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3.
Clin Nutr ; 42(5): 687-699, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36947988

RESUMO

The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched the Sarcopenic Obesity Global Leadership Initiative (SOGLI) to reach expert consensus on a definition and diagnostic criteria for Sarcopenic Obesity (SO). The present paper describes the proceeding of the Sarcopenic Obesity Global Leadership Initiative (SOGLI) meeting that was held on November 25th and 26th, 2022 in Rome, Italy. This consortium involved the participation of 50 researchers from different geographic regions and countries. The document outlines an agenda advocated by the SOGLI expert panel regarding the pathophysiology, screening, diagnosis, staging and treatment of SO that needs to be prioritized for future research in the field.


Assuntos
Sarcopenia , Humanos , Cidade de Roma , Liderança , Obesidade , Itália
4.
Nutrients ; 15(3)2023 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-36771419

RESUMO

Medical nutrition therapy (MNT) is an indisputable component of the multidisciplinary therapeutic approach in rheumatoid arthritis (RA). Previous research has suggested that in chronic disease where nutrition is an important effector of prognosis, healthy dietary choices might take an unhealthy turn, with patients developing disordered eating in the form of orthorexia nervosa (ON). ON is characterized by a pathological preoccupation with "healthy", "pure" eating, associated with restrictive dietary patterns, nutrient deficiencies and worsening disease outcomes. The aim of the present cross-sectional study was to evaluate ON tendencies in a sample of adult patients with RA. A total of 133 patients with RA were recruited, and completed the ORTO-15 questionnaire for the assessment of ON tendencies. Most of the patients were overweight/obese (53.4%). The results revealed ON tendencies in the sample, with the median ORTO-15 score reaching 36 (IQR: 33-39). Greater ON tendencies were associated with the female gender, and lowered ON tendencies with increasing age and body mass index. The present findings highlight the need for health professional awareness regarding the problem of ON in patients with RA and the importance of screening patients.


Assuntos
Artrite Reumatoide , Transtornos da Alimentação e da Ingestão de Alimentos , Adulto , Humanos , Feminino , Comportamentos Relacionados com a Saúde , Ortorexia Nervosa , Estudos Transversais , Comportamento Alimentar , Inquéritos e Questionários
5.
Nutrition ; 105: 111861, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36401998

RESUMO

Front-of-pack labels (FOPLs) aim at communicating to consumers the health value of food items in support of public health policies. Two main types can be discerned: directive and semidirective FOPLs using color schemes (e.g., Nutri-Score) and informative FOPLs (e.g., Nutrinform Battery). Directive approaches tend to show a "wear-out effect" and, additionally, they tend to have various underlying conceptual problems. Usually, their nutritional scores are calculated using changing, arbitrary algorithms and involve a reductionist set of parameters of debatable validity. Thus, they overstate the effects of selected nutritional factors, such as saturated fat and energy, while overlooking the food matrix and the more holistic aspects of nourishment. Moreover, they do not reflect the portion that is consumed, ignore the preparation steps at home, and fail to serve as a useful basis for composing a healthy diet. Also, so long as the nutritional formulations match the algorithmic standards, they tend to allow ultra-processed products. Thus, this might confuse and mislead consumers. Overconfidence in green-colored labels could even result in unbalanced dietary choices, whereas avoidance of red products may eliminate certain foods from the diet that are rich in essential nutrients (e.g., cheese), leading to opposite results than aimed for. The latter is particularly relevant to vulnerable populations, such as the young, pregnant women, and older adults, or for individuals with specific needs. Taken together, directive FOPLs such as Nutri-Score contradict the declared intent of the European Commission to empower consumers to undertake healthy and balanced diets based on easily accessible and robust information. Although informative systems usually also keep the focus on a few selected nutritional parameters, they have are less paternalizing and obviate the need to classify foods as healthy or unhealthy. They also focus attention on the individual portions that are consumed (even if the definition of portion size remains contentious). Given the importance of dietary patterns, rather than individual foods or nutrients, directiveFOPLs of the Nutri-Score type represent a regretful case of nutritionism. Finally, attempts to associate the adoption of a FOPL with an improvement in the health status are few and mainly applied in virtual settings; none of which are longitudinal, nor have they been able to identify a causal link.


