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Montalvão-Sousa TM, Ferreira PDA, Colombelli NL, de Carvalho KMB, Blazevich AJ, Lima RM. Sarcopenic obesity defined by the ESPEN and EASO consensus statement in older women: Risk of falls and bone mineral density implications. Arch Gerontol Geriatr 2024; 124:105444. [PMID: 38643667 DOI: 10.1016/j.archger.2024.105444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/08/2024] [Accepted: 04/11/2024] [Indexed: 04/23/2024]
Abstract
PURPOSE To apply the ESPEN-EASO diagnostic criteria for Sarcopenic Obesity (SO) in older women and to assess its association with the risk of falls, fear of falls (FOF), and bone mineral density (BMD). METHODS After exclusion criteria, 232 women aged ≥60 years (68.2 ± 6.1) were enrolled in the study. Volunteers had handgrip strength (HGS; dynamometer) and body composition assessed by DXA before risk of falls was evaluated using the QuickScreen and FOF evaluated by the Falls Efficiency Scale. SO was defined according to the ESPEN-EASO algorithm, which includes reduced HGS and fat-free mass, and elevated fat mass. RESULTS The prevalence of SO was 6.5 %, which was associated with a higher proportion of fallers in the previous year (X2 6.2, P = 0.04), reduced reaction time (X2 6.2, P = 0.04), reduced sit-to-stand performance (X2 6.2, P = 0.04), and a higher probability of falls [ꭓ2(6) = 17.689, p = 0.004]. FOF was lower in the eutrophic group (ꭓ2(2) = 15,662, p < 0,001) than both the obesity (p = 0.001) and SO (p = 0.05) groups. For total and femoral neck BMD, the eutrophic group presented significantly lower values (1.05 and 0.79 g/cm2) than the obesity group (1.10 and 0.87 g/cm2), but similar to the SO group (1.02 and 0.83 g/cm2). These results remained significant after adjustments for potential confounders. CONCLUSIONS SO specified by the ESPEN-EASO framework was associated with a higher risk of falls but not with increased FOF than obesity alone. The favorable influence of overweight and obesity on BMD seems to be attenuated in individuals with SO. Our findings support the clinical significance of the ESPEN-EASO definition.
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Affiliation(s)
| | | | | | | | - Anthony J Blazevich
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Ricardo M Lima
- Faculty of Physical Education, University of Brasília, Brasília, Distrito Federal, Brazil
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Mendes MM, Araújo MM, Botelho PB, de Carvalho KMB. Seasonal and sex-related variation in vitamin D status and its association with other biochemical markers in young individuals: A cross-sectional study. PLoS One 2024; 19:e0298862. [PMID: 38551916 PMCID: PMC10980231 DOI: 10.1371/journal.pone.0298862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 02/01/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND While several studies have investigated the association between vitamin D deficiency and biochemical parameters, the results are still inconsistent and mostly overlook seasonal variations. This study explored the relationships between 25-hydroxy-vitamin D (25(OH)D) concentrations, biochemical markers, and seasonal variation among young males and females. METHODS A cross-sectional study was conducted among 203 individuals aged 18-24 years of both sexes residing in Brasilia, Brazil (latitude: 15°S). Sociodemographic variables, season of blood collection, and serum levels of 25(OH)D, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, glycated hemoglobin (HbA1c), glucose, insulin, hs-CRP, parathyroid hormone, ionized calcium, and alkaline phosphatase were included. Descriptive statistics and differences among groups, correlations, and linear regression tests were performed. RESULTS The mean age of the participants was 21.17±1.7 years, and the mean serum 25(OH)D level was 25.76±7.0 ng/mL. Of the participants, 50.7% had vitamin D insufficiency (20 to 29.9 ng/mL), and 23.2% were vitamin D deficient (≤20 ng/mL). Vitamin D deficiency was higher in the spring (53.2%) and among females (29.5%). In young men with vitamin D insufficiency/deficiency (≤29.9 ng/mL) (n = 49), 25(OH)D levels were inversely correlated with HOMA-β (r = -0.234, p = 0.032) and triglyceride (r = -0.415, p = 0.003) levels. However, there were no significant correlations between 25(OH)D concentrations and biochemical markers among women with insufficient and deficient vitamin D levels. CONCLUSION This study found a high prevalence of vitamin D insufficiency/deficiency among young individuals living in Brasília, Brazil, particularly women and during the spring season. Our findings suggest that lower 25(OH)D levels (≤29.9 ng/mL) may be associated with insulin resistance and an increased risk of cardiovascular disease in young men studied. However, further studies with larger representative samples are needed to explore the mechanisms underlying the association between vitamin D and biochemical parameters.
