Group Nutrition Counseling or Individualized Prescription for Women With Obesity? A Clinical Trial.

Background: This study investigates the effects of group counseling vs. individual dietary prescription on physical, nutritional, and mental health in overweight or obese women. Methods: Seventy-four women aged 40-59 years with body mass index ≥ 25 kg/m2 were randomized into 2 intervention arms: group nutrition counseling (GNC) or individualized nutrition prescription (INP). Twenty-seven women completed the 12-week intervention protocol. The GNC received counseling once a week and the INP received an individualized prescription once a month. All participants attended physical exercise sessions 3 times a week following the same protocol. Body mass, body mass index, fat mass, body fat percentage, lean mass, lipid profile, hemoglobin A1c, insulin and liver transaminases were measured pre- and post-intervention in both arms. A 3 day food record was applied to calculate the intake of calories, carbohydrates, proteins, and lipids. Body image dissatisfaction, level of anxiety, self-esteem measure and pathological eating attitudes were measured. Results: Both dietary interventions decreased body mass, body mass index, fat mass, body fat percentage, total caloric intake, carbohydrates, proteins, lipids, body dissatisfaction, anxiety, and saturated and polyunsaturated fats (p < 0.05). Lean mass, metabolic variables, self-esteem and pathological eating attitudes remained unchanged (p > 0.05). Conclusion: Both nutritional interventions combined with concurrent exercise were effective to improve anthropometrics, body composition, food intake, and some mental health parameters. We suggest that the choice of nutritional intervention (GNC or INP) could be based on the participants preference, considering the adherence and satisfaction, to promote health and quality of life.

Reduced bioavailability of oral amoxicillin tablets compared to suspensions in Roux-en-Y gastric bypass bariatric subjects.

AIMS: To evaluate the relative bioavailability of oral amoxicillin (AMX) tablets in comparison to AMX suspension in Roux-en-Y gastric bypass bariatric subjects. METHODS: A randomized, double-blind, cross-over study was performed on the bioavailability of oral AMX tablets and suspension in Roux-en-Y gastric bypass subjects operated at least 3 months previously . Doses of 875 mg of the AMX tablet or 800 mg of the AMX suspension were given to all the subjects, allowing a washout of 7 days between the periods. Blood samples were collected at 0, 0.25, 0.5, 1, 1.5, 2, 4, 6 and 8 hours after drug administration and the AMX levels were quantified by liquid chromatography coupled with triple quadrupole tandem mass spectrometry. The pharmacokinetic parameters were calculated by noncompartmental analysis, normalized to an 875 mg dose and the bioavailability of the AMX from the tablets was compared to that from the suspension formulation. RESULTS: Twenty subjects aged 42.65 ± 7.21 years and with a body mass index of 29.88 ± 4.36 kg/m2 were enrolled in the study. The maximum AMX plasma concentration of the tablets and the suspension (normalized to 875 mg) were 7.42 ± 2.99 mg/L and 8.73 ± 3.26 mg/L (90% confidence interval of 70.71-99.11), and the total area under the curve from time zero to infinity were 23.10 ± 7.41 mg.h/L and 27.59 ± 8.32 mg.h/L (90% confidence interval of 71.25-97.32), respectively. CONCLUSION: The tablets presented a lower bioavailability than the suspension formulation and the total absorbed amount of AMX in these subjects was lower in comparison to the standard AMX absorption rates in nonbariatric subjects, regardless of the formulation.

Proposal of a normative table for body fat percentages of Brazilian young adults through bioimpedanciometry.

Identification of the body fat (BF) percentage allows health professionals to detect healthy or risky patterns in a population. However, no studies have elaborated BF cutoff points using the bioelectrical impedance method in young Brazilian adults. Thus, the objective of the present study was to elaborate normative tables for BF in Brazilian men and women (sedentary and physically active) between 18 and 39 years of age. A total of 3,111 adults (958 men and 2,153 women) were evaluated using bioimpedance measurements with the InBody 520 device. The data were distributed normally and divided into percentiles (P3, P10, P25, P50, P75, P90, and P97). The following values were observed: for men: P3=8.9%-12.5%; P10=12.6%-17.5%; P25=17.6%-25.3%; P50=25.4%-35.1%; P75=35.2%-43.0%; P90=43.1%-49.4% and P97=49.5%; for women: P3=18.7%-23.1%; P10=23.2%-28.7%; P25=28.8%-35.7%; P50=35.8%-42.9%; P75=43.0%-49.1%; P90=49.2%-52.1% and P97≥52.2%. These percentiles can be used to classify the adiposity of sedentary and physically active individuals evaluated by bioimpedanciometry.

Cardiorespiratory fitness in adolescents with obesity: a 6-month follow-up study / Aptidão Cardiorrespiratória em Adolescentes com obesidade: um estudo de seguimento de 6 meses

The aim of this study was to investigate whether the effects of a multidisciplinary intervention on cardiorespiratory fitness are maintained after 6-month follow-up in adolescents with obesity. One-hundred and seven adolescents with obe-sity were intentionally allocated in two groups: experimental or control. Adolescents in experimental group underwent a multidisciplinary intervention (supervised aerobic exercise, psychological, nutritional, and clinical counseling). Cardiorespiratory fitness (direct gas analysis), body composition (dual-energy-DXA), anthropometry and blood lipids were measured before intervention (baseline), at the end of the 24-week intervention (post-intervention) and six months after the end of the intervention (follow-up). Cardiorespiratory fitness reduced in control group with no changes in experimental group, and these differences were maintained in the follow-up assessment (control group: 24.2±4.4 ml.kg-1.min-1to 22.6±4.9 ml.kg-1.min-1; follow-up: 22.6±4.9 ml.kg-1.min-1 vs. experimental group: 28.0±4.0 ml.kg-1.min-1 to 29.7±4.0 ml.kg-1.min-1; follow-up: 28.9±5.7 ml.kg-1.min-1). Reductions in z-score body mass index (BMI) and increases HDL-C af-ter multidisciplinary intervention were maintained after a 6-month follow-up. In conclusion, the benefits of a multidisciplinary intervention on cardiorespiratory fitness, BMI and blood lipids are maintained after a 6-month follow-up. These findings indicate that multidisciplinary interventions produce long-term health consequences on cardiorespiratory fitness. Reinforcing the importance of lifestyle changes as a therapeutic approach for the treatment of obesity in adolescents.

O objetivo do presente estudo foi investigar se os efeitos da intervenção multidisciplinar sobre a aptidão cardiorrespiratória são mantidos após um período de segmento de 6 meses em adolescentes com obesidade. Cento e sete adolescentes com obesidade foram intencionalmente alocados em dois grupos: experimental e controle. Os adolescentes do grupo experimental foram submetidos a intervenção multidisciplinar composta por acompanhamento psicológico, nutricional, clínico e treinamento aeróbio. Aptidão cardiorrespiratória (análise de gases), composição corporal (DEXA), antropometria e perfil lipídico foram avaliados no momento basal, após 24 semanas de intervenção e 6 meses após (follow up). A aptidão cardiorrespiratória reduziu no grupo controle sem alterações no grupo experimental, mesmo após o período de 6 meses (controle: 24,2±4,4 ml.kg-1.min-1 para 22,6±4,9 ml.kg-1.min-1; follow-up: 22,6±4,9 ml.kg-1.min-1 vs. grupo experimental: 28,0±4,0 ml.kg-1.min-1 para 29.7±4.0 ml.kg-1.min-1; follow-up: 28,9±5,7 ml.kg-1.min-1). Redução no escore-z do índice de massa corporal (Z-IMC) e elevação do HDL-c verificadas após 24 semanas, foram mantidas após o período de segmento. Os resultados indicam que os efeitos da intervenção multidisciplinar são mantidos após 6 meses de seguimento. Estes achados sugerem que intervenções multidisciplinares podem produzir alterações benéficas de longo prazo na capacidade cardiorrespiratória.

Comportamentos associados à manutenção dos resultados após cirurgia bariátrica / Behaviours associated to maintenance of the results after bariatricsurgery

A Cirurgia Bariátrica (CB) é um método de tratamento da obesidade que vem recebendo destaque principalmente devido aos resultados positivos no tratamento das comorbidades associados ao excesso de peso. No entanto, esse tipo de intervenção necessita de uma fase de adaptação e mudanças de estilo de vida principalmente devido a complicações pós-cirúrgicas relacionadas à deficiência de algumas vitaminas e mineiras. Nesse sentido, o objetivo do estudo foi associar o perfil antropométrico, composição corporal e tempo desde a realização da CB com a adesão a comportamentos alimentares saudáveis de pacientes submetidos a esse procedimento. Estudo do tipo transversal realizado com 98 pacientes submetidos ao bypass gástrico em Y de Roux. Foram avaliados peso, estatura, circunferência da cintura (CC) e quadril, massa de gordura, massa muscular esquelética e o comportamento alimentar por meio do questionário Bariatric Surgery Self-management Questionnaire Seven, que possui 7 domínios referentes ao comportamento alimentar (CA), à ingestão de fluidos (IF), à atividade física(AF), à gestão da síndrome de dumping (GSD), à admissão de suplementos (AS), ao consumo de rutas, vegetais e grãos integrais (CFVGI) e à ingestão de proteínas (IP). Foi verificada associação entre adesão total dos comportamentos alimentares, CFVGI, IP com o estado nutricional e CC após a CB...

Bariatric Surgery (BS) is a method for obesity treatment which has been receiving attention mainly due to the positive results in the treatment of comorbidities associated with overweight. However, this type of intervention requires a period of adaptation and change of lifestyle mainly due to post surgery complications related to vitamins and minerals deficits. In this way, the objective of this study was to associate the anthropometric profile, body composition and time since the surgery with the adherence to healthy behavior eating on patients who underwent this procedure. A cross-sectional study was conducted with 98 patients who underwent gastric bypass Roux-Y. We evaluated weight, height, waist (WC) and hip circumferences, body fat (BF), skeletal muscle mass and feeding behavior by the Bariatric Surgery Self management Questionnaire Seven, which has 7 domains related to feeding behavior (FB), the fluidintake (FI), physical activity (PA), management of Dumping Syndrome (MDS), admission of supplements (AS), consume of fruits, vegetables and whole grains (CFVWG) and protein intake (PI). We verify association between total adherence of eating behaviors, CFVWG, and PI with nutritional status and WC after BS.We also observed lower weight, BMI and WC, % and quantity of BF in patients who presented good adherence in these domains. In the domains FB, FI, and PA the patients who had operated in less time present better adherence. The younger subjects showed higher PA adhesion compared to the older ones. In conclusion, feeding behaviors adherence after BS was associated with nutritional status and WC, as well as time since BS. It is suggested to carry out studies that propose intervention models for the better control and maintenance of feeding behaviors in patients who underwent BS...

Comparação entre equipamentos de impedância bioelétrica bipolar e octapolar para a estimativa da massa livre de gordura e da gordura relativa em adolescentes com sobrepeso e obesidade / Comparison between bipolar and octapolar bioelectrical impedance analyzer for estimating fat free mass and relative fat in overweght and obese adolescents

O objetivo do estudo foi comparar equipamentos de impedância bioelétrica bipolar (IB2) (frequência: 50Hz) e octapolar (IB8) (frequência: 5, 50 e 500Hz) para a estimativa da massa livre de gordura (MLG) e da gordura relativa (G%), antes e após 16 semanas de intervenção, em adolescentes com sobrepeso e obesidade. A MLG e a G% foram medidas por meio da IB2 e da IB8, antes e após 16 semanas de intervenção multiprofissional focada na mudança de comportamento alimentar e atividade física. A MLG e a G% obtidas nas IBs foram comparadas pela ANOVA de medidas repetidas e correlacionadas através da Correlação de Pearson. Foram observadas diferenças (p<0,05) entre os equipamentos para a estimativa da MLG e G% apenas no momento pré intervenção nas meninas. Concluiu-se que as estimativas da MLG e da G% não foram estatisticamente diferentes pelos dois equipamentos (octapolar e bipolar), bem como a variação dessas duas variáveis.

The aim of this study was to compare bipolar (BI2) (frequency: 50Hz) and octapolar (BI8) (frequency: 5, 50 e 500Hz) bioelectrical impedance analyzers to estimate fat-free mass (FFM) and relative body fat (BF%) before and after 16 weeks of intervention in overweight and obese adolescents. The FFM and BF% were measured by BI2 and BI8 before and after 16 weeks of multidisciplinary intervention focused on changing eating and exercise habits. FFM and BF% obtained in the IBs were compared by ANOVA for repeated measures and correlated by Pearson Correlation Coefficient. Differences (p<0.05) were observed between the analyzers for the estimation of FFM and BF% only in the pre intervention moment for the girls. We conclude that the estimations of FFM and BF% were not significantly different between the two BI (octapolar and bipolar), especially for the variation of these two variables.

Programa de tratamento multiprofissional da obesidade: os desafios da prática / Multiprofessional treatment program of the obesity: the challenges of the practice

O aumento da prevalência da obesidade entre crianças e adolescentes representa um complexo desafio para as famílias e a sociedade, pois, uma vez instalada, predispõe a uma série de comorbidade, além de afetar, deforma expressiva, a qualidade de vida dessas pessoas. Deste modo, a Associação de Obesos de Maringá -AOM, em parceira com o Departamento de Educação Física da Universidade Estadual de Maringá, vem desenvolvendo, há aproximadamente dois anos, o programa Vivendo com Saúde, que atende adolescentes de 11 a 17 anos. O propósito deste trabalho foi descrever as características do programa e dos participantes, comparando-o a outros programas similares. O programa tem duração de 16 semanas por semestre. Até oprimeiro semestre de 2007, foram atendidos 40 adolescentes, dos quais 29 concluíram o programa. A taxa de desistentes é comparável a de outros estudos e representa uma questão a ser trabalhada nestes programas. Outro aspecto comum entre os vários programas analisados e a presente intervenção diz respeito à redução depeso, que costuma ser pequena. No entanto, há evidentes melhoras na aptidão física dos participantes.

The increase in the prevalence of obesity among children and adolescents represents a complex challenge for families and society at large, because once manifested, this condition can lead to several comorbidities and significantly affect the quality of life of those involved. As a result, the Maringá Obesity Association (AOM) incooperation with the Physical Education department at the State University of Maringá have been developing foralmost 2 years a program named “Living Healthy”, which assists youngsters between 11 and 17 years old. The purpose of this study was to describe the characteristics of the program and its participants, comparing it toothers similar programs. The program has the duration of 16 weeks per semester. Up to the first semester of2007, 40 teenagers had been assisted, of which 29 finished the program. The drop-out rate is comparable toother studies, and represents an issue to be dealt in these programs. Another aspect in common with many other analyzed programs has to do with actual weight reduction, which has usually been unsatisfactory. Nonetheless,there have been evident improvements in the physical aptitude of participants.

El aumento del predominio de la obesidad entre niños y adolescentes representa un complejo desafío para lasfamilias y la sociedad, porque una vez que esto se instala puede causar muchas comorbididades, y afecta muy expresivamente la calidad de vida de estas personas. De este modo, la Asociación de Obesos de Maringa –AOM, en sociedad con el Departamento de Educación Física de la Universidad Estatal de Maringa, viene desarrollando, hace aproximadamente 2 años, el programa Viviendo con Salud, que atiende adolescentes de 11a 17 años. El propósito de este trabajo fue describir las características del programa y de los participantes, comparándolo con los otros programas similares. El programa tiene la duración de 16 semanas por semestre. Hasta el primer semestre de 2007, fueron atendidos 40 adolescentes, de estos 29 concluyeron el programa. Latasa de desistimientos es comparable a otros estudios y representa una cuestión a ser trabajada en estos programas. Otro aspecto común entre los varios programas analizados y la presente intervención dice respectoa la reducción de peso, que acostumbra ser pequeña. Sin embargo, hay evidentes mejoras en la aptitud físicade los participantes.