Effects of balanced diet associated with sports on the health of obese university students / Análise dos efeitos da dieta balanceada associada aos esportes na saúde dos estudantes universitários obesos / Análisis de los efectos de la dieta equilibrada asociada al deporte en la salud de estudiantes universitarios obesos

ABSTRACT Introduction The student, when entering university, is subject to new cycles and major changes in his routine, which includes exercise and nutritious habits. Objective Explore the effect of a balanced diet and physical exercise on the health of university students. Methods Through literature studies, a questionnaire was developed where the physical condition, nutritional habits, dietary structure, and exercise practice of obese college students were investigated and analyzed. Results The BMI index of those investigated exceeded the standard limit of BMI > 25. The longer the time of physical exercise, the more evident the difference between male and female students in terms of physical endurance factor. The body weight, BMI, and body fat index of both groups showed a downward trend after the intervention. Six weeks of aerobic exercise combined with a proper diet can significantly improve body mass index, body mass index, and physiological and biochemical indices of obese college students. Conclusion Balanced diet and exercise positively affect the health of obese college students. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução O estudante, ao ingressar na universidade, está sujeito a novos ciclos e grandes mudanças em sua rotina, que inclui os hábitos de exercício e alimentares. Objetivo Explorar o efeito de uma dieta balanceada e exercícios físicos na saúde de estudantes universitários. Métodos Através de estudos da literatura, elaborou-se um questionário onde foram investigadas e analisadas a condição física, os hábitos alimentares, a estrutura alimentar e a prática de exercícios nos universitários com obesidade. Resultados o índice de IMC dos investigados ultrapassou o limite padrão de IMC > 25. Quanto maior o tempo de exercício físico, mais evidente é a diferença entre estudantes do sexo masculino e feminino no fator da resistência física. O peso corporal, IMC e índice de gordura corporal dos dois grupos apresentaram tendência de queda após a intervenção. Seis semanas de exercícios aeróbicos combinados com dieta razoável podem melhorar significativamente o índice de massa corporal, índice de massa corporal e índices fisiológicos e bioquímicos de estudantes universitários obesos. Conclusão Dieta balanceada e exercício físico possuem um efeito positivo sobre a saúde dos estudantes universitários obesos. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción El estudiante, al entrar en la universidad, se ve sometido a nuevos ciclos y a grandes cambios en su rutina, que incluye el ejercicio y los hábitos alimenticios. Objetivo Explorar el efecto de una dieta equilibrada y el ejercicio físico en la salud de los estudiantes universitarios. Métodos A través de estudios bibliográficos, se elaboró un cuestionario en el que se investigó y analizó la condición física, los hábitos alimentarios, la estructura de la dieta y la práctica de ejercicio en estudiantes universitarios con obesidad. Resultados El índice de IMC de los investigados superaba el límite estándar de IMC > 25. Cuanto mayor es el tiempo de ejercicio físico, más evidente es la diferencia entre los alumnos y las alumnas en el factor de resistencia física. El peso corporal, el IMC y el índice de grasa corporal de ambos grupos mostraron una tendencia a disminuir después de la intervención. Seis semanas de ejercicios aeróbicos combinados con una dieta razonable pueden mejorar significativamente el índice de masa corporal, el índice de masa corporal y los índices fisiológicos y bioquímicos de los estudiantes universitarios obesos. Conclusión La dieta equilibrada y el ejercicio tienen un efecto positivo en la salud de los estudiantes universitarios obesos. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Fascículo 1: protocolos de uso do guia alimentar para a população brasileira na orientação alimentar de pessoas adultas com obesidade, hipertensão arterial e diabetes mellitus: bases teóricas e metodológicas - versão preliminar / Issue 1: protocols for the use of the food guide for the Brazilian population in the dietary guidance of adults with obesity, arterial hypertension and diabetes mellitus: theoretical and methodological bases - preliminary version

Este é o primeiro fascículo da série intitulada "Protocolos de Uso do Guia Alimentar para a População Brasileira na orientação alimentar de pessoas adultas com obesidade, hipertensão arterial e diabetes mellitus". Um conjunto de três protocolos compõe essa série que foi elaborada com a finalidade de disseminar as recomendações do Guia Alimentar para a População Brasileira e instrumentalizar a orientação alimentar individualizada pelos profissionais da Atenção Primária à Saúde (APS). O presente fascículo apresenta a base teórica e metodológica utilizada para a construção de cada protocolo, a partir das recomendações do Guia Alimentar adaptadas ao contexto de cada doença.

