Maternity waiting Home-use and associated factors among mothers in northwest Ethiopia, The application of the integrated behavioral model

Maternal mortality in Ethiopia is the highest in the world (412/100,000). Health facility delivery is the cornerstone in reducing maternal mortality. However, health facility delivery is low in Ethiopia, due to poor access and ill-equipped health facilities. Maternity waiting home(MWH)is one of the comprehensive packages of essential obstetric services, enabling women to access well-equipped health facilities. However, there are limited studies on maternal waiting home use in Ethiopia. This study aimedto use the integrated behavioral model, toassess maternal waiting home use and associated factors among mothers in the East Bellessa district, northwest Ethiopia.Method:A community-based cross-sectional study was conducted fromthe1-27 of March 2020. The multistage sampling technique was used to select a total of 624 mothers. Data was collected usingthe face-to-face interview technique. The reliability and validity of the itemswere checked using exploratory factor analysis. Multivariable logistic regressions wereconducted toidentify the factors associated with maternal waiting home use. Findings with a p-value <0.05 with a 95% confidence interval were considered statistically significant in the final model.Result.Overall, 20.5% (95% CI=17.3-23.7) of mothers used maternity waiting homes for the index of childbirth. Husband educational status (AOR=3.78, CI =1.44-9.93), the knowledge on maternitywaiting homes(AOR=3.97, CI=2.27-6.95), between 2 and 3antenatal care follow ups(AOR=0.14 CI=0.06-0.31), experiential attitude (AOR=2.37, CI=1.64-3.44), descriptive norms(AOR=0.66, CI=0.47-0.94), perceived behavioral control (AOR=1.07, CI=1.02-1.13) and behavioral intention (AOR=1.37, CI=1.1-1.71) were associated with maternity waiting home use.Conclusion:Maternity waiting home utilization was low. Husband's education status, antenatal care follow-up, knowledge on maternal waiting homes, experiential attitude, descriptive norms, perceived behavioral control and behavioralintention were positively significantly associated with MWH utilization. Therefore, strengthening the use antenatal care services, husbands'education, and developing a positive attitude towards MWH may improve the use of maternity waitinghomesamong women. [Ethiop. J. Health Dev. 2022; 36(2):000-000]Keyword:Maternity waiting home, mothers,integrated behavioral model, Ethiopia

Predictors of weight reduction in a Nigerian family practice setting

Objectives: This study identified the predictors of weight reduction among adult obese patients in a Family Practice Setting and developed a statistical model to predict weight reduction. Design: A prospective cohort design. Setting: The Family Practice Clinic, University College Hospital, Ibadan, Nigeria Participants and study tools: Obese adults were recruited into a three-month weight reduction program. Patient Information Leaflets were used for counselling, while questionnaires were administered to obtain socio-demographic and lifestyle factors. Potential predictors were assessed using the Multidimensional Scale of Perceived Social Support, Zung Depression Scale, Rosenberg Self-Esteem scale, Garner's Eating Attitude Test-26 (EAT-26), 24-hour dietary recall and International Physical Activity Questionnaire-short form. Anthropometric indices, blood pressure and Fasting Lipid Profile were assessed. Descriptive and inferential statistics were used for analysis with a significance set at α0.05. Results: Most 99(76.2%) of the 130 participants achieved weight reduction and had a median weight change of -2.3kg (IQR-4, -0.5), with 66 (66.7%) out of 99 attaining the weight reduction target of 10%. The regression model showed predictors of weight reduction to be Total Cholesterol [TC] (p=0.01) and Low-Density Lipoprotein Cholesterol [LDLC] (p=0.03). The statistical model derived for Weight reduction = 0.0028 (LDL-C) -0.029 (TC)-0.053 (EAT-26) +0.041(High-Density Lipoprotein Cholesterol). The proportion of variance of the model tested was R 2 = 0.3928 (adjusted R2 = 0.2106). Conclusion: Predictors of weight reduction among patients were eating attitude score, Total Cholesterol, Low-Density Lipid and High-Density Lipoprotein Cholesterol levels. A statistical model was developed for managing obesity among patients

Unhealthy weight control behaviors, disordered eating, and body image dissatisfaction in adolescents from São Paulo, Brazil

Objective: To identify the frequency of disordered eating (DE) and unhealthy weight control behaviors (UWCB) among adolescents and associations with age, sex, actual weight status, perceived weight status, and body image dissatisfaction. Methods: Cross-sectional study of 1,156 adolescents. DE was assessed using a specific self-report questionnaire, UWCB by specific behaviors that were not typically recommended for weight management, and body dissatisfaction by Stunkard's silhouettes. Results: The frequency of DE was 17.3%, and that of UWCB, 31.9%; 80.1% of participants were dissatisfied with body image. Perception of oneself as overweight was associated with 1.795-fold odds of DE. Those with UWCB had 7.389-fold odds of DE, while DE increased the odds of UWCB 7.280-fold. Girls, participants who perceived themselves as overweight, and those who reported body dissatisfaction were 2.266, 2.381, and 1.752 times more likely to have UWCB, respectively. Conclusion: A high prevalence of UWCB and a moderate prevalence of DE behaviors was found in adolescents from the city of São Paulo, Brazil. Those who perceived themselves as overweight had more DE and UWCB, and both behaviors were related. UWCB was more common in girls and among those dissatisfied with their bodies.

