Ayuno intermitente como opción terapéutica para pacientes con sobrepeso y obesidad / Intermittent fasting as a therapeutic option for overweight and obese patients

Los regímenes basados en la restricción intermitente de la ingesta de alimentos, como el ayuno intermitente, pueden parecer novedosos pero constituyen en realidad una práctica milenaria. Muchas veces en nuestras consultas como médicos de familia los pacientes con problemas de sobrepeso u obesidad nos preguntan sobre estas prácticas y sus efectos en la salud. A partir de la viñeta clínica de uno de esos pacientes, revisamos la evidencia disponible sobre el tema y encontramos que la restricción intermitente puede ser una intervención eficaz para la disminución de peso, aunque sin diferencias significativas con respecto a la restricción continua. Para otros desenlaces analizados, como el riesgo cardiovascular, la evidencia no es tan clara. Si bien la restricción alimentaria intermitente puede ser una opción útil en para los pacientes que desean disminuir su peso, se necesitan más estudios para determinar la variante más adecuada, su duración óptima, la mejor frecuencia semanal y sus beneficios a largo plazo. (AU)

Intermittent dietary restriction, like intermittent fasting, may seem like a novel diet, but it's actually an age-old practice. Many times in our practice as family physicians, patients with overweight or obesity problems ask us about this practice and its effects on health. From the clinical vignette of one of our patients, we reviewed the available evidence on the subject and found that intermittent dietary restriction could be an effective intervention for weight loss, but without significant differences with respect to continuous caloric restriction. For other outcomes analyzed, such as cardiovascular risk, the evidence is not as clear. Al though intermittent dietary restriction may be a useful option in our patients, more studies are needed to determine which variant is the most appropriate, its optimal duration, weekly frequency, and long-term benefits. (AU)

Atención y educación nutricional para los funcionarios de la Universidad Estatal a Distancia, Costa Rica / Attention and Nutrition Education for officials of the UNED in Costa Rica´s State University at Distance

Resumen En 2012 y 2013, se desarrolló en la Escuela de Ciencias Exactas y Naturales (ECEN) de la Universidad Estatal a Distancia (UNED) un Proyecto de Atención y Educación Nutricional (PATENU), para funcionarios con el propósito de realizar modificaciones en sus hábitos alimentarios y prevenir enfermedades crónicas no transmisibles (ECNT). Esta iniciativa surgió de los resultados de una Feria de la Salud realizada en octubre 2011, donde 60% de los participantes presentaron problemas de mal nutrición. Se recolectó la información mediante entrevistas y mediciones antropométricas durante las consultas de seguimiento. En total, participaron en PATENU 69 personas, 55% con sobrepeso u obesidad. 37% de los participantes, realizaron cambios en sus hábitos de alimentación, reduciendo 10% del sobrepeso. Se concluye que las intervenciones nutricionales de corto tiempo, producen resultados positivos.

Abstract In 2012 and 2013, a Project of Nutritional Attention and Education (PATENU) was developed in the School of Exact and Natural Sciences (ECEN) of the State University at Distance (UNED), for officials with the purpose of making changes in their eating habits and prevent chronic non communicable diseases (CNCD). This initiative emerged from the results of a Health Fair held in October 2011, where 60% of the participants presented problems of malnutrition. The information was obtained through interviews and anthropometric measurements during the follow-up consultations. In total, 69 people participated in PATENU, 55% were overweight or obese. 37% of the participants made changes in their eating habits, reducing 10% of overweight. It concluded that short-term nutritional interventions produce positive results.

Association between the perceived environment and overweight in adults and elderly: a cross-sectional study

BACKGROUND: Overweight is a global issue of epidemic proportions, and its negative influence on individual health is clear. However, the relation between environment and overweight is not thoroughly clear, especially concerning to the perceived environment and the physical and social aspects. Therefore, this study aimed to analyze potential associations between the perceived environment and overweight in adults and elderly in a medium-sized city. METHODS: A cross-sectional population-based study was conducted with 808 adult and elderly individuals. Overweight was defined as body mass index≥25 kg/m2based on the World Health Organization criteria. The Neighborhood Environment Walkability Scale was used evaluating the perceived environment. Poisson regression was performed evaluating the relationships between the perceived environment and overweight .RESULTS: The frequency of overweight was 50.4 %. Adjusted models showed association between overweight and the variable of surrounding neighborhood as follows:"1- to 3-story apartments or condos"(most category; PR = 0.30; CI 0.12­0.76) and"4- to 6-story apartments or condos"(all categories) (PR ranged 0.40 to 0.46;p< 0.05), and also,"l and-use mix-diversity" was associated with overweight in this population (PR 0.81; CI 0.66­0.99).CONCLUSIONS: In addition to individual characteristics, the environmental aspects are relevant to the occurrence of overweight in this population. Population-based studies using primary data on overweight remain scarce in Brazil. Finally, this study contributes to improve the understanding of the complex relationship between perceived environment and overweight, and we believe that our findings provide further justification for the development of future interventions and health promotion strategies.