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)

Principales Estrategias de Intervención Nutricional realizadas en Chile en el decenio 2010-2020: avances y desafíos / Main Nutritional Intervention Strategies carried out in Chile in the 2010-2020 decade: progress and challenges

La alta prevalencia de obesidad en Chile, y su tendencia al aumento, constituye un problema de Salud Pública por su asociación con enfermedades crónicas no transmisibles. Durante la década 2010-2020, el estado de Chile implementó estrategias de intervención nutricional dirigidas a mantener o disminuir la prevalencia de obesidad. Regulaciones como la ley 20.606 sobre composición nutricional de los alimentos y su publicidad para modificar los entornos alimentarios, sistema elige vivir sano como modelo de gestión intersectorial constituido por políticas, planes y programas elaborados y ejecutados por distintos organismos del Estado, destinados a contribuir a generar hábitos y estilos de vida saludable y a prevenir y disminuir los factores y conductas de riesgo asociados a las enfermedades no transmisibles. A pesar de todos los esfuerzos, las encuestas poblacionales han demostrado que la obesidad continúa en aumento a lo largo del ciclo vital, por lo que es necesario fortalecer las estrategias existentes, pero con enfoque de determinantes sociales y de salud en todas las políticas, y a su vez mejorar los sistemas de evaluación de las estrategias implementadas en la población, midiendo su impacto además de su ejecución.

The high prevalence of obesity in Chile, and its increasing trend, constitutes a Public Health problem due to its association with chronic non-communicable diseases. During the 2010-2020 decade, the state of Chile implemented nutritional intervention strategies aimed at maintaining or reducing the prevalence of obesity. Regulations such as Law 20.606 on the nutritional composition of food and its advertising to modify food environments, Sistema chooses to live healthy System "EVS" Choose Healthy lifestyles as an intersectoral management model made up of policies, plans and programs prepared and executed by different State agencies, intended to contribute to healthy habits and lifestyles and to prevent and reduce risk factors and behaviors associated with non-communicable diseases. Despite all efforts, population surveys have shown that obesity continues to increase throughout the life cycle, which is why it is necessary to strengthen existing strategies, but with a focus on social and health determinants in all policies, since in turn, improve the evaluation systems of the strategies implemented in the population, measuring their impact, in addition to their implementation.

Estudo comparativo da excreção de flavonoides entre indivíduos eutróficos e obesos, após a ingestão de sucos de laranja, cv. Pera e cv. Moro / Comparative study of excretion of flavonoids among eutrophic and obese individuals, after ingestion of orange juice, cv. Pera and cv Moro

As laranjas e seus derivados, principalmente os sucos, possuem compostos bioativos, tais como os flavonoides, entre eles as flavanonas hesperidina e narirutina, que podem estar relacionados à promoção e benefícios à saúde. A absorção e metabolização de flavonoides podem ser afetadas por diversos fatores como a microbiota e fatores antropométricos, o que pode afetar a sua bioatividade. Assim, o objetivo deste estudo foi comparar o metabolismo e excreção dos flavonoides entre indivíduos eutróficos e obesos após a ingestão de sucos de laranja pasteurizado obtidos das cvs. Pera e Moro. Em um estudo cross-over randomizado 20 voluntárias eutróficas e 10 voluntárias obesas, com idade entre 19 e 40 anos, consumiram em dose única 600 mL de cada suco, que contém as flavanonas narirutina e hesperidina, além das antocianinas no suco Moro. Os metabólitos de flavanonas e de antocianinas foram identificados e quantificados em urina coletada em diferentes períodos de tempo durante 24 horas. Não foi observada diferença significativa na permeabilidade intestinal entre os grupos. Foram detectados e identificados 8 metabólitos de fase II da hesperitina e naringenina, principalmente mono e diglicuronidados e sulfatos, além de três ácidos fenólicos catabólitos de flavanonas formados pela microbiota intestinal, entre elas o ácido hipúrico, ácido protocatecuico e ácido 3-(3-hidroxifenil)-3-hidroxipropiônico. Os ácidos fenólicos foram os metabólitos majoritários recuperados na urina, principalmente o ácido hipúrico. Ainda, os metabólitos de fase II apresentaram maior excreção entre o período de 4-8h e 8-12h (13 a 27% do total de metabólitos excretados). Não foi observada diferença significante (p<0,05) no total de metabólitos de naringenina e hesperitina excretados na urina durante o período de 24 h entre os dois grupos e para os sucos de laranja, nem para o total de metabólitos, provavelmente devido à grande variabilidade interindividual na excreção. Assim, não foi observada diferença entre a metabolização de flavanonas de laranja entre os eutróficos e obesos e nenhuma correlação com os parâmetros antropométricos avaliados