Markers of inflammation and insulin resistance in dogs before and after weight loss versus lean healthy dogs / Marcadores de inflamação e resistência à insulina em cães antes e depois da perda de peso versus cães saudáveis e magros

Chronic low-grade inflammation in obesity is characterized by an increased production of pro-inflammatory cytokines that contribute to insulin resistance. For this study body composition, markers of inflammation and of insulin resistance in dogs before and after weight loss were compared to those of lean dogs. Eleven client-owned obese adult dogs underwent a weight loss program with commercial dry food for weight loss and reached an ideal body condition score (BCS) six months after the beginning of the weight loss program. A Control Group of nine dogs with ideal BCS were selected for the comparison. Shapiro-Wilk test was used to test for normality, Mann Whitney were used for non-normally distributes data, and Student t-test was used for normally distributed parameters. In the Obese Group body fat decreased from 41.6% (30.7-58.6) to 29.1% (18.6-46.3) (P<0.01) and dogs maintained lean body mass throughout the weight loss program (P>0.05). Obese dogs presented higher concentration of fructosamine, triglycerides, insulin, IGF-1 and leptin than the Control Group before weight reduction (P<0.05). Serum concentrations of triglycerides, IL-2, IL-6, TNF-α, insulin, leptin and IGF-1 decreased after weight loss (P<0.01), and these concentrations were similar to the Control Group (P>0.05), except for leptin (P<0.001). No alteration on peptide YY was found. Leptin (r=0.60, P=0.01), fructosamine (r=0.44, P=0.02) and triglycerides (r=0.40, P=0.04) concentrations correlated with the reduction of body fat. Weight loss reduced the concentrations of inflammatory and insulin resistance markers and most parameters became similar to dogs that have always been lean, reinforcing the importance of weight loss in small animal practice.(AU)

A inflamação crônica de baixo grau na obesidade é caracterizada pela produção aumentada de citocinas pró-inflamatórias que contribuem para a resistência à insulina. Para este estudo a composição corporal e os marcadores de inflamação e de resistência à insulina em cães antes e após a perda de peso foram comparados aos de cães magros. Onze cães adultos obesos pertencentes a tutores foram incluídos em um programa de perda de peso com ração comercial hipocalórica e alcançaram escore de condição corporal (ECC) ideal seis meses após o início do regime. Um Grupo Controle de nove cães com ECC ideal foi selecionado para a comparação. O teste de Shapiro-Wilk foi usado para testar a normalidade, Mann Whitney foi usado para análise dos dados que não atenderam distribuição normal e o teste t de Student foi usado para parâmetros que atenderam a normalidade. No Grupo Obesidade, a gordura corporal diminuiu de 41,6% (30,7-58,6) para 29,1% (18,6-46,3) (P<0,01) e os cães mantiveram massa magra ao longo do programa de perda de peso (P>0,05). Cães obesos apresentaram maior concentração de frutosamina, triglicérides, insulina, IGF-1 e leptina do que o Grupo Controle antes da redução de peso (P<0,05). As concentrações séricas de triglicerídeos, IL-2, IL-6, TNF-α, insulina, leptina e IGF-1 diminuíram após a perda de peso (P<0,01) e, essas concentrações foram semelhantes ao Grupo Controle (P>0,05), com exceção da leptina (P<0,001). Nenhuma alteração no peptídeo YY foi encontrada. As concentrações de leptina (r=0,60; P=0,01), frutosamina (r=0,44; P=0,02) e triglicerídeos (r=0,40; P=0,04) correlacionaram-se com a redução da gordura corporal. A perda de peso reduziu as concentrações de marcadores inflamatórios e de resistência à insulina e a maioria dos parâmetros tornaram-se semelhante aos dos cães que sempre foram magros, reforçando a importância da perda de peso na prática clínica de pequenos animais.(AU)

Porcentaje de grasa corporal en adolescentes asociado con conductas alimentarias de riesgo, hogar y sexo / Body fat percentage in adolescent among eating risk behaviors, home and sex

Resumen: Objetivo: Determinar la asociación de las conductas alimentarias de riesgo (CAR) y el hogar con el porcentaje de grasa corporal (PGC) en los adolescentes, modificado por sexo. Material y métodos: Se analizó la información de una cohorte de 2 388 adolescentes de Morelos, México, de 2004 a 2007. Se realizaron técnicas descriptivas y modelos de regresión lineal múltiple de efectos mixtos. Resultados: El cambio del PGC es -1.4 puntos porcentuales (EE 0.22), en hombres -3.1 (EE 0.35) y en mujeres 0.2 (EE 0.21). El cambio del PGC en relación con CAR y el hogar es diferente por sexo. El modelo múltiple muestra que realizar dieta se asocia con el incremento del PGC (1.25 IC95% 0.68-1.83) en mujeres y en hombres (1.74 IC95% 0.60-2.88). En relación con la familia, las mujeres muestran una relación positiva con el incremento del PGC de acuerdo con que sientan o no que su familia no las quiere a veces o nunca (valor p de tendencia <0.001); los hombres muestran en la variable de "Satisfecho de la ayuda que recibe se su familia" una asociación marginal. Conclusiones: Realizar dieta sin supervisión se asocia con el incremento en el PGC, lo que da un efecto contrario a lo deseado; esto se asocia con relaciones familiares y es diferente entre sexo.

Abstract: Objective: To determine the association of risky eating behaviors and the home with the percentage of body fat in adolescents, modified by gender. Materials and methods: We analyzed the information of a cohort of 2 388 adolescents from Morelos in Mexico, from 2004 to 2007. Descriptive techniques and multiple linear regression models of mixed effects were performed. Results: The change in body fat percentage (PGC) is -1.4 percentage points, in men -3.1, in women 0.2. The change of the PGC in relation to CAR's and the household is different by sex. The multiple model shows that diet is associated with an increase in PGC (1.25 IC95% 0.68-1.83) in women, in men of 1.74 (95% CI 0.60-2.88). In relation with the family, women show a positive relationship with the increase in the percentage of body fat according to whether they feel that their family does not love them sometimes or never (value p of trend <0.001), men show in the variable "Satisfied with the help your family receives", a marginal association. Conclusions: Performing a diet without supervision is associated with an increase in the PGC, giving an effect contrary to what is desired. This is associated with family relationships, and is different between sex.