Assuntos
Dieta Saudável , Rotulagem de Alimentos , Humanos , Feminino , Gravidez , Idoso , Valor Nutritivo , Dieta , Comportamento do Consumidor , Preferências Alimentares
6.
Eat Weight Disord ; 2022 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-36436144

RESUMO

PURPOSE: Since the term orthorexia nervosa (ON) was coined from the Greek (ὀρθός, right and ὄρεξις, appetite) in 1997 to describe an obsession with "correct" eating, it has been used worldwide without a consistent definition. Although multiple authors have proposed diagnostic criteria, and many theoretical papers have been published, no consensus definition of ON exists, empirical primary evidence is limited, and ON is not a standardized diagnosis. These gaps prevent research to identify risk and protective factors, pathophysiology, functional consequences, and evidence-based therapeutic treatments. The aims of the current study are to categorize the common observations and presentations of ON pathology among experts in the eating disorder field, propose tentative diagnostic criteria, and consider which DSM chapter and category would be most appropriate for ON should it be included. METHODS: 47 eating disorder researchers and multidisciplinary treatment specialists from 14 different countries across four continents completed a three-phase modified Delphi process, with 75% agreement determined as the threshold for a statement to be included in the final consensus document. In phase I, participants were asked via online survey to agree or disagree with 67 statements about ON in four categories: A-Definition, Clinical Aspects, Duration; B-Consequences; C-Onset; D-Exclusion Criteria, and comment on their rationale. Responses were used to modify the statements which were then provided to the same participants for phase II, a second round of feedback, again in online survey form. Responses to phase II were used to modify and improve the statements for phase III, in which statements that met the predetermined 75% of agreement threshold were provided for review and commentary by all participants. RESULTS: 27 statements met or exceeded the consensus threshold and were compiled into proposed diagnostic criteria for ON. CONCLUSIONS: This is the first time a standardized definition of ON has been developed from a worldwide, multidisciplinary cohort of experts. It represents a summary of observations, clinical expertise, and research findings from a wide base of knowledge. It may be used as a base for diagnosis, treatment protocols, and further research to answer the open questions that remain, particularly the functional consequences of ON and how it might be prevented or identified and intervened upon in its early stages. Although the participants encompass many countries and disciplines, further research will be needed to determine if these diagnostic criteria are applicable to the experience of ON in geographic areas not represented in the current expert panel. LEVEL OF EVIDENCE: Level V: opinions of expert committees.

8.
Eat Weight Disord ; 27(7): 2481-2496, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35297008

RESUMO

PURPOSE: Anorexia nervosa (AN) is a serious and complex mental disorder affecting mainly young adult women. AN patients are characterized by low body weight in combination with self-induced starvation, intense fear of gaining weight, and distortion of body image. AN is a multifactorial disease, linked by recent evidence to a dysregulation of the immune system. METHODS: In this pilot study, 22 blood serums from AN patients were tested for the presence of autoantibodies against primate hypothalamic periventricular neurons by immunofluorescence and by a home-made ELISA assay. Cellular fluorescence suggests the presence of autoantibodies which are able to recognize these neurons (both to body cell and fiber levels). By means of ELISA, these autoantibodies are quantitatively evaluated. In addition, orexigenic and anorexigenic molecules were measured by ELISA. As control, 18 blood serums from healthy age matched woman were analysed. RESULTS: All AN patients showed a reactivity against hypothalamic neurons both by immunofluorescence and ELISA. In addition, ghrelin, pro-opiomelanocortin (POMC), and agouti-related peptide (AGRP) were significantly higher than in control serums (p < 0.0001). In contrast, leptin was significantly lower in AN patients than controls (p < 0.0001). CONCLUSIONS: Immunoreaction and ELISA assays on AN blood serum suggest the presence of autoantibodies AN related. However, it is not easy to determine the action of these antibodies in vivo: they could interact with specific ligands expressed by hypothalamic cells preventing their physiological role, however, it is also possible that they could induce an aspecific stimulation in the target cells leading to an increased secretion of anorexigenic molecules. Further studies are needed to fully understand the involvement of the immune system in AN pathogenesis. LEVEL OF EVIDENCE: V, descriptive study.


