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1.
Einstein (Sao Paulo) ; 18: eAO4784, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31553356

RESUMO

OBJECTIVE: To evaluate the effect of three types of muscular resistance training on adiposity, inflammation levels and insulin activity in Swiss mice with fat-rich diet-induced obesity. METHODS: Lean and obese male Swiss mice were selected and allocated to one of eight groups comprising eight mice each, as follows: standard diet + no training; standard diet + muscular resistance training; standard diet + hypertrophy training; standard diet + strength training; high-fat diet + no training; high-fat diet + muscular resistance training; high-fat diet + hypertrophy training; high-fat diet + strength training. The training protocol consisted of stair climbing for a 10-week period. Blood samples were collected for lactate analysis, glucose level measurement and insulin tolerance test. After euthanasia, adipose tissues were removed and weighed for adiposity index determination. Fragments of epididymal adipose tissue were then embedded for histological analysis or homogenized for tumor necrosis factor alpha level determination using the ELISA method. RESULTS: Ausency of differences in total training volume and blood lactate levels overall emphasize the similarity between the different resistance training protocols. Body weight loss, reduced adipocyte area and lower adiposity index were observed in trained obese mice, regardless of training modality. Different training protocols also improved insulin sensitivity and reduced inflammation levels. CONCLUSION: Resistance training protocols were equally effective in reducing body fat, inflammation levels and insulin resistance in obese mice.


Assuntos
Adiposidade/fisiologia , Hipertrofia/fisiopatologia , Inflamação/fisiopatologia , Resistência à Insulina/fisiologia , Exercícios de Alongamento Muscular/métodos , Obesidade/fisiopatologia , Condicionamento Físico Animal/fisiologia , Tecido Adiposo Branco/fisiopatologia , Animais , Glicemia/análise , Peso Corporal/fisiologia , Dieta Hiperlipídica , Ensaio de Imunoadsorção Enzimática , Masculino , Camundongos , Camundongos Obesos , Reprodutibilidade dos Testes , Treinamento de Resistência/métodos , Fatores de Tempo , Fator de Necrose Tumoral alfa/análise
2.
Acta colomb. psicol ; 22(2): 148-177, July-Dec. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1019280

RESUMO

Abstract The objective of the present study was to design, validate and obtain the reliability of the Maternal Attitudes Towards Overweight and Childhood Obesity Scale. The validation of this instrument was carried out in four stages: a) Study 1: Exploratory, with N= 95 mothers and grandmothers aged 20 to 46 years (M age = 32.43, SD = 7.9) which used the semantic networks technique to inquire about the psychological meaning of overweight and obesity; b) Study 2: Content Validity, where 33 items were written and the content validity was obtained through five judges; c) Study 3: First Validation, which included 346 mothers aged 18 to 62 (M age = 33.08, SD = 6.8) with preschool children; 11 items were obtained distributed in three factors denominated: negative attitude (α = .72), meaning (α = .63) and importance (α = .56), with α = .77 of the total scale and an explained variance of 54.50%; d) Study 4: Second Validation, in which 369 mothers and grandmothers (3 %) aged between17 and 63 years (M age = 32.43, SD = 7.9) participated. The final scale was two-dimensional, composed of 11 items with an α =.85 and an explained variance of 46%, which evaluates the negative attitudes perceived towards obesity and its consequences.


Resumo O objetivo do presente estudo foi desenhar e validar a Escala de atitudes maternas com respeito ao sobrepeso e à obesidade infantil. Em particular, a validação consistiu de quatro etapas: (a) um estudo exploratório (Estudo 1) com 95 mães e avós de 20 a 46 anos (M idade = 32.43, DP = 7.9), no qual se utilizou a técnica de redes semânticas para conhecer o significado psicológico do sobrepeso e da obesidade; (b) um estudo de validade de conteúdo (Estudo 2), no qual 33 reativos foram escritos e a validade de conteúdo foi obtida por meio do conceito de cinco juizes; (c) um estudo para uma primeira validação (Estudo 3) com 346 mães de 18 a 62 anos (M idade = 33.08, DP = 6.8) com filhos em idade pré-escolar, com a qual foram obtidos 11 reativos distribuidos em três fatores, denominados atitude negativa (α = .72), significado (α = .63) e importância (α = .56), com um α = .77 na escala total e uma variância explicada de 54,50%, e (d) um estudo para uma segunda validação (Estudo 4), no qual participaram 369 mães e avós (3 %) de 17 a 63 anos (M idade = 32.43, DE = 7.9). Como resultado, a escala foi bidimensional, composta por 11 reativos, com um α = .85 e uma variância explicada de 46%, que avalia as atitudes negativas percebidas com respeito à obesidade e suas consequências.


