Vitamin D status, oxidative stress, and inflammation in children and adolescents: A systematic review

Vitamin D deficiency is considered a global public health problem with high prevalence in children and adolescents. The majority of the studies in the literature have identified a relationship between vitamin D insufficiency/deficiency and obesity, as well as other traditional cardiometabolic risk factors in children and adolescents. Scarce studies address vitamin D status with oxidative stress and inflammation in the young population. The aim of this systematic review was to evaluate the evidence of the association of vitamin D status with oxidative stress and inflammation in children and adolescents. This is a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guideline on reporting systematic reviews. Eight studies were selected for this review. All included studies evaluated inflammatory biomarkers and two out of eight evaluated biomarkers of oxidative stress. The majority of the studies (five out of eight) found association of vitamin D status with biomarkers of oxidative stress and inflammation such as C-reactive protein (CRP), interleukin-6 (IL-6), cathepsin S, vascular cell adhesion molecule-1 (VCAM-1), malondialdehyde (MDA), myeloperoxidase, 3-nitrotyrosine, and superoxide dismutase (SOD). Vitamin D status is associated with oxidative stress and inflammation in the majority of the studies with children and adolescents. Thus, the assessment of vitamin D status is important because it is associated with nontraditional cardiometabolic markers in the pediatric population (review registration: PROSPERO CRD42018109307).

Regulatory roles of miR-155 and let-7b on the expression of inflammation-related genes in THP-1 cells: effects of fatty acids

The main aim of this investigation was to study the regulatory roles of let-7b and miR-155-3p on the expression of inflammation-associated genes in monocytes, macrophages, and lipopolysaccharide (LPS)-activated macrophages (AcM). A second goal was to analyze the potential modulatory roles of different fatty acids, including oleic, palmitic, eicosapentaenoic (EPA), and docosahexaenoic (DHA), on the expression of these miRNAs in the three cell types. This hypothesis was tested in human acute monocytic leukemia cells (THP-1), which were differentiated into macrophages with 2-O-tetradecanoylphorbol-13-acetate (TPA) and further activated with LPS for 24 h. Monocytes, macrophages, and AcM were transfected with a negative control, or mimics for miR-155-3p and miR-let-7b-5p. The expression of both miRNAs and some proinflammatory genes was analyzed by qRT-PCR. Interestingly, let-7b mimic reduced the expression of IL6 and TNF in monocytes, and SERPINE1 expression in LPS-activated macrophages. However, IL6, TNF, and SERPINE1 were upregulated in macrophages by let-7b mimic. IL6 expression was higher in the three types of cells after transfecting with miR-155-3p mimic. Similarly, expression of SERPINE1 was increased by miR-155-3p mimic in monocytes and macrophages. However, TLR4 was downregulated by miR-155-3p in monocytes and macrophages. Regarding the effects of the different fatty acids, oleic acid increased the expression of let-7b in macrophages and AcM and also increased the expression of miR-155 in monocytes when compared with DHA but not when compared with non-treated cells. Overall, these results suggest anti- and proinflammatory roles of let-7b and miR-155-3p in THP-1 cells, respectively, although these outcomes are strongly dependent on the cell type. Noteworthy, oleic acid might exert beneficial anti-inflammatory effects in immune cells (i.e., non-activated and LPS-activated macrophages) by upregulating the expression of let-7b.

Saturated fatty acids trigger TLR4-mediated inflammatory response

Toll-like receptors (TLR) mediate infection-induced inflammation and sterile inflammation by endogenous molecules. Among the TLR family, TLR4 is the best understood. However, while its downstream signaling pathways have been well defined, not all ligands of TLR4 are currently known. Current evidence suggests that saturated fatty acids (SFA) act as non-microbial TLR4 agonists, and trigger its inflammatory response. Thus, our present review provides a new perspective on the potential mechanism by which SFAs could modulate TLR4-induced inflammatory responses: (1) SFAs can be recognized by CD14-TLR4-MD2 complex and trigger inflammatory pathways, similar to lipopolysaccharide (LPS). (2) SFAs lead to modification of gut microbiota with an overproduction of LPS after a high-fat intake, enhancing this natural TLR4 ligand. (3) In addition, this metabolic endotoxemia leads to an oxidative stress thereby producing atherogenic lipids - oxLDL and oxidized phospholipids - which trigger CD36-TLR4-TLR6 inflammatory response. (4) Also, the high SFA consumption increases the lipemia and the mmLDL and oxLDL formation through oxidative modifications of LDL. The mmLDL, unlike oxLDL, is involved in activation of the CD14-TLR4-MD2 inflammatory pathway. Those molecules can induce TLR4 inflammatory response by MyD88-dependent and/or MyD88-independent pathways that, in turn, promotes the expression of proinflammatory transcript factors such as factor nuclear kappa B (NF-κB), which plays a crucial role in the induction of inflammatory mediators (cytokines, chemokines, or costimulatory molecules) implicated in the development and progression of many chronic diseases.

