Unravelling gender-specific factors that link obesity to albuminuria.

BACKGROUND: Obesity is a major public health problem, which continues to be diagnosed and classified by BMI, excluding the most elemental concepts of the precision medicine approach. Obesity does not equally affect males and females, even with the same BMI. Microalbuminuria is a risk marker of cardiovascular disease closely related to obesity. The aim of this study was to evaluate the gender-dependent differences in the development of early obesity-related disease, focusing on pathologic microalbuminuria (PMA). MATERIAL AND METHODS: We developed a single-centre cross-sectional study including 1068 consecutive adults from May 2016 to January 2018, divided into two groups: one including the first 787 patients attended, evaluated as a description population; the second group included 281 subjects analysed as an external validation population. Collected data included medical history, anthropometric measures, abdominal bioimpedance and routine laboratory tests. RESULTS: First, we confirmed the lack of accuracy of classic obesity measures in predicting microalbuminuria. Second, we tested the utility of a tailored evaluation to predict PMA, with an area under the ROC curve of 0.78 for females and 0.82 for males. We also confirmed the different physiology of visceral adiposity for males when compared to females, in which small variations of fat mass entail major changes in the clinical repercussion. Third, we performed an external validation of our results, achieving a 77% accuracy rate. CONCLUSIONS: Our findings support that there is an individual threshold of fat amount necessary to develop obesity-dependent PMA and that gender plays a major role in the interplay between PMA and adiposity.

Effect of Combining Impact-Aerobic and Strength Exercise, and Dietary Habits on Body Composition in Breast Cancer Survivors Treated with Aromatase Inhibitors.

This study examines both the effect of a twice-weekly combined exercise-1 h session of strength and 1 h session of impact-aerobic-on body composition and dietary habits after one year of treatment with aromatase inhibitors (AI) in breast cancer survivors. Overall, forty-three postmenopausal women with a BMI ≤ 35 kg/m2, breast cancer survivors treated with AI, were randomized into two groups: a control group (CG) (n = 22) and a training group (IG) (n = 21). Body composition, i.e., abdominal, visceral, and subcutaneous adipose tissue) was measured by magnetic resonance. In addition, some questionnaires were used to gather dietary data and to measure adherence to the Mediterranean diet. After one year, women in the IG showed a significant improvement in body composition, indicated by decreases in subcutaneous and visceral adipose tissue, and total fat tissue. Furthermore, the dietary habits were compatible with moderate adherence to the Mediterranean diet pattern and a low dietary intake of Ca, Zn, Folic Ac, and vitamins D, A, and E. A twice-weekly training program combining impact aerobic exercise and resistance exercise may be effective in improving the body composition for postmenopausal women who have breast cancer treated with AI, and the results suggest the need for nutritional counselling for this population.

Weight-loss diet alone or combined with progressive resistance training induces changes in association between the cardiometabolic risk profile and abdominal fat depots.

BACKGROUND/AIMS: A weight-loss diet alone or combined with a progressive resistance training program induced different adaptations on cardiometabolic risk, i.e. regional changes in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) volume distribution patterns. We hypothesized that a heterogeneous adipose tissue metabolism may exist between visceral fat at different discal levels. METHODS: Thirty-four obese women, aged 40-60 years, were randomized to three groups: a control group (n = 9), a diet group (WL; n = 12) with a caloric restriction of 500 kcal/day during 16 weeks, or a diet-plus-resistance-training group (WL+RT; n = 13) with the same caloric restriction and a 16-week resistance training of 2 sessions per week. RESULTS: The association pattern between abdominal fat depots and glucose metabolism variables showed a change from the L4-L5 region (preintervention) to VAT L2-L3 and SAT L2-L3 in the WL and WL+RT groups, respectively. It is noteworthy that accumulation of fat in the midthigh was not characterized by a more favorable lipid profile or glucose metabolism. CONCLUSION: Our results reinforce the importance of considering L2-L3 images to predict insulin resistance after a weight-loss diet, alone or combined with resistance training.

Effects of DHA-Rich n-3 Fatty Acid Supplementation and/or Resistance Training on Body Composition and Cardiometabolic Biomarkers in Overweight and Obese Post-Menopausal Women.

