program (P < .05). Multivariate linear regression analysis showed associations of IRS2 rs1865434 with high basal fiber intake, IRS1 rs2943634 with low postprogram carbohydrate intake, and MC4R rs17782313 with low postprogram total fat and saturated fatty acid intakes (P < .05). Although significant associations did not survive correction for multiple comparisons using the Benjamini-Hochberg method in this exploratory study, polymorphisms in IRS1, IRS2, MC3R, and MC4R influence metabolic and inflammatory status in Brazilian adults. IRS1 and MC4R variants may influence carbohydrate, total fat, and saturated fatty acid intakes in response to a diet-oriented program in subjects with obesity.

[Food environment and excess weight in schoolchildren: a South American systematic reviewAmbiente alimentario y exceso de peso en la población escolar: revisión sistemática en América del Sur]. / Ambiente alimentar e excesso de peso em escolares: uma revisão sistemática sul-americana.

Objective: To identify and compile the findings of observational studies analyzing the relationship of factors from the school food environment and individual factors related to food consumption in school with excess weight in schoolchildren from South America in the period from 2011 to 2021. Method: The literature review involved a search performed in five databases (PubMed, Web of Science, SciELO, Scopus, and LILACS) and in Google Scholar, as well as a consultation with specialists. Studies were selected if they had an observational design, included schoolchildren aged 5 to 19 years, were performed in South America, and used objective measures such as body mass index (World Health Organization and/or International Obesity Task Force) to assess weight in association with school food environment factors and individual school consumption factors. The protocol was registered in PROSPERO (CRD42020212383). Results: Of 906 identified records, 13 cross-sectional studies (one from Argentina, one from Ecuador, and 11 from Brazil) were included in the review. The prevalence of overweight ranged from 7.5% to 32.5%, and of obesity, from 1.7% to 28.0%. School environment factors from the policy and physical domains (such as unsatisfactory food and nutrition education and unavailability of school-prepared meals) were associated with increased prevalence of excess weight. Individual factors related to adherence to the school meal program (such as consumption of meals offered by the school instead of bringing a snack from home) were associated with lower prevalence of excess weight. Conclusions: Only a few studies are available in South America with a focus on individual and/or school food environment factors and excess weight in schoolchildren. Since the available evidence is restricted to local or regional contexts, new national-level studies are warranted.

Objetivo: Identificar y recopilar los resultados de estudios observacionales realizados en América del Sur, en los cuales se analizó la relación entre los factores del ambiente alimentario escolar y los factores individuales de consumo de la población escolar con exceso de peso en el período del 2011 al 2021. Métodos: La investigación se realizó en cinco bases de datos (PubMed, Web of Science, SciELO, Scopus y LILACS), en Google Scholar y mediante consulta a expertos. Se seleccionaron estudios observacionales realizados en América del Sur con escolares de 5 a 19 años, en los cuales se emplearon medidas objetivas para evaluar el exceso de peso como el índice de masa corporal (Organización Mundial de la Salud y International Obesity Task Force) en relación con factores del ambiente alimentario escolar y factores individuales de consumo en la escuela. El protocolo se registró en la plataforma PROSPERO (CRD42020212383). Resultados: De los 906 registros identificados, en la revisión se incluyeron 13 estudios transversales (uno de Argentina, uno de Ecuador y 11 de Brasil). Las tasas de prevalencia del sobrepeso fluctuaron entre 7,5% y 32,5% y las de la obesidad, entre 1,7% y 28,0%. Los factores del ambiente alimentario escolar de los dominios político y físico (como educación poco satisfactoria en cuanto a alimentos y nutrición, y la falta de comidas preparadas en la escuela) guardaron relación con mayores tasas de prevalencia del exceso de peso. Los factores individuales referentes a la adhesión al programa de alimentación escolar (como el consumo de la alimentación ofrecida por la escuela en vez de la merienda llevada de la casa) guardaron relación con menores tasas de prevalencia del exceso de peso. Conclusiones: Son escasos los estudios realizados en América del Sur sobre la relación entre los factores del ambiente alimentario escolar y los factores individuales y el exceso de peso de la población escolar. El hecho de que la evidencia se limite a los contextos locales o regionales crea un incentivo para realizar nuevos estudios de alcance nacional.

Lack of validity of free-living physical activity energy expenditure estimated from ActiGraph equations in severely obese women: A doubly labelled water study.