Oranges and orange juices contain bioactive compounds, such as flavonoids, mainly the flavanones hesperidin and narirutin, which may be related to the promotion and health benefits. The absorption and metabolization of flavonoids can be affected by several factors such as the gut microbiota and anthropometric parameters, which may affect its bioactivity. Thus, the aim of this study was to compare the metabolism and excretion of flavonoids among eutrophic and obese people after ingestion of two pasteurized orange juice obtained from cvs. Pera and Moro. In a randomized cross-over study 20 eutrophic volunteers and 10 obese volunteers, aged 19-40 years, consumed a single dose of 600 mL of each juice. The metabolites of flavanones and anthocyanins were identified and quantified in urine collected at different time points for 24 hours. No significant difference in intestinal permeability was observed between groups. Eight Phase II metabolites of hesperitin and naringenin, mainly mono and diglycerides and sulfates, and three phenolic catabolites of flavanones formed by the gut microbiota were detected and identified, among them hippuric acid, protocatecuic acid and 3- (3-hydroxyphenyl) ) -3-hydroxypropionic acid. Phenolic acids were the major metabolites recovered in urine, mainly hippuric acid. Furthermore, phase II metabolites had greater excretion between the period of 4-8h and 8-12h (13-27% of total metabolites excreted). No significant difference (p <0.05) was observed in the total of naringenin and hesperitin metabolites excreted in the urine during the 24 h period between the two groups, probably due to interindividual variability in excretion. Thus, no difference was observed on metabolism of flavanones between the eutrophic and obese and no correlation was observed with the anthropometric parameters evaluated

Análise dos efeitos da suplementação dietética com Camu-Camu comparada à gastrectomia vertical no controle de peso de ratos Wistar / Dietary supplementation with Camu-Camu versus sleeve gastrectomy in Wistar rats weight control

RESUMO Objetivo: comparar os efeitos do extrato hidroalcoólico da casca do Camu-Camu, uma planta frutífera pertencente à família Myrtaceae amplamente distribuída na bacia amazônica, com os da gastrectomia vertical, sobre o peso e a glicemia de ratos Wistar. Métodos: vinte e quatro ratos Wistar foram submetidos à indução de obesidade através de dieta hiperlipídica por oito semanas (período de engorda), e randomizados em três grupos: Grupo Controle (GC), Grupo Camu-Camu (GCC) e Grupo Cirurgia Bariátrica (GCB). Após esse período, todos os animais retornaram a uma dieta normal e iniciou-se o período de intervenção: o GC não sofreu nenhuma intervenção além da mudança da dieta; o GCC foi submetido ao procedimento de gavagem para administração de extrato hidroalcoólico de Camu-Camu 1g/kg/dia por quatro semanas; e o GCB foi submetido ao procedimento cirúrgico de gastrectomia vertical. Todos os animais foram acompanhados por quatro semanas. Resultados: houve apenas uma perda no GCB devido à fístula gástrica. Observou-se variações significativas no peso médio dos animais: o GC evoluiu com aumento de peso mesmo após a retirada da dieta de engorda, enquanto os outros dois grupos apresentaram redução de peso. O GCB apresentou redução significativa do peso e do IMC (p<0,05); o GCC obteve redução significativa apenas do IMC (p<0,05). Não houve alterações estatisticamente significantes nos níveis glicêmicos. Conclusão: apesar de reduzir o peso, o extrato hidroalcoólico bruto da casca do Camu-Camu não foi capaz de se mostrar tão eficiente quanto a cirurgia de gastrectomia vertical no controle do peso corporal em ratos Wistar.