Effect of a high-fat meal containing conventional or high-oleic peanuts on post-prandial lipopolysaccharide concentrations in overweight/obese men

BACKGROUND

An increased plasma lipopolysaccharide (LPS) concentration may favour metabolic disorders such as insulin resistance. The meal composition influences plasma LPS concentrations. The present study aimed to investigate the effect of the acute consumption of a high-fat meal (49% of energy from fat) containing conventional or high-oleic peanuts on post-prandial LPS concentrations and its relationship with lipaemia and insulinaemia in overweight and obese men.

METHODS

The test meal consisted of a shake containing conventional peanuts (CVP; n = 21), high-oleic peanuts (HOP; n = 23) or a control biscuit (CT; n = 21). Blood samples were collected in the fasting state and 1, 2 and 3 h post-prandially. LPS, insulin, lipids and glucose concentrations were assessed.

RESULTS

LPS concentrations were lower in CVP [mean (SE) 0.7 (0.5) EU mL(-1) ] and HOP [1.0 (0.9) EU mL(-1) ] groups compared to CT [1.6 (1.2) EU mL(-1) ] at 3 h post-prandially. Triacylglycerol and insulin concentrations increased in all groups. Triacylglycerol started to increase only after 2 h in the CVP and HOP groups. LPS correlated positively with triacylglycerol. Insulin returned to basal concentrations at 3 h only in the CVP and HOP groups.

CONCLUSIONS

The acute consumption of peanuts delayed the increase in serum triacylglycerol and favoured the quicker return of insulin to basal concentrations, especially in the CVP group. Our results suggest that the consumption of conventional or high-oleic peanuts may help to reduce the risk of endotoxaemia and metabolic disorders.

Human ration does not alter weight and body composition, but improves the lipid profile of overweight woman

BACKGROUND

In Brazil, a mixture of cereals known as "Human Ration" (HR) has been consumed as a substitute for meals due to effects in satiation and weight loss.

METHODS

This paper evaluated the effect of HR consumption for 45 days as a breakfast replacement, on body composition, biochemical profile and eating behavior in women (n = 20) between 18-45 years old and with BMI between 27-35 kg/m².

RESULTS

The intake of HR did not promote significant changes in the body composition as well as in the mean serum values of glucose, HDL, VLDL, TC/HDL, AST and ALT. However, a significant change was noticed in the levels of TC, LDL and triglycerides (p < 0.05). Average daily intake of calories and macronutrients of the volunteers during the period of HR consumption did not differ from their habitual ingestion (p > 0.05). Regarding the consumption of total fibers, there was a significant increase (p < 0.05) in intake at breakfast during the period of HR consumption when compared to the usual intake. The consumption of HR did not intervene in the sensations of satiation, hunger and prospective intake among the subjects, presenting only instantaneous significant alterations throughout the study.

CONCLUSION

The results are clinically relevant, since they may contribute to the reduction of risk factors for chronic noncommunicable diseases.

Flaxseed energy and macronutrients balance

BACKGROUND/OBJECTIVES

Flaxseed has functional properties in the reduction of the risk of chronic non-communicable diseases such as cardiovascular disease, diabetes and cancer. Regardless of its high energy density, the consumption of flaxseed tends to promote body weight maintenance. The purpose of this study was to evaluate energy and macronutrient balance after flaxseed consumption.

SUBJECTS/METHODS

Twenty four healthy volunteers were allocated into 3 experimental groups, when they consumed flaxseed (FS), defatted flaxseed flour (FF), or flaxseed oil (FO). During the control period they were provided a diet without flaxseed products for 7-9 days. Following that diets containing 70 g of one of the flaxseed products were consumed for another 7-9 day- period. Test foods were consumed exclusively in the laboratory and fecal excretion was collected during the study. There was a higher energy excretion (P < 0.05) in the FF and FS groups, compared to their control and FO group.