Association of overweight and obesity with decline in academic performance among female high-school students, Riyadh, Saudi Arabia

The aim of this study was to evaluate the association between overweight/obesity and future academic performance among high-school students in Saudi Arabia. This was a retrospective cohort study of 257 12th grade female students in Alabna [Ministry of Defence] high schools in Riyadh during 2013/14. Overweight/obesity was based on weight and height at 10th grade. Decline in academic performance was defined as a reduction by > 1 standard deviation in marks between 10th and 12th grades. One hundred and five students were overweight/obese and 30 had declined academic performance. Self-esteem scale was similar in both groups. In a multiple logistic regression model adjusted for sociodemographic characteristics, study-related lifestyle and self-esteem, overweight/obesity was associated with declining academic performance. Other independent associates included paternal and maternal education, and living outside governmentally provided housing. We report a negative independent association between overweight/obesity and subsequent academic performance among female high-school students in Saudi Arabia. The results highlight the need for community and school programmes to target overweight/obesity among high-school students

Chronic intermittent hypoxia increases encoding pigment epithelium-derived factor gene expression, although not that of the protein itself, in the temporal cortex of rats, / Hipóxia intermitente crônica aumenta a expressão gênica, mas não proteica, de pigment epithelium-derived factor no córtex temporal de ratos

Objective: Obstructive sleep apnea syndrome is mainly characterized by intermittent hypoxia (IH) during sleep, being associated with several complications. Exposure to IH is the most widely used animal model of sleep apnea, short-term IH exposure resulting in cognitive and neuronal impairment. Pigment epithelium-derived factor (PEDF) is a hypoxia-sensitive factor acting as a neurotrophic, neuroprotective, and antiangiogenic agent. Our study analyzed performance on learning and cognitive tasks, as well as PEDF gene expression and PEDF protein expression in specific brain structures, in rats exposed to long-term IH. Methods: Male Wistar rats were exposed to IH (oxygen concentrations of 21-5%) for 6 weeks-the chronic IH (CIH) group-or normoxia for 6 weeks-the control group. After CIH exposure, a group of rats were allowed to recover under normoxic conditions for 2 weeks (the CIH+N group). All rats underwent the Morris water maze test for learning and memory, PEDF gene expression and PEDF protein expression in the hippocampus, frontal cortex, and temporal cortex being subsequently assessed. Results: The CIH and CIH+N groups showed increased PEDF gene expression in the temporal cortex, PEDF protein expression remaining unaltered. PEDF gene expression and PEDF protein expression remained unaltered in the frontal cortex and hippocampus. Long-term exposure to IH did not affect cognitive function. Conclusions: Long-term exposure to IH selectively increases PEDF gene expression at the transcriptional level, although only in the temporal cortex. This increase is probably a protective mechanism against IH-induced injury. .

Objetivo: A síndrome da apneia obstrutiva do sono caracteriza-se principalmente por episódios de hipóxia intermitente (HI) durante o sono e associa-se a diversas complicações. A exposição à HI é o mais usado modelo animal de apneia do sono, e protocolos de curta duração causam diversos prejuízos cognitivos e neuronais. Pigment epithelium-derived factor (PEDF, fator derivado do epitélio pigmentado) é um fator neurotrófico, neuroprotetor e antiangiogênico sensível à hipóxia celular. Nosso estudo analisou o desempenho em tarefas cognitivas e de aprendizagem, bem como a expressão do gene PEDF e da proteína PEDF em estruturas cerebrais específicas em ratos expostos a HI de longa duração. Métodos: Ratos Wistar foram expostos a HI (21-5% de oxigênio) durante 6 semanas - o grupo HI crônica (HIC) - ou a normóxia durante 6 semanas - o grupo controle. Após a exposição à HIC, um grupo de ratos foi exposto a normóxia durante 2 semanas (o grupo HIC+N). Todos os animais foram submetidos ao labirinto aquático de Morris para avaliação de memória e aprendizado; avaliou-se também a expressão do gene PEDF e da proteína PEDF no hipocampo e nos córtices frontal e temporal. Resultados: Os grupos HIC e HIC+N apresentaram um aumento de expressão do gene PEDF no córtex temporal, porém sem aumento dos níveis proteicos. A expressão do gene PEDF e da proteína PEDF manteve-se inalterada nas demais estruturas. A exposição de longa duração à HI não afetou a função cognitiva. Conclusões: A exposição de longa duração à HI aumenta seletivamente a expressão do gene PEDF ao nível transcricional, embora apenas no córtex temporal. Esse aumento é provavelmente um mecanismo de proteção contra a HI. .

Estado nutricional e condições de saúde de idosos de Francisco Beltrão, Paraná / Nutritional status and health conditions of elderly from Francisco Beltrão, Paraná

OBJECTIVE: to evaluate the relationship between nutritional status and demographic, economic and self morbidities variables of elderly assisted by the Strategy Family Health Program of Francisco Beltrão, Parana. METHODS: This cross-sectional study assessed a population based sample of elderly aged over 60 years, and used a questionnaire with demographic, socioeconomic and the mentioned diseases data. The anthropometric measurements included weight, height and waist circumference. "T-Student", chi-square tests and multiple linear regression analysis were applied. Results: The study included 402 subjects, 72.1% composed by women. It was characterized by a high overweight prevalence 57.6%; being higher for women. Based on waist circumference, 73% of individuals had greatly increased risk for cardiovascular disease. Among the diseases aforementioned we found a prevalence of 73.9% for high blood pressure. There was a significant association between overweight nutritional status, women, age progression and increased waist circumference. CONCLUSION: This study reveals a high overweight prevalence, risk of cardiovascular disease and presence of hypertension, especially among women