Effects of curcumin on cardiovascular risk factors in obese and overweight adolescent girls: a randomized clinical trial

ABSTRACT BACKGROUND: Obese adolescents are at higher risk of development of cardiovascular risk factors and obesity in later life. Dietary intake of antioxidants, particularly curcumin, as an active ingredient of turmeric extract, may have noticeable effects on obesity and its important complications such as cardiovascular risk factors. Therefore, the aim of this study was to assess the effects of curcumin supplementation on cardiovascular risk factors among overweight and obese female adolescents. DESIGN AND SETTING: Randomized placebo-controlled clinical trial; Pediatric Cardiovascular Research Center, Isfahan, Iran. METHODS: 60 adolescent girls (aged 13-18 years) were randomly assigned to receive either placebo or intervention. The adolescents were asked to consume one 500 mg tablet per day, containing either standardized 95% turmeric extract or placebo, and to undergo a weight maintenance or a mild weight loss diet for 10 weeks. Anthropometric and biochemical indices were assessed at the baseline and the end of the intervention. RESULTS: Curcumin supplementation had beneficial effects on body mass index (P = 0.019), waist circumference (P = 0.008), hip circumference (P = 0.030), high-density lipoprotein levels (P = 0.042) and triglyceride/high-density lipoprotein ratio (P = 0.021). However, in univariate analysis of covariance, no significant differences were found between the intervention and placebo groups after 10 weeks of supplementation (P > 0.05). CONCLUSIONS: Prescription of curcumin supplementation along with use of a slight weight loss diet might have beneficial effects on some cardiovascular risk factors among overweight and obese female adolescents. Larger clinical trials with higher curcumin doses and longer duration are needed to confirm the results from the current study. CLINICAL TRIAL REGISTRATION: IRCT20171107037302N1

Concentración de adiponectina posterior a reducción de masa corporal en un grupo de mujeres obesas premenopáusicas en Lima, Perú / Adiponectin concentration after a body mass reduction in a group of premenopausal obese women living in Lima, Peru

Objetivo: Investigar el cambio en la concentración de adiponectina circulante en plasma en 23 mujeres obesas premenopáusicas de la ciudad de Lima luego de la reducción de la masa corporal como resultado de un programa de actividad física aeróbica y una dieta baja en calorías.Materiales y métodos: Se llevó a cabo un estudio analítico y cuasi-experimental con el grupo de mujeres obesas. Adicionalmente, 24 mujeres se consideraron como control o de referencia de la concentración de adiponectina y otros marcadores bioquímicos. La cuantificación de adiponectina se realizó mediante la prueba de ELISA. La concentración de glucosa en ayunas en sangre, colesterol, lipoproteína de alta densidad y triglicéridos fueron cuantificados mediante análisis clínicos de rutina.Resultados: Antes del programa el grupo control mostró altos valores de adiponectina (mediana: 8,54 µg/mL; rango: 6,14 µg/mL a 13,49 µg/mL) en comparación con el grupo obesidad (mediana: 7,03 µg/mL, rango: 3;77 µg/mL a 17,23 µg/mL); sin embargo, la diferencia no fue estadísticamente significativa (P = 0.0563). Luego de la finalización del programa se observó que el grupo obesidad presentó una reducción estadísticamente significativa del índice de masa corporal (P = 5.98e-08) y de la circunferencia abdominal (P = 1.55e-08) así como un incremento estadísticamente significativo de los niveles de adiponectina (mediana, 8.79 µg/mL; rango, 5.50 µg/mL a 19.37 µg/mL) (P = 0.0127). Conclusiones: Basándonos en los resultados, concluimos que en mujeres obesas premenopáusicas la concentración de adiponectina se incrementa cuando la masa corporal se reduce como resultado de actividad física aeróbica y una dieta baja en calorías.

Objective: To investigate the changes in the plasma-circulating adiponectin concentration in 23 premenopausal obese women living in Lima after a body mass reduction as a result of an aerobic physical activity program and a low-calorie diet.Materials and methods: An analytical and quasi-experimental study was conducted in a group of obese women. In addition, another 24 women were considered as control or reference group for comparing their adiponectin concentration and other biochemical markers. The quantification of adiponectin was carried out using the ELISA test. Fasting blood glucose concentration, cholesterol, high-density lipoprotein and triglycerides levels were quantified by routine clinical analysis.Results: Before beginning the program, the control group showed high adiponectin levels (median, 8.54 µg/mL; range, 6.14 µg/mL to 13.49 µg/mL) compared to the obesity group (median, 7.03 µg/mL; range, 3.77 µg/mL to 17.23 µg/mL). However, the difference was not statistically significant (P = 0.0563). Once the program was finished, the obesity group showed a statistically significant reduction in the body mass index (P = 5.98e-08) and abdominal circumference (P = 1.55e-08), and a statistically significant increase in the adiponectin levels (median, 8.79 µg/mL; range, 5.50 µg/mL to 19.37 µg/mL) (P = 0.0127). Conclusions: Based on the results, we conclude that the adiponectin concentration in premenopausal obese women increases when the body mass is reduced as a result of aerobic physical activity and a low-calorie diet.