Resumen El objetivo del presente estudio fue diseñar y validar la escala de actitudes maternas hacia el sobrepeso y la obesidad infantil. En particular, la validación consistió en cuatro etapas: (a) un estudio exploratorio (Estudio 1) con 95 madres y abuelas de 20 a 46 años (M edad = 32.43, DE = 7.9), en el que se utilizó la técnica de redes semánticas para conocer el significado psicológico del sobrepeso y la obesidad; (b) un estudio de validez de contenido (Estudio 2), en el que se redactaron 33 reactivos, y la validez de contenido se obtuvo mediante el concepto de cinco jueces; (c) un estudio para una primera validación (Estudio 3) con 346 madres de 18 a 62 años (M edad = 33.08, DE = 6.8), con hijos en edad preescolar, con el cual se obtuvieron 11 reactivos distribuidos en tres factores, denominados actitud negativa (α = .72), significado (α = .63) e importancia (α = .56), con un α = .77 en la escala total y una varianza explicada del 54.50 %; y (d) un estudio para una segunda validación (Estudio 4), en el que participaron 369 madres y abuelas (3 %) de 17 a 63 años (M edad = 32.43, DE = 7.9). Como resultado, la escala fue bidimensional, compuesta por 11 reactivos, con un α = .85 y una varianza explicada del 46 %, que evalúa las actitudes negativas percibidas hacia la obesidad y las consecuencias de esta.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Sobrepeso , Mães , Obesidade
3.
S D Med ; 72(9): 419-423, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31581377

RESUMO

BACKGROUND: A disparity in overweight/obesity prevalence exists between rural and urban youth; however, definitions of 'rural' vary widely and the degree to which rurality impacts overweight/obesity prevalence is unclear. Therefore, the purpose of this study was to examine the school height and weight data in a rural Midwest state to determine differences in overweight and obesity prevalence among youth by using Rural-Urban Continuum (RUC) codes to define county-level degree of urbanization. METHODS: De-identified statewide data were obtained in electronic format from the state Department of Health. Height, weight, sex and age were used to calculate body mass index (BMI) z-scores, which were used to determine BMI percentile and categories. The county variable was used to assign a RUC code to each individual. Logistic regression was used to examine binary weight classifications by rural status while controlling for age, sex and race/ethnicity. RESULTS: Odds of obesity and of overweight/obesity were higher among rural youth compared to non-rural. Odds of overweight/obesity increased with increasing rurality. Compared to youth who lived in counties with a RUC code of 3, youth who lived in counties with RUC codes of 5, 7, 8 and 9 had greater odds of overweight/obesity. The number of youth classified as 'rural' ranged from 11-48 percent, depending on how 'rural' was defined. Likewise, overweight/obesity prevalence differed by 4.6 percent depending on how 'rural' was defined. CONCLUSIONS: Consistently defining 'rural' and determining degree of rurality is important in understanding how geographic location plays a role in overweight/obesity among youth. Future research should work to assess the physical and social environments of these different types of rural areas to better understand the role that rurality plays in contributing to overweight/obesity among youth. Assessing social determinants of health and its impact on health in rural youth is essential for designing effective public health interventions that can be implemented to address the issue.


Assuntos
Obesidade , Sobrepeso , População Rural , População Urbana , Adolescente , Índice de Massa Corporal , Criança , Humanos , Meio-Oeste dos Estados Unidos/epidemiologia , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Prevalência
4.
Medicine (Baltimore) ; 98(39): e17303, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574857

RESUMO

Treatment with nitisinone (NTBC) has brought about a drastic improvement in the treatment and prognosis of hereditary tyrosinemia type I (HT1). We conducted a retrospective observational multicentric study in Spanish HT1 patients treated with NTBC to assess clinical and biochemical long-term evolution.We evaluated 52 patients, 7 adults and 45 children, treated with NTBC considering: age at diagnosis, diagnosis by clinical symptoms, or by newborn screening (NBS); phenotype (acute/subacute/chronic), mutational analysis; symptoms at diagnosis and clinical course; biochemical markers; doses of NTBC; treatment adherence; anthropometric evolution; and neurocognitive outcome.The average follow-up period was 6.1 ±â€Š4.9 and 10.6 ±â€Š5.4 years in patients with early and late diagnosis respectively. All patients received NTBC from diagnosis with an average dose of 0.82 mg/kg/d. All NBS-patients (n = 8) were asymptomatic at diagnosis except 1 case with acute liver failure, and all remain free of liver and renal disease in follow-up. Liver and renal affectation was markedly more frequent at diagnosis in patients with late diagnosis (P < .001 and .03, respectively), with ulterior positive hepatic and renal course in 86.4% and 93.2% of no-NBS patients, although 1 patient with good metabolic control developed hepatocarcinoma.Despite a satisfactory global nutritional evolution, 46.1% of patients showed overweight/obesity. Interestingly lower body mass index was observed in patients with good dietary adherence (20.40 ±â€Š4.43 vs 24.30 ±â€Š6.10; P = .08) and those with good pharmacological adherence (21.19 ±â€Š4.68 vs 28.58 ±â€Š213.79).intellectual quotient was ≥85 in all NBS- and 68.75% of late diagnosis cases evaluated, 15% of which need pedagogical support, and 6.8% (3/44) showed school failure.Among the 12 variants identified in fumarylacetoacetate hydrolase gene, 1 of them novel (H63D), the most prevalent in Spanish population is c.554-1 G>T.After NTBC treatment a reduction in tyrosine and alpha-fetoprotein levels was observed in all the study groups, significant for alpha-fetoprotein in no NBS-group (P = .03), especially in subacute/chronic forms (P = .018).This series confirms that NTBC treatment had clearly improved the prognosis and quality of life of HT1 patients, but it also shows frequent cognitive dysfunctions and learning difficulties in medium-term follow-up, and, in a novel way, a high percentage of overweight/obesity.