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

Adaptação da dieta DASH (Dietary Approaches to Stop Hypertension) para cuidado nutricional no período pós-parto, no âmbito da Atenção Básica / Adaptation of DASH diet (Dietary Approach to Stop Hypertension) for postpartum nutritional care at primary healthcare

Resumo: Introdução: A retenção de peso pós-parto é fator preditor para desenvolvimento de obesidade. Entretanto, não existe um protocolo para o cuidado nutricional de mulheres no período pós-parto, no Brasil. Objetivo: Este estudo teve por objetivo adaptar a dieta Dietary Approaches to Stop Hypertension (DASH) para orientação nutricional de mulheres no período pós-parto, no âmbito da Atenção Básica. Método: Estudo metodológico, desenvolvido em 2016, em uma comunidade do Rio de Janeiro. Foi constituído de quatro etapas: tradução, adaptação dos alimentos e grupos alimentares, identificação de acessibilidade geográfica e financeira e avaliação da viabilidade. Resultados: Os grupos de alimentos da dieta original foram estruturados para o padrão brasileiro de consumo. Após avaliação da viabilidade da proposta, observou-se que a orientação deve ser direcionada de forma compatível com a realidade local, para que seja possibilitada maior adesão. Para orientação nutricional, foi elaborado um plano alimentar qualitativo e ilustrado. Conclusão: A adaptação da dieta DASH para cuidado nutricional de mulheres no período pós-parto parece estar de acordo com o padrão alimentar brasileiro, mantendo as características nutricionais que lhe imputam os benefícios à saúde previamente estudados. Atualmente, está sendo utilizada em estudo de intervenção realizado em dois Serviços de Atenção Básica do município do Rio de Janeiro.

ABSTRACT: Introduction: Postpartum weight retention has been found to predict obesity. However, in Brazil, there's no national strategy for nutritional care of postpartum woman. Objective: This study aimed to adapt DASH diet (Dietary Approaches to Stop Hypertension) for nutritional counseling of postpartum woman, at primary healthcare. Method: Methodological study, carried out in 2016, at low-income urban neighborhood in the city of Rio de Janeiro. It was developed in four steps: translation, food and food groups adaptation, identification of geographic and economic access to food and viability evaluation. Results: The food groups of original diet were structured to Brazilian dietary pattern. After viability analysis, it was observed that the geographical access of food should be accounted to enable greater adherence. A qualitative and illustrated meal plan was elaborated for nutritional counseling. Conclusion: The adapted DASH diet for nutritional care of postpartum woman seems to be according to the Brazilian dietary pattern, maintaining nutritional characteristics that provide the health benefits previously demonstrated. Currently, it's being used in interventional study in two primary healthcare unities at the city of Rio de Janeiro.

Hiperandrogenismo y trastornos metabólicos en mujeres con síndrome de ovario poliquístico / Hyperandrogenism and metabolic disorders among women with polycystic ovary syndrome

Introducción: El síndrome de ovario poliquístico es el trastorno ovulatorio más frecuente en la mujer de edad reproductiva. Se asocia a trastornos metabólicos que pudieran tener relación con el hiperandrogenismo. Objetivo: Identificar los trastornos metabólicos en mujeres portadoras de síndrome de ovario poliquístico y su relación con el hiperandrogenismo. Métodos: Se realizó un estudio transversal, descriptivo, de diciembre 2016 a junio 2017 en el Centro de Reproducción Asistida de Baja Tecnología de Matanzas. Fueron incluidas todas las mujeres que asistieron a la consulta de infertilidad, que cumplieran los criterios de Rotterdam para el diagnóstico de síndrome de ovario poliquístico (n = 38). Se recolectaron los datos generales, antecedentes patológicos personales y examen físico. Se realizó prueba de tolerancia a la glucosa, se determinaron los valores de hormona folículo estimulante, hormona luteinizante, prolactina, testosterona, insulina, glucemia, hemoglobina glucosilada, triglicéridos, colesterol total, colesterol de lipoproteína de alta densidad, creatinina y ácido úrico. Se calculó el HOMA-IR y se identificaron las portadoras de síndrome metabólico. Para el análisis estadístico se crearon 2 grupos: uno con hiperandrogenismo (n = 17) y otro sin hiperandrogenismo (n = 21). Resultados: Los trastornos metabólicos fueron frecuentes en toda la serie. Las pacientes con hiperandrogenismo tuvieron mayor frecuencia de obesidad (82,4 por ciento; p = 0,013), circunferencia abdominal ≥ 88 cm (94,1 por ciento; p = 0,005), tolerancia a la glucosa alterada (41,2 por ciento; p = 0,001) e hiperuricemia (17,6 por ciento; p = 0,045). Conclusiones: Los trastornos metabólicos fueron frecuentes en este grupo de pacientes. Las portadoras de hiperandrogenismo tuvieron trastornos metabólicos más marcados que las no hiperandrogénicas, sobre todo tolerancia a la glucosa alterada e hiperuricemia, probablemente mediados por la obesidad(AU)