OBJETIVO: Avaliar a relação entre estado nutricional e variáveis demográficas, econômicas e doenças referidas de idosos atendidos na Estratégia Saúde da Família de Francisco Beltrão, Paraná, Brasil. Métodos: Trata-se de estudo transversal que avaliou uma amostra populacional de idosos com idade igual ou superior a 60 anos. Foi utilizado questionário contendo informações demográficas, socioeconômicas e doenças referidas. As medidas antropométricas incluídas foram o peso, estatura e circunferência da cintura. Foram aplicados os testes T-Student, Qui-quadrado e análise de regressão linear múltipla. Resultados: Foram incluídos no estudo 402 indivíduos, sendo 72,1%composta por mulheres. Amostra foi caracterizada por elevada prevalência de sobrepeso 57,6%, sendo superior para as mulheres. Com base na circunferência da cintura, 73%dos indivíduos apresentaram risco muito aumentado para as doenças cardiovasculares. Entre as doenças referidas foi encontrada prevalência de 73,9% para hipertensão arterial. Houve associação significativa entre a condição nutricional de sobrepeso, mulheres, progressão da idade e circunferência da cintura elevada. CONCLUSÕES: Este estudo revela elevada prevalência de excesso de peso, risco de doenças cardiovasculares e presença de hipertensão arterial, sobretudo entre a condição nutricional de sobrepeso, mulheres, progressão da idade e circunferência da cintura elevada. Conclusões: Este estudo revela elevada prevalência de excesso de peso, risco de doenças cardiovasculares e presença de hipertensão arterial, sobretudo entre as mulheres

A randomized triple-masked controlled trial on the effects of synbiotics on inflammation markers in overweight children / Ensaio clínico controlado randomizado triplo-cego dos efeitos de simbióticos sobre marcadores de inflamação em crianças com sobrepeso

OBJECTIVE: the low degree of inflammation in obesity contributes to systemic metabolic dysfunction. Recent experimental studies proposed some effects of alteration in gut microbiota on inflammatory factors. This study aimed to assess the anti-inflammatory effects of a synbiotic supplement on inflammation markers in overweight and obese children and adolescents. METHODS: this randomized triple-masked controlled trial was conducted among 70 participants aged 6 to 18 years, with a body mass index (BMI) equal or higher than the 85th percentile. They were randomly assigned into two groups of equal number to receive synbiotic or placebo for eight weeks. RESULTS: fifty-six of 70 participants (80%) completed the study. Compared with the placebo group, the synbiotic group had significant decrease in mean values of tumor necrosis-α and interleukin-6, with significant increase in adiponectin; these changes were no longer significant after adjustment for BMI. There was no significant change in the mean values of high-sensitive C-reactive protein. CONCLUSION: the present findings suggest the positive influence of synbiotic supplementation on inflammation factors, which are dependent to its effect on weight reduction in overweight and obese children. .

OBJETIVO: o baixo grau de inflamação na obesidade contribui para disfunção metabólica sistêmica. Estudos experimentais recentes propuseram alguns efeitos de alteração na microbiota intestinal sobre fatores inflamatórios. O objetivo deste estudo foi avaliar os efeitos anti-inflamatórios de um suplemento simbiótico sobre marcadores de inflamação em crianças e adolescentes com sobrepeso e obesos. MÉTODOS: este ensaio clínico controlado randomizado triplo-cego foi conduzido entre 70 participantes com idade entre seis e 18 anos, com índice de massa corporal (IMC) igual ou acima do 85º percentil. Eles foram aleatoriamente divididos em dois grupos de igual número de participantes para receber simbiótico ou placebo por oito semanas. RESULTADOS: no todo, 56 de 70 participantes (80%) concluíram o estudo. Em comparação ao grupo placebo, o grupo simbiótico teve redução significativa nos valores médios de necrose tumoral-α e interleucina-6, com aumento significativo na adiponectina; essas alterações não eram mais expressivas após o ajuste do IMC. Não houve alteração importante nos valores médios da proteína C-reativa altamente sensível. CONCLUSÃO: nossas conclusões sugerem a influência positiva da suplementação simbiótica sobre fatores inflamatórios, dependente de seu efeito sobre a redução de peso em crianças com sobrepeso e obesas. .

Aderência às recomendações dietéticas do Institute of Medicine (Estados Unidos) e o seu efeito no peso durante a gestação / Adherence to dietary recommendations by the Institute of Medicine and the effect on body weight during pregnancy / Adhesión a las recomendaciones dietéticas del Institute of Medicine (Estados Unidos) y su efecto en el peso durante la gestación

O objetivo do trabalho foi estimar o efeito que a aderência às recomendações do Institute of Medicine (IOM) dos Estados Unidos acerca da ingestão de energia e/ou da composição dos macronutrientes da dieta exercem no peso durante a gestação. Trata-se de estudo prospectivo com três pontos de observação que incluiu 255 gestantes. A variável dependente foi o peso aferido ao longo da gestação e a independente a adequação dietética segundo as recomendações do IOM para ingestão de energia e macronutrientes, categorizada em ingestão adequada ou excessiva. As análises estatísticas foram realizadas com modelos de efeitos mistos para medidas repetidas. As gestantes com ingestão excessiva eram 3,59kg (EP = 0,92kg) mais leves na linha de base (p < 0,01). Em média, o peso das gestantes variou 1,83kg (EP = 0,40kg) por trimestre, mas as gestantes com ingestão excessiva apresentaram um aumento de peso superior de 1,70kg (EP = 0,43kg), no mesmo período quando comparadas às com ingestão adequada (p < 0,01). Mulheres que aderiram às recomendações de ingestão dietética segundo o IOM aumentaram menos de peso durante a gestação.