Assuntos
Cicloexanonas/uso terapêutico , Diagnóstico Tardio , Nitrobenzoatos/uso terapêutico , Obesidade , Qualidade de Vida , Tirosinemias , Adulto , Criança , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Diagnóstico Tardio/efeitos adversos , Diagnóstico Tardio/prevenção & controle , Inibidores Enzimáticos/uso terapêutico , Feminino , Seguimentos , Humanos , Recém-Nascido , Nefropatias/diagnóstico , Nefropatias/etiologia , Masculino , Determinação de Necessidades de Cuidados de Saúde , Triagem Neonatal/métodos , Obesidade/diagnóstico , Obesidade/etiologia , Prognóstico , Estudos Retrospectivos , Espanha , Tempo para o Tratamento , Tirosinemias/complicações , Tirosinemias/diagnóstico , Tirosinemias/tratamento farmacológico , Tirosinemias/psicologia
5.
Exp Suppl ; 111: 419-441, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31588542

RESUMO

Obesity is caused by an imbalance between energy intake and output, influenced by numerous environmental, biological, and genetic factors. Only a minority of people with obesity have a genetic defect that is the main cause of their obesity. A key symptom for most of these disorders is early-onset obesity and hyperphagia. For some genetic obesity disorders, the hyperphagia is the main characteristic, often caused by disruptions of the leptin-melanocortin pathway, the central pathway that regulates the body's satiety and energy balance. For other disorders, obesity is part of a distinct combination of other clinical features such as intellectual disability, dysmorphic facial features, or organ abnormalities. This chapter focuses on genetic obesity disorders and also summarizes the present knowledge on the genetics of the more common polygenic/multifactorial obesity.


Assuntos
Hiperfagia/genética , Obesidade/genética , Ingestão de Energia , Metabolismo Energético , Humanos , Leptina , Melanocortinas , Saciação
7.
Z Psychosom Med Psychother ; 65(3): 224-238, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31476994

RESUMO

App-controlled feedback devices can support sustainability of weight loss. Multicentre QUANT-study shows additional weight loss and gain of QoL via multiple feedback-devices in OPTIFAST®52-program Objective: Are three app-controlled feedback devices, tested against a simple pedometer in a weight reduction program, supporting sustainable therapy success and quality of life (QoL)? Methods: In this multi-centre randomised controlled study adults with obesity (n = 89, m = 46.5 years, women n = 54), achieved high weight loss (from 42.7 kg/m² to 35.2 kg/m²) while completing the first three month of the OPTIFAST®52-program. Thereafter the intervention group (IG) used feedback devices (BIA scale, blood pressure monitor, step counter), the control group a mechanical pedometer without app for another year. Intention-to-treat analysis (ITT) and As-treated analysis (AT) were carried out. Results: Feedback devices had a positive effect on fat-loss and secondary study objectives like QoL, leading to a better sustainability of these improvements. Participants in IG (AT for t2-t0) had improvements for Waist-to-Height-ratio (WHtR) and physically and mentally quality of life. Conclusion: The results are presumably based on an increase in self-efficacy and the experience of control. Future studies should be preceded by a pilot study to analyse acceptance problems.


Assuntos
Manutenção do Peso Corporal , Retroalimentação , Aplicativos Móveis , Obesidade/terapia , Qualidade de Vida , Perda de Peso , Programas de Redução de Peso/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
8.
Adv Exp Med Biol ; 1167: 129-155, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31520353

RESUMO

Multiple large-scale epidemiological studies have identified obesity as an important risk factor for a variety of human cancers, particularly cancers of the uterus, gallbladder, kidney, liver, colon, and ovary, but there is much uncertainty regarding how obesity increases the cancer risks. Given that obesity has been consistently identified as a major risk factor for uterine tumors, the most common malignancies of the female reproductive system, we use uterine tumors as a pathological context to survey the relevant literature and propose a novel hypothesis: chronic downregulation of the cyclin-dependent kinase 8 (CDK8) module, composed of CDK8 (or its paralog CDK19), Cyclin C, MED12 (or MED12L), and MED13 (or MED13L), by elevated insulin or insulin-like growth factor signaling in obese women may increase the chances to dysregulate the activities of transcription factors regulated by the CDK8 module, thereby increasing the risk of uterine tumors. Although we focus on endometrial cancer and uterine leiomyomas (or fibroids), two major forms of uterine tumors, our model may offer additional insights into how obesity increases the risk of other types of cancers and diseases. To illustrate the power of model organisms for studying human diseases, here we place more emphasis on the findings obtained from Drosophila melanogaster.