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Affiliation(s)
- Marcela Moraes Mendes
- Department of Nutrition, Graduate Program in Human Nutrition, University of Brasilia, Brasília, Federal District, Brazil
- Postgraduate Program, Faculty of Nutrition, Federal University of Goias, Goiania/GO, Brazil
| | - Maísa Miranda Araújo
- Department of Nutrition, Graduate Program in Human Nutrition, University of Brasilia, Brasília, Federal District, Brazil
| | - Patrícia Borges Botelho
- Department of Nutrition, Graduate Program in Human Nutrition, University of Brasilia, Brasília, Federal District, Brazil
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De Moraes ACF, Medeiros-Oliveira VC, Burford K, Schaan BD, Bloch K, de Carvalho KMB, Cureau FV, Nascimento-Ferreira MV. Association Between Sleep Time and Pro- and Anti-Inflammatory Biomarkers Is Mediated by Abdominal Obesity Among Adolescents. J Phys Act Health 2023; 20:926-933. [PMID: 37295784 DOI: 10.1123/jpah.2022-0468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 04/03/2023] [Accepted: 04/27/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Movement behaviors and abdominal obesity are associated with higher inflammatory biomarkers. However, the role of waist circumference as a mediating factor is still unknown. Thus, our aims were to (1) test the associations between 24-hour movement behavior variables (physical activity, sedentary behavior, and sleep), abdominal obesity, and pro- and anti-inflammatory biomarkers; and (2) investigate whether abdominal obesity had a mediating effect between the investigated associations. METHODS This multicenter cross-sectional study included 3591 adolescents (aged 12-17 y) from 4 Brazilian cities. Waist circumference (in centimeters; at half the distance between the iliac crest and at the lower costal margin), 24-hour movement behaviors (validated questionnaire), high-sensitive C-reactive protein, and adiponectin (serum plasma) were evaluated. We used multiple mediation regression models (95% confidence interval) to determine if waist circumference mediated the association between 24-hour movement behaviors and pro- and anti-inflammatory biomarkers. RESULTS The results revealed that screen time and moderate to vigorous physical activity were not associated with pro- or anti-inflammatory biomarkers. However, sleep duration (in hours per day) was negatively associated with pro- (C-reactive protein, β = -0.08; 95% confidence interval, -0.38 to -0.02) and anti- (adiponectin, β = -0.31; 95% confidence interval, -2.13 to -0.12) inflammatory biomarkers. Our results also showed that waist circumference mediated the association between sleep duration and high-sensitive C-reactive protein (2.7%), and adiponectin (2.8%). CONCLUSION Sleep duration was inversely associated with pro- and anti-inflammatory biomarkers, and these relations were mediated by abdominal obesity. Therefore, adolescents having healthy sleep can have implications for reducing waist circumference and inflammatory indicators.