The current study aimed to investigate the validity of three ActiGraph predictive equations that are available to estimate free-living physical activity energy expenditure (PAEE) in women with severe obesity. The study included 20 women with class III obesity (age: 22-38 years). During 14 days of free-living conditions, total energy expenditure was measured using the doubly labelled water method; in addition, participants wore a triaxial accelerometer (model GT3X+) on the hip. The resting metabolic rate was measured by indirect calorimetry. At group level, the Freedson VM3 Combination was found to be more precise (bias = -61 kcal/day) than the Williams Work-Energy (bias = -283 kcal/day) and the Freedson Combination equations (bias = -186 kcal/day) for estimating PAEE. However, the three predictive equations had a wider limit of agreement (Williams Work-Energy [258, -824 kcal/day], Freedson Combination equations [324, -697 kcal/day] and Freedson VM3 Combination [424, -546 kcal/day]), indicating great uncertainty of the estimate. In conclusion, a wide variation was observed in the performance of different ActiGraph equations in estimating free-living PAEE among women with class III obesity. Therefore, our data do not support the use of these equations, and more studies are needed to improve predictive performance in free-living conditions.

Food Availability in Different Food Environments Surrounding Schools in a Vulnerable Urban Area of Santiago, Chile: Exploring Socioeconomic Determinants.

The analysis of the food environment is used to identify areas with gaps in the availability of healthy foods and can be used as a public policy assessment tool. In recent decades, Chile has implemented several strategies and regulations to improve food environments, with encouraging results. Little is known about the scope of these measures in socially vulnerable environments. This study is part of a project that seeks to build an integrated intervention model for healthy school environments in a vulnerable area of Santiago, Chile. The objective of this study was to evaluate the availability of healthy and unhealthy foods around schools and the relationship between it and socioeconomic determinants of the school community in the Chilean context. A cross-sectional study to measure the food environment of informal markets (street food), formal markets (stores), and institutions (schools) was conducted in and around 12 schools (100 m surrounding schools) in a vulnerable urban area of Santiago, Chile. A lack of healthy foods was observed, which was related to some socio-economic determinants and the multidimensional poverty was the most relevant. The diagnosis of food environments around schools can represent an important target for governments to implement policies focused at improving the availability of healthy foods.

Lack of association between 11 gene polymorphisms on weight loss 1 year after Roux-en-y gastric bypass surgery in woman.

BACKGROUND: Although effective, the impact of bariatric surgery on weight loss is variable, and little is known about the influence of single-nucleotide polymorphisms (SNPs). The present study investigated the association of eleven SNPs related to obesity with weight loss 1 year after Roux-Y gastric bypass (RYGB) surgery in female patients. METHODS: This prospective study included 351 women with obesity. The genotypes for eleven SNPs (GHRL-rs26802; GHSR-rs572169; LEP-rs7799039; LEPR-rs1137101; 5HT2C-rs3813929; UCP2-rs659366; UCP3-rs1800849; SH2B1-rs7498665; TAS1R2-rs35874116; TAS1R2-rs9701796; FTO-rs9939609) were determined using a real-time polymerase chain reaction and TaqMan assays. Anthropometric measurements were performed before and 1 year after RYGB surgery. To evaluate the factors that influenced the proportion of weight loss 1 year after surgery, beta regression analysis was used. The models were estimated using the GLIMMIX procedure in SAS statistical software. p < 0.05 was considered statistically significant. RESULTS: The mean ± SD percentage of total body weight loss in 1 year was 64.4 ± 5.8% and the median was 65.0%. When assessing the proportion of weight loss in 1 year after surgery, using univariate analysis (beta regression), no SNPs influenced weight loss. Furthermore, in the multiple analysis, with stepwise process of variable selection, no variable was significant to compose the multiple model. CONCLUSIONS: The 11 SNPs investigated did not influence weight loss 1 year after RYGB surgery in female patients. This result indicates that individual behaviours and other factors might better contribute to the magnitude of loss weight loss in a short period after bariatric surgery.

Compliance of the Physical Activity Guidelines Accumulated in Bouts ≥10 Min and Nonbouts and Its Association With Body Composition and Physical Function: A Cross-Sectional Study in Brazilian Older Adults.