Risk behavior for bulimia among adolescents / Comportamento de risco para bulimia em adolescentes

ABSTRACT Objective: To analyze the risk behavior for bulimia among female adolescents from public and private high schools. Methods: A cross-sectional study with a random sample of 850 female students aged 15-18 years was carried out in a city in northeastern Brazil, using the Bulimic Investigatory Test of Edinburgh (BITE) to assess the risk behavior for bulimia. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software and the Pearson's chi-square , Fisher's exact and robust Poisson regression tests, adopting the significance level of 5%. Results: Less than half of the sample (42.0%) showed standards of dietary risk and weight control practices; in 1.4% of the sample, bulimia signs were already installed. Fear of gaining weight was reported by 62.8% of the subjects. Risk practices were lower among students from public schools; (Odds Ratio - OR - 0.82; confidence interval of 95% - 95%CI - 0.69-0.97). Among restrictive practices, fasting for a whole day was the most applied (29.9% of the students). Among individuals who were at risk situation, almost half believed to have normal eating habits (prevalence ratio - PR - 0.42; 95%CI 0.36-0.49). Individuals who consider their eating habits normal, who are afraid of gaining weight, those who seek emotional comfort in food and follow strict diets had higher risk for bulimia (p<0.05). Conclusions: The number of female adolescent students with risk behavior practices for bulimia is high, and the frequency of those unaware of this situation is also very high. Risk situations emerge as a collective health problem, and individuals from private schools were more likely to be in this situation.

RESUMO Objetivo: Analisar comportamentos de risco para bulimia em adolescentes do sexo feminino de escolas públicas e particulares. Métodos: Estudo transversal com amostra aleatória de 850 estudantes do sexo feminino, com idades entre 15 e 18 anos, realizado em cidade do Nordeste do Brasil, utilizando o Bulimic Investigatory Test of Edinburgh (BITE) para avaliar comportamentos de risco para transtornos alimentares. Os dados foram analisados utilizando o teste do qui-quadrado de Pearson, o teste exato de Fisher e a regressão de Poisson, com o software Statistical Package for the Social Sciences (SPSS), adotando o nível de significância de p<0,05. Resultados: Da amostra estudada, 42,0% apresentou padrões de risco e práticas de dieta e controle de peso e 1,4% já apresentava sinais de bulimia instalados. O medo de ganhar peso foi relatado por 62,8% das adolescentes. As práticas de risco foram menos frequentes em estudantes de escolas públicas (Odds Ratio - OR - 0,82; intervalo de confiança de 95% - IC95% - 0,69-0,97). Entre as práticas restritivas, jejum por um dia inteiro foi o mais aplicado pelas participantes (29,9%). Entre os indivíduos com situação de risco, quase metade acreditava ter hábitos alimentares normais (razão de prevalência - RP - 0,42; IC95% 0,36-0,49). Estudantes que consideram seus hábitos alimentares normais, que têm medo de ganhar peso, que procuram conforto emocional em alimentos e seguem dietas rigorosas tiveram maior risco para bulimia (p<0,05). Conclusões: O número de estudantes com práticas de comportamento de risco para bulimia é alto, e o número daquelas que desconhecem essa situação também é muito alto. As situações de risco emergem como problemas de saúde coletiva, e indivíduos de escolas particulares são mais propensos a apresentar transtornos alimentares.

Very low-calorie diet in candidates for bariatric surgery: change in body composition during rapid weight loss

OBJECTIVE: To analyze the changes in the body composition of morbidly obese patients induced by a very low-calorie diet. METHODS: We evaluated 120 patients selected from a university hospital. Body composition was assessed before and after the diet provided during hospitalization, and changes in weight, body mass index, and neck, waist and hip circumferences were analyzed. Bioimpedance was used to obtain body fat and fat-free mass values. The data were categorized by gender, age, body mass index and diabetes diagnosis. RESULTS: The patients consumed the diet for 8 days. They presented a 5% weight loss (without significant difference among groups), which represented an 85% reduction in body fat. All changes in body circumference were statistically significant. There was greater weight loss and a greater reduction of body fat in men, but the elderly showed a significantly higher percentage of weight loss and greater reductions in body fat and fat-free mass. Greater reductions in body fat and fat-free mass were also observed in superobese patients. The changes in the diabetic participants did not differ significantly from those of the non-diabetic participants. CONCLUSIONS: The use of a VLCD before bariatric surgery led to a loss of weight at the expense of body fat over a short period, with no significant differences in the alteration of body composition according to gender, age, body mass index and diabetes status.

Relationship between adiponectin and leptin on osteocalcin in obese adolescents during weight loss therapy

ABSTRACT Objectives: Obesity is a multifactorial disease characterized by the presence of the pro-inflammatory state associated with the development of many comorbidities, including bone turnover marker alterations. This study aimed to investigate the role of the inflammatory state on bone turnover markers in obese adolescents undergoing interdisciplinary weight loss treatment for one year. Subjects and methods: Thirty four post-pubescent obese adolescents with primary obesity, a body mass index (BMI) greater than > 95th percentile of the CDC reference growth charts, participated in the present investigation. Measurements of body composition, bone turnover markers, inflammatory biomarkers and visceral and subcutaneous fat were taken. Adolescents were submitted to one year of interdisciplinary treatment (clinical approach, physical exercise, physiotherapy intervention, nutritional and psychological counseling). Results: Reduction in body mass, body fat mass, visceral and subcutaneous fat, as well as, an increase in the body lean mass and bone mineral content was observed. An improvement in inflammatory markers was seen with an increase in adiponectin, adiponectin/leptin ratio and inteleukin-15. Moreover, a positive correlation between the adiponectin/leptin ratio and osteocalcin was demonstrated. Further, both lean and body fat mass were predictors of osteocalcin. Negative associations between leptin with osteocalcin, adiponectin with Beta CTX-collagen, and visceral fat with adiponectin were observed. Conclusions: It is possible to conclude that the inflammatory state can negatively influence the bone turnover markers in obese adolescents. In addition, the interdisciplinary weight loss treatment improved the inflammatory state and body composition in obese adolescents. Therefore, the present findings should be considered in clinical practice.