The study's objective was to estimate the effect of adherence to dietary recommendations by the Institute of Medicine (IOM) concerning energy intake and/or macronutrient composition of diet on weight during pregnancy. This was a prospective study with observations at three time points, with a sample of 255 pregnant women. The dependent variable was gestational weight, and the independent variable was dietary adequacy according to IOM recommendations for energy and macronutrient intake, categorized as adequate versus excessive intake. Statistical analyses were performed using mixed effects models for repeated measures. Pregnant women with excessive intake were 3.59kg lighter at baseline (SE = 0.92kg; p < 0.01). On average, gestational weight varied by 1.83kg (SE = 0.40kg) per trimester, but pregnant women with excessive intake showed a higher weight increase of 1.70kg (SE = 0.43kg) during the same period as compared to women with adequate intake (p < 0.01). Women who adhered to IOM dietary recommendations gained less weight during pregnancy.

El objetivo del trabajo fue estimar el efecto que la adhesión a las recomendaciones del Institute of Medicine (IOM) de los Estados Unidos, acerca de la ingestión de energía y/o de la composición de los macronutrientes de la dieta, ejerce en el peso durante la gestación. Se trata de un estudio prospectivo con tres puntos de observación que incluyó a 255 gestantes. La variable dependiente fue el peso estimado lo largo de la gestación y la independiente la adecuación dietética, según las recomendaciones del IOM para la ingestión de energía y macronutrientes, categorizada como ingestión adecuada o excesiva. Los análisis estadísticos fueron realizados con modelos de efectos mixtos para medidas repetidas. Las gestantes con ingestión excesiva eran 3,59kg (EP = 0,92kg) más leves en la línea de base (p < 0,01). En media, el peso de las gestantes varió 1,83kg (EP = 0,40kg) por trimestre, sin embargo, las gestantes con ingestión excesiva presentaron un aumento de peso superior, de 1,70kg (EP = 0,43kg), en el mismo período cuando se comparan con quienes tienen ingestión adecuada (p < 0,01). Las mujeres que se adhirieron a las recomendaciones de ingestión dietética, según el IOM, aumentaron menos de peso durante la gestación.

Interventions to increase physical activity and healthy eating among overweight and obese children in Mexico / Intervenciones para incrementar la actividad física y alimentación saludable en niños mexicanos con sobrepeso y obesidad

Objective. The purpose of the present study was to conduct a systematic literature review of obesity interventions that focused on increasing physical activity and healthy eating among overweight and obese children in Mexico. Materials and methods. Data was taken from a larger literature review focused on obesity interventions for Latinos in Latin America and the United States. Study design suitability, quality of execution, and effect size were assessed for a subset of these articles. Results. There were six intervention studies included in the present review. Five studies showed reductions in obesity-related outcomes, while one study reported gains in body mass index (BMI). Conclusions. Physical activity and healthy eating remain constant components in obesity treatment interventions, which highlights the importance of understanding evidence-based strategies to guide future research to reduce childhood obesity in Mexico.

Objetivo. El propósito del presente estudio fue realizar una revisión sistemática de la literatura en intervenciones relacionadas con la obesidad enfocadas en incrementar la actividad física y alimentación saludable en niños mexicanos con obesidad y sobrepeso. Material y métodos. La información forma parte de una revisión sistemática de la literatura enfocada en intervenciones para prevenir o tratar la obesidad en población latina habitante de Latinoamérica y Estados Unidos. La adecuación del diseño del estudio, la calidad de ejecución y el efecto de la muestra fueron evaluados para una submuestra de estos artículos. Resultados. Se incluyeron seis estudios dentro de la revisión. Cinco estudios encontraron una reducción en los resultados relacionados con la obesidad, mientras que un estudio encontró ganancias en el índice de masa corporal (IMC). Conclusiones. La actividad física y alimentación saludables fueron componentes constantes de las intervenciones para tratamiento de la obesidad. Esto resalta la importancia de entender las estrategias basadas en evidencia para guiar futuras investigaciones en la reducción de la obesidad infantil en México.

Dietary counseling on long-term weight loss in overweight hypertensive patients

OBJECTIVE: This study aimed to evaluate long-term weight loss in overweight hypertensive patients receiving dietary counseling. METHODS: Longitudinal study included overweight hypertensive patients who had an initial individual consultation with a nutritionist between January 2002 and December 2005 and were followed for four years in a hypertension clinic. Patients who had at least four consultations during the follow-up period were included in the dietary counseling group. Those who scheduled their first consultation but missed that appointment or had fewer than four consultations during the follow-up period were allocated to the control group. Target Energy intake was calculated at 20-25 kcal/kg actual body weight/day. RESULTS: The study included 102 patients aged 55 + 1 years old (58 in the dietary counseling group). As compared with the control group, patients in the dietary counseling group showed a significantly greater reduction in body weight (-3.6 + 0.8 vs. 0.8 + 0.7 kg), which remained significant after controlling for age, gender, baseline body mass index, and the use of different antihypertensive and antidiabetic drugs. Weight loss between 5.0 percent and 9.9 percent was observed in a significantly higher percentage of patients in the dietary counseling group (28 percent vs. 11 percent). A weight loss of at least 10 percent was only observed in dietary counseling group patients, who had a significantly lower odds ratio for increasing the number and/or dosage of antihypertensive agents, even after controlling for age, gender, and baseline body mass index. CONCLUSIONS: Dietary counseling may be associated with long-term weight loss in overweight hypertensive patients.