Introduction: Polycystic ovary syndrome is the most common ovulatory disorder among women of childbearing age. It is associated to metabolic disorders which might in turn be related to hyperandrogenism. Objective: Identify the metabolic disorders among women with polycystic ovary syndrome and their relationship to hyperandrogenism. Methods: A cross-sectional descriptive study was conducted at the Low-Technology Assisted Reproduction Center in Matanzas from December 2016 to June 2017. The study included all the women attending infertility consultation who met the Rotterdam criteria for polycystic ovary syndrome diagnosis (n = 38). General data and information on personal pathological antecedents were collected and physical examination performed. The glucose tolerance test was applied and determination was made of values for follicle-stimulating hormone, luteinizing hormone, prolactin, testosterone, insulin, glycemia, glycated hemoglobin, triglycerides, total cholesterol, high-density lipoprotein cholesterol, creatinine and uric acid. HOMA-IR was estimated and metabolic syndrome carriers were identified. Two groups were formed for statistical analysis: one with hyperandrogenism (n = 17) and one without hyperandrogenism (n = 21). Results: Metabolic disorders were common across the series. Patients with hyperandrogenism had a higher frequency of obesity (82.4 percent; p = 0.013), waist circumference ? 88 cm (94.1 percent; p = 0.005), impaired glucose tolerance (41.2 percent; p = 0.001) and hyperuricemia (17.6 percent; p = 0.045). Conclusions: Metabolic disorders were common in this group of patients. Hyperandrogenism carriers had more marked metabolic disorders than non-carriers, particularly as concerns impaired glucose tolerance and hyperuricemia, probably mediated by obesity(AU)

Comparação entre dietas com restrição de carboidratos e de gorduras no combate à obesidade: uma revisão sistemática / Comparison of diets with carbohydrate and fat restriction to fight obesity: a systematic review

OBJETIVO: Comparar dietas com restrição de carboidratos e com restrição de gorduras, para analisar a eficácia de ambas em relação a perda de peso, LDL-c, HDL-c, triglicerídeos, glicemia em jejum e pressão arterial. MÉTODOS: Foram analisados, em três diferentes bancos de dados, estudos de intervenção randomizados publicados entre 2002 e 2016. Após avaliação de qualidade, oito artigos foram selecionados para o presente estudo. RESULTADOS: Dietas com restrição de carboidratos demonstraram maior eficácia em relação à perda ponderal, à elevação dos níveis de HDL-c e à diminuição dos níveis de triglicerídeos, glicemia de jejum e pressóricos. A única variável em que houve maior benefício aparente com a restrição de gorduras foi a diminuição dos níveis de LDL-c. CONCLUSÃO: Uma dieta com restrição de carboidratos pode ser uma alternativa mais eficaz do que com restrição de gorduras no combate à obesidade e à síndrome metabólica. No entanto, a realização de estudos mais aprofundados é essencial para avaliar alterações em outros marcadores metabólicos importantes. (AU)

OBJECTIVES: To compare low-carbohydrate and low-fat diets to analyze their efficacy in relation to weight loss, LDL-cholesterol, HDL-cholesterol, triglycerides, fasting glycaemia and blood pressure. METHODS: For this, three randomized intervention studies published between 2002 and 2016 were analyzed in three different databases. After being evaluated for quality, eight articles were selected for the present study. RESULTS: Low-carbohydrate diets demonstrated greater efficacy concerning weight loss, elevated HDL-C levels and a decrease in triglyceride levels, fasting glycaemia and blood pressure levels. The only variable in which there was a greater apparent benefit with low-fat diet was the decrease in LDL-C levels. CONCLUSION: A low-carbohydrate diet may be a more effective alternative than a low-fat diet in the fight against obesity and metabolic syndrome. However, more in-depth studies are essential to evaluate changes in other important metabolic markers. (AU)