Assuntos
Anorexia Nervosa , Pró-Opiomelanocortina , Proteína Relacionada com Agouti , Animais , Autoanticorpos , Feminino , Grelina , Humanos , Leptina , Transtornos Fóbicos , Projetos Piloto
9.
Clin Nutr ; 41(4): 990-1000, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35227529

RESUMO

INTRODUCTION: Loss of skeletal muscle mass and function (sarcopenia) is common in individuals with obesity due to metabolic changes associated with a sedentary lifestyle, adipose tissue derangements, comorbidities (acute and chronic diseases), and during the ageing process. Co-existence of excess adiposity and low muscle mass/function is referred to as sarcopenic obesity (SO), a condition increasingly recognized for its clinical and functional features that negatively influence important patient-centred outcomes. Effective prevention and treatment strategies for SO are urgently needed, but efforts are hampered by the lack of an universally established SO Definition and diagnostic criteria. Resulting inconsistencies in the literature also negatively affect the ability to define prevalence as well as clinical relevance of SO for negative health outcomes. AIMS AND METHODS: The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched an initiative to reach expert consensus on a Definition and diagnostic criteria for SO. The jointly appointed international expert panel proposes that SO is defined as the co-existence of excess adiposity and low muscle mass/function. The diagnosis of SO should be considered in at-risk individuals who screen positive for a co-occurring elevated body mass index or waist circumference, and markers of low skeletal muscle mass and function (risk factors, clinical symptoms, or validated questionnaires). Diagnostic procedures should initially include assessment of skeletal muscle function, followed by assessment of body composition where presence of excess adiposity and low skeletal muscle mass or related body compartments confirm the diagnosis of SO. Individuals with SO should be further stratified into Stage I in the absence of clinical complications, or Stage II if cases are associated with complications linked to altered body composition or skeletal muscle dysfunction. CONCLUSIONS: ESPEN and EASO, as well as the expert international panel, advocate that the proposed SO Definition and diagnostic criteria be implemented into routine clinical practice. The panel also encourages prospective studies in addition to secondary analysis of existing datasets, to study the predictive value, treatment efficacy, and clinical impact of this SO definition.


Assuntos
Sarcopenia , Adiposidade/fisiologia , Composição Corporal , Índice de Massa Corporal , Humanos , Músculo Esquelético , Obesidade/complicações , Obesidade/diagnóstico , Obesidade/epidemiologia , Estudos Prospectivos , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia , Sarcopenia/terapia
10.
Obes Facts ; 15(3): 321-335, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35196654

RESUMO

INTRODUCTION: Loss of skeletal muscle mass and function (sarcopenia) is common in individuals with obesity due to metabolic changes associated with a sedentary lifestyle, adipose tissue derangements, comorbidities (acute and chronic diseases) and during the ageing process. Co-existence of excess adiposity and low muscle mass/function is referred to as sarcopenic obesity (SO), a condition increasingly recognized for its clinical and functional features that negatively influence important patient-centred outcomes. Effective prevention and treatment strategies for SO are urgently needed, but efforts are hampered by the lack of a universally established SO definition and diagnostic criteria. Resulting inconsistencies in the literature also negatively affect the ability to define prevalence as well as clinical relevance of SO for negative health outcomes. AIMS AND METHODS: The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched an initiative to reach expert consensus on a definition and diagnostic criteria for SO. The jointly appointed international expert panel proposes that SO is defined as the co-existence of excess adiposity and low muscle mass/function. The diagnosis of SO should be considered in at-risk individuals who screen positive for a co-occurring elevated body mass index or waist circumference, and markers of low skeletal muscle mass and function (risk factors, clinical symptoms, or validated questionnaires). Diagnostic procedures should initially include assessment of skeletal muscle function, followed by assessment of body composition where presence of excess adiposity and low skeletal muscle mass or related body compartments confirm the diagnosis of SO. Individuals with SO should be further stratified into stage I in the absence of clinical complications or stage II if cases are associated with complications linked to altered body composition or skeletal muscle dysfunction. CONCLUSIONS: ESPEN and EASO, as well as the expert international panel, advocate that the proposed SO definition and diagnostic criteria be implemented into routine clinical practice. The panel also encourages prospective studies in addition to secondary analysis of existing data sets, to study the predictive value, treatment efficacy and clinical impact of this SO definition.


Assuntos
Sarcopenia , Adiposidade/fisiologia , Composição Corporal , Índice de Massa Corporal , Humanos , Músculo Esquelético , Obesidade/complicações , Obesidade/diagnóstico , Obesidade/epidemiologia , Estudos Prospectivos , Sarcopenia/complicações , Sarcopenia/diagnóstico
11.
Eat Weight Disord ; 27(6): 2073-2080, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35092001