Assuntos
Drosophila melanogaster , Obesidade/complicações , Neoplasias Uterinas/patologia , Animais , Quinase 8 Dependente de Ciclina/genética , Modelos Animais de Doenças , Proteínas de Drosophila/genética , Feminino , Humanos , Complexo Mediador/genética , Fatores de Risco
9.
Coluna/Columna ; 18(3): 222-225, July-Sept. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1019775

RESUMO

ABSTRACT Objective The aim of this study was to evaluate the clinical and functional results of endoscopic lumbar discectomy in obese patients. Methods We selected 56 patients with lumbar disc hernia refractory to clinical treatment that underwent endoscopic discectomy. Twenty-five patients with a body mass index (BMI) greater than or equal to 30 kg/m 2 were analyzed through the Visual Analogue Scale and functional evaluation using the Oswestry Disability Index questionnaire and compared to 31 patients in the control group (BMI between 18.5 and 24.9 kg/m 2 ). These data were obtained in the preoperative period, in the immediate postoperative period, at 1 month, 3 months, 6 months and one year after surgery. Results The mean BMI in the control group was 22.1 kg/m 2 , and in the obese group, 33.6 kg/m 2 . In both groups there was a statistically significant improvement in clinical and functional analyzes. There was no statistical difference between the groups. Conclusions Lumbar transforaminal endoscopic discectomy has been shown to be a safe, effective and minimally invasive alternative for the treatment of lumbar disc herniation in obese patients. Level of Evidence III; Retrospective and Comparative Study.


RESUMO Objetivo A meta do estudo foi avaliar os resultados clínicos e funcionais da discectomia endoscópica lombar nos pacientes obesos. Métodos Foram selecionados 56 pacientes portadores de hérnia de disco lombar refratário ao tratamento clínico submetidos à discectomia endoscópica. Através de avaliação clínica - pela Escala Visual Analógica - e funcional - pelo questionário de Oswestry Disability Index. Foram analisados 25 pacientes com índice de massa corpórea (IMC) maior ou igual de 30 kg/m 2 e comparados com 31 pacientes do grupo controle (IMC entre 18,5 e 24,9 kg/m 2 ). Esses dados foram obtidos no período pré-operatório, no pós-operatório imediato, com 1 mês, 3 meses, 6 meses e um ano após a cirurgia. Resultados O IMC médio no grupo controle foi de 22,1 kg/m 2 , e no grupo obeso de 33,6 kg/m 2 . Em ambos os grupos houve melhora estatisticamente significativa nas análises clínicas e funcionais. Não se observou diferença estatística entre os grupos. Conclusão A discectomia endoscópica transforaminal lombar mostrou ser uma alternativa segura, efetiva e minimamente invasiva para o tratamento de hérnia de disco lombar em pacientes obesos. Nível de Evidência III; Estudo Retrospectivo, Comparativo.


RESUMEN Objetivo El objetivo de este estudio fue evaluar los resultados clínicos y funcionales de la discectomía lumbar endoscópica en pacientes obesos. Métodos Se seleccionaron 56 pacientes portadores de hernia discal lumbar refractaria al tratamiento clínico, sometidos a discectomía endoscópica. Se analizaron 25 pacientes con índice de masa corporal (IMC) mayor o igual a 30 kg/m 2 ) por medio de la Escala Visual Analógica y evaluación funcional mediante el cuestionario Índice de Discapacidad de Oswestry y se compararon a 31 pacientes del grupo control (IMC entre 18,5 kg/m 2 y 24,9 kg/m 2 ). Estos datos fueron obtenidos en el preoperatorio, en el postoperatorio inmediato, al mes, a los 3 meses, 6 meses y un año después de la cirugía. Resultados El IMC promedio en el grupo control fue de 22,1 kg/m 2 y en el grupo obeso, de 33,6 kg/m 2 . En ambos grupos hubo una mejoría estadísticamente significativa en los análisis clínicos y funcionales. No hubo diferencia estadística entre los grupos. Conclusiones La discectomía endoscópica transforaminal lumbar se ha mostrado una alternativa segura, eficaz y mínimamente invasiva para el tratamiento de hernia discal lumbar en pacientes obesos. Nivel de Evidencia III; Estudio Retrospectivo y Comparativo.