Resistance training (RT) and n-3 polyunsaturated fatty acids (n-3 PUFA) supplementation have emerged as strategies to improve muscle function in older adults. Overweight/obese postmenopausal women (55-70 years) were randomly allocated to one of four experimental groups, receiving placebo (olive oil) or docosahexaenoic acid (DHA)-rich n-3 PUFA supplementation alone or in combination with a supervised RT-program for 16 weeks. At baseline and at end of the trial, body composition, anthropometrical measures, blood pressure and serum glucose and lipid biomarkers were analyzed. Oral glucose tolerance tests (OGTT) and strength tests were also performed. All groups exhibit a similar moderate reduction in body weight and fat mass, but the RT-groups maintained bone mineral content, increased upper limbs lean mass, decreased lower limbs fat mass, and increased muscle strength and quality compared to untrained-groups. The RT-program also improved glucose tolerance (lowering the OGTT incremental area under the curve). The DHA-rich supplementation lowered diastolic blood pressure and circulating triglycerides and increased muscle quality in lower limbs. In conclusion, 16-week RT-program improved segmented body composition, bone mineral content, and glucose tolerance, while the DHA-rich supplement had beneficial effects on cardiovascular health markers in overweight/obese postmenopausal women. No synergistic effects were observed for DHA supplementation and RT-program combination.

Twice-weekly progressive resistance training decreases abdominal fat and improves insulin sensitivity in older men with type 2 diabetes.

OBJECTIVE: To evaluate the influence of a twice-weekly progressive resistance training (PRT) program, without a concomitant weight loss diet, on abdominal fat and insulin sensitivity in older men with type 2 diabetes. RESEARCH DESIGN AND METHODS: Nine older men (aged 66.6 +/- 3.1) with type 2 diabetes participated in a 16-week PRT supervised program (50-80% of the one repetition maximum), for all main muscle groups. Basal glycemia, HbA(1c), diet, habitual physical activity, body composition, and upper/lower maximal strength were measured. Insulin sensitivity was determined according to Bergman's minimal model procedure and abdominal fat was obtained by computed tomography. The measurements were taken 4 weeks before training (-4), immediately before training (0), and at 8-week intervals (i.e., weeks 8 and 16) during the 16-week training period. RESULTS: No significant variation was observed in any of the above selected parameters during the 4-week control period. After PRT, both leg and arm maximal strength increased significantly by 17.1 and 18.2%, respectively. Visceral and subcutaneous abdominal fat decreased significantly by 10.3% (from 249.5 +/- 97.9 to 225.6 +/- 96.6 cm(3), P < 0.01) and by 11.2% (from 356.0 +/- 127.5 to 308.6 +/- 118.8 cm(3), P < 0.01), respectively, while no changes were observed in body mass. PRT significantly increased insulin sensitivity by 46.3% (from 2.0 +/- 1.2 to 2.8 +/- 1.6 . 10(4) . min(-1) . muU(-1) . ml(-1), P < 0.01), whereas it significantly decreased (-7.1%, P < 0.05) fasting blood glucose (from 146.6 +/- 28.3 to 135.0 +/- 29.3 mg/dl). Finally, a 15.5% increase in energy intake (from 2,287.1 +/- 354.7 to 2,619.0 +/- 472.1 kcal/day, P < 0.05) was observed. CONCLUSIONS: Two sessions per week of PRT, without a concomitant weight loss diet, significantly improves insulin sensitivity and fasting glycemia and decreases abdominal fat in older men with type 2 diabetes.

Resistance training improves cardiovascular risk factors in obese women despite a significative decrease in serum adiponectin levels.

Increased circulating adiponectin and insulin sensitivity are usually observed after body fat loss induced by a weight-loss diet. Progressive resistance training (PRT) without a concomitant weight-loss diet significantly decreases visceral fat, thus improving insulin sensitivity. Therefore, the purpose of this study was to ascertain the effects of combined 16-week PRT and weight-loss diet on circulating adiponectin and insulin sensitivity index. Thirty-four obese (BMI: 30-40 kg/m(2)) women, aged 40-60 year, were randomized to three groups: a control group (C; n = 9); a diet group (WL; n = 12) with a caloric restriction of 500 kcal/d; and a diet plus resistance training group (WL+RT; n = 13) with the same caloric restriction as group WL and a 16-week supervised whole body PRT of two sessions/week. Both WL and WL+RT groups showed similar decreases in body mass (-6.3% and -7.7%) and visceral fat (-19.9% and -20.5%). WL resulted in an expected increase in circulating levels of adiponectin (P = 0.07) and insulin sensitivity. However, circulating total adiponectin decreased (P < 0.05) in WL+RT group, whereas an improvement in different cardiovascular risk factors (insulin sensitivity, low-density lipoprotein cholesterol (LDL-C), etc.) was observed. In conclusion, in obese women a 16-week combined PRT and weight-loss diet is accompanied by significant improvements in different cardiovascular risk factors in spite of a significant decrease of circulating adiponectin.