Proposal for a new cut-off point for waist-to-hip ratio in women with severe obesity: A cross-sectional study.

BACKGROUND: Obesity is a chronic disease that increases the risk of cardiovascular diseases (CVD), including systemic arterial hypertension (SAH), underestimated in this population. The high mortality related to CVD reveals the need for early screening. One of the training tools is the waist-to-hip ratio (WHR). However, few studies evaluate its relationship with metabolic changes in severe obesity, making necessary a new cut-off point. METHOD: Cross-sectional study with 75 Brazilian women with severe obesity (mean age: 37,6 years; weight of 122 kg and body mass index (BMI) of 47,8 kg/m2). Height, weight, neck circumference (NC), hip (HC), waist (WC) and waist-to-hip ratio (WHR) were obtained. Blood samples were collected for lipid/glucose profile. The Receiver Operating Characteristic (ROC) was explored to define cut-off points for WHR based on SAH. Women were compared using the t-Student/Mann Whitney test. Pearson/Spearman correlations were performed, and the significance level was set at 5%. RESULTS: The ROC curve indicated that WHR ≥0.92 best predicted SAH. The group with WHR ≥0.92 had higher Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) (p = 0.037), insulin (p = 0.037), NC (p = 0.004), and Atherogenic Index of Plasma (AIP) (p = 0.038). WHR correlated with NC (p = 0.002; r = 0.358), glucose (p = 0.026; r = 0.270); insulin (p = 0.05; r = 0.238); HOMA-IR (p = 0.01; r = 0.3238), triglycerides (p = 0.006; r = 329) and AIP (p = 0.02; r = 0.370). CONCLUSIONS: A new cut-off point for WHR related to SAH in severe obesity is suggested.

The impact of the obesity onset on the inflammatory and glycemic profile of women with severe obesity.

BACKGROUND: The stage of life at the onset of obesity is an important factor in assessing inflammatory state and cardiometabolic risk. OBJECTIVES: This study aimed to evaluate the relationship between the obesity onset and the inflammatory profile in women with severe obesity. SETTING: Public hospital, Brazil. METHODS: Forty-eight women with severe obesity (20-59 yr old) were evaluated according to weight, height, neck circumference (NC), waist circumference (WC), and hip circumference, as well blood metabolic and inflammatory parameters. The participants were grouped according to obesity onset stage of life (early group: ≤19 yr; late group: >19 yr). RESULTS: The demographic means of the participants were: age of 39.7 years, weight of 122.7 kg and body mass index (BMI) of 48.4 kg/m2. The late group presented significantly higher values of leptin (lep)/adiponectin (adipo) ratio and homeostatic model assessment for insulin resistance (HOMA-IR) than the early group. The late group also had a lower adipo/lep ratio. Moreover, the late group showed correlations between the lep/adipo ratio and BMI (r = .460, P = .021), NC (r = .478, P = .016), and WC (r = .535, P = .006). Adipo was also correlated with NC (r = -.418, P = .038), WC (r = -.437, P = .029), and glycated hemoglobin (HbA1C) (r = -.485, P = .019). By contrast, in the early group, the lep/adipo ratio showed correlations with insulin (r = .647, P = .004) and HOMA-B (r = .564, P = .015). CONCLUSIONS: The inflammatory profile is correlated with anthropometric values in women with late-onset obesity. Inflammatory markers seemed to correlate with the glycemic profile in women with early-onset obesity. Furthermore, inflammation was higher in women with late-onset obesity compared to those with early-onset obesity.

The degree of food processing can influence serum fatty acid and lipid profiles in women with severe obesity.

Background: The increase in the prevalence of obesity is associated with the increase in the consumption of ultra-processed foods and may be related to the increase in the disorders involving metabolism and the transport and storage of fatty acids. Objective: To evaluate the effect of processed food consumption according to the degree of processing on the serum fatty acid levels and lipid profile of women with severe obesity. Methods: This was a cross-sectional study. Data were collected from anthropometric assessments, the food frequency questionnaire (FFQ), and blood tests for lipidogram studies and serum fatty acid measurements. The foods consumed were identified through the FFQ and classified according to the degree of processing based on the NOVA rating, and the frequencies of consumption were transformed into scores, as proposed by Fornés methodology. Data were analyzed using IBM SPSS Statistics, version 21. The significance level for the analysis was set at 5%. Results: This study included 44 women with a mean age of 40.59 years and mean body mass index of 48.61 kg/m2. An inverse association was observed between the consumption of unprocessed and the occurrence of hypertriglyceridemia (p = 0.021) and levels of triglycerides (p = 0.047), total cholesterol (p = 0.030), and very low-density lipoprotein-cholesterol (p = 0.039). The consumption of processed foods was positively associated with the presence of hypertriglyceridemia (p = 0.044) and omega 6/3 ratio (p = 0.001) and negatively associated with total omega 3 levels (p = 0.011). The consumption of processed foods was positively associated with total cholesterol (p = 0.041) and negatively associated with the omega 3/6 ratio (p = 0.001). A negative correlation was found between the average consumption of ultra-processed foods (at least once a week) and serum level of high-density lipoprotein (p = 0.035). Conclusion: The consumption of processed and ultra-processed foods was associated with unfavorable lipid profiles and fatty acid levels in women with severe obesity. These results emphasize the importance of promoting the consumption of unprocessed food to mitigate metabolic disorders linked to processed food intake.