RESUMO

BACKGROUND: Within the literature, there is a variety of different measurement methods for orthorexic behaviours. The ORTO-15 is the one that attracted most research attention. Many scholars criticized the ORTO-15 for its unstable factor structure and over-estimation of the prevalence of orthorexia nervosa. For this purpose, Rogoza and Donini (Eat Weight Disord 26:887-895, 2020) re-assessed the original data and created a new tool, ORTO-R. The development of the ORTO-R theoretically solved many ambiguities associated with its parent measure. However, to date, no study, including the original one, tested the validity of the ORTO-R, leaving its utility somewhat speculative. METHODS: We gathered data from 363 Lebanese individuals, who answered the ORTO-R questions and a set of measures used to determine the validity of the scale (eating attitudes, perfectionism, body dissatisfaction, self-esteem, anxiety, and depression). Within this study, we analysed the internal consistency of the scale and different aspects of its validity (factorial, convergent, and divergent). RESULTS: Results supported all expectations; we successfully confirmed a one-factor measurement model of the ORTO-R, which appeared to be internally consistent. The ORTO-R score correlated positively to other orthorexic behaviours as well as to disordered eating attitudes, perfectionism, anxiety, and depression. It was also negatively related to self-esteem, but was unrelated to body dissatisfaction. CONCLUSION: The ORTO-R may be deemed as a valid instrument for the assessment of orthorexic behaviours. LEVEL OF EVIDENCE: V: Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Perfeccionismo , Atitude , Comportamento Alimentar , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Comportamentos Relacionados com a Saúde , Humanos , Inquéritos e Questionários , Adulto Jovem
12.
Hormones (Athens) ; 21(2): 251-260, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35092606

RESUMO

PURPOSE: The present study aimed to validate the ORTO-15 questionnaire for orthorexia nervosa (ON), translated by our group into the Greek language, and replicate the findings of the recently proposed 6-item ORTO-R. METHODS: The tool was translated into the Greek language (ORTO-15-GR) using the forward-backward-forward method. A total of 848 adults participated in the validation study by filling in the questionnaires and providing general characteristics (age, gender, educational level, body weight, and height). The internal consistency of the tool was assessed by the omega (ω) coefficient, and confirmatory factor analyses (CFA) examined its factorial structure. Using the original six items of the ORTO-15 tool, a separate CFA model examined the factorial structure of the proposed ORTO-R tool. Furthermore, regression models tested the association of ORTO-R with study variables. RESULTS: For ORTO-15-GR, the omega coefficient was 0.70 and for the ORTO-R 0.65. For the latter, the CFA revealed acceptable goodness-of-fit (standardized factor loadings from 0.36 to 0.64); however, all ORTO-15 models were characterized by a poor fit. In addition, there was a negative association between ORTO-R score and female gender, body mass index (BMI), and having a nutrition-related health problem. CONCLUSION: The replication of ORTO-R indicates that it is a reliable tool in the field of ON. Therefore, the use of a 6-item questionnaire for ON assessment appears promising in research and clinical settings.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Adulto , Comportamento Alimentar , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Feminino , Grécia , Comportamentos Relacionados com a Saúde , Humanos , Ortorexia Nervosa , Reprodutibilidade dos Testes , Inquéritos e Questionários
13.
World J Biol Psychiatry ; 23(5): 401-409, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-34842504

RESUMO

OBJECTIVES: Eating disorders (EDs) are severe psychiatric conditions characterised by malnutrition, dysfunctional behaviours, and hypovitaminosis D. In various psychiatric conditions, including EDs, preliminary evidence has correlated impulsivity to a low level of 25-hydroxyvitamin D [25(OH)D]. This study aims to reinforce this evidence by examining different facets, both behavioural and psychological, of the impulsivity construct in patients with ED. METHODS: A sample of 119 women was evaluated with a validated questionnaire and computerised neuropsychological tasks: the UPPS-P impulsive behaviour scale, a go/no-go task, and the Balloon Analogue Risk Task (BART). A clinical evaluation for EDs and blood sample collection were also performed to assess specific psychopathology and determine the serum level of 25(OH)D. RESULTS: Significant correlations were found between serum levels of 25(OH)D and BART scores (p = 0.012) and lack of perseverance (p = 0.034). Moreover, regression analyses showed that higher BART scores may be explained by hypovitaminosis D and higher levels of lack of perseverance in patients with EDs. CONCLUSIONS: The specific aspect of impulsivity linked to goal strategy and behaviours may be explained in patients with EDs by hypovitaminosis D. A possible connection to the brain inflammatory system is also discussed, along with possible directions for future research.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Deficiência de Vitamina D , Humanos , Feminino , Comportamento Impulsivo , Vitamina D , Deficiência de Vitamina D/psicologia
14.
Nutrition ; 93: 111487, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34655953