Dietary supplementation with camu-camu and continuous exercises in the treatment of obesity / Suplementação dietética com camu-camu e exercícios contínuos no tratamento da obesidade

ABSTRACT Objective The goal of this study were to investigate the effects of continuous exercise with/or without the ingestion the Camu-camu pulp in a rat model of obesity. Methods Neonate male Wistar rats, receiving monosodium glutamate, subcutaneously were separated into foour groups: sedentary group S (no treatment), exercise group E (continuous swimming training), Camu-camu group C (25mL of pulp of Camu-camu/day) and exercise and Camu-camu group EC (25mL of pulp of Camu-camu/day, continuous swimming). After 12 weeks, the animals were received euthanasia. Results The exercise program was conducted for five days for 12 weeks and the effects of supplementation with or without Camu-camu in obese rats were analyzed, showing that the relative levels of the variables cholesterol, triglycerides, glucose, High Density Lipoprotein and Low Density Lipoprotein and in all groups there was a significant reduction (.<0.001), except for the control group. Body weight and feed intake, epididymal and visceral fat deposits were not significantly different between the means of groups C and E, but these groups showed a significant difference when compared to the EC group (.<0.001). Conclusion The results demonstrate the effectiveness of continuous exercise and diet supplemented with Camu-camu fruit pulp to control obesity.

RESUMO Objetivo O objetivo deste estudo foi investigar os efeitos do exercício contínuo, com ou sem a ingestão da polpa de camu-camu, em um modelo de ratos obesos. Métodos Ratos machos neonatos Wistar receberam glutamato monossódico subcutaneamente e foram separados em três grupos. grupo de exercício E (treinamento de natação contínuo); grupo exercitado e suplementado com camu-camu - EC (natação contínua e administração de camu-camu); e grupo sedentário S (sem tratamento), como controle. Concluído o experimento, os animais sofreram eutanásia. Resultados O experimento teve a duração de doze semanas. O protocolo de exercício de natação (120min) e a ingestão da suplementação com camu-camu de polpa (25mL) tiveram a mesma duração e foram feitas simultaneamente cinco vezes por semana. Os resultados apontaram redução significativa (p<0,001) dos níveis relativos das variáveis colesterol, triglicérides, glicose, High Density Lipoprotein e Low Density Lipoprotein nos dois primeiros grupos, quando comparados ao grupo controle. Quanto a peso corporal e consumo de ração, depósitos de gordura epididimal e visceral, não houve diferença significativa entre as médias dos grupos C e E - porém, estes grupos apresentaram diferença significativa quando comparados ao grupo suplementado com camu-camu (p<0,001). Conclusão Os resultados demonstraram a efetividade do exercício contínuo e da dieta suplementada com a polpa de camu-camu para o controle da obesidade.

Effects of aerobic exercise plus diet control on serum levels of total IGF-1 and IGF-1 binding protein-3 in female obese youths and adolescents / 中国应用生理学杂志

OBJECTIVE@#To investigate the effects of 4-week moderate aerobic exercise plus diet control on serum levels of total insulin-like growth factor 1(IGF-1) and IGF-1 binding protein-3 (IGFBP-3) as well as IGF-1 activity (reflected by molar ratio of IGF-1/IGFBP-3) in female obese adolescents and youths, and their possible role on fat loss, and improvement of glucose and lipid metabolism.@*METHODS@#Nine female obese youths (age:18~19 y) and 30 female obese adolescents (age:14~16 y) were recruited and undertook 4-week aerobic exercise such as swimming and jogging (6 days/week, twice a day, 2 h/time with 5 min rest per 30 min exercise) with gradual increase of intensity from low (heart rate immediately post-exercise of 1st week:100~120 beats/min) to moderate (heart rate immediately post-exercise of 2-4 weeks:120~140 beats/min) level, combined with a diet intervention (total daily energy intake of 1 400 or 1 600 kcal according to basal metabolism rate) in Shanghai Dianfeng weight loss enclosed camp. Nine normal weight young women and 9 female children matched at age and nationality were recruited as the normal control. Before and after the experimental period, anthropometric index (body weight, body mass index(BMI) and waist circumference), glucose and lipid metabolism parameters including fasting blood glucose (FBG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride (TG); total cholesterol (TC), low density lipoprotein (LDL) and high density lipoprotein (HDL), and serum levels of total IGF-1 and IGFBP-3 were measured, and IGF-1 activity was calculated in the obese and normal control female adolescents.@*RESULTS@#①Compared with normal control, the serum levels of total IGF-1 and IGFBP-3 were decreased in the female obese youths and adolescents, and IGF-1 activity was reduced only in the obese female adolescents. ②The serum level of IGFBP-3 was down-regulated and IGF-1 activity was up-regulated while no change of serum total IGF-1 was induced by 4-week moderate aerobic exercise plus diet control, accompanied with significant decreases of body weight, BMI and waist circumference as well as improvement of glucose and lipid metabolism in the female obese youths and adolescents. Except for a positive association between the increased IGF-1 activity and the decreased waist circumference was found in the female obese youths by Pearson's correlation analysis, there was no relation of the decreased IGFBP-3, the increased IGF-1 activity with the improvements of anthropometric index and glucose and lipid metabolism in female obese youths and adolescents.@*CONCLUSIONS@#The serum level of IGFBP-3 was down-regulated and the IGF-1 activity was up-regulated by 4-week moderate aerobic exercise plus diet control in female obese youths and adolescents. The increase of IGF-1 activity might be associated with the exercise-plus-diet-induced decrease of waist circumstance in female obese youths.