[Comparison of the effects of narrative therapy and diet therapy on the body mass index in overweight and obese women]

This study was carried out with the aim of comparing the effect of diet therapy and narrative intervention on the extent of body mass index [BMI] reduction in overweight and obese women. This was a quasi experimental-interventional study, in which 30 overweight women were selected by random sampling from among those consulting the Diet Clinic and randomly assigned to one of 2 intervention [group 1, diet therapy alone; group 2, diet therapy plus narrative therapy] and a control group [receiving no intervention]. The period of intervention was 5 weeks. Weight of all the subjects with light clothing was measured by a Seca scale to the nearest 0.5 kg and their height by a stadio-meter to the nearest 0.5 cm. The BMI was calculated by dividing weight [in kg] by squared height [m2]. The data were analyzed using the SPSS 16 software, the statistical test being covariance analysis and paired t- test. Data analysis showed that diet therapy alone [group 1] had no significant effect on the BMI [P>0.05], while in group 2 [diet therapy plus narrative therapy] BMI decreased significantly [P<0.001]. Inter-group comparison [among the 3 groups] showed that there were no significant difference between diet therapy and narrative therapy with regard to BMI. The findings show that in the first phase of intervention life narratives about overweight help obese women correct their nutritional habits. This is followed by BMI reduction in the second phase. Since diet therapy is not consistent with the women's life narratives, it plays no role in correcting life narratives for more successful dieting. Considering the efficacy of narrative therapy in body mass index reduction and no effect by diet therapy alone, further studies on the life narratives of overweight women and their correction are recommended

Efeito da dieta hipoenergética sobre a composição corporal e nível sérico lipídico de mulheres adultas com sobrepeso / Effect of a low-energy diet on the body composition and serum lipid levels of overweight adult women

OBJETIVO: Verificar o efeito de 12 semanas de dieta hipocalórica sobre a composição corporal e o nível sérico lipídico de mulheres adultas com sobrepeso. MÉTODOS: A amostra foi composta por vinte mulheres (23,80, desvio-padrão de 2,73 anos) da academia Westfit-Bangu, divididas randomicamente em dois grupos de dez: grupo controle e grupo dieta hipoenergética. Foi realizada uma avaliação da composição corporal (massa corporal, percentual de gordura, índice de massa corporal e massa magra) e do nível sérico lipídico (colesterol total, triglicerídeos, lipoproteína de baixa densidade, lipoproteína de alta densidade e lipoproteínas de muito baixa densidade). Utilizou-se a estatística descritiva (média e desvio-padrão) e o teste t de Student na análise inter e intragrupos. O nível de significância foi de p<0,05. RESULTADOS: O grupo dieta hipoenergética apresentou reduções significativas (p<0,05) nas variáveis antropométricas (massa corporal, percentual de gordura, índice de massa corporal e massa magra) e nas variáveis lipídicas (triglicerídios, colesterol total, lipoproteína de baixa densidade e lipoproteínas de muito baixa densidade). Quanto à variável: lipoproteína de alta densidade, foi observada uma redução, porém não significativa. CONCLUSÃO: A partir dos resultados apresentados pode-se concluir que a dieta hipoenergética foi uma excelente opção no tratamento da obesidade e no controle do nível sérico dos lipídeos, contribuindo desta forma, para a redução dos riscos cardiovasculares na população estudada.

OBJECTIVE: This study verified the effects of a 12-week low-calorie diet on the body composition and serum lipid levels of overweight adult women. METHODS: The sample consisted of 20 females (23.80 years with a standard deviation of 2.73 years) of the Westfit-Bangu gym. They were randomly divided into two groups of ten: the Control Group and the Diet Group. Body composition (body mass, percentfat, body mass index and lean body mass) and serum lipid levels (total cholesterol, triglycerides and high-, low- and very low-density lipoproteins) were assessed. Descriptive (central tendency and dispersion) and inferential statistics (Student's t-test) were used for inter and intragroup analysis. The significance level was set at p<0.05. RESULTS: The Diet Group presented a significant decrease (p<0.05) in anthropometric variables (body mass, percent of fat, BMI and lean mass) and serum lipids (triglycerides, total cholesterol and low- and very low-density lipoproteins). The level of high-density lipoprotein also decreased but not significantly. CONCLUSION: In conclusion, the low-calorie diet was an excellent option for the treatment of obesity and to control serum lipid levels, decreasing the cardiovascular risk of the studied population.