RESUMO

OBJECTIVES: The hospital catering service plays a decisive role in responding to clinical and nutritional needs and in providing food that is acceptable to patients. Unfortunately, at the moment, most hospital catering services provide a service deemed insufficient by users and are burdened by a high proportion of food waste that may negatively affect the nutritional and clinical status of patients. The aim of this study was to verify the efficacy of the NI-Nutritional Intelligence project in improving the nutritional and sensorial quality of hospital meals. METHODS: The study was conducted in the Cristo Re Hospital of Rome (Italy), where two different cooking techniques were compared: traditional procedures and the low-aggression gastronomic procedures of the Niko Romito Food Processing Technique. Data were collected on both objective (food waste) and subjective (customer satisfaction) evaluations of the food service. RESULTS: The proportion of participants wasting at least 50% of dishes served dropped from 25.9% to 20% for the first course, from 32.8% to 20% for the main course, and from 29.3% to 20.4% for the side (P < 0.05 in all cases). Regarding customer satisfaction, the percentage of participants who gave a positive opinion on the variety of the menus gradually increased from 74.1% to 95% (P < 0.05). The same happened for opinions concerning the presentation of the dishes (smell, color, flavor): positive judgments went from 51.7% to 76% (P < 0.05). The overall scoring of the food service (0-10) went from 6.38 ± 2.3 to 7.6 ± 2.1 (P < 0.05). CONCLUSION: The hospital catering service must be able to provide patients with meals with an adequate supply of energy and nutrients to allow them to recover their health and reduce hospital stays. The Nutritional Intelligence project, based on the gastronomic method proposed in the Niko Romito Food Processing Technique, significantly reduces food waste and improves customer satisfaction without imposing service costs related to catering staff and foodstuffs.


Assuntos
Serviço Hospitalar de Nutrição , Eliminação de Resíduos , Culinária , Hospitais , Humanos , Refeições
16.
Nutrition ; 85: 111131, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33545539

RESUMO

OBJECTIVES: Knowledge of factors determining dietary intake is important to develop targeted strategies to prevent malnutrition and age-related diseases. The aim of the present systematic review was to analyze the state of the art regarding the role of social status, cultural aspects, and psychological distress on dietary intake in community-dwelling older adults. METHODS: A systematic search was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedure. Titles, abstracts, and full texts were screened for predefined inclusion and exclusion criteria. RESULTS: Thirty-nine studies were included. Seven different groups of psychosocial and cultural determinants were associated with dietary intake. Family structure and living situation (e.g., loneliness, marital status), educational level, and income were the most important determinants associated with dietary choices and eating behavior. Less frequently, social assets, demographic parameters, psychosocial status, and awareness of current dietary recommendations were associated with the quality of the eating pattern. CONCLUSIONS: The results of our review indicate heterogeneity of the studies in the field of social and psychological determinants of dietary patterns in older adults, but some important conclusions can be drawn. Further research harmonizing and integrating approaches and methodologies are required to better understand the determinants of dietary intake and the complexity of their interactions.


Assuntos
Vida Independente , Desnutrição , Idoso , Dieta , Ingestão de Alimentos , Exercício Físico , Humanos
17.
Nutr Metab Cardiovasc Dis ; 31(11): 2993-3003, 2021 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-34518088

RESUMO

Epidemiological evidence has confirmed the potential causal relationship between specific dietary factors and non-communicable diseases. However, currently nutrition was shown to be insufficiently integrated into medical education, regardless of the country. Without an adequate nutrition education, it is reasonable to assume that future physicians, as well as other health care professionals, will be not able to provide the highest quality care to patients in preventing and treating non-communicable diseases. Furthermore, the insufficient availability of physicians with specializations in nutrition has posed the basis for the development of non-medical careers in the field of nutrition. The present document was drafting by the Italian College of Academic Nutritionists, MED-49 (ICAN-49), with the aim to provide an overview on the nutritional competency standards covered by several health care professionals (Physicians Clinical Nutrition Specialists, Clinical Dietitians, Professional Clinical Nutrition Specialists, etc) for the prevention of diseases and/or support of pharmacological therapies. The aim of the ICAN 49 is to suggest a major shift in practice opportunities and roles for many nutritionists, especially for the management of the metabolic diseases, and promote a paradigm change: a clinical and educational leadership role for Physician Clinical Nutrition Specialists in the hospital setting.