Assuntos
Humanos , Discotomia Percutânea , Procedimentos Cirúrgicos Minimamente Invasivos , Endoscopia , Deslocamento do Disco Intervertebral , Obesidade
10.
Braz J Med Biol Res ; 52(9): e8402, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31482976

RESUMO

Cardiopulmonary fitness assessment is a valuable resource to obtain quantitative indicators of an individual's physical performance. The cardiopulmonary exercise test (CPX), considered the gold standard test for this evaluation, is costly and difficult to be accessed by the general population. In order to make this evaluation more accessible, and to better reflect the performance of daily life activities, alternative tests were proposed. Morbidly obese patients present limitations that impair physical performance assessment and could benefit from a test of shorter duration, provided it is validated. This observational study aimed to validate the two-minute step test (2MST) as a tool to evaluate functional capacity (FC) in obese with comorbidities and morbidly obese patients, compared the 2MST with CPX as a measure of physical performance, and developed a predictive equation to estimate peak oxygen uptake (VO2) in the 2MST. The CPX and the 2MST were performed and metabolic and ventilatory parameters were recorded in 31 obese individuals (BMI>35 kg/m2). Pearson correlation and multiple linear regression analyses were performed to evaluate the peak VO2 best predictors. Bland-Altman analysis was performed to assess the agreement between the two methods. Peak VO2 measured by CPX and 2MST showed a strong correlation (r=0.70, P<0.001) and there was a moderate correlation between peak VO2 of the 2MST and the number of up-and-down step cycles (UDS) (r=0.55; P=0.01). The reference equation obtained was: VO2 (mL·kg-1·min-1) = 13.341 + 0.138 × total UDS - (0.183 × BMI), with an estimated standard error of 1.3 mL·kg-1·min-1. The 2MST is a viable, practical, and easily accessible test for FC. UDS and BMI can predict peak VO2 satisfactorily.


Assuntos
Aptidão Cardiorrespiratória/fisiologia , Tolerância ao Exercício/fisiologia , Frequência Cardíaca/fisiologia , Obesidade/fisiopatologia , Consumo de Oxigênio/fisiologia , Teste de Caminhada/métodos , Adolescente , Adulto , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/fisiopatologia , Fatores de Tempo , Adulto Jovem
11.
J Agric Food Chem ; 67(38): 10595-10603, 2019 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-31475817

RESUMO

While ß-cryptoxanthin is hypothesized to have a preventive effect on lifestyle-related diseases, its underlying mechanisms are unknown. We investigated the effect of ß-cryptoxanthin on energy metabolism in adipose tissues and its underlying mechanism. C57BL/6J mice were fed a high-fat diet (60% kcal fat) containing 0 or 0.05% ß-cryptoxanthin for 12 weeks. ß-cryptoxanthin treatment was found to reduce body fat gain and plasma glucose level, while increasing energy expenditure. The expression of uncoupling protein (UCP) 1 was elevated in adipose tissues in the treatment group. Furthermore, the in vivo assays showed that the Ucp1 mRNA expression was higher in the ß-cryptoxanthin treatment group, an effect that disappeared upon cotreatment with a retinoic acid receptor (RAR) antagonist. In conclusion, we report that ß-cryptoxanthin reduces body fat and body weight gain and that ß-cryptoxanthin increases the expression of UCP1 via the RAR pathway.


Assuntos
Tecido Adiposo/efeitos dos fármacos , Tecido Adiposo/metabolismo , beta-Criptoxantina/administração & dosagem , Obesidade/tratamento farmacológico , Receptores do Ácido Retinoico/metabolismo , Proteína Desacopladora 1/genética , Animais , Metabolismo Energético/efeitos dos fármacos , Expressão Gênica/efeitos dos fármacos , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Obesidade/genética , Obesidade/metabolismo , Receptores do Ácido Retinoico/genética , Transdução de Sinais/efeitos dos fármacos , Proteína Desacopladora 1/metabolismo
12.
Ther Umsch ; 76(3): 111-116, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31498044

RESUMO

Health effects of sugar consumption and possible alternatives Abstract. A wide range of chronic diseases is associated with sugar consumption: Caries, obesity, metabolic syndrome with impaired glucose tolerance and / or diabetes, elevated blood, lipids arterial, hypertension, hepatic steatosis and cardiovascular morbidity and mortality. There is an urgent need to reduce sugar consumption. Sugar surrogates may help achieving this goal. However, artificial sweeteners seem to be associated with adverse metabolic effects such as insulin resistance, obesity, and altered gut microbiota composition. Naturally occurring sweeteners such as xylitol, erythritol and rare sugars are possibly more favorable, but have to be studied in detail.