This study aimed to investigate the association between compliance with the guidelines of moderate to vigorous physical activity (MVPA) accumulated in bouts of ≥10 min or nonbouts with body composition and physical function in older adults. The authors evaluated 230 noninstitutionalized older adults. Body composition was estimated using bioimpedance, and physical function was assessed using four physical tests. Physical activities were monitored for 7 days using an accelerometer. Older adults who were physically active according to MVPA in bouts of ≥10 min were less likely to have low appendicular skeletal muscle mass (odds ratio [OR] = 0.12), excess body fat (OR = 0.30), and abdominal obesity (OR = 0.34) and more likely to have a higher physical function (OR = 5.78). No significant association was observed with MVPA nonbout. Our findings indicate that older adults who accumulate MVPA in bouts of  ≥10 min have better parameters for body composition and physical function.

Correction to: Agreement Between Body Composition Assessed by Bioelectrical Impedance Analysis and Doubly Labeled Water in Obese Women Submitted to Bariatric Surgery : Body Composition, BIA, and DLW.

The name of author Michele Novaes Ravelli was misspelled in the original article - it is correct here.

Agreement Between Body Composition Assessed by Bioelectrical Impedance Analysis and Doubly Labeled Water in Obese Women Submitted to Bariatric Surgery : Body Composition, BIA, and DLW.

INTRODUCTION: Bariatric surgery has a significant influence on body composition (BC), which should be monitored. However, there is a need to recommend low-cost practical methods, with good estimation of BC for class III obese and/or bariatric patients. OBJECTIVE: The aim of this study was to determine accuracy and agreement between BC assessed by direct segmental multifrequency bioelectrical impedance analysis (DSM-BIA) and doubly labeled water (DLW) as reference method. MATERIAL AND METHODS: Twenty class III obese women (age 29.3 ± 5.1 years; body mass index 44.8 ± 2.4 kg/m2) underwent Roux-en-Y gastric bypass surgery. BC (fat mass [FM], fat-free mass [FFM], and total body water [TBW]) was assessed by InBody 230 and DLW in the following periods: before and 6 and 12 months after surgery. Accuracy between the methods was evaluated by the bias and root mean square error. Pearson's correlation, concordance correlation coefficient (CCC), and Bland-Altman method were used to evaluate agreement between the methods. RESULTS: Correlations were significant (p < 0.001) and CCC was good/excellent between both methods for the evaluation of FM (r = 0.84-0.92, CCC = 0.84-0.95), FFM (r = 0.73-0.90, CCC = 0.68-0.80), and TBW (r = 0.76-0.91, CCC = 0.72-0.81) before and after bariatric surgery. In addition, no significant bias was observed between DSM-BIA and DLW for FM (mean error [ME] = - 1.40 to 0.06 kg), FFM (ME = 0.91-1.86 kg), and TBW (ME = 0.71-1.24 kg) measurements. CONCLUSION: The DSM-BIA was able to estimate the BC of class III obese women submitted to bariatric surgery with values consistent with those of the DLW method.

Changes in Physical Activities and Body Composition after Roux-Y Gastric Bypass Surgery.

PURPOSE: Given the importance of physical activities for health outcomes, it is still unclear whether bariatric surgery per se and the standard care after surgery would result in an increase of physical activity level. This study aimed to determine physical activities preoperatively and at 6 and 12 months postoperatively among female patients who underwent bariatric surgery, and to investigate its relationship with body composition changes. MATERIAL AND METHODS: Thirty-four women who had Roux-Y gastric bypass (RYGB) surgery completed the study. Physical activity was measured objectively for 7 consecutive days by using an ActiGraph GT3X+ accelerometer. Body composition was estimated by using multifrequency bioimpedance analysis. RESULTS: The percentage of time spent in moderate-to-vigorous physical activity (MVPA) changed significantly from preoperatively to 6 months postoperatively; however, no difference was observed at 12 months. No significant changes were detected for other physical activity variables. Multivariable regression analysis suggested that the percentage of time spent in sedentary activity was associated with fat-free mass loss at 6 months (ß = - 0.323; 95% CI = - 0.649 to 0.003) and 12 months (ß = - 0.510; 95% CI = - 0.867 to - 0.154) postoperatively. CONCLUSION: The overall MVPA increased at 6 months post-RYGB surgery; however, this change was not maintained at 12 months. Despite the considerable body mass loss postoperatively, most of the subjects were classified as being physically inactive and did not change their sedentary behavior. These findings indicate that female patients undergoing bariatric surgery should be encouraged to increase their physical activity level.