RESULTS

The excretions of total lipid and the PUFA α-linolenic acid were higher in FS group (P < 0.05).

CONCLUSIONS

The intake of 70 g/day of FS and FF raised lipid and energy excretion, which may mitigated the effect of flaxseed consumption on body weight.

Energy expenditure: components and evaluation methods

INTRODUCTION

The determination of energy expenditure, considering the physical activity level and health status, is very important to adjust the individuals' nutritional supply. Energy expenditure can be determined by using indirect calorimetry, bioelectrical impedance, doubly labeled water, predictive equations, among others. All these methods have been used in clinical and research areas. However, considering the inconsistence in several research results, there is no consensus yet about the applicability of many of these methods.

OBJECTIVES

The aim of this review is to describe the components of energy expenditure and the methods for its determination and estimation, summarizing their main advantages and limitations.

RESULTS AND DISCUSSION

Indirect calorimetry and doubly labeled water are considered more accurate methods, but expensive. On the other hand, even though other methods present limitations, they are convenient and less expensive, and can be used with some caution.

Peroxisome proliferator-activated receptor: effects on nutritional homeostasis, obesity and diabetes mellitus

The obesity and the metabolic disorders associated characterize the metabolic syndrome, which has increased at an alarming rate around the world. It is known that environmental and genetic factors are involved in the genesis of obesity. Peroxisome Proliferator-Activated Receptors (PPARs) stand out among these factors. They compose the nuclear receptor superfamily and there are in three isoforms (PPARα,PPARβ/δ and PPARγ), which play an important role in the regulation of the metabolism of carbohydrates, lipids and proteins. The present review aims to understand the relationship between the diet, the PPARs and the control of the blood glucose and body weight, since the understanding about the mechanisms by which these receptors act may benefit the development of the strategies aiming at prevention and elaboration of therapeutics actions which are more effective for the treatment of obesity and diabetes.

Appetitive and Dietary Effects of Consuming an Energy-Dense Food (Peanuts) with or between Meals by Snackers and Nonsnackers

Background. Energy-dense foods are inconsistently implicated in elevated energy intake (EI). This may stem from other food properties and/or differences in dietary incorporation, that is, as snacks or with meals. Objective. Assess intake pattern and food properties on acute appetitive ratings (AR) and EI. Design. 201 normal and overweight adults consuming a standard lunch. Test loads of 1255.2 kJ (300 kcal) were added to the lunch or provided as snack. Loads (peanuts, snack mix, and snack mix with peanuts) were energy, macronutrient, and volumetrically matched with a lunch portion as control. Participants completed meal and snack sessions of their randomly assigned load. Results. No differences were observed in daily EI or AR for meal versus snack or treatment versus control. Consumption of peanuts as a snack tended to strengthen dietary compensation compared to peanuts or other loads with a meal. Conclusions. Inclusion of an energy-dense food as a snack or meal component had comparable influence on AR and EI. Peanuts tended to elicit stronger dietary compensation when consumed as a snack versus with a meal. If substantiated, this latter observation suggests that properties other than those controlled here (energy, macronutrient content, and volume) modify AR and EI.

Effect of the diet components on adiponectin levels

The prevalence of obesity has reached epidemic proportions worldwide, which requires nutritional interventions for its effective control. Adiponectin has antiinflammatory capacity, improves glucose tolerance and presents decreased plasma expression and concentration in obese individuals. Studies with animals reveal improvement in insulin resistance after the infusion of adiponectin; in humans, caloric restriction increases its levels. The present study aimed to analyze the effects of dietary components on gene expression and plasma concentration of adiponectin. Sixteen articles were found following a literature review--seven with interventions in animal models and nine in human. The results in animal models demonstrate that the consumption of hyperlipidemic diets, rich in saturated fat, reduces the levels of adiponectin, while the diets rich in polyunsaturated fatty acids and supplementation with omega-3 and eicosapentaenoic acid increase its gene expression and plasma levels. In humans, the consumption of a healthy and Mediterranean diet are positively associated with adiponectin levels, although the mechanisms are not fully understood. Due to the importance of adiponectin in preventing metabolic diseases and reducing cardiovascular risk, more research are needed on food strategies to promote the increase of adiponectin levels. Therefore, studies must be carried out to evaluate the response to different sources and levels of various dietary components and the safety of the supplementation of specific nutrients.

