Cardiorespiratory fitness and fat oxidation during exercise as protective factors for insulin resistance in sedentary women with overweight or obesity.

INTRODUCTION: obesity is a global pandemic and it is the biggest risk factor for death worldwide nowadays. Studies suggest that both cardiorespiratory fitness and fat oxidation in exercise are related to insulin resistance and type 2 diabetes mellitus, and they could be used as metabolic fitness markers. OBJECTIVES: the aim of this study is to determine if cardiorespiratory fitness (VO2) and fat oxidation during exercise are protective factors of insulin resistance (IR) in sedentary women with obesity or overweight. METHODS: sixty women were selected for fat oxidation analysis and 55 for cardiorespiratory fitness analysis that fitted the inclusion and exclusion criteria. VO2, maximal fat oxidation (MFO) and the intensity where MFO is reached (FATmax) were determined through an incremental test on a cycle ergometer with gas analysis. The subjects with a Homeostatic model assessment of IR index greater or equal to 2.5 were considered as insulin-resistant. Participants were divided into 2 groups, IR group (n = 38) and Non-IR group (n = 22). RESULTS: VO2(%) and MFO were lower in the IR group (76.1% vs.83.2%; p = 0.015 and 1.08 mg × kg-1 × min-1 vs. 1.62 mg × kg-1 × min-1; p= 0.044, respectively) compared to the Non-IR group. There was an association between VO2(%) and IR (OR = 0.92, p = 0.017) and between MFO and IR (OR = 0.52, p = 0.035), both models adjusted for age and body mass index. CONCLUSIONS: VO2(%) and MFO are independent protective factors for IR. No association was found between FATmax and IR.

Cardiorespiratory fitness and fat oxidation during exercise as protective factors for insulin resistance in sedentary women with overweight or obesity / Fitness cardiorrespiratorio y oxidación de grasas durante el ejercicio como factores protectores de resistencia a la insulina en mujeres sedentarias con sobrepeso u obesidad

Introduction: obesity is a global pandemic and it is the biggest risk factor for death worldwide nowadays. Studies suggest that both cardiorespiratory fitness and fat oxidation in exercise are related to insulin resistance and type 2 diabetes mellitus, and they could be used as metabolic fitness markers. Objectives: the aim of this study is to determine if cardiorespiratory fitness (VO2) and fat oxidation during exercise are protective factors of insulin resistance (IR) in sedentary women with obesity or overweight. Methods: sixty women were selected for fat oxidation analysis and 55 for cardiorespiratory fitness analysis that fitted the inclusion and exclusion criteria. VO2, maximal fat oxidation (MFO) and the intensity where MFO is reached (FATmax) were determined through an incremental test on a cycle ergometer with gas analysis. The subjects with a Homeostatic model assessment of IR index greater or equal to 2.5 were considered as insulin-resistant. Participants were divided into 2 groups, IR group (n = 38) and Non-IR group (n = 22). Results: VO2(%) and MFO were lower in the IR group (76.1% vs. 83.2%; p = 0.015 and 1.08 mg × kg-1 × min-1 vs. 1.62 mg × kg-1 × min-1; p = 0.044, respectively) compared to the Non-IR group. There was an association between VO2(%) and IR (OR = 0.92, p = 0.017) and between MFO and IR (OR = 0.52, p = 0.035), both models adjusted for age and body mass index. Conclusions: VO2(%) and MFO are independent protective factors for IR. No association was found between FATmax and IR

Introducción: la obesidad es una pandemia global y actualmente es el mayor factor de riesgo de muerte a nivel mundial. Estudios sugieren que tanto el fitness cardiorrespiratorio (VO2) como la oxidación de grasas durante el ejercicio podrían ser utilizados como marcadores del fitness metabólico. Objetivos: el objetivo de este estudio es determinar si el VO2 y la oxidación de grasas durante el ejercicio son factores protectores de resistencia a la insulina en mujeres sedentarias con obesidad o sobrepeso. Métodos: fueron seleccionadas 60 mujeres para análisis de oxidación de grasas y 55 para análisis de VO2 que cumplieran con los criterios de inclusión y exclusión. El VO2, la máxima oxidación de grasas (MFO) y la intensidad donde se alcanza el MFO (FATmax) fueron determinados mediante un test incremental en cicloergómetro con análisis de gases. Los sujetos con un índice HOMA-IR mayor o igual a 2,5 fueron considerados con resistencia a la insulina. Los participantes fueron divididos en dos grupos, IR (n = 38) y No-IR (n = 22). Resultados: el VO2(%) y la MFO fueron menores en el grupo IR en comparación al grupo No-IR (76,1% versus 83,2%; p = 0,015 y 1,08 mg × kg-1 × min-1 versus 1,62 mg × kg-1 × min-1; p = 0,044, respectivamente). Mediante el análisis de regresión logística se encontró una asociación entre VO2(%) e IR (OR = 0,92; p = 0,017) y entre MFO e IR (OR = 0,52; p = 0,035), ambos modelos ajustados por edad e índice de masa corporal. Conclusión: el VO2(%) y la MFO son factores protectores independientes de IR. No se encontró asociación entre el FATmax y la IR

The Use of Multivitamin/Multimineral Supplements: A Modified Delphi Consensus Panel Report.