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Affiliation(s)
- Augusto César Ferreira De Moraes
- The University of Texas Health Science Center at Houston School of Public Health Austin Campus, Department of Epidemiology, Human Genetics, and Environmental Science, Michael & Susan Dell Center for Healthy Living, Austin, TX,USA
- Department of Epidemiology, Graduate Program in Public Health and Graduate Program in Epidemiology, School of Public Health, University of Sao Paulo, Sao Paulo, SP,Brazil
- YCARE (Youth/Child and cArdiovascular Risk and Environmental) Research Group, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP,Brazil
| | - Vanessa Cassia Medeiros-Oliveira
- Department of Epidemiology, Graduate Program in Public Health and Graduate Program in Epidemiology, School of Public Health, University of Sao Paulo, Sao Paulo, SP,Brazil
- YCARE (Youth/Child and cArdiovascular Risk and Environmental) Research Group, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP,Brazil
| | - Katie Burford
- The University of Texas Health Science Center at Houston School of Public Health Austin Campus, Department of Epidemiology, Human Genetics, and Environmental Science, Michael & Susan Dell Center for Healthy Living, Austin, TX,USA
| | - Beatriz D Schaan
- Faculty of Medicine, Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS,Brazil
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS,Brazil
- Faculty of Medicine, Graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS,Brazil
| | - Katia Bloch
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ,Brazil
| | | | - Felipe Vogt Cureau
- Graduate Program in Cardiology and Cardiovascular Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS,Brazil
| | - Marcus Vinicius Nascimento-Ferreira
- YCARE (Youth/Child and cArdiovascular Risk and Environmental) Research Group, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP,Brazil
- HEALth, pHYsical activity and Behavior ReseArch (HEALTHY-BRA) group, Federal University of Tocantins, Campus Miracema, Miracema, TO,Brazil
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Duarte ACS, da Silva NR, Santos Gonçalves VS, Corgosinho FC, de Carvalho KMB, Horst MA. The Influence of Single Nucleotide Polymorphisms On Body Weight Trajectory After Bariatric Surgery: A Systematic Review. Curr Obes Rep 2023; 12:280-307. [PMID: 37389759 DOI: 10.1007/s13679-023-00514-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 07/01/2023]
Abstract
PURPOSE OF REVIEW To conduct a systematic review to summarize the results of studies on this subject and to identify whether single nucleotide polymorphisms (SNPs) are good prognostic markers for body weight trajectory after bariatric surgery. RECENT FINDINGS A considerable number of events can influence the body weight trajectory after bariatric surgery, and in the post-genomic era, genetic factors have been explored. This study is registered with PROSPERO (CRD42021240903). SNPs positively associated with poor weight loss after bariatric surgery were rs17702901, rs9939609, rs1360780, rs1126535, rs1137101, rs17782313, rs490683, and rs659366. Alternatively, SNPs rs2229616, rs5282087, rs490683, rs9819506, rs4771122, rs9939609, rs4846567, rs9930506, rs3813929, rs738409, rs696217, rs660339, rs659366, rs6265, rs1801260, and rs2419621 predicted a higher weight loss after bariatric surgery. Six studies performed with a genetic risk score (GRS) model presented significant associations between GRS and outcomes following bariatric surgery. This systematic review shows that, different SNPs and genetic models could be good predictors for body weight trajectory after bariatric surgery. Based on the results of the selected studies for this Systematic Review is possible to select SNPs and metabolic pathways of interest for the GRS construction to predict the outcome of bariatric surgery to be applied in future studies.
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Affiliation(s)
- Amélia Cristina Stival Duarte
- Nutritional Genomics Research Group, Faculty of Nutrition, Federal University of Goiás (UFG), Goiânia, 74690-900, Brazil.
| | - Nara Rubia da Silva
- Nutritional Genomics Research Group, Faculty of Nutrition, Federal University of Goiás (UFG), Goiânia, 74690-900, Brazil
| | | | - Flávia Campos Corgosinho
- Graduate Program in Nutrition and Health. School of Nutrition, Federal University of Goiás (UFG), Goiânia, 74690-900, Brazil
- Graduate Program in Health Science. School of Medicine, Federal University of Goiás (UFG), Goiânia, 74690-900, Brazil
| | - Kênia Mara Baiocchi de Carvalho
- Graduate Program in Public Health, University of Brasilia (UnB), Brasilia, 70910-900, Brazil
- Graduate Program in Human Nutrition, University of Brasilia (UnB), Brasilia, 70910-900, Brasil
| | - Maria Aderuza Horst
- Nutritional Genomics Research Group, Faculty of Nutrition, Federal University of Goiás (UFG), Goiânia, 74690-900, Brazil
- Graduate Program in Nutrition and Health. School of Nutrition, Federal University of Goiás (UFG), Goiânia, 74690-900, Brazil