[Influence of dietary intake on plasma biomarkers of oxidative stress in humans]

Oxidative stress is related to an imbalance between the production of reactive species and the antioxidant defenses. In essence, oxidative stress has been defined as a disturbance in the pro-oxidant/antioxidant balance, leading to potential damage. It has been suggested that oxidative stress is involved in the etiology of several chronic diseases including cardiovascular disease, diabetes, cancer and neurodegenerative processes. The antioxidant defenses include nonenzymatic (especially dietary antioxidants) and antioxidant enzymes. Vitamins, minerals and phytochemicals (polyphenols and carotenoids) are among the major dietary antioxidants. The assessment of oxidative stress status though specific biomarkers has acquired great importance. The major biomarkers include the products of the attack of free radicals and reactive species to various substrates: lipids, proteins and nucleic acids. Measurement of antioxidant capacity may also involve the assessment of specific oxidative stress biomarkers. Most of the studies that have examined the association between diet and oxidative stress consider the effects of antioxidant supplements (vitamins and minerals), drinks and foods with bioactive compounds or dietary patterns on oxidative stress biomarkers. Some of these studies have demonstrated beneficial results on oxidative stress markers. However, the role of diet on oxidative stress biomarkers remains unclear and represents a potentially fruitful area for further research in the health area.

[Energy expenditure of healthy Brazilian adults: a comparison of methods]

There are many available methods to measure the human energy consumption. Due to the high cost and small number of laboratories able to perform it, the direct calorimetry and doubly labeled water technique are rarely used to measure the energy expenditure. As consequence, there is an increase use of the indirect calorimetry and bioelectrical impedance analysis methods by researchers and predictive equations by physicians to calculate the total energy requirements in research and in clinic.

OBJECTIVE

To evaluate the basal energy expenditure (GEB) and total energy expenditure (GET) of healthy subjects comparing results of indirect calorimetry (CI), bioelectrical impedance analysis (BIA) and predictive equations such as estimated energy requirements (EER), Fleish, FAO/WHO/UNU 1985 and 2001.

MATERIAL AND METHODS

It was evaluated the energy expenditure in 81 subjects of both gender by CI and BIA. Of these, the GEB by predictive equations FAO/WHO/UNU 1985 and 2001 and the GET by EER, Fleisch and FAO/WHO/UNU 1985 and 2001 were calculated. The data was analyzed with the software Sigma Stat for Windows version 2.03 and Dunn's test was used for comparison of mean obtained with methods and equations (p < 0.05).

RESULTS

It was verified that 60.5% of the participants were men. The majority of subjects were eutrofic. BIA showed significant differences between men and women. The differences between the values of GEB, obtained by BIA and CI, were statistically significant only for women (p < 0.05) with an underestimation of the GEB results obtained by BIA in relation to those obtained by CI. Significant difference was found between the predictive equations and CI for both sexes, also demonstrating an underestimation of the equations in relation to CI. It was observed an overestimation of GET with the predictive equations of FAO/WHO/UNU/85 and 2001 in relation to EER and Fleisch for both sexes.

CONCLUSION

The estimation of GEB can be carried out by both BIA and CI, although BIA must be used with criteria since it underestimates in a significant way for women. In relation to the predictive equations, overestimation can develop positive energy balance in populations with risks for overweight and obesity. Thus, it is necessary comparisons to identify the limitations of each method.

A soybean cultivar lacking lipoxygenase 2 and 3 has similar calcium bioavailability to a commercial variety despite higher calcium absorption inhibitors

The aim of this study was to evaluate calcium bioavailability of a new soybean variety without 2 lipoxygenases with better taste and flavor than a commercial variety containing all 3 isozymes. Using the femur (45)Ca uptake method, calcium absorption from a new Brazilian variety, UFV-116, was compared to a common Brazilian variety, OCEPAR 19. Male Sprague-Dawley growing rats weighing 150 to 170 g (10/group) received test meals of whole fat soy flour prepared from UFV-116 or OCEPAR-19 seeds labeled with 10 microCi of (45)Ca. Femurs were removed after 48 h for determination of (45)Ca uptake. Calcium fractional absorption was equivalent between the 2 varieties. The higher oxalate:calcium molar ratio and the higher content of oxalate and phytate (P < 0.05) found in the UFV-116 variety did not affect calcium absorption. Therefore, the new variety is a comparable source of high bioavailable calcium.