Weight-teasing: does body dissatisfaction mediate weight-control behaviors of Brazilian adolescent girls from low-income communities? / Provocações em relação ao peso corporal: a insatisfação com o próprio corpo afeta o comportamento de controle de peso de adolescentes brasileiras de comunidades de baixa renda? / Burlas y acoso por el peso: ¿la insatisfacción corporal afecta al comportamiento para el control del peso en adolescentes brasileñas dentro de comunidades con baja renta?

The objective was to examine the mediation hypothesis of body dissatisfaction and analyze their association with weight-teasing and body satisfaction. A total of 253 girls who attended 10 schools from São Paulo, Brazil, participated in this study. Data collection was carried out through a validated and self-reported questionnaire. Study variables were weight-teasing (independent), body satisfaction (mediation), and weight control behavior (outcome). Effect mediation analyses showed a significance level of 5% (p < 0.05). Prevalence of family and peers weight-teasing were 38.5% and 40.6%, respectively. Body dissatisfaction was associated with unhealthy weight control behaviors when controlled by family and peer weight-teasing. Data indicate that family and peers teasing are important aspects that interfere in body satisfaction and weight control behaviors.

O estudo teve como objetivo examinar a hipótese da mediação pela insatisfação com o próprio corpo e analisar as associações com a provocação por terceiros e com a satisfação com o corpo. A amostra incluiu um total de 253 adolescentes do sexo feminino matriculadas em dez escolas na cidade de São Paulo, Brasil. Os dados foram coletados com um questionário validado e auto-preenchido. As variáveis de estudo foram as provocações feitas por outros em relação ao peso da adolescente (independente), a satisfação com o corpo (de mediação) e o comportamento de controle do peso (desfecho). As análises de mediação mostraram um efeito estatisticamente significativo (p < 0,05). As taxas de prevalência de provocações relacionadas ao peso, feitas por familiares e colegas, foram 38,5% e 40,6%, respectivamente. Depois de ajustar para a provocação por familiares e colegas, a insatisfação com o próprio corpo esteve associada a comportamentos prejudiciais de controle de peso. Os dados indicam que as provocações por familiares e colegas são aspectos importantes que interferem na satisfação com o corpo e com os comportamentos de controle de peso.

El objetivo fue examinar la mediación en la hipótesis de la insatisfacción corporal y analiza su asociación con las burlas y acoso por el peso y la satisfacción corporal. Un total de 253 niñas que iban a diez escuelas de São Paulo, Brasil, participaron en este estudio. La obtención de datos se llevó a cabo mediante un cuestionario validado y autoinformado. Las variables de estudio fueron acoso por peso (independiente), satisfacción corporal (mediación), y control de peso comportamiento (resultado). El efecto de los análisis de mediación mostró un nivel de significancia del 5% (p < 0.05). La prevalencia de la familia y las burlas/acoso por el peso entre compañeras fueron de un 38,5% y un 40,6%, respectivamente. La insatisfacción corporal se asoció con comportamientos poco saludables de control de peso, cuando estuvo controlada por la familia y las burlas y acoso por el peso entre colegas. Los datos indican que la familia y las burlas/acoso entre compañeras son aspectos importantes que interfieren en la satisfacción corporal y comportamientos sobre el control de peso.

Nutritional counseling promotes changes in the dietary habits of overweight and obese adolescents with polycystic ovary syndrome / O aconselhamento nutricional promove mudanças nos hábitos alimentares de adolescentes com excesso de peso e obesas e com síndrome dos ovários policísticos

Abstract Objective To evaluate the effects of nutritional counseling on the dietary habits and anthropometric parameters of overweight and obese adolescentswith polycystic ovary syndrome (PCOS). Methods This was a prospective, longitudinal and auto-controlled study. Thirty adolescents aged 13-19 years-old, diagnosed with PCOS received nutritional counseling and were followed-up for 6 months. After the follow-up period, the results were evaluated through body weight, body mass index (BMI) and waist circumference (WC). Results Sixty-percent of the adolescents adhered to the nutritional counseling and, of these, 50% lost weight. Adolescents who lost weight changed their dietary habits by adopting hypocaloric diets and eating more meals per day, as per nutritional counseling. The waist circumference (WC) decreased significantly, although the body weight decreased non-significantly after adoption of a hypocaloric diet. Conclusion Although there was no significant weight loss, there was a considerable reduction in theWCassociated with hypocaloric diets and with eating a greater number of meals per day.

Resumo Objetivo Avaliar os efeitos do aconselhamento nutricional sobre os hábitos alimentares e os parâmetros antropométricos de adolescentes com sobrepeso e obesidade e com síndrome do ovário policístico (SOP). Métodos Este foi um estudo prospectivo, longitudinal e autocontrolado. Trinta adolescentes com idades entre 13 e 19 anos e diagnosticadas com SOP receberam aconselhamento nutricional. Após 6 meses de acompanhamento, os resultados foram avaliados através do peso corporal, índice demassa corporal (IMC) e a circunferência da cintura (CC). Resultados Sessenta por cento das adolescentes aderiram ao aconselhamento nutricional e, destas, 50% perderam peso. Adolescentes que perderam peso mudaram seus hábitos alimentares adotando dietas hipocalóricas e comendo mais refeições por dia, seguindo orientação nutricional. A circunferência da cintura (CC) diminuiu significativamente, embora o peso corporal tenha diminuído de forma não significativa após a adoção de uma dieta hipocalórica. Conclusão Embora a perda de peso não tenha sido significativa, houve redução considerável da CC associada a dietas hipocalóricas e à ingestão de um maior número de refeições por dia.