Effects of energetic restriction diet on butyrylcholinesterase in obese women from southern Brazil - A longitudinal study

Objective Butyrylcholinesterase (BChE) activity has been associated with obesity, lipid concentrations, and CHE2 locus phenotypes. This, the aim of this study was to evaluate the effects of an energetic restriction diet intervention on anthropometrical and biochemical variables and on absolute and relative BChE activity in CHE2 C5+ and CHE2 C5- individuals. Subjects and methods One hundred eleven premenopausal obese women from Southern Brazil participated in an energetic restriction diet intervention (deficit of 2500 kJ/day) for 8 weeks. Their anthropometric and biochemical parameters were evaluated before and after the intervention. Plasma BChE activity was measured, and BChE bands in plasma and CHE2 locus phenotypes were detected by electrophoresis. Results The dietetic intervention decreased anthropometric and biochemical parameters as well as absolute BChE activity and relative activity of the G4 band. The CHE2 C5+ phenotype presented a different effect when compared with the CHE2 C5- phenotype. The CHE2 C5+ phenotype showed an effect in absolute BChE activity and in the relative activity of the G4 form, maintaining higher BChE activity regardless of the metabolic changes. Conclusion In our study, 8 weeks was not sufficient time to lower the body mass index to normal, but it was enough to significantly reduce the absolute BChE activity, which became similar to the levels in nonobese individuals. CHE2 C5+ individuals were resistant to the decrease in BChE activity compared to CHE2 C5- individuals. This shows that the diet did not affect the CHE2 and G4 fraction complex and that the products of the CHE2 locus in association with BChE have a role in energy metabolism, maintaining high levels of enzymatic activity even after dietary intervention.

Quality of diet plans for weight loss featured in women's magazines. A cross-sectional descriptive study / Qualidade de planos dietéticos para perda de peso veiculados em revistas femininas. Um estudo descritivo transversal

ABSTRACT CONTEXT AND OBJECTIVE: Brazil has the fifth largest population of obese individuals in the world. Women's magazines publish a large number of diet plans, and therefore the objective of this study was to assess the quality of these plans. DESIGN: Cross-sectional descriptive study. METHODS: We included the Brazilian women's magazines of highest circulation published between January and June 2014 that advertised diets for weight loss on their covers. We extracted the quantities of macro and micronutrients from each of these diet plans and compared these quantities with the World Health Organization nutritional guidelines for adult women. We also checked the total energy quantities of these plans, and any recommendations about water intake and physical activity. RESULTS: We identified 136 potentially eligible magazine issues; 41 were excluded and 95 issues of 6 different magazines were included in the study. We found that 83.1 % of the plans had carbohydrate and fiber levels below the recommendations. On the other hand, the protein and saturated fatty acid levels were above the recommendations in 97.8% and 95.7% of the plans, respectively; 75.7% of the diets had inadequate calcium levels and 70.5% had low iron levels. Only 30 plans specified the total daily quantity of dietary energy and in 53.3% of these, the information was inconsistent with our estimates; 20% of the plans had no recommendations on daily water intake and 37.5% did not give recommendations regarding physical activity practices. CONCLUSION: The diet plans for weight loss featured in Brazilian women's magazines are of low quality.