Assuntos
Diabetes Mellitus , Açúcares/administração & dosagem , Açúcares/efeitos adversos , Edulcorantes/administração & dosagem , Diabetes Mellitus/prevenção & controle , Humanos , Resistência à Insulina , Obesidade/etiologia , Obesidade/prevenção & controle , Edulcorantes/efeitos adversos
13.
Ther Umsch ; 76(3): 117-121, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31498046

RESUMO

Obesity: epidemiology, socio-political implications and conventional management Abstract. Obesity is a chronic and complex psychosomatic disorder of multifactorial origin associated with cardiovascular, metabolic, respiratory, orthopedic and psychological comorbidities. This polimorbidity requires lifelong monitoring and specialized multidisciplinary management. In addition, the silent nature of these diseases, associated with the aging of the population and growing life expectancy, further increases the impact of this chronic disease on the overall morbidity and mortality. In Switzerland, obesity is now epidemic, as it is worldwide, and affects about 11 % of our population. This percentage is gradually increasing to the point that obesity is considered a public health problem. The direct and indirect costs of obesity account for about 8 % of total health consumption. The management of this complex disease must always be long-term and must integrate the dietary, behavioral and psychological aspects according to the profile of the patient.


Assuntos
Expectativa de Vida , Obesidade , Comorbidade , Humanos , Morbidade , Obesidade/economia , Obesidade/epidemiologia , Obesidade/terapia , Suíça
14.
Rev Col Bras Cir ; 46(4): e2238, 2019 Sep 09.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31508735

RESUMO

OBJECTIVE: to compare the effects of the hydroalcoholic extract from the peel of Camu-Camu, a fruit plant belonging to the Myrtaceae family, widely distributed in the Amazon basin, with those of sleeve gastrectomy, on the weight and glycemia of Wistar rats. METHODS: twenty-four Wistar rats underwent obesity induction through a hyperlipid diet for eight weeks (fat period), and were randomized into three groups: Control Group (CG), Camu-Camu Group (CCG) and Bariatric Surgery Group (BSG). After this period, all animals returned to a normal diet and the intervention period began: CG did not undergo any intervention beyond diet change; CCG animals underwent gavage procedure for administration of Camu-Camu hydroalcoholic extract, 1g/kg/day, for four weeks; and the BSG was submitted to the surgical procedure of sleeve gastrectomy. We followed all animals for four weeks. RESULTS: there was only one loss in BSG due to a gastric fistula. We observed significant variations in the animals' mean weight: the CG evolved with weight gain even after the withdraw of the hypercaloric diet, while the other two groups presented weight reduction. BSG presented a significant reduction of weight and BMI (p<0.05); CCG achieved a significant reduction only of the BMI (p<0.05). There were no statistically significant changes in the glycemic levels. CONCLUSION: in spite of reducing weight, the crude hydroalcoholic extract of the Camu-Camu peel was not able to be as efficient as sleeve gastrectomy in the control of body weight in Wistar rats.


Assuntos
Cirurgia Bariátrica , Myrtaceae/química , Obesidade/dietoterapia , Obesidade/cirurgia , Perda de Peso , Animais , Suplementos Nutricionais , Modelos Animais de Doenças , Frutas/química , Masculino , Terapia Nutricional , Obesidade/etiologia , Ratos , Ratos Wistar
15.
Am Surg ; 85(8): 927-933, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31560314

RESUMO

Selection of orthotopic liver transplantation (OLT) candidates is increasingly inclusive of patients with high BMI. We aim to characterize the influence of obesity on the surgical outcome measures of prolonged operative time and unplanned reoperation. We reviewed the records of obese and normal weight OLT recipients over a 10-year period from a single institution. Variables that trended (P < 0.1) with endpoints on univariate analysis were put into multivariate logistic regression models to determine independent association (P < 0.05). We included 195 obese and 171 normal weight OLT recipients in our study. On multivariate analysis, obesity was the only preoperative risk factor that trended with unplanned reoperation (odds ratio 2, P = 0.05). Similarly, only obesity remained independently associated with prolonged length of operation (defined as ≥275 minutes) on multivariate analysis (odds ratio 1.7, P = 0.04). In summary, obesity may make OLT more technically challenging and, thus, represents an independent risk factor for unplanned reoperations and prolonged operative time.


Assuntos
Transplante de Fígado , Obesidade/complicações , Duração da Cirurgia , Reoperação/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Tennessee/epidemiologia
16.
J Assoc Physicians India ; 67(8): 52-56, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31562717