Em busca do peso perdido: a institucionalização de demandas culturais nos Vigilantes do Peso / In search of lost weight: the institutionalization of cultural demands on Weight Watchers / A la búsqueda del peso perdido: la institucionalización de demandasculturales en los Vigilantes del Peso

O espírito do tempo pode ser apreendido pela sua produção cultural, que se constitui como expressão da identidade cultural do grupo que a produz. Na nossa sociedade, a demanda pela posse e exibição de certo ideal corpóreo manifesta-se sob a forma de instituições que funcionam como legitimadoras de um saber pragmático orientado para aquisição do corpo idealizado, como os Vigilantes do Peso. Esta instituição promove uma forma contemporânea de sociabilidade a partir de grupos de auxílio mútuo nos quais as pessoas buscam conformar o próprio corpo ao padrão visado. A partir do estudo de peças midiáticas dos Vigilantes do Peso, três mecanismos estratégicos discursivos são observados: i) o diferencial ostentado em relação à concorrência se baseia na razão e no saber científico; ii) as estratégias retóricas se baseiam na valorização da individualidade; e iii) o paradoxo que essas estratégias representam, uma vez que o valor indivíduo está subordinado à opinião dos outros.(AU

The zeitgeist of a society can be caught in its cultural production, which is an expression of the culturalidentity of the groups that produces it. In our society, the demand for the acquisition and for the exhibitionof an ideal body is manifested by institutions such as the Weight Watchers that legitimate a pragmatic knowledge in quest of the ideal body. This institution promotes sociability by means of mutual aid groupswhere people seek to conform their own body to the idealized pattern. Through the analysis of the media communication of the Weight Watchers, three strategic discursive mechanisms were observed: i) their alleged difference regarding their competitors is based on reason and scientific knowledge; ii) the rhetorical strategies are based on the importance of individuality; and iii) the paradox that these strategies represent,as the value of individuality is being subordinated to the opinion of others.

El espíritu del tiempo de una sociedad puede ser aprehendido por su producción cultural, que es unaexpresión de la identidad cultural del grupo que la produce. En nuestra sociedad, la demanda por la obtención y exibición de un cuerpo ideal se manifesta en instituciones que actúan como legitimadoras de la búsqueda del cuerpo ideal, como los Vigilantes del Peso. Esta institución promueve sociabilidad mediante grupos de ayuda mutua donde la gente busca conformar sus cuerpos al ideal propuesto. A partir del estudio de piezas de comunicación de los Vigilantes del Peso se observan tres mecanismos estratégicos discursivos:i) la diferencia alegada hacia sus competidores se basa en la razón y en el conocimiento científico; ii) las estrategias retóricas exaltan el valor de la individualidad; y iii) la paradoja que estas estrategias presentan, en vista del valor del individuo estar subjecto a la evaluación de los otros.

Le régime sans gluten en Algérie : observance, difficultés et problèmes d'application chez les malades coeliaques

L'objectif de la présente étude, menée chez des sujets porteurs d'une maladie coeliaque, est la mesure de l'observance du régime sans gluten et la détermination des difficultés rencontrés et les problèmes engendrés par l'application de ce régime.Une enquête auprès de 100 malades coeliaques aété réalisée dans deux services de la santé de la ville de Tébessa (Algérie), entre 2008 et 2014. Les résultats obtenus montrent que l'observance du régime sans gluten est médiocre pour la majorité des sujets suivis. Un tiers des répondants de l'enquête (33 %) a reconnu la mauvaise observance du RSG. Le strict respect du RSG a été déclaré pour 19 % des cas. Cependant, 48%des répondants ont déclaré ne pas éprouver une amélioration clinique coeliaque malgré qu'ils aient mené un RSG strict. Plusieurs facteurs influencent l'observance du RSG. La majorité des patient 81% déclarent que le régime sans gluten n'a pasapporté une amélioration. Selon toujours les patients, 99 % des patients déclarent la présence de plusieurs difficultés qui empêchent l'application stricte du régime. L'alimentation hors domicile et le manque d'appétit sont les majeurs problèmes engendrés par l'application du RSG chez les patients enquêtés avec respectivement 90 % et 84 %

Effets de 3 mois de pratique régulière des activités physiques et sportives de maintien sur la composition corporelle et les paramètres psychologiques chez des femmes obèses ou en surpoids au Cameroun

28 femmes obèses ou en surpoids (IMC>25), nouvellement admises à un programme de remise en forme, âgées de 39 ± 10 ans, ont pris part à une étude dont le but était d'évaluer, sur une période de 3 mois (T0, T1, T2, T3), la variation du poids, l'indice de masse corporelle (IMC), la masse grasse (%MG), la masse musculaire (MM), la densité osseuse (DO) et le pourcentage d'eau (%H2O) d'une part et, d'autre part celle de l'estime de soi (ES) et de la qualité de vie (QV). Elles ont été soumises à des séances d'activités physiques aérobies, quatre fois par semaine, d'une heure trente minutes de durée. Le poids, l'IMC, la MM, la DO et le %H2O n'ont pas varié significativement. Une analyse par classe d'âge montre des baisses significatives de l'IMC (p< 0,01) et du %MG de l'ordre de 9,7% (p<0,0001).Le test post-hoc de Tukey révèle des différences significatives (p< 0,05) sur la MM et le %H2O. L'ES et la QV ont eu des variations respectives de 19,9% et 15,2% (p<0,001). Trois mois d'expérimentation améliorent le bien être psychologique mais, n'ont pas suffi pour améliorer les paramètres corporels