RESUMO CONTEXTO E OBJETIVO: O Brasil tem a quinta maior população de obesos do mundo. Revistas femininas publicam um grande número de planos dietéticos. Assim, o objetivo deste estudo foi avaliar a qualidade desses planos. TIPO DE ESTUDO: Estudo descritivo transversal. MÉTODOS: Incluímos as revistas femininas brasileiras de maior circulação publicadas entre janeiro e junho de 2014 que tivessem uma chamada de dieta para perda de peso em sua capa. De cada plano dietético, foi extraída a quantidade de macro e micronutrientes. Comparamos esses valores com as diretrizes nutricionais da Organização Mundial de Saúde para mulheres adultas. Verificamos também a quantidade total de energia, se o plano recomendava consumo de água e prática de atividade física. RESULTADOS: Um total de 136 exemplares potencialmente elegíveis foi identificado; 41 foram excluídos e 95 exemplares de 6 revistas diferentes foram incluídos no estudo. A análise mostrou que 83,1 % dos planos apresentaram valores de carboidratos e de fibras menores do que os recomendados. Por outro lado, o teor de proteína e de ácidos graxos saturados foi maior do que o recomendado em 97,8% e 95,7% dos planos, respectivamente, e 75,7% dos planos tinham teor inadequado de cálcio e 70,5% de ferro. Apenas 30 planos especificaram a quantidade total de energia diária e em 53,3% desses, a informação foi discordante com nossas estimativas; 20% dos planos não recomendavam consumo diário de água, 35,7% não recomendavam a prática de atividade física. CONCLUSÃO: A qualidade dos planos dietéticos para perda de peso veiculados em revistas femininas brasileiras é baixa.

Can food addiction replace binge eating assessment in obesity clinics?

Introduction: Food addiction [FA] is a new terminology that uses the similarities between the craving for food and drug addiction. The Yale Food Addiction Scale [YFAS] is a recently developed tool that assesses the various symptomatology of FA and diagnoses FA when there are 3 symptoms with clinically significant functional impairment

As Egypt is one of the highest African countries in obesity prevalence, this study aimed at assessment of the presence of FA in a representative sample of Egyptian adolescents and to compare this new diagnosis to binge eating which has some common features with FA particularly loss of control eating, in order to define the true magnitude of the problem and explore the relationship between both so that preventive measures could be planned to combat the rapidly rising obesity prevalence

Subjects and methods: A cross section study using a stratified random sampling technique was conducted on 401 adolescents aged 11-18 years chosen from public, distinguished governmental and private schools

All participants had their weight and height measured with calculation of the body mass index and were interviewed to fill in the Binge Eating Scale [BES] and the Yale Food Addiction Scale [YFAS]

Results: The study included 221 females [55.1%] and 180 males [49.9%]. Their mean age was 13.98 +/-1.93 years. Clinical BE was present in 77 adolescents [19.2%]. FA was diagnosed in 81 subjects [20.2%]. Each of BE and FA showed significant differences in the different weight categories. Significant relationships were found between the various symptoms of FA and the scoring of the BE scale

Conclusion: This study proved a reconciliation between BE and FA in a non-clinical sample of Egyptian adolescents

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.

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.

The effects of frenotomy on breastfeeding

Although the interference of tongue-tie with breastfeeding is a controversial subject, The use of lingual frenotomy has been widely indicated by health professionals. Objective : To observe changes in breastfeeding patterns after lingual frenotomy concerning the number of sucks, pause length between groups of sucking and mother's complaints. Material and Methods : Oral yes/no questions about breastfeeding symptoms and sucking/swallowing/breathing coordination were answered by the mothers of 109, 30 day old infants. On the same day the infants had their lingual frenulum assessed by administering a lingual frenulum protocol. After the assessment, all tongue-tied infants were referred for frenotomy; nevertheless, only 14 underwent the surgery. Of the 109 infants, 14 infants who did not have frenulum alterations were included as controls. Birth order and gender were the criteria for recruiting the control group. The tongue-tied infants underwent lingual frenotomy at 45 days of age. At the conclusion of the frenotomy, the infants were breastfed. At 75 days old, both groups – control and post-frenotomy – were reassessed. Before the reassessment the same oral yes/no questions were answered by the mothers of the 14 infants who underwent frenotomy. The mothers of the control group answered the questionnaire only at the time of the first assessment. Data were subjected to statistical analysis. Results : After frenotomy, the number of sucks increased and the pause length between sucking decreased during breastfeeding. The controls maintained the same patterns observed in the first assessment. From the questionnaire answered by the mothers of the 14 tongue-tied infants, at 30 days and 75 days, we observed that the symptoms concerning breastfeeding and sucking/swallowing/breathing coordination were improved after lingual frenotomy Conclusions : after lingual frenotomy, changes were observed in the breastfeeding patterns of the the tongue-tied ...

Vitamin A as a key regulator of obesity & its associated disorders: Evidences from an obese rat model.

