[Validation of body composition estimation equations by bioelectric impedance in postmenopausic women with metabolic syndrome]. / Validación del uso de ecuaciones para estimar la composición corporal por análisis de impedancia bioeléctrica en mujeres postmenopáusicas con síndrome metabólico.

INTRODUCTION: Postmenopausal women have excess adiposity due to the lack of estrogens, which is related with an increase in the prevalence of metabolic syndrome (MS) risk factors. Few equations have been developed to measure body fat mass (FM) by bioelectric impedance (BIA) for Mexican women and none of the existing equations have been evaluated in Mexican postmenopausal women with MS. MATERIAL AND METHODS: We describe the association and agreement between two different BIA equations: NHANES III and Macias, et al. to estimate FM in 86 women (42-72 years old). Anthropometric and body composition measurements (BIA) were done in all women; FM was measured by densitometry (DXA). Mean differences by age group (< 55 years old and > or = 55 years old) (Student t test), correlations, simple linear regression models and agreement analysis (Bland-Altman method) were done. RESULTS: The two equations showed underestimation of % FM compared to DXA. The equation that presents the greatest correlation and agreement with the gold standard is the NHANES equation, in both age groups. CONCLUSIONS: The NHANES equation is valid to estimate FM in Mexican postmenopausal women with MS. We recommend the use of this equation in the clinical practice.

Dietary changes associated with improvement of metabolic syndrome components in postmenopausal women receiving two different nutrition interventions.

OBJECTIVE: This study aims to examine the association between dietary changes and improvement of metabolic syndrome components in Mexican postmenopausal women receiving two different nutrition interventions. METHODS: Women (n = 118) with metabolic syndrome were randomly assigned to group 1 (n = 63; structured hypocaloric diet) or group 2 (n = 55; behavioral therapy). Metabolic and nutrition assessment was performed at baseline and after 2, 4, and 6 months of intervention. Dietary changes throughout the study and achievement of cardioprotective dietary goals were assessed at the end of the intervention. RESULTS: There was a significant increase in the number of women who met recommended servings for fruits/vegetables, low-fat dairy, and sugars in both groups. In group 1, elimination of high-energy refined grains increased the probability of having normal fasting glucose (relative risk, 1.514; 95% CI, 0.989-2.316; P = 0.035). In this group, women who met the low-fat dairy goal at the end of the study had lower diastolic blood pressure (P = 0.012) and higher high-density lipoprotein cholesterol (P = 0.001). In group 2, women who met the high-fat dairy goal had greater probability of having normal fasting glucose (relative risk, 1.915; 95% CI, 1.123-3.266; P = 0.026). In all women, exclusion of high-fat dairy decreased by 60% the probability of having impaired fasting glucose (relative risk, 0.40; 95% CI, 0.181-0.906; P = 0.028). CONCLUSIONS: Both strategies promote achievement of cardioprotective dietary goals for fruits/vegetables, sugars, soda and sweetened beverages, low-fat dairy, and high-energy refined grains, and improve some metabolic syndrome components. Elimination of high-fat dairy decreases the risk of impaired fasting glucose. Dietary strategies should be flexible and individualized based on metabolic profile.

Structured hypocaloric diet is more effective than behavioral therapy in reducing metabolic syndrome in Mexican postmenopausal women: a randomized controlled trial.

OBJECTIVE: This study aims to compare the effects of a lifestyle intervention using a behavioral therapy (BT) approach with the effects of a cardioprotective structured hypocaloric diet on metabolic syndrome in Mexican postmenopausal women. METHODS: This study is a randomized clinical trial (2006-2009) of Mexican postmenopausal women with metabolic syndrome (Adult Treatment Panel III criteria) who were recruited from the Postmenopause Clinic of the National Institute of Perinatology in Mexico City. Women were assigned to one of two groups--group 1 (structured hypocaloric diet; n = 63): energy restriction (-300 to -500 kcal/d) emphasizing cardioprotective dietary changes; and group 2 (BT; n = 55): goal setting, problem-solving, and stimulus control to achieve cardioprotective dietary and lifestyle recommendations. Metabolic syndrome prevalence, as well as weight, waist circumference, fat mass, and fasting biochemical markers (glucose and lipid profile), were measured at baseline and at 2, 4, and 6 months after the intervention. Metabolic syndrome risk (relative risk and absolute risk reduction), mean differences between groups, and logistic regression were evaluated using Statistical Package for the Social Sciences software, version 17.0. RESULTS: A total of 118 women were studied (mean [SD] age, 53.81 [6.43] y). No baseline differences were observed between groups. At the end of the study, a higher reduction in metabolic syndrome prevalence was observed in group 1 (-38.1%) compared with group 2 (-12.7%; relative risk, 0.237; 95% CI, 0.092-0.608; P = 0.003). The effect was maintained even when adjusted by age, hormone therapy and antihypertensive drug use. CONCLUSIONS: A cardioprotective structured hypocaloric diet is more effective than the BT approach in reducing metabolic syndrome after 6 months of intervention. Both strategies have positive effects on different individual cardiovascular risk factors.

Low Glycemic Index Carbohydrates versus All Types of Carbohydrates for Treating Diabetes in Pregnancy: A Randomized Clinical Trial to Evaluate the Effect of Glycemic Control.

Background. Due to the higher prevalence of obesity and diabetes mellitus (DM), more pregnant women complicated with diabetes are in need of clinical care. Purpose. Compare the effect of including only low glycemic index (GI) carbohydrates (CHO) against all types of CHO on maternal glycemic control and on the maternal and newborn's nutritional status of women with type 2 DM and gestational diabetes mellitus (GDM). Methods. Women (n = 107, ≤29 weeks of gestation) were randomly assigned to one of two nutrition intervention groups: moderate energy and CHO restriction (Group 1: all types of CHO, Group 2: low GI foods). Results. No baseline differences in clinical data were observed. Capillary glucose concentrations throughout pregnancy were similar between groups. Fewer women in Group 2 exceeded weight gain recommendations. Higher risk of prematurity was observed in women in Group 2. No differences in glycemic control were observed between women with type 2 DM and those with GDM. Conclusions. Inclusion of low GI CHO as part of a comprehensive nutrition intervention is equally effective in improving glycemic control as compared to all types of CHO. This strategy had a positive effect in preventing excessive maternal weight gain but increased the risk of prematurity.