Fatores intervenientes na adesão ao tratamento da obesidade / Factores intervinientes en la adhesión al tratamiento de la obesidad / Factors involved in adherence to obesity treatment

Objetivo: Analisar os fatores intervenientes na adesão ao tratamento da obesidade. Método: Pesquisa descritiva com abordagem quahtativa realizada com 15 pessoas com obesidade acompanhadas ambulatoriamente em um serviço de referência em obesidade. A coleta de dados se fez por meio de entrevistas semiestruturadas e os resultados analisados pela técnica de anáhse temática. Resultados: Emergiram das falas dos participantes cinco categorias temáticas: compreensão do tratamento da obesidade; fatores da adesão relacionados à terapêutica; fatores da adesão relacionados às condições psicossociais e econômicas; influência dos profissionais de saúde na adesão ao tratamento; e influência dos familiares na adesão ao tratamento. Os resultados evidenciaram que a problemática da adesão ao tratamento é um fenômeno complexo e requer o envolvimento de diferentes áreas do conhecimento, uma vez que abrange aspectos relacionados ao indivíduo, à doença, à terapêutica e até mesmo ao relacionamento com o profissional e com a família. Conclusão: Em função dos fatores intervenientes na adesão serem complexos, variados e inerentes a cada pessoa, é necessário que as estratégias de atendimento multiprofissional levem em conta a individualidade dos sujeitos, de forma a ajudá-los a enfrentar e superar as barreiras.

Objective: To analyze the factors involved in adhesion to obesity treatment. Method: A descriptive research with a qualitative approach performed with 15 people suffering from obesity, who were accompanied along their treatment as an outpatient at an obesity treatment center. Data was coUected by means of semi-structured interviews and the results were analyzed using the thematic analysis technique. Results: Five categories emerged from the narratives of the participants: awareness of the treatment for obesity; adherence factors related to the medical therapy; adherence factors related to psycho-social and economic conditions; influence ofhealth professionals on adherence to the treatment; and influence of the family on adherence to the treatment. The results show that the issue of adherence to treatment is a complex phenomenon, since it involves aspects related to the individual, the disease, the treatment and even to the relationship with the professional and with the family. Conclusion: in view of the fact that factors involved in the adherence are complex, varied and inherent to each person, it is necessary for the multi-professional care to consider the individuaUty of the patients in order to help them face and overcome obstacles.

Objetivo: Anahzar los factores intervinientes en la adhesión al tratamiento de la obesidad: Método: Pesquisa descriptiva con abordaje cualitativa realizada con 15 personas con obesidad, acompañadas ambulatoriamente en un servicio de referencia en obesidad. La colecta de datos se hace por medio de entrevistas semiestructuradas y los resultados analizados por medio de la técnica de análisis temático. Resultados: Emergieron de las hablas de los participantes cinco categorías temáticas: comprensión del tratamiento de obesidad; factores de la adhesión relacionados a la terapéutica; factores de la adhesión relacionados a las condiciones psicosociales y económicas; influencia de los profesionales de salud en la adhesión al tratamiento; e influencia de los familiares en la adhesión al tratamiento. Los resultados evidenciaron que la problemática de la adhesión al tratamiento es un fenómeno complejo y requiere involucramiento de diferentes áreas del conocimiento, una vez que abarca aspectos relacionados al individuo, a la enfermedad, a la terapéutica y hasta el involucramiento con el profesional y con la familia. Conclusión: Debido al hecho que los factores intervinientes en la adhesión son complejos, variados e inherentes a cada persona, es necesario que las estrategias de atención multiprofesional tomen en cuenta la individuaUdad de los sujetos, de manera de ayudarlos a enfrentar y superar las barreras.

A influência das crenças de autoeficácia na manutenção do emagrecimento / The influence of self-efficacy beliefs in maintaining weight loss

Este artigo de revisão narrativa da literatura aborda questões referentes à manutenção do emagrecimento e sua relação com as crenças de autoeficácia, tanto de pacientes obesos quanto com sobrepeso, sob o viés da psicoterapia cognitivo-comportamental. A manutenção da perda de peso é um dos estágios mais importantes e mais difíceis enfrentados pelas pessoas que almejam manter o emagrecimento. Portanto, este artigo busca entender de que forma a sensação de competência pessoal interfere na manutenção do emagrecimento, já que grande parte das pessoas que tenta emagrecer readquire o peso em até um ano depois. Autoeficácia pode ser definida como a confiança na capacidade de organizar e executar determinadas ações. A conclusão é de que as crenças de autoeficácia interferem diretamente na manutenção do peso e seu monitoramento, portanto seu desenvolvimento e reestruturação também devem ser foco de atenção dos psicoterapeutas e pacientes que tem por objetivo terapêutico o emagrecimento e manutenção do mesmo.(AU)

The following article addresses issues related to the maintenance of weight loss and its relation with self-efficacy beliefs in both obese and overweight patients under the bias of cognitive-behavioral psychotherapy. The maintenance of the weight loss is one of the most important as well as the most difficult stages faced by people that aims to maintain the weight loss. Therefore, this article seeks to understand how the sense of personal competence interferes with the maintenance of weight loss, giving that numbers of people who try to lose weight end up to getting fat after one year. Self-efficacy can be defined as the confidence in the own ability to organize and perform certain actions. The conclusion is that self-efficacy beliefs directly interfere in the maintenance of weight and it is continued checking, therefore its development and restructuration should be a focus of the work of psychotherapists and patients whose therapeutic goal are weight loss and maintenance.(AU)