PURPOSE: Evidence supporting the use of dietary supplements, in particular, multivitamin/multimineral supplements (MVMS), has been mixed, complicating the ability of health care professionals to recommend their use. To clarify the role that MVMS can play in supporting human health, a series of consensus statements was developed based on expert opinion. METHODS: A panel of 14 international experts in nutritional science and health care was convened to develop consensus statements related to using MVMS in supporting optimal human health. The modified Delphi process included 2 rounds of remote voting and a final round of voting at a roundtable meeting where evidence summaries were presented and discussed. The level of agreement with each of 9 statements was rated on a 5-point Likert scale: agree strongly; agree with reservation; undecided; disagree; or disagree strongly. Consensus was predefined as ≥80% of the panel agreeing strongly or agreeing with reservation to a given statement. FINDINGS: Consensus was reached for all statements. The panel determined that MVMS can broadly improve micronutrient intakes when they contain at least the micronutrients that are consumed insufficiently or have limited bioavailability within a specified population. MVMS formulations may also be individualized according to age, sex, life cycle, and/or other selected characteristics. There are specific biological processes and health outcomes associated with deficient, inadequate, and adequate micronutrient levels. Adequate intake is necessary for normal biological functioning required for good health; in some instances, higher than recommended micronutrient intakes have the potential to provide additional health benefits. Meeting daily intakes established by dietary reference values should be an explicit public health goal for individuals and populations. Use of MVMS is one approach to ensure that adequate micronutrient needs are met in support of biological functions necessary to maintain health. Long-term use of MVMS not exceeding the upper limit of recommended intakes has been determined to be safe in healthy adults. There is insufficient evidence to indicate that MVMS are effective for the primary prevention of chronic medical conditions, including cardiovascular disease and cancer. However, for certain otherwise healthy subpopulations (eg, pregnant women, older adults) and some individuals with existing medical conditions who experience inadequacies in micronutrient intake, addressing inadequacies by using MVMS can provide health benefits. IMPLICATIONS: This consensus panel has described key issues related to the use of MVMS among individuals at risk of or presenting with inadequacies in micronutrient intake or biomarker status.

Cambios en los factores de riesgo metabólicos en pacientes obesos en tratamiento / The effect of treatment on metabolic risk factors in obese patients

Background: Obesity is a threaten to health due to its association with cardiovascular risk factors. Aim: To assess the change in metabolic risk factors after weight reduction in obese patients. Patients and methods: A retrospective analysis of 277 obese patients (198 female) aged 39.5ñ12 years old, that completed a six month treatment period, consisting in a calori restricted diet (800-1200 Kcal/day), physical activity, education and group psychological counseling. At the beginning and at the end of the program, weight, waist circumference, resting energy expenditure (REE), serum lipid profile, plasma glucose and plasma insulin levels were measured. Results: During the treatment period, body mass index decreased from 38ñ7 to 33.2ñ6.4 kg/m2 with a weight loss of 11.7 kg, waist circumference decreased from 106.6ñ14.6 to 93.9ñ13.5 cm, REE decreased from 1774ñ383 to 1585ñ267 Kcal/day, blood glucose fell by 5.8 percent, plasma insulin fell by 40.4 percent, total cholesterol fell by 7.5 percent, LDL cholesterol fell by 8.7 percent, triglycerides fell by 26.6 percent, and total cholesterol/HDL ratio fell by 12.2 percent. Conclusions: Weight loss was associated with improvement in metabolic cardiovascular risk factors in obese patients

Obesidad mórbida: morbilidad, mortalidad y resultados iniciales con el by pass gastroyeyunal / Morbid obesity: morbidity, mortality and early resultats with gastrojejunal by pass

Se presenta la experiencia del Hospital Clínico de la Universidad Católica con 92 enfermos cosecutivos operados por obesidad mórbida. En todos se utilizó el by pass gastroyeyunal. En los primeros 42 pacientes se ocluyó el estómago con corchetes en tanto que en los últimos 50 se usó rutinariamente sección gástrica. El rango de edad fue de 16 a 64 años. El peso preoperatorio promedio fue de 131ñ32 kg (DS). En 67 enfermos el IMC fue mayor de 40, destacando 25 con más de 50. Las patologías asociadas más frecuentes fueron la diabetes, la hipertensión arterial y las dislipidemias. No hubo mortalidad en la serie. Entre las complicaciones precoces hubo 4 enfermos con hemorragia digestiva y, entre las tardías, 5 enfermos de los primeros 42 presentaron apertura de los corchetes. En el 80 por ciento de los pacientes el procedimiento fue exitoso (reducción de más del 50 por ciento del exceso de peso). De los 18 con fracaso, en 16 no se efectuó sección gástrica y están entre los primereos 30 pacientes. La patología asociada dismuyó significativamente, con remisión de la diabetes en el 76 por ciento y de la dislipidemia en un 87 por ciento. Se concluye que esta técnica es útil y segura en el tratamiento de los pacientes con obesidad mórbida