Zinc and iron bioavailability of genetically modified soybeans in rats

The aim of this work was to evaluate zinc and iron bioavailability of UFV-116, a new variety without 2 lipoxygenases, with better taste and flavor than a commercial variety OCEPAR 19, containing all 3 isozymes. To evaluate zinc absorption using 65Zn whole body retention and femur 65Zn uptake, rats were given 3 g of a 65ZnCl2 labeled test meal (0.25 microCi). The 2 varieties were tested at the level of 9 and 30 ppm of zinc as defatted soy flour. Two other groups (control) received egg white as source of protein and ZnS04.H20 as the zinc source. To evaluate iron absorption, using 59Fe whole body retention, animals were given a 3 g 59FeCl3 labeled test meal (0.2 microCi). The 2 varieties were tested at 12 and 25 ppm iron as defatted soy flour. Whole fat soy flour of variety 1 (UFV-116) was higher (P < 0.05) in Ca, K, Mg, phytic acid, and oxalate than variety 2 (OCEPAR-19). No difference was observed among the soybean varieties (P > 0.05) for femur 65Zn retention, at different levels of zinc. However, whole body retention was lower (P < 0.05) for UFV-116 than for OCEPAR-19. Femur 65Zn uptake was correlated with the whole body retention; however, whole body retention was more sensitive. Whole body 59Fe retention from UFV-116 was lower (P < 0.05) than from OCEPAR-19. Zinc and iron bioavailability was lower for UFV-116, possibly due to its higher content of antinutrient factors, especially phytate.

Peanut digestion and energy balance

OBJECTIVE

To explore the effects of peanut consumption on fecal energy excretion with a balanced, non-vegetarian diet.

DESIGN

Four arm parallel group design (that is, whole peanut (P), peanut butter (PB), peanut oil (PO) or peanut flour (PF) consumption) with one crossover (control and intervention).

SUBJECTS

In total 63 healthy men and women from Ghana, Brazil and USA (N=15-16 per group) with an average body mass index of 21.8 kg m(-2).

MEASUREMENTS

Percent fat of fecal wet weight daily energy excretion during the control and the treatment periods.

RESULTS

Compared to control, the percentage of fat in the feces increased significantly for the P group (5.22+/-0.29%) relative to the other three groups ((PO=3.07+/-0.36%, PB=3.11+/-0.31% (P=0.001), and PF=3.75+/-0.40% (P=0.019)). The same findings held for kJ g(-1) of feces excreted. During the P supplementation period, the energy excretion was 21.4+/-1.0 kJ g(-1) versus 18.7+/-1.0 kJ g(-1) for PO (P=0.034), 18.8+/-0.7 kJ g(-1) for PB (P=0.042) and 18.5+/-0.8 kJ g(-1) for PF (P=0.028).

CONCLUSION

Fecal fat and energy loss is greater with consumption of whole peanuts compared to peanut butter, oil or flour. This may contribute to the less than predicted change of body weight observed with peanut consumption. There were no cultural differences.

Effects of food form on appetite and energy intake in lean and obese young adults

OBJECTIVE

To investigate the independent effect of food form on appetite and energy intake in lean and obese adults using high carbohydrate, fat or protein food stimuli.

DESIGN

Crossover dietary challenge with matched beverage and solid food forms: high carbohydrate (watermelon and watermelon juice); high protein (cheese and milk); high fat (coconut meat and coconut milk). A total of 120 lean (18-23 kg/m(2); N=60) and obese (30-35 kg/m(2); N=60) adults (18-50 years old) with stable body weight. Forty different participants (N=20 lean and 20 obese) were tested with each of the food systems.

MEASUREMENTS

Appetitive sensations, food palatability and dietary intake.

RESULTS

Regardless of the predominant energy source, the beverage food form elicited a weaker compensatory dietary response than the matched solid food form. Thus, total daily energy intake was significantly higher by 12.4, 19 and 15% on days the beverage forms of the high-carbohydrate, -fat and -protein foods were ingested, respectively. This was due more to a weak effect on satiety than satiation. The obese participants had higher energy intake at the lunch, including the beverage high-protein load, but overall differences between lean and obese participants were small and not systematic.

CONCLUSION

Food rheology exerts an independent effect on energy intake. Dietary compensation for beverages is weaker than for solid food forms of comparable nutrient content. Thus, they pose a greater risk for promoting positive energy balance.

[Effect of high sucrose- and high-fat diets ingested under free-living conditions in insulin resistance in normal weight and overweight women]

OBJECTIVE

The purpose of this study was to investigate the effect of high sucrose diet (HD) and high fat diet (RFD) ingested under free-living conditions, on insulin homeostasis, verifies the association between insulin resistance and body composition as well.