RESUMO

Background: There have been many studies conducted so far on Non Alcoholic Fatty Liver Disease (NAFLD) with its many aspects including its association with 25 hydroxy Vitamin D levels and its rather complex interplay with pro-inflammatory cytokines such as Interleukin-1a (IL-1a), Interleukin-6 (IL-6) and Tumour Necrosis Factor-Alpha (TNF-α), Interleukin-17a (IL-17a) and anti-inflammatory cytokines such as Interleukin-4 (IL-4) and Interleukin-10 (IL-10). This study was designed to show the development of NAFLD in the young tribal population of Tripura and the link between 25(OH) Vitamin D and pro-inflammatory cytokines (IL-1a, IL-6, IL-17a and TNF-ɑ) and -inflammatory cytokines such as IL - 4 and IL - 10 and the development of NAFLD while at the same time throws light on the prevalence of 25(OH) Vitamin D deficiencies and the levels of pro-inflammatory cytokines in the study group. Methods: The study is an analytical cross-sectional study with final population of 94 cases between 18 to 40 years of age fulfilling inclusion and exclusion criteria and an equal number of subjects from same tribal community age and sex matched taken as control population. Results: There was a significant relationship between level of 25(OH) Vitamin D and fatty liver (OR: 9.46, 95% CI: 4.82 - 18.59; p < 0.001). The mean serum 25(OH) Vitamin D level in the cases was significantly higher than the controls (17.21 ng/ ml + 6.34 ng/ml vs 26.56 ng/ml + 10.63 ng/ml; p < 0.001). There was a significant difference between the mean serum levels of IL-1a (11.50 Pg/ml ± 2.75 Pg/ml vs 8.28 Pg/ml ± 2.08 Pg/ml; p < 0.001), IL-4 (0.69 Pg/ml ± 0.43 Pg/ml vs 0.84 Pg/ml ± 0.36 Pg/ml; p = 0.009), IL-6 (2.99 ± 1.11 Pg/ml vs 2.22 ± 1.08 Pg/ml; p < 0.001), IL-10 (6.50 ± 2.76 Pg/ml vs 5.23 Pg/ml ± 2.67 Pg/ml; p = 0.002), IL-17a (5.33 Pg/ml ± 2.22 Pg/ml vs 3.64 Pg/ml ± 1.99 Pg/ml; p < 0.001) and TNF-α (6.99 ± 2.81 Pg/ml vs 5.40 ± 3.08 Pg/ml; p < 0.001) of the cases and the controls Low serum 25(OH) D [OR: 0.87 (95% CI: 0.83 - 0.92), p = 0.0001], and high IL-1a [OR: 1.52 (95% CI: 1.26 - 1.84), p < 0.0001] were independently associated with the risk of NAFLD. Conclusion: 25(OH) Vitamin D concentration are lower while that of IL-1a, IL-4, IL-6, IL-10, IL-17a and TNF-α are higher in subjects with fatty liver in comparison to those without. 25(OH) Vitamin D deficiency and high levels of serum IL-1a were independently associated with the risk of development of NAFLD.


Assuntos
Hepatopatia Gordurosa não Alcoólica , Obesidade , Deficiência de Vitamina D , Adolescente , Adulto , Estudos Transversais , Humanos , Vitamina D , Vitaminas , Adulto Jovem
17.
Artigo em Alemão | MEDLINE | ID: mdl-31529189

RESUMO

BACKGROUND: The current results of the "German Health Interview and Examination Survey for Children and Adolescents" (KiGGS Wave 2, 2014-2017) indicate that the prevalence of overweight and obesity among children and adolescents in Germany has hardly changed during this period. OBJECTIVES: What are the current prevalences for the other categories of the BMI distribution (severe underweight, underweight, and extreme obesity) and what changes have occurred between the KiGGS baseline survey (2003-2006) and KiGGS Wave 2 with regard to the BMI categories and the distribution of BMI values? MATERIALS AND METHODS: KiGGS Wave 2 analyses are based on data from 1762 boys and 1799 girls aged 3 to 17 years with valid measurements of height and weight. The KiGGS baseline survey provides information on 7531 boys and 7215 girls for trend evaluations. RESULTS: For underweight prevalence as well as for the prevalence of extreme obesity no change over time can be observed. The BMI percentiles also show only minor differences between the two survey periods with a marginal shift of the upper BMI percentiles downwards before puberty and a slight increase after puberty. There is no clear shift in the BMI distribution towards lower BMI values. DISCUSSION: There are now many activities at the national, regional, and local level that focus on prevention and intervention to reduce overweight and obesity. The marginal shifts in the upper BMI percentiles in the upper BMI percentiles before puberty observed here suggest that some success may have been achieved in obesity prevention among children in Germany.


Assuntos
Índice de Massa Corporal , Obesidade/epidemiologia , Magreza/epidemiologia , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Alemanha/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência
18.
Rev Col Bras Cir ; 46(4): e2252, 2019 Sep 09.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31508737