During the last century, vitamin A has evolved from its classical role as a fat-soluble vitamin and attained the status of para-/autocrine hormone. Besides its well-established role in embryogenesis, growth and development, reproduction and vision, vitamin A has also been implicated in several other physiological processes. Emerging experimental evidences emphasize adipose tissue as an active endocrine organ with great propensity to continuous growth (throughout life). Due to various genetic and lifestyle factors, excess energy accumulates in adipose tissue as fat, resulting in obesity and other complications such as type 2 diabetes, hypertension, and cardiovascular disease. recent in vitro and in vivo studies have shed light on vitamin A metabolites; retinaldehyde and retinoic acid and participation of their pathway proteins in the regulation of adipose tissue metabolism and thus, obesity. In this context, we discuss here some of our important findings, which establish the role of vitamin A (supplementation) in obesity and its associated disorders by employing an obese rat model; WNIN/Ob strain.

Factores bioquímicos y biofísicos que intervienen o interfieren en el arte de curar / Biochemical and biophysical factors involved or interfere in the art of healing

El propósito de este trabajo es revisar los factores bioquímicos y biofísicos que intervienen o interfieren en el tratamiento homeopático y cómo la alimentación deficiente o mal equilibrada puede convertirse en un obstáculo para la curación. Hemos observado que el abordaje de temas relacionados con la alimentación surge en laconsulta homeopática desde el motivo de consulta de una patología relacionada,como dislipemia, diabetes (DBT), obesidad, hipertensión arterial (HTA), etcétera, odesde los deseos y aversiones. Pero raramente se aborda el tipo de alimentación en la consulta, pudiendo ser este punto un fuerte obstáculo.

The purpose of this paper is to review the biochemical and biophysical factors involved or interfere in the homeopathic treatment and how poor or poorly balanced diet can become an obstacle to healing. We noted that addressing issues related to food arises in the homeopathic consultation from the complaint of a related disease , such as dyslipidemia , diabetes ( DBT ), obesity , high blood pressure ( hypertension ) , etc., or from the desires and dislikes. But the type of power rarely addressed in the consultation, this point can be a major obstacle.

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. .

Prevención de los trastornos de conducta alimentaria en la era de la obesidad: rol del clínico / Preventing eating disorders in the age of obesity: the clinician's role

El incremento de la obesidad y de los trastornos alimentarios en la población infanto-juvenil hace necesario que en la prevención y tratamiento de la primera, se evite favorecer inadvertidamente los últimos. En este artículo se aborda la epidemiología y las consecuencias de la obesidad y los trastornos alimentarios en la adolescencia; la asociación entre ambas patologías y los posibles mecanismos tras ella; además de la factibilidad de contribuir al desarrollo de un desorden alimentario durante el tratamiento de la malnutrición por exceso en este grupo etario. Finalmente se describe la necesidad de una prevención integrada de la obesidad y los trastornos alimentarios, tanto a través de programas de prevención conjunta como de acciones que pueden realizar los profesionales en la atención de salud.

The increase of both obesity and eating disorders in young people makes it necessary to avoid inadvertently favoring the latter during the prevention and treatment of the first. This article address the epidemiology and consequences of obesity and eating disorders in adolescence, the association between the two conditions and the possible mechanisms behind it, and the feasibility of contributing to the development of an eating disorder during the treatment of overweight in this age group. Finally, the need for integrated prevention of obesity and eating disorders is described, both through joint prevention programs and actions that health care providers can do during their clinical work.

The role of intestinal microbiota in energetic metabolism: new perspectives in combating obesity

The knowledge that the composition of intestinal microbiota is different in lean and obese humans indicates that the microbiota plays an important role in the pathophysiology of obesity. Studies show that diet composition promotes the modification of intestinal bacterial species, favoring the increase of energy extraction from the diet, insulin resistance and obesity. Unbalanced diets, with overload fat and low fiber content, lead to increased Firmicutes and Proteobacteria phyla favoring dysbiosis, endotoxemia and inflammation. The use of probiotics, prebiotics and symbiotics, in order to modulate the composition of intestinal microbiome, may be a promising therapy for the reduction of the metabolic complications of obesity; however, further studies should be conducted to establish which probiotic species are suitable to help in the treatment of obesity...