Dietary inflammatory index and its relation to the pathophysiological aspects of obesity: a narrative review.

Obesity, a complex disease that involves energy imbalance and chronic low-grade inflammation, is implicated in the pathogenesis of several chronic non-communicable diseases. As dietary components modulate the human body's inflammatory status, the Dietary Inflammatory Index (DII®), a literature-derived dietary index, was developed in 2009 to characterize the inflammatory potential of a habitual diet. Abundant research has been conducted to investigate the associations between DII and obesity. In this narrative review, we examined the current state of the science regarding the relationships between DII and the inflammatory pathophysiological aspects related to obesity. DII is associated with inflammation in obesity. The most pro-inflammatory diet was directly related to higher levels of pro-inflammatory markers, which included C-reactive protein (CRP), interleukin-6 (IL-6), IL-1ß, and tumor necrosis factor-α (TNF-α). Therefore, evidence suggests that the use of the DII may be useful for understanding the relationship between diet and the inflammatory process related to obesity.

Dietary inflammatory index and its relation to the pathophysiological aspects of obesity: a narrative review

ABSTRACT Obesity, a complex disease that involves energy imbalance and chronic low-grade inflammation, is implicated in the pathogenesis of several chronic non-communicable diseases. As dietary components modulate the human body's inflammatory status, the Dietary Inflammatory Index (DII®), a literature-derived dietary index, was developed in 2009 to characterize the inflammatory potential of a habitual diet. Abundant research has been conducted to investigate the associations between DII and obesity. In this narrative review, we examined the current state of the science regarding the relationships between DII and the inflammatory pathophysiological aspects related to obesity. DII is associated with inflammation in obesity. The most pro-inflammatory diet was directly related to higher levels of pro-inflammatory markers, which included C-reactive protein (CRP), interleukin-6 (IL-6), IL-1β, and tumor necrosis factor-α (TNF-α). Therefore, evidence suggests that the use of the DII may be useful for understanding the relationship between diet and the inflammatory process related to obesity.

Dietary fibers as beneficial microbiota modulators: A proposed classification by prebiotic categories.

Dietary fiber is a group of heterogeneous substances that are neither digested nor absorbed in the small intestine. Some fibers can be classified as prebiotics if they are metabolized by beneficial bacteria present in the hindgut microbiota. The aim of this review was to specify the prebiotic properties of different subgroups of dietary fibers (resistant oligosaccharides, non-starch polysaccharides, resistant starches, and associated substances) to classify them by prebiotic categories. Currently, only resistant oligosaccharides (fructans [fructooligosaccharides, oligofructose, and inulin] and galactans) are well documented as prebiotics in the literature. Other fibers are considered candidates to prebiotics or have prebiotic potential, and apparently some have no prebiotic effect on humans. This dietary fiber classification by the prebiotic categories contributes to a better understanding of these concepts in the literature, to the stimulation of the processing and consumption of foods rich in fiber and other products with prebiotic properties, and to the development of protocols and guidelines on food sources of prebiotics.

Passion fruit peel intake decreases inflammatory response and reverts lipid peroxidation and adiposity in diet-induced obese rats.

This study investigated Passiflora edulis peel flour (PEPF) intake and its effect against high-fat diet-induced obesity. PEPF is a source of fiber and phenolic compounds, which can decrease oxidative stress and inflammatory cytokines, both linked to chronic inflammatory response and fat deposition in obesity. Therefore, we hypothesized that PEPF intake could decrease inflammatory cytokines and oxidative stress observed in obesity, leading to decrease of fatness and chronic inflammatory response. The aims of the study were to evaluate the lipid peroxidation, the expression of antioxidants enzymes, and inflammatory parameters in obese rats. Male Sprague-Dawley rats were divided into 3 groups (n = 8 per group) according to the diets: control (based on AIN-93G), high-fat (HF, 35% fat w/w), and HF with PEPF (HFPF), and the experiment lasted for 10 weeks. PEPF showed high dietary fiber content and bioactive compounds, such as ferulic acid, and ß-carotene. PEPF intake was effective in reducing body weight gain (13.31%) and total body fat (22.58%). The lipid peroxidation in the liver and adipose tissue decreased in the HFPF group compared to HF-fed animals, whereas hepatic glutathione peroxidase and glutathione reductase activity and their expressions in the liver were higher in HFPF than HF. In addition, the PEPF intake decreased inflammatory cytokines in serum. These results suggest that PEPF intake decreases oxidative stress, possibly by the increase of antioxidant enzymes expression. Furthermore, PEPF decreases inflammatory response and protects from adiposity. Then, PEPF could act as an adjuvant to control of early parameters in obesity dysfunction.