Estilo de vida e estado nutricional de universitarios ingressantes em cursos da area de saude do Recife/PE / Lifestyle and nutritional status of university students studying in health care in Recife/PE

O objetivo deste estudo foi avaliar o estilo de vida e estado nutricional de universitarios ingressantes em cursos da area da saude da Universidade de Pernambuco (UPE) -Recife/PE. A populacao do estudo foi constituida de 253 estudantes ingressantes nos cursos de ciencias da saude da UPE de ambos os generos. Para avaliacao do nivel de atividade fisica e habitos alimentares foi utilizado o Questionario Saude na Boa (QSB) e o estado nutricional foi determinado atraves do indice de massa corporal (IMC), por auto-relato da massa corporal e estatura. Para a comparacao entre a frequencia das respostas entre os cursos foi aplicado o teste qui-quadrado, e na comparacao intercursos das variaveis, idade, massa corporal, estatura e IMC, utilizou-se a analise de variancia (ANOVA) com post-hoc Tukey. A prevalencia de sobrepeso relatada foi de 8,82% para medicina, 9,23% para educacao fisica, 5,25% para ciencias biologicas, 9,75% para odontologia 14,63% para enfermagem. Os alunos do curso de educacao fisica apresentaramse mais ativos que os demais (51,6%) e os de medicina os menos fi sicamente ativos (8,8%), com relacao aos habitos alimentares, mais uma vez, os academicos de educacao fisica apresentam melhor comportamento quando comprados aos demais (p<0,05). Dessa forma, observou-se que, em geral, os estudantes nao apresentam um estilo de vida saudavel, o que os coloca em situacao de risco para o desenvolvimento de varios agravos a saude, especialmente de doencas cronico degenerativas. Tal comportamento e ainda mais preocupante em um publico que sera disseminador de um estilo de vida saudavel.

The aim of this study was to assay life style and nutritional status in college students from healthy science courses from Pernambuco University (UPE) ? Recife/PE. Sample was composed by 235 student?s beginners in healthy sciences classes from UPE, from both genders. Physical activity level and nutritional habits were assessed by Saude na Boa Questionnaire (QSB) and the nutritional status was determinate by body mass index (BMI), by self report of body mass and height. The data was categorized in Epidata and statistical analyses were performed in SPSS version 13. To compare the frequency of answer between courses was used chi-square, and to age, body mass, height and BMI, was used ANOVA with Tukey as post-hoc. The level of significance was set up in p< .05. The overweight prevalence was the 8,82% to medicine, 9,23% to physical education, 5,25% to biological science, 9,75% to dentistry and 14,63% to nursing. The physical education students were the most physically active (51,6%), and the medicine ones were the less physically active (8,8%), related to nutritional habits, once more, physical education students present better nutritional behavior than the other students. In this way, we can conclude that college students do not have a healthy life style, situation this that put then in risk to develop healthy problems, especially those ones related to chronic degenerative diseases. This behavior is more still worst in individuals that will be healthy professionals.

Frecuencia y factores de riesgo asociados a sobrepeso y obesidad en universitarios de Colima, México / The frequency of risk factors associated with obesity and being overweight in university students from Colima, Mexico

Objetivo Determinar la frecuencia y factores de riesgo para sobrepeso y obesidad en jóvenes universitarios. Métodos Se realizó un estudio transversal analítico en 821 alumnos inscritos de la Universidad de Colima. Entre las variables analizadas se encuentran: edad, género, alcoholismo, tabaquismo y utilización de medicamentos o sustancias para control de peso. Resultados Se estudiaron 821 alumnos (380 hombres y 441 mujeres) con una edad promedio de 20,9±2,5 años. Las frecuencias de sobrepeso y obesidad en hombres fueron de 27,8 por ciento y 14,7 por ciento y en mujeres de 17 por ciento y 5,2 por ciento. En hombres el tabaquismo (OR 2,1, IC 95 por ciento 1,4-3,8;p=0,01) y etilismo (OR 2,1, IC 95 por ciento 1,2-3,6;p=0,003), estuvieron asociados a sobrepeso y obesidad. Fueron factores protectores en ambos géneros el uso de sustancias para control de peso (OR 0,4, IC 95 por ciento 0,2-0,8;p=0,01); mientras que el control dietético fue un factor protector sólo en las mujeres (OR 2,2, IC 95 por ciento 1,1- 3,4;p=0,01). Conclusiones En estudiantes universitarios, el 31,6 por ciento presentó sobrepeso y obesidad. En hombres, el tabaquismo y etilismo se asociaron a sobrepeso y obesidad. El uso de sustancias para bajar de peso y control dietético fueron factores protectores.

Objective Determining risk factor frequency regarding obesity and being overweight in university students. Methods A cross-sectional analytic study was carried out on 821 students from the University of Colima. Some variables analysed were age, gender, alcoholism, smoking and weight-control drug use. Results 821 students were included (380 male, 441 female), 20.9±2.5 average age. 27.8 percent of males were overweight and 14.7 percent suffered from obesity; this was 17 percent and 5.2 percent in females, respectively. Smoking (2.1 OR; 1.4-3.8 95 percent CI; p=0.01) and alcoholism (2.1 OR; 1.2-3.6 95 percent CI; p=0.003) were associated with being overweight and being obese. Weight-control drug use was a protective factor in both genders (0.4 OR; 0.2-0.8 95 percent CI; p=0.01); diet control was only a protective factor in women (2.2. OR; 1.1-3.4 95 percent CI; p=0.01). Conclusions 31.6 percent of university students were overweight and suffered from obesity. Smoking and alcoholism in males were associated with being overweight and suffering from obesity. Weight-control and diet-control drug use were protective factors.