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Melendez-Araújo MS, do Carmo AS, Vieira FT, Lamarca F, Nakano EY, Lima RM, Dutra ES, de Carvalho KMB. Long-Term Lifestyle Habits and Quality of Life after Roux-in-Y Gastric Bypass in Brazilian Public versus Private Healthcare Systems: Beyond Weight Loss. Int J Environ Res Public Health 2023; 20:6494. [PMID: 37569034 PMCID: PMC10419078 DOI: 10.3390/ijerph20156494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023]
Abstract
Lifestyle and health-related quality of life (HRQoL) are good markers of surgical obesity treatment. This study aimed to investigate the lifestyle and HRQoL of patients at least five years after Roux-en-Y gastric bypass in public (SUS) and private (PVT) Brazilian healthcare systems. In this cross-sectional study, weight loss (WL), % of excess WL (%EWL), diet quality, physical activity, alcohol consumption, and HRQoL were evaluated. Analysis of covariance, binary and multinomial logistic regression, adjusted for confounders, were performed. The SUS group had more vulnerable socioeconomic statuses than the PVT group. Total %WL and % EWL were 24.64 ± 0.99% and 60.46 ± 2.41%, respectively, without difference between groups. In the Pain/Discomfort and Anxiety/Depression domains of HRQoL, more than 50% reported moderate problems without differences between groups. Processed food ingestion was higher in the PVT (132.10 ± 60.15 g/1000 kcal) than in the SUS (103.43 ± 41.72 g/1000 kcal), however, without statistical significance (p = 0.093). The PVT group showed lower physical activity (OR: 0.23; 95%CI: 0.87-0.63; p = 0.004) and a higher risk of alcohol-related problems (OR: 3.23; 95%CI; 1.03-10.10; p = 0.044) compared to SUS group. Participants generally achieved satisfactory WL, regardless of healthcare systems. However, PVT participants had unfavorable lifestyle characteristics, highlighting the need for studies investigating environmental issues post-bariatric surgery.
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Affiliation(s)
- Mariana S. Melendez-Araújo
- Graduate Program of Human Nutrition, University of Brasília, Brasília 70910-900, Brazil; (M.S.M.-A.); (F.T.V.); (F.L.); (R.M.L.); (E.S.D.)
| | | | - Flávio Teixeira Vieira
- Graduate Program of Human Nutrition, University of Brasília, Brasília 70910-900, Brazil; (M.S.M.-A.); (F.T.V.); (F.L.); (R.M.L.); (E.S.D.)
| | - Fernando Lamarca
- Graduate Program of Human Nutrition, University of Brasília, Brasília 70910-900, Brazil; (M.S.M.-A.); (F.T.V.); (F.L.); (R.M.L.); (E.S.D.)
- Department of Applied Nutrition, Rio de Janeiro State University (UERJ), Rio de Janeiro 23900-000, Brazil
| | | | - Ricardo M. Lima
- Graduate Program of Human Nutrition, University of Brasília, Brasília 70910-900, Brazil; (M.S.M.-A.); (F.T.V.); (F.L.); (R.M.L.); (E.S.D.)
- Graduate Program in Physical Education, University of Brasilia, Brasília 70910-900, Brazil
| | - Eliane Said Dutra
- Graduate Program of Human Nutrition, University of Brasília, Brasília 70910-900, Brazil; (M.S.M.-A.); (F.T.V.); (F.L.); (R.M.L.); (E.S.D.)
| | - Kênia Mara Baiocchi de Carvalho
- Graduate Program of Human Nutrition, University of Brasília, Brasília 70910-900, Brazil; (M.S.M.-A.); (F.T.V.); (F.L.); (R.M.L.); (E.S.D.)
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Araújo MM, Pizato N, Rodrigues LS, de Andrade LS, de Moraes VD, de Carvalho KMB, Dutra ES, Botelho PB, Gonçalves VSS. Development and Validation of Protocol Based on Brazilian Dietary Guidelines for Adults with Diabetes Mellitus Who Attended Primary Health Care. Int J Environ Res Public Health 2023; 20:ijerph20105784. [PMID: 37239513 DOI: 10.3390/ijerph20105784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/28/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND To date, there is no protocol providing dietary guidelines to assist health care professionals in counseling Brazilian individuals with Diabetes Mellitus (DM) assisted in primary health care (PHC) according to the Dietary Guidelines for the Brazilian Population (DGBP). Therefore, this study aimed to develop and validate a protocol based on the DGBP for health care, non-nutritionist professionals in counseling adults with DM in PHC. METHODS We systematized the recommendations published in the DGBP, the Diabetes Brazilian Society guidelines, and the scientific literature regarding food and nutrition needs of adults with DM. The clarity and relevance were validated by an expert panel (n = 19) and the understanding and applicability were validated by PHC professionals (n = 12). The degree of agreement of the experts was assessed using a Content Validity Index (CVI). Items receiving CVI > 0.8 were considered appropriate. RESULTS The protocol consisted of six dietary recommendations that encouraged the daily consumption of beans, vegetables, and fruits, advised the avoidance of sugar-sweetened beverages and ultra-processed foods, stimulated eating in appropriate environments, and gave additional guidance addressed to the particularities of DM. The protocol clarity, relevance, and applicability were successfully validated. CONCLUSION The protocol supports health care, non-nutritionist professionals in the guidance of dietary recommendations and promoting adequate and healthy eating habits for adults with DM in PHC.