Micronutrient supplementation in gastric bypass surgery: prospective study on inflammation and iron metabolism in premenopausal women.

BACKGROUND: Low-grade chronic inflammation in morbid obesity is associated with impaired iron metabolism. Bariatric surgery is effective in weight loss; however, it can induce specific nutritional deficiencies, such as iron, especially in premenopausal women. Alternatively, after surgery, there is an improvement in systemic inflammation, raising questions concerning the dosages of micronutrient supplementation. OBJECTIVES: This study aimed to assess the effect of two micronutrient supplementation schemes before and 6 months after a Roux-en-Y gastric bypass (RYGB) surgery on inflammation and iron metabolism in premenopausal women. METHODS: This prospective study included 45 premenopausal women (aged 20-45 years; body mass index [BMI] ≥ 35 kg/m2) divided into two supplementation schemes: group 1 (n = 34): daily supplemental dose of 1 RDA 30 days before surgery and 2 RDAs during the six months following surgery; and group 2 (n = 11): daily supplementation of 1 RDA during the 6 months postsurgery. Anthropometry, dietary intake, inflammation, and iron metabolism were monitored. RESULTS: Evident reductions in BMI, high-sensitivity C-reactive protein, and ferritin levels for both groups occurred 6 months after surgery. Additionally, anemia was 9% in both groups after surgery. However, group 1 exhibited an increased transferrin saturation index and reduced transferrin levels. Multivariate regression analysis suggested serum iron, hepcidin, and iron intake determined ferritin values before and after RYGB surgery. CONCLUSION: Six months after RYGB, systemic inflammation was reduced in both supplementation schemes. However, supplementation of 1 RDA before and 2 RDAs after surgery resulted in better improvements on iron metabolism.

Gene polymorphisms as a predictor of body weight loss after Roux-en-Y gastric bypass surgery among obese women.

This study aimed to investigate the association between twelve gene polymorphisms and body weight loss, 12 months after Roux-en-Y gastric bypass (RYGB) surgery. Three hundred and fifty-one obese women participated in this study. The statistical software WEKA was used to identify which gene polymorphisms were potential predictors of postoperative percentage of excess weight loss (%EWL). Our results indicate that the only gene polymorphism that predicted %EWL was rs3813929, which is related to the serotonin receptor gene (5-HT2C). Therefore, the 5-HT2C gene polymorphism rs3813929 (more specifically, the TT genotype) predicted greater %EWL 12 months after RYGB surgery among female patients.

[Population coverage of the food and nutrition surveillance system in the state of São Paulo, Brazil]. / Cobertura populacional do Sistema de Vigilância Alimentar e Nutricional no Estado de São Paulo, Brasil.

This article sets out to estimate the population coverage of the Food and Nutrition Surveillance System (SISVAN) at different phases of life and to evaluate its operation in the state of Sao Paulo. The study included 65 cities divided in 14 state regions. The coverage of SISVAN was estimated using data from nutritional status monitoring available in public reports and on government websites, as well as the number of users attended by the public health services. Total users of public health services were obtained by the difference between the total number of inhabitants of 65 cities and the number of beneficiaries of private health plans. Most regions presented reduced population coverage (< 10%). Approximately 57% revealed population coverage of between 5 and 10%. There was a preponderance of records of the nutritional status of children for all regions of the state. A startling statistic was the low coverage for the elderly population, which was zero or near zero in most regions. Despite the efforts by the government to expand and enhance SISVAN, nutritional monitoring in Sao Paulo is still insufficient. This condition hinders the use of SISVAN to produce effective changes in food and nutrition policies.

Association between indicators of dementia and nutritional status in institutionalised older people.