Assuntos
Educação de Pós-Graduação em Medicina , Corpo Clínico Hospitalar/educação , Doenças Metabólicas/dietoterapia , Terapia Nutricional , Ciências da Nutrição/educação , Estado Nutricional , Nutricionistas/educação , Competência Clínica/normas , Consenso , Hospitalização , Humanos , Corpo Clínico Hospitalar/normas , Doenças Metabólicas/diagnóstico , Doenças Metabólicas/fisiopatologia , Terapia Nutricional/normas , Ciências da Nutrição/normas , Nutricionistas/normas , Especialização , Resultado do Tratamento
18.
Curr Opin Clin Nutr Metab Care ; 24(1): 33-41, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33323715

RESUMO

PURPOSE OF REVIEW: Tough plenty of literature investigated therapeutic options for body composition changes targeting elderly people, evidence concerning potential treatments of sarcopenic obesity as a unique condition is scarce. The aim of the present review was to summarize recent evidence regarding treatment of sarcopenic obesity in adult and older individuals. RECENT FINDINGS: Exercise-based interventions were effective in ameliorating lean mass or sarcopenia-related indices and reducing total adiposity. Importantly, in one study, modifications of body composition were obtained in the absence of significant changes in body mass index. The majority of studies relied on resistance training, and all provided with beneficial effects in body composition. Conversely, effects in terms of muscle strength and functional ability were heterogeneous. Electrical acupuncture and whole-body electromyostimulation associated with nutritional supplementation resulted to be novel effective strategies in inducing body composition changes. Nonetheless, findings from nutritional supplementations are not conclusive, leading to conflicting results on strength and functional outcomes. SUMMARY: Specific interventions could improve sarcopenic obesity, but overall significance is limited by scarcity of data and lack of uniformity in the definition of sarcopenic obesity itself. Further research should clarify optimal treatment options for sarcopenic obesity in age classes other than the geriatric population.


Assuntos
Sarcopenia , Adiposidade , Idoso , Composição Corporal , Humanos , Força Muscular , Músculo Esquelético , Obesidade/complicações , Obesidade/terapia , Sarcopenia/terapia
19.
Eur J Phys Rehabil Med ; 57(4): 630-638, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33165313

RESUMO

BACKGROUND: Obesity is a clinical condition that contributes to the development of related disability in different areas (physical, psychological and social). Multidisciplinary treatment calls for specific instruments able to evaluate all related functional problems. We have developed a tool (an ICF-based assessment instrument, the ICF-OB schedule) to evaluate obesity-related disability, composed of an inventory of 71-items from the WHO International Classification of Functioning, Disability and Health (ICF). AIM: The aim of the present study was to validate this new tool for the definition of obesity-related disability. We also sought to examine the relationship between obesity disability, an index of multimorbidity (Cumulative Illness Rating Scale [CIRS]) and a well-validated score of perceived obesity-related disability (Italian Obesity Society Test for Obesity-Related Disability [TSD-OC]). DESIGN: Process validation of the ICF-OB schedule. SETTING: Baseline conditions of out- and in-patients. POPULATION: A large cohort of obese patients recruited from 9 multidisciplinary centers belonging to the Italian Obesity Society (SIO) network, which provide specialized obesity care. METHODS: A total of 353 patients (F: 70%, age: 50.2±12.7yrs, BMI: 41.4±8.3kg/m2) were enrolled between January 2017 and June 2018. The ICF-OB was used to define patients' functioning and disability profiles in order to set and appraise rehabilitation goals. RESULTS: We described the distribution of body functions (BF), body structures (BS) and activities and participations (A&P) categories and the agreement rates were significant for the majority of these. The ICF-OB was more often significantly associated, and with stronger coefficients, with patients' comorbidities as described by the CIRS rather than with Body Mass Index (BMI). The TSD-OC also presented a strong association with A&P indexes. CONCLUSIONS: The complexity of clinical condition, that generates disability in obesity might be well identified with the use of this new instrument that appear significant related to the perceived disability for each patients and also with their multimorbidity. CLINICAL REHABILITATION IMPACT: The ICF-OB shows great promise as a tool for goal setting in the rehabilitation of obese patients.


Assuntos
Avaliação da Deficiência , Classificação Internacional de Funcionalidade, Incapacidade e Saúde , Obesidade/classificação , Obesidade/fisiopatologia , Inquéritos e Questionários/normas , Atividades Cotidianas , Adulto , Estudos de Coortes , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Obesidade/reabilitação
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