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Affiliation(s)
- Maísa Miranda Araújo
- Graduate Program in Human Nutrition, Department of Nutrition, University of Brasilia, Campus Darcy Ribeiro, Brasília 70910-900, Brazil
| | - Nathalia Pizato
- Graduate Program in Human Nutrition, Department of Nutrition, University of Brasilia, Campus Darcy Ribeiro, Brasília 70910-900, Brazil
| | - Lorrany Santos Rodrigues
- Graduate Program in Public Health, Department of Nutrition, University of Brasilia, Campus Darcy Ribeiro, Brasília 70910-900, Brazil
| | - Laila Santos de Andrade
- Nutrition and Health Research Group-PENSA, Department of Nutrition, University of Brasilia, Campus Darcy Ribeiro, Brasília 70910-900, Brazil
| | - Verena Duarte de Moraes
- Oswaldo Cruz Foundation, Laboratory of Regional Endemic Situations, Rio de Janeiro 21045-900, Brazil
| | - Kênia Mara Baiocchi de Carvalho
- Graduate Program in Human Nutrition, Department of Nutrition, University of Brasilia, Campus Darcy Ribeiro, Brasília 70910-900, Brazil
- Graduate Program in Public Health, Department of Nutrition, University of Brasilia, Campus Darcy Ribeiro, Brasília 70910-900, Brazil
| | - Eliane Said Dutra
- Graduate Program in Human Nutrition, Department of Nutrition, University of Brasilia, Campus Darcy Ribeiro, Brasília 70910-900, Brazil
| | - Patrícia Borges Botelho
- Graduate Program in Human Nutrition, Department of Nutrition, University of Brasilia, Campus Darcy Ribeiro, Brasília 70910-900, Brazil
| | - Vivian Siqueira Santos Gonçalves
- Graduate Program in Public Health, Department of Nutrition, University of Brasilia, Campus Darcy Ribeiro, Brasília 70910-900, Brazil
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Araújo MM, Mendes MM, Costa LM, Lima RM, Lanham-New SA, Baiocchi de Carvalho KM, Botelho PB. Determinant factors of bone health after long-term of Roux-en-Y gastric bypass surgery: A cross-sectional study. Nutrition 2023; 108:111937. [PMID: 36640632 DOI: 10.1016/j.nut.2022.111937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/01/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate bone health and the potential influencing factors of bone metabolism disorders in adults ≥5 y after Roux-en-Y gastric bypass (RYGB) surgery. METHODS In this cross-sectional study, patients who were ≥5 y post-RYGB were invited. Bone health considered as bone mineral content (BMC) and bone mineral density (BMD) in this study was assessed by dual x-ray absorptiometry. We also assessed 25-hydroxy-vitamin D concentrations, individual ultraviolet B radiation levels, serum ionized calcium, alkaline phosphatase, parathyroid, anthropometric, and body composition. RESULTS The study evaluated 104 adults (90% women; 49.6 ± 9.1 y old; postoperative period 8.7 ± 2.2 y). Lumbar and femoral BMC and BMD were positively correlated to body mass index (BMI), appendicular lean mass (ALM), and negatively to %excess of weight loss (EWL). Femoral BMD was negatively correlated to age, and both femoral BMD and BMC were positively correlated to weekly exposed body part score. Sex, age, BMI, ALM, and weekly exposed body part score explained 35% and 54% of the total variance of femoral BMD and BMC, respectively. CONCLUSIONS The present findings suggested that older age, lower BMI, higher %EWL, lower ALM, and lower weekly body part exposure score are important determinants in lowering BMD and BMC parameters in long-term post-bariatric surgery individuals, rather than serum 25-hydroxy-vitamin D and parathyroid.