BACKGROUND AND AIMS: Dementia weakens older people and can lead to malnutrition; therefore, the objective of this study was to assess the association between indicators of dementia and biochemical indicators, anthropometric indicators and food intake in institutionalised older people. METHODS: A total of 150 older people of both genders participated in this study. Nutritional status was determined by body mass index and other anthropometric variables, and biochemical indicators were used to analyse the differences between individuals with and without dementia. Energy and nutrient intakes were determined by food records, and dementia was investigated with the Mini-Mental State Examination. The data were analysed by the chi-square test, Student's t-test and Mann-Whitney tests. RESULTS: Of the 150 individuals studied, 48% were men with a mean age of 73 ± 10 years and 52% were women with a mean age of 80 ± 9 years. Thirty-six per cent had some degree of malnutrition and 48% presented dementia, which was more prevalent in women (59%). The nutritional status of men and women individuals with and without dementia differed significantly (P < 0.001 for men and women). The only variables that presented a significant difference between individuals with and without dementia were those associated with muscle mass in men. There were no differences in energy and nutrient intakes between individuals with and without dementia except for vitamin C intake, which differed among women (P = 0.032). CONCLUSION: In the conditions of the present study, dementia was associated with nutritional status, but not with energy and nutrient intakes, suggesting that older people with dementia may have higher nutritional requirements. Implications for practice. Investigation of dementia may contribute to the nutritional status assessment of older people and energy expenditure and immobility should be investigated for a more complete assessment.

Food intake in women two years or more after bariatric surgery meets adequate intake requirements.

Restricted food intake after bariatric surgery can be an important factor both in the long-term control of body weight and in the onset of nutritional deficiencies. The objective of this study was to assess the adequacy of food intake in women two or more years after bariatric surgery according to the excess weight lost. A group of 141 women who underwent banded Roux-en-Y gastric bypass (RYGB) was divided according to the percentage of excess weight they lost (%EWL)<50; 50┤75; = 75. The habitual energy and nutrient intakes were determined by a 24-hour recall over two days and the probability of adequate intake was based on the Dietary Reference Intake. The mean total estimated energy requirement (EER) as well as energy, macronutrient and cholesterol intakes did not differ among the groups. Only the %EWL<50 group had an intake equal to their EER, but they presented a higher number of inadequacies, such as low levels of magnesium, folic acid and vitamins C and E. Calcium and dietary fiber intakes were extremely low in all three groups. In conclusion, weight loss after surgery is associated with food habits that favor energy intake over micronutrient intake.

Food intake and nutritional status of hospitalised older people.

BACKGROUND AND AIMS: Disease is influenced by the nutritional status of the individual. We have assessed the relationship between nutritional status and food intake among recently hospitalised older people. METHODS: A cross-sectional study was undertaken with 240 older people in a hospital that provides care for the public and private healthcare systems. Nutritional status was classified by the MNA (Mini Nutritional Assessment) into: malnourished, risk of malnutrition and without malnutrition. Food intake was estimated by the reported food intake during a typical day. The Kruskal-Wallis test was used to compare the medians and the correlation coefficient of Spearman to verify the relationship between the consumption of energy, protein and vitamin C and MNA scores. RESULTS: 33.8% were classified as adequate regarding nutritional status; 37.1% were classified as being at risk of malnutrition and 29.1% were classified as malnourished. The malnourished individuals reported significantly less energy and nutrient intake than those at risk of malnutrition or those without malnutrition (P = 0.001). Not all nutrient intake, just some (iron, cholesterol and fibre), were lower in malnourished people. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Deterioration of the nutritional status of older people is accompanied by a reduction in energy and some nutrient intake. The investigation of food intake in older people could provide important information about nutritional risk.

Food aversions in women during the 2 years after Roux-en-Y gastric bypass.

The anatomical and physiological changes of the gastrointestinal tract after Roux-en-Y gastric bypass lead to changes in dietary patterns and their effects are still little known. Hence, the objective of this work was to characterize the prevalence, the associated factors and the list of food aversions with the effect of surgery on the body weight of women in the first two years after Roux-en-Y gastric bypass. A total of 141 women were studied. Their food aversions were assessed with a short food frequency questionnaire (FFQ-S) containing 26 items before and 6, 12 and 24 months after surgery. The FFQ-S was filled out during individual interviews and referenced in the medical records. The association between total aversion score and body weight variables and general characteristics of the group was analyzed. Variation of food aversions over time was assessed for 26 foods individually and grouped. Of all the studied variables, a weak but significant negative correlation (rs = -0.1944; p = 0.0208) was found between total aversion score and shorter postoperative period and a weak but significant positive correlation was found between total aversion score and percentage of weight regained (rs = -0.1759; p = 0.0369). Food aversions were more common in the first six months after surgery, especially to red meats, rice, chicken, eggs, pasta, milk and others. Food aversions in the early postoperative period are associated with weight variations in the first two years after surgery and subside significantly over time, probably because of a physiological and cognitive adaptation of the individual to the surgical procedure.