Subclinical atherosclerosis determinants in morbid obesity.

BACKGROUND AND AIMS: Obesity is associated with increased cardiovascular risk. However, the impact of morbid obesity on vascular structure and function is not well understood. This study was designed to appraise subclinical atherosclerosis markers, including carotid intima media thickness (cIMT), endothelial function, and arterial wall stiffness, and their determinants, in morbidly obese patients. METHODS AND RESULTS: In this cross-sectional study 194 overweight and obese patients were distributed in morbid-obese patients (MOP, n = 110), obese (OP, n = 84) and overweight patients (OwP, n = 33) groups. Demography, anthropometry, clinical and standard biochemical data were recorded. cIMT, endothelial function, defined as the small artery reactivity index (saRHI), and artery wall rigidity, studied by the augmentation index, were determined. More than 50% of the MOP, OP and OwP had a cIMT above the 75th percentile per age and gender. No differences in cIMT or saRHI were observed, although overweight and obese patients (OOP) had higher arterial rigidity compared with the morbid-obese patients. In a multivariate regression test, while cholesterol was the main determinant of cIMT in overweight and obese patients, glucose metabolism was the determinant in MOP. CONCLUSION: More than half of the population have a cIMT above general population ranges. OwP, OP and MOP have similar cIMT and saRHI. However, OOP have greater arterial wall rigidity. Dysglycemia is the main factor associated with subclinical atherosclerosis in MOP.

Body weight loss by very-low-calorie diet program improves small artery reactive hyperemia in severely obese patients.

BACKGROUND: Endothelial dysfunction is a major underlying mechanism for the elevated cardiovascular risk associated with increased body weight. We aimed to assess the impact of weight loss induced by an intensive very-low-calorie diet (VLCD) on arterial wall function in severely obese patients (SOP). METHODS: Thirty-four SOP were admitted to the metabolic ward of the hospital for a 3-week period. A VLCD characterized by a liquid diet providing 800 kcal/day was administered. The small artery reactivity to postischemic hyperemia index (saRHI), a surrogate marker of endothelial function, was assessed before and 1 week after hospital discharge. Anthropometry and biochemical parameters were also measured. Obese and non-obese age- and gender-matched groups were recruited for baseline comparisons. RESULTS: SOP had significantly lower saRHI compared with obese and non-obese individuals. SaRHI significantly increased after the intervention in SOP (1.595 ± 0.236 vs. 1.737 ± 0.417, p = 0.015). A significant improvement in glucose (p = 0.026), systolic blood pressure (p = 0.049), LDLc (p < 0.001), and inflammatory parameters was observed. Body weight loss was associated with a higher saRHI (r = -0.385, p = 0.033), and it was the main determinant of saRHI variation independently of confounders (ß -0.049, IC 95 % -0.091-0.008, p = 0.021). CONCLUSIONS: Weight loss induced by a VLCD in SOP improved small artery reactivity, and it was associated with the amelioration of metabolic and inflammation markers. Endothelial dysfunction may be softened by body weight loss interventions and useful in the management of cardiovascular risk factors in SOP.

[Nutrient content and health effects of nuts]. / Composición nutritiva y efectos sobre la salud de los frutos secos.

Nuts are foods with a high energy density, due in part to its small water content. They also present a low saturated fat content (<7%) but a high unsaturated fat contribution (40-60%). They represent one of the richest sources of dietary fiber, which is basically of the insoluble type. The effects of nut intake on health have been widely studied. Several prospective epidemiological studies performed on large cohorts have consistently shown that regular consumption of small amounts of nuts is negatively related to the risk of cardiovascular disease and to the risk of cardiovascular or all-cause mortality. From these studies can be concluded that regular consumption of small amounts of nuts leads to a 30-50% reduction in the risk of cardiovascular disease. Additionally, intervention studies have shown a positive effect of nut intake on lipid profile with significant reductions in total and LDL cholesterol levels and small or null effects on the HDL fraction. More recently, some studies have focused on the effect of nuts on body weight. At present, no evidences support a detrimental effect of nut consumption on body weight. On the contrary some weight loss studies suggest a beneficial effect of nut intake on body weight regulation.

Composición nutritiva y efectos sobre la salud de los frutos secos / Nutrient content and health effects of nuts

Los frutos secos son alimentos caracterizados por una alta densidad energética debida en parte a su escaso contenido hídrico. Además, presentan un bajo contenido en grasa saturada (<7 por ciento) y un elevado aporte de grasa insaturada (40-60 por ciento). Constituyen también una de las fuentes más ricas de fibra dietética, fundamentalmente insoluble. Se ha estudiado ampliamente cuales son los efectos que la ingestión de frutos secos tiene sobre la salud. Diversos estudios epidemiológicos prospectivos realizados sobre amplias cohortes han mostrado consistentemente una relación negativa entre el consumo regular de pequeñas cantidades de frutos secos y el riesgo de enfermedad cardiovascular o el riesgo de mortalidad de origen cardiovascular y de mortalidad por todas las causas. El análisis de estos estudios refleja que el consumo regular de pequeñas cantidades de frutos secos reduce el riesgo de enfermedad cardiovascular en un 30-50 por ciento. Los estudios de intervención demuestran que la toma regular de suplementos de frutos secos mejora el perfil lipídico, reduciendo significativamente los niveles de colesterol total y colesterol LDL con escaso o nulo efecto sobre las HDL. El efecto de los frutos secos sobre el peso corporal ha sido también recientemente estudiado. Hasta el momento no existen evidencias de un aumento de peso corporal asociado al consumo de estos alimentos y, sin embargo, algunos estudios de pérdida ponderal sugieren un posible efecto beneficioso en la regulación del peso corporal

Nut consumption, body weight and insulin resistance.

The beneficial effects of nuts on cardiovascular health are well known. However, since nuts provide a high caloric and fat content, some concern exists regarding a potential detrimental effect on body weight and insulin resistance. The current data available did not support such a negative effect of nut consumption on the short term or when nuts are included on diets that meet energy needs. Furthermore, there is some intriguing evidence that nuts can help to regulate body weight and protect against type II diabetes. This, however, still has to be proved and more research is needed to address the specific effects of nuts on satiety, energy balance, body weight and insulin resistance.