Associação entre excesso de peso e consumo de feijão em adultos / Association between overweight and intake of beans among adults

OBJETIVO: Avaliar associação entre excesso de peso e consumo de feijão em adultos. MÉTODOS: O estudo constou de indivíduos adultos (>18 anos), moradores em Belém (PA), em 2005. A amostragem foi realizada por sorteio de residências com telefone fixo e de um morador adulto de cada casa sorteada. A variável desfecho foi excesso de peso, a variável explanatória consumo de feijão e as variáveis de controle foram idade, escolaridade e situação conjugal, além de atividade física no lazer e hábitos alimentares de risco. A análise dos dados foi feita pelo teste do qui-quadrado e por regressão logística. RESULTADOS: Foram avaliados 2 352 indivíduos (39,8 por cento do sexo masculino). O excesso de peso atingiu mais os homens, 49,3 por cento, do que as mulheres, 34,0 por cento (p<0,001). A prevalência de excesso de peso apresentou associação direta com idade em ambos os sexos e com escolaridade para homens, para as mulheres a associação com a escolaridade foi inversa. A variável referente ao consumo alimentar que melhor se associou com excesso de peso foi o consumo de feijão. Após ajuste para as demais variáveis, o risco de excesso de peso foi cerca de 1,4 vez maior para os homens que consomem feijão menos do que cinco vezes na semana, porém o inverso para as mulheres. CONCLUSÃO: Os resultados indicam a necessidade de estudos mais controlados para melhor entendimento da associação entre consumo de feijão e excesso de peso.

OBJECTIVE: The objective of this study was to assess the association between overweight and intake of beans in adults. METHODS: The study population was 2,352 adults (>18 years of age) living in Belém (PA), Brazil, in 2005. Sampling was done by randomly selecting households with a telephone landline and then selecting an adult in the household. The dependent variable was overweight, the explanatory variable was intake of beans and the confounding variables were age, education level, marital status, leisure-time physical activity and risky food habits. The data were analyzed by the chi-square test and logistic regression. RESULTS: A total of 2,352 individuals were assessed where 39.8 percent were males. The prevalence of overweight was higher in men (49.3 percent) than in women (34.0 percent, p<0.001). Overweight was directly associated with age in both genders and with education level in men. In women, overweight was inversely associated with education level. The food behavior variable that best associated with overweight was intake of beans. After adjustment for the other variables, the risk of overweight was approximately 1.4 times greater in men who ate beans less than five times per week, but the inverse was true for women. CONCLUSION: The data show that better controlled studies are needed to understand the association between intake of beans and excess weight.

[ comparison between efficacy of narrative therapy and diet therapy on body image in overweight and obese women]

Body image is an important concern in overweight women; thus, this study was carried out to compare the effect of diet therapy and narrative therapy on improvement of body image. This was an interventional study. Among the women who were referred to the clinic of nutrition and diet therapy, 30 overweight women were selected through randomized sampling and were randomly divided to two interventions and one control group. Group 1 only received diet therapy [for 5 weeks], group 2 received narrative therapy in addition to diet therapy and the control group received no intervention. Narrative therapy was a group therapy that consisted of 12 sessions, each lasting 50 minutes; the sessions were held twice a week. Weight of subjects was measured with light cloths by a Seca balance scale to the nearest 0.5 kg and their height was measured by stadio-meter to 0.5 cm. Body Mass Index was calculated by dividing weight [in kg] to squared height [in m[2]]. Data of Body Image were gathered through Multidimensional Body-Self Relation Questionnaire. Data were analyzed by covariance analysis, Tukey and paired t test using SPSS 16 software. At the beginning of the study, the mean score of body image in the control group was 135.20 and it was 134.60 after the intervention. In group 1, at the beginning of the study the mean score was 148.1 and after the intervention was 147.50. In group 2, at the beginning of the study the mean score was 150.80 and after the intervention the result was 163.90. Data analysis showed that at the end of the study diet therapy had no significant effect on improvement of body image [P>0.05]. But narrative therapy was more effective than diet therapy in the improvement of body image in overweight women [P<0.001]. Narrative therapy can better improve body image; thus, this method is more suitable and has greater results in weight loss

Adiponectina, insulina y glicemia, en individuos con sobrepeso u obesidad sometidos a un régimen de alimentación rico en carbohidratos complejos / Adiponectin, insulin and glucose concentrations in overweight and obese subjects after a complex carbohydrates (fiber) diet

La adiponectina es una citoquina secretada por el tejido adiposo, que regula el metabolismo energético, estimula la oxidación de ácidos grasos, reduce los triglicéridos plasmáticos y mejora el metabolismo de la glucosa mediante aumento de la sensibilidad a la insulina. Se evaluaron niveles séricos de adiponectina, insulina y glicemia, y su relación con pérdida de peso en 56 individuos con diagnostico de sobrepeso y obesidad bajo un régimen de alimentación hipocalórico, basado en el consumo de carbohidratos complejos (cereal rico en fibra durante seis semanas). Se realizó antropometría y determinación de adiponectina e insulina (ELISA), glicemia (Colorimetrico-enzimático). Los datos se analizaron por pruebas no paramétricas para comparaciones de muestras independientes o relacionadas. Los participantes fueron (12 hombres, 44 mujeres, 20 a 55 años) 17 con diagnostico de sobrepeso y 39 con obesidad. La adiponectina se encontró significativamente baja al inicio del programa en todos los participantes (4,47 ±1,64µg/mL), mayor en mujeres que en hombres (4,62±1,57 vs 3,93±1,86µg/mL). Para la glicemia e insulina sérica, los valores estuvieron dentro del rango normal (82,46±26,51 µg/dL) y (14,12±10,15l µU/mL) respectivamente sin diferencias significativas por sexo. Los participantes con sobrepeso tuvieron concentraciones significativamente mayores de adiponectina que los obesos desde el inicio hasta el final del programa. El régimen de alimentación promovió cambios en la concentración de adiponectina sérica durante el período de evaluación, notables a la segunda y sexta semana, encontrándose un incremento significativo en sus niveles séricos, y correlación negativa con el IMC y sexo a medida que perdían peso corporal.

Adiponectin one of the cytokines secreted by the adipose tissue that regulates the energetic metabolism through glucose and insulin interactions., stimulates the oxidation of fatty acids, reduces the plasmatic triglycerides and improves glucose metabolism by increasing insulin sensibility. Serum concentrations of adiponectin, insulin and glucose were assessed in order to establish association to weight loss after a dietary regime based on consumption of complex carbohydrates (fiber) during six weeks. Overweight and obese subjects (n=56) were studied by anthropometry. Adiponectin and insulin were measured by ELISA and glucose by Colorimetry. Data was analyzed by non parametric tests to compare independent or related samples. 12 men and 44 women, aged 20 to 55 years, 17 overweight and 39 obese were assessed. Adiponectin concentration was significantly low at basal determination in all the subjects (4,47 ±1,64); being higher in women (4,62±1,57 vs 3,93±1,86 µU/mL in men), while glucose and insulin values were at normal range (82,46±26,51 µg/dL and 14,12±10,15 µU/mL) respectively with no significant differences for sex. Overweight subjects had significantly higher adiponectin concentrations than obese participants, at all measurements. Dietary regime promoted significant increase in adiponectin concentration at second and sixth week, with a negative correlation to body mass index and gender as they lost body weight.

Leptina e insulina sérica en adultos con sobrepeso y obesos en régimen hipocalórico con alto contenido de carbohidratos complejos / Serum leptin and insulin in obese adults on hypocaloric dietary regimen of high complex carbohydrate content

En situaciones de cambios en el peso, la evidencia sobre la relación entre la leptina y la insulina con el contenido de grasa corporal no es concluyente. Se planteó establecer asociaciones entre leptina e insulina (ELISA) y pérdida de peso (antropometría) durante un régimen hipocalórico alto en fibra, en 71 individuos (sobrepeso/ obesos), al inicio (I), a dos (2s) y a seis semanas (6s) del régimen. Se aplicaron pruebas no paramétricas para muestras independientes y relacionadas. Hubo disminución significativa de la leptina entre I, 2s y 6s, similar entre sobrepeso y obesidad, normalizándose a las 6s (sobrepeso fueron normales a las 2s y obesos a las 6s). Aumentó la prevalencia de valores normales (leptina <15 ng/mL) durante el régimen. La leptina fue significativamente mayor en obesos que en los con sobrepeso y en mujeres que en hombres, sin diferencias significativas por género para la insulina. Asociación significativa entre leptina e indicadores de adiposidad (índice de masa corporal, circunferencia abdominal). A las 2s, hubo correlación positiva entre leptina e insulina, no evidente a las 6s. El régimen basado en el consumo de fibra fue eficiente para lograr cambios en los parámetros antropométricos y bioquímicos, en especial, una disminución de la leptina.

Leptin acts as a regulatory signal for food intake, body energy balance, body fat content and body weight stability. In order to establish associations among serum leptin, serum insulin and weight loss, 71 obese or overweight adults were assessed by anthropometry and serum determination of leptin at the beginning (B), two weeks (2w) and six weeks (6w) after consuming a dietary regime based on complex carbohydrates intake. Data was analyzed by non parametrical tests for independent and related samples. There was a significant decrease of leptin among B, 2w and 6w of similar nature between overweight and obese participants, with all of them reaching normal values at 6w (overweight at 2w and obese at 6 w). Prevalence of normal leptin values (<15 ng/mL) increased among B, 2w and 6w. Leptin levels were significantly higher in obese vs. overweight and in women vs. men with no differences in serum glucose or insulin by sex. There was a significant association between leptin and adiposity indicators (body mass index and abdominal circumference). At 2w, but not at 6w, a positive correlation between leptin and insulin was found. A dietary regime based on increased consumption of complex carbohydrate (fiber) was efficient to induce favorable changes in anthropometrical and biochemical indicators, especially serum leptin.

Effect of a high dairy diet on serum antibody titers to heat shock protein 27 in overweight and obese children

An immune response to heat shock proteins appears to be involved in atherogenesis. To date, there has been no report on the impact of dairy or calcium consumption on serum antibody titers to heat shock protein 27 [anti-HSP27]. We have investigated whether an increase in dairy food consumption is capable of affecting serum antibody titers to heat shock protein 27 [anti-HSP27] level in children. Overweight and obese children [n=99, age: 12-18 y, body mass index: 27-40 kg/m2] were randomized to receive a calorie restricted diet providing a 500 kcal/d deficit from total energy expenditure and two [n=38], three [n=26] or four [n=35] servings of dairy products/day. Serum anti-HSP27 level in addition to the serum hs-CRP and lipid profile were measured at baseline and after 12 weeks. Serum anti-HSP27 concentrations did not change significantly in any of the mentioned groups. Serum hs-CRP and lipid profile did not change significantly either, apart from a significant increase in HDL-cholesterol in the low-dairy group. An increased intake of dairy products does not lead to a significant change in serum anti-HSP27 level in overweight and obese children