RESEARCH METHODS AND PROCEDURES

20 healthy women, 13 normal-weight (22.5 +/- 2.1 years of age; BMI 22.2 +/- 1.9 kg/m2) and 7 over-weight (21.8 +/- 2.8 years of age; BMI 28.4 +/- 3.2 kg/m2), included in 2 groups G1 and G2 respectively, they were randomized to intake HD diets (59% carbohydrate including 23.0% of sucrose; 28.0% lipid; 13.0% protein; 20.2 g fiber) or HDF (42.0% carbohydrates including 1.3% of sucrose; 45.0% lipid; 13.0% protein; 22.2 g fiber) after initial assessment (BD). It was taken anthropometric measures, body composition and blood samples were obtained for fasting and post-prandial glucose and insulin determinations.

RESULTS

Glycemia, insulinemia and HOMA-IR did not differ between groups (p > 0.05). Although on BD, HOMA-IR correlates positively with weight (r = 0.750), BMI (r = 0.929), waist circumference (WC) (r = 0.750) and percentage body fat (r = 0.857) for G2 group. The values of fasting HOMA-IR on BD were significantly greater than HFD for G1 group (p < 0.05). On HD the total carbohydrates amount and sucrose are greater than BD and HFD.

CONCLUSION

The results confirm direct correlation between HOMA-IR, abdominal obesity and body fat. Therefore diet can modulate the insulinemic action.

[Effect of diet and PPARgamma2 and beta2-adrenergic receptor genes on energy metabolism and body composition in obese women]

OBJECTIVE

To evaluate the effect of diet and PPARgamma2 and beta2-adrenergic receptor genes on energy metabolism and body composition in obese women.

MATERIAL AND METHODS

60 obese women, aged 34.59 +/- 7.56 years were studied at the Department of Physiology and Nutrition at Navarra University. Anthropometric, biochemical, metabolic and molecular evaluations were carried out, and the women were submitted to short-term and long-term hypocaloric diets, varying the macronutrients. The groups were formed according to gene polymorphism, as follows: Pro12Pro(PPARgamma2)/Gln27Gln (beta2-adrenergic receptor genes) - A, Pro12Pro (PPARgamma2)/Gln27Glu (beta2-adrenergic receptor genes) - B, Pro12Pro (PPARgamma2)/ Glu27Glu (beta2-adrenergic receptor genes)-C and Pro1Ala (PPARgamma2)/Gln27Glu beta2-adrenergic receptor genes) - D.

RESULTS

In group A, fat oxidation was correlated positively with body mass index (BMI), but an increase in fat and saturated fatty acids (SFA) in the diet did not reflect in increased oxidation. In group B, total fat and SFA intake did not lead to fat oxidation increase. In group C, fat and complex carbohydrates (CHO) resulted in lower fat oxidation, and long-term increase of monounsaturated fatty acid (MUFA) intake resulted in increase of CHO oxidation and smaller weight loss. In group D, greater energy expenditure was obtained after diet high in SFA in a short-term, and fat basal and postprandial oxidation correlated positively with its intake. Hypocaloric diet high in polyunsaturated fatty acid (PUFA) resulted in increase of fat oxidation.

CONCLUSIONS

Polymorphism in PPARgamma2 gene resulted in increased fat oxidation, regardless of genotype of beta2-adrenergic receptor gene. It is recommended control of the total intake of fats and SFA in Pro12Pro/Gln27Gln and Pro12Pro/Gln27Glu, and complex CHO and MUFA in Pro12Pro/Glu27Glu. In Pro12Ala/Gln27Glu, AGPI intake can result in greater body weight loss.

[Comprehensive treatment of obesity and its prevention]

Obesity is associated to chronic metabolic entities affecting the quality of life and life expectancy. An early treatment, if efficient, can overcome most of the problems. The normalisation of body composition, of energy reserves and their distribution, as well as the minimisation of weight dependent metabolic upsets and the establishment of therapeutic priorities, according to the repercussions of obesity, are important factors for the treatment of this disease. Prevention is important and its basis is teaching and the setting in healthy life style with modification of the food habits and the incorporation of physical work into everyday activities. Diet therapy, physical activity, pharmacotherapy, surgery education and psychology are the forms proposed for the treatment and prevention of obesity.