RESUMO

OBJECTIVE: to present a descriptive analysis of the results of a care bundle applied to obese patients submitted to bariatric surgery, regarding infection control. METHODS: a care bundle was designed to control surgical site infection (SSI) rates in patients undergoing bariatric surgery. The bundle included smoking cessation, bathing with 4% chlorhexidine two hours before surgery, cefazolin (2g bolus) in anesthetic induction associated with a continuous infusion of the same drug at a dose of 1g over a two-hour period, appropriate trichotomy, glycemic control, supplemental oxygen, normothermia, intraspinal morphine for the relief of pain, and sterile dressing removal 48 hours after surgery. All patients were followed up for 30 days. RESULTS: among the 1,596 included patients, 334 (20.9%) underwent open surgery and 1,262 (79.1%) underwent videolaparoscopic surgery. SSI rates were 0.5% in the group submitted to laparoscopic surgery and 3% in the one submitted to open surgery. The overall incidence of SSI was 1%. Intra-abdominal, respiratory tract, and urinary tract infections occurred in 0.9%, 1.1%, and 1.5% of the sample, respectively. Higher body mass index was associated with higher incidence of SSI (p=0.001). Among patients with diabetes, 2.2% developed SSI, while the rate of infection among non-diabetics was only 0.6%. CONCLUSION: the established care bundle, structured by core evidence-based strategies, associated with secondary measures, was able to maintain low SSI rates after bariatric surgery.


Assuntos
Cirurgia Bariátrica/efeitos adversos , Cirurgia Bariátrica/métodos , Pacotes de Assistência ao Paciente , Infecção da Ferida Cirúrgica/prevenção & controle , Adolescente , Adulto , Idoso , Índice de Massa Corporal , Brasil/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/cirurgia , Assistência Perioperatória/métodos , Estudos Prospectivos , Fatores de Risco , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/etiologia , Adulto Jovem
19.
Rev Saude Publica ; 53: 66, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31553376

RESUMO

OBJECTIVE: To evaluate the performance of the ratio between the waist circumference and the height in the identification of health risk compared with the correlation matrix between the anthropometric parameters body mass index and waist circumference. METHODS: A population-based study presenting a transversal cut in a representative sample of the Brazilian adult and older population. The combination of the body mass index with the waist circumference resulted in health risk categories, and the cutoff points of the ratio between the waist circumference and the height as anthropometric indicator were used for classification of low and increased risk. Poisson regression was used to verify the association of systemic arterial hypertension with the health risk categories. RESULTS: The results showed 26% of adult men, 10.4% of adult women and more than 30% of the older adults of both genders classified as without risk by the combination matrix between body mass index and waist circumference presented a ratio between the waist circumference and height that showed increased risk. All risk categories continued to be associated with hypertension after control for confounding factors, being almost two times higher for adults with moderate and high risk according to both methods. When the waist-to-height ratio was used as a risk indicator, the prevalence of hypertension ratios for the older adults was 1.37 (95%CI 1.16-1.63) and 1.35 (95%CI 1.12-1.62) for men and women, respectively, being these values close to the combination matrix body mass index and waist circumference. CONCLUSIONS: The waist-to-height ratio identified more individuals at early health risk than the combination matrix between the body mass index and the waist circumference and showed comparable ability to identify health risk, regardless of gender and age, regarding the prevalence ratios for systemic arterial hypertension.


Assuntos
Sobrepeso/complicações , Medição de Risco/métodos , Razão Cintura-Estatura , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Sobrepeso/fisiopatologia , Distribuição de Poisson , Valores de Referência , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais , Circunferência da Cintura , Adulto Jovem
20.
J Agric Food Chem ; 67(37): 10352-10360, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31503479

RESUMO

The potential for apple peels to mitigate the deleterious effects of a high-fat diet in mice was investigated here. Mice were fed a high-fat diet supplemented with apple powders from three apple varieties or a commercial apple polyphenol. Polyphenols were characterized using colorimetric assays and high-performance liquid chromatography. Mice were tested for standard metabolic parameters. There was a dose response to dietary apple peels, with the higher intake leading to reduced weight gain and adipose tissue mass relative to the lower intake, but none of the treatments were statistically different from the control. The gene expression of liver enzyme stearoyl-CoA desaturase (Scd-1) was correlated with adipose weight, and liver enzyme cytochrome P51 (Cyp51) was downregulated by the apple diets. The feces from a subset of mice were analyzed for polyphenols and for bacteria taxa by next-generation sequencing. The results revealed that the makeup of the fecal microbiota was related to the metabolism of dietary polyphenols.


Assuntos
Biflavonoides/análise , Catequina/análise , Fezes/química , Frutas/metabolismo , Microbioma Gastrointestinal , Malus/metabolismo , Obesidade/dietoterapia , Proantocianidinas/análise , Animais , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Biflavonoides/metabolismo , Catequina/metabolismo , Dieta Hiperlipídica/efeitos adversos , Frutas/química , Humanos , Masculino , Malus/química , Camundongos , Obesidade/genética , Obesidade/metabolismo , Obesidade/microbiologia , Polifenóis/análise , Polifenóis/metabolismo , Proantocianidinas/metabolismo , Estearoil-CoA Dessaturase/genética , Estearoil-CoA Dessaturase/metabolismo , Esterol 14-Desmetilase/genética , Esterol 14-Desmetilase/metabolismo
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