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Affiliation(s)
| | | | - Lorena Morais Costa
- Graduate Program in Human Nutrition, University of Brasília, Brasília, Brazil
| | - Ricardo Moreno Lima
- Graduate Program in Human Nutrition, University of Brasília, Brasília, Brazil; Graduate Program in Physical Education, University of Brasília, Brasília, Brazil
| | - Susan A Lanham-New
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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Okamura AB, Gonçalves VSS, de Carvalho KMB. School Feeding as a Protective Factor against Insulin Resistance: The Study of Cardiovascular Risks in Adolescents (ERICA). Int J Environ Res Public Health 2022; 19:10551. [PMID: 36078265 PMCID: PMC9518190 DOI: 10.3390/ijerph191710551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/03/2022] [Accepted: 07/20/2022] [Indexed: 06/15/2023]
Abstract
The objective of this study was to use ERICA data from adolescents from Brazilian public schools to investigate the role of school feeding in insulin resistance markers. Public school students (12-17 years old) with available biochemical examinations were selected. Adolescents answered a self-administered questionnaire, and contextual characteristics were obtained through interviews with principals. A multilevel mixed-effects generalized linear model was performed at the contextual and individual levels with each insulin resistance marker (fasting insulin, HOMA-IR, and blood glucose levels). A total of 27,990 adolescents were evaluated (50.2% female). The prevalence of (1) altered insulin was 12.2% (95% CI; 11.1, 13.5), (2) high HOMA-IR was 24.7% (95% CI; 22.8, 26.7), and (3) high blood glucose was 4.6% (95% CI; 3.8, 5.4). School feeding was positively associated with an insulin resistance marker, decreasing by 0.135 units of HOMA-IR (95% CI; -0.19, -0.08), 0.469 μU/L of insulin levels (95% CI; -0.66, -0.28), and 0.634 mg/dL of blood glucose (95% CI; -0.87, -0.39). In turn, buying food increased blood glucose by 0.455 mg/dL (95% CI; 0.16, 0.75). School feeding was positively associated with insulin resistance variables, demonstrating the potential of planned meals in the school environment to serve as a health promoter for the adolescent population.
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Vieira FT, Godziuk K, Lamarca F, Melendez-Araújo MS, Lima RM, Prado CM, de Carvalho KMB, Dutra ES. Sarcopenic obesity diagnosis by different criteria mid-to long-term post-bariatric surgery. Clin Nutr 2022; 41:1932-1941. [DOI: 10.1016/j.clnu.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/23/2022] [Accepted: 07/03/2022] [Indexed: 11/16/2022]
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Vieira FT, de Oliveira GS, Gonçalves VSS, Neri SGR, de Carvalho KMB, Dutra ES. Effect of physical exercise on muscle strength in adults following bariatric surgery: A systematic review and meta-analysis of different muscle strength assessment tests. PLoS One 2022; 17:e0269699. [PMID: 35687555 PMCID: PMC9187088 DOI: 10.1371/journal.pone.0269699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/25/2022] [Indexed: 11/18/2022] Open
Abstract
Individuals following bariatric surgery are considered at high risk for the development of sarcopenic obesity (excess fat mass, low muscle mass and low physical function), and exercise may play an important role in its prevention and treatment. We systematically reviewed 5 scientific databases (Embase, Medline, Scopus, SPORTDiscus, and Web of Science) and 2 grey literature databases (ProQuest and Google Scholar) for clinical trials that evaluated the effect of exercise on muscle strength in adults following bariatric surgery and conducted a separate meta-analysis for studies that used different muscle strength tests. Random-effect models, restricted maximum likelihood method and Hedges’ g were used. The review protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42020152142). Fifteen studies were included (638 patients), none had a low risk of bias, and all were included in at least 1 of the 5 meta-analyses (repetition maximum [lower and upper limbs], sit-to-stand, dynamometer, and handgrip tests). Exercise interventions improved both upper (effect size, 0.71; 95% CI, 0.41–1.01; I2 = 0%) and lower (effect size, 1.37; 95% CI, 0.84–1.91; I2 = 46.14) limb muscle strength, as measured by repetition maximum tests. Results were similar for the sit-to-stand (effect size, 0.60; 95% CI, 0.20–1.01; I2 = 68.89%) and dynamometer (effect size, 0.46; 95% CI, 0.06–0.87; I2 = 31.03%), but not for the handgrip test (effect size, 0.11; 95% CI, -0.42–0.63; I2 = 73.27%). However, the certainty level of the meta-analyses was very low. Exercise with a resistance training component performed post bariatric surgery may improve muscle strength, which is related to sarcopenic obesity, functional capacity, and mortality risk, therefore should be included in the follow-up.
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Affiliation(s)
- Flávio Teixeira Vieira
- Graduate Program in Human Nutrition of the University of Brasilia, Brasilia, Brazil
- * E-mail:
| | | | | | - Silvia G. R. Neri
- Graduate Program in Physical Education of the University of Brasilia, Brasilia, Brazil
| | | | - Eliane Said Dutra
- Graduate Program in Human Nutrition of the University of Brasilia, Brasilia, Brazil
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Araújo MM, Mendes MM, Lanham-New SA, Borges LPSL, da Costa THM, de Carvalho KMB, Botelho PB. Frequency of Vitamin D Deficiency and Associated Factors in Long-term Bariatric Surgery Patients: a Cross-sectional Study. Obes Surg 2022; 32:2386-2396. [PMID: 35513763 DOI: 10.1007/s11695-022-06090-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 04/17/2022] [Accepted: 04/26/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Vitamin D deficiency is a common consequence of bariatric surgery (BS). However, few studies have evaluated influential factors and to date there are no studies investigating individual ultraviolet B (UVB) radiation levels in BS patients. This study aimed to evaluate vitamin D deficiency and its associated factors, including UVB radiation, in Roux-Y gastric bypass (RYGB) patients. METHODS This study included 104 adults (90.4% female) at least 5 years after RYGB. Patients underwent surgery in private hospitals (Private; n = 47) or in two public hospitals, one with ongoing outpatient care (Active; n = 17), and the other with discontinued service for BS (Discontinued; n = 40). 25-hydroxyvitamin D (25(OH)D) concentrations were analyzed by chemiluminescence, individual UVB radiation levels by dosimeter badges. Vitamin D intake, anthropometric, skin phototype, sociodemographic and lifestyle patterns were also assessed. RESULTS Mean age was 49.6 ± 9.1 years and post-operative period 8.7 ± 2.2 years. The prevalence of 25(OH)D deficiency and insufficiency was 25.0% and 51.9% respectively. 25(OH)D concentration differed among the hospitals (private = 26.2 ± 8.5; active = 28.7 ± 11.4; discontinued = 23.5 ± 6.5 ng/mL; p = 0.038). A total of 26.2% of the variance observed in 25(OH)D concentrations was explained by daily UVB radiation levels (β = 0.224; p = 0.032) and vitamin D intake (β = 0.431; p < 0.001), controlling for age and BMI. CONCLUSION A quarter of the evaluated patients presented vitamin D deficiency, which was associated with the discontinuation of the health care, higher BMI, lower vitamin D intake, and lower individual UVB radiation levels.
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Affiliation(s)
- Maísa Miranda Araújo
- Department of Nutrition, Faculty of Health Science, Federal District, University of Brasília, Brasília, 70910-900, Brazil
| | - Marcela Moraes Mendes
- Department of Nutrition, Faculty of Health Science, Federal District, University of Brasília, Brasília, 70910-900, Brazil
| | - Susan A Lanham-New
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK
| | | | - Teresa Helena Macedo da Costa
- Department of Nutrition, Faculty of Health Science, Federal District, University of Brasília, Brasília, 70910-900, Brazil
| | | | - Patrícia Borges Botelho
- Department of Nutrition, Faculty of Health Science, Federal District, University of Brasília, Brasília, 70910-900, Brazil
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12
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Lima LR, Okamura AB, Carvalho KMBD, Dutra ES, Gonçalves VSS. Hipertensão Arterial e Parâmetros Lipídicos, Glicídicos e