Aqueous extract of berry (Plinia jaboticaba) byproduct modulates gut microbiota and maintains the balance on antioxidant defense system in rats.

Previous studies have assessed the properties of aqueous extracts, using byproducts such as jaboticaba peel. We have assessed potential antioxidant effects of jaboticaba extract (Plinia jaboticaba) (JAE = 50 g/L) in vitro and in vivo. Healthy Wistar rats received ad libitum JAE for either 15 or 49 days in vivo. Cyanidin-3-O-glucoside, delphinidin-3-O-glucoside, gallic acid, rutin, myricetin, and quercetin were identified as the main polyphenols in JAE. Lipid peroxidation values in the serum and colon were similar throughout the groups. In addition, JAE did not disturb the antioxidant systems. JAE also altered gut microbiota, increasing since Lactobacillus, Bifidobacterium and Enterobacteriaceae counts. Bacterial metabolites were higher in the colon content of rats fed with JAE than in the control group. Given these results, under healthy conditions, JAE dietary supplementation could perform in vivo modulation of gut microbiota, without disturbing the antioxidant system. PRACTICAL APPLICATION: Jaboticaba (Plinia jaboticaba) peel is a rich and often-wasted source of bioactive compounds, such as polyphenols. Previous studies have shown that physiological benefits of this berry. The jaboticaba peel could contribute to antioxidant defense systems; it may also have an effect over gut microbiota related to polyphenols contents. Aqueous extraction may be a practical way of employing the bioactive compounds of jaboticaba peel; these compounds can be consumed daily and safely, and thus have attracted particular attention. This work showed positive impacts of jaboticaba peel treatments on microbiota and antioxidant defense systems, and could guide future clinical studies.

Fructooligosaccharide intake promotes epigenetic changes in the intestinal mucosa in growing and ageing rats.

PURPOSE: The aim of this study was to investigate the relationship between fructooligosaccharide (FOS) intake at different life stages of Wistar rats and its stimulatory effects on intestinal parameters. METHODS: Recently weaned and ageing female rats were divided into growing and ageing treatments, which were fed diets that partially replaced sucrose with FOS for 12 weeks. RESULTS: Dietary FOS intake induced a significant increase in the numbers of Bifidobacterium and Lactobacillus in growing rats. FOS intake was associated with increased butyric acid levels and a reduced pH of the caecal contents at both ages. Differential gene expression patterns were observed by microarray analysis of growing and ageing animals fed the FOS diet. A total of 133 genes showed detectable changes in expression in the growing rats, while there were only 19 gene expression changes in ageing rats fed with FOS. CONCLUSION: These results suggest that dietary FOS intake may be beneficial for some parameters of intestinal health in growing rats.

Passiflora edulis peel intake improves insulin sensitivity, increasing incretins and hypothalamic satietogenic neuropeptide in rats on a high-fat diet.

OBJECTIVE: This study aimed to investigate the effect of Passiflora edulis peel flour (PEPF) intake on hypothalamic neuropeptides messenger RNA expression, insulin sensitivity, and other metabolic parameters in Sprague-Dawley rats fed a high-fat (HF) diet. METHODS: Sprague-Dawley rats were divided in 3 groups: a control group, fed on a normal fat diet; a HF group, fed on a high-fat diet (35% fat [w/w]); and a high-fat Passiflora flour (HFPF) group, fed on a HF diet containing PEPF. The rats from the HFPF group as well as the HF group were kept on an HF diet for the first 4 wk to induce metabolic conditions related to obesity. Then the HFPF group was switched to a HF diet containing PEPF for additional 6 wk. Other groups were kept on normal-fat and HF diet without addition of PEPF during the whole period of experiment. The glucose tolerance and insulin sensitivity were evaluated through the glucose tolerance test (GTT) and the insulin tolerance test (ITT). Gut hormones and adipokines were measured through an immunoassay. The hypothalamic neuropeptides expression was assessed by real-time polymerase chain reaction. RESULTS: The PEPF intake increased the hypothalamic cocaine- and amphetamine-regulated transcript expression (CART) (P < 0.05), counteracted cumulative body weight gain (P < 0.001), decreased adiposity (P < 0.05) and leptin level (P < 0.01), whereas increased adiponectin (P < 0.01), glucose-dependent insulinotropic polypeptide (P < 0.01), and glucagon-like peptide-1 (GLP-1) (P < 0.001) improved the insulin sensitivity in diet-induced obesity rats by increasing the kITT (glucose disappearance rate) (P < 0.01), which was calculated during the ITT. Other gut hormones (peptide tyrosine tyrosine, pancreatic polypeptide, and amylin) and interleukins (IL) (IL-6, tumor necrosis factor-α, IL-1ß, and monocyte chemoattractant protein-1) were not changed by the PEPF intake. CONCLUSION: Our findings provide a further understanding of how the PEPF works as a dietary component to improve glucose homeostasis and demonstrate a molecular mechanism that may increase satiety by PEPF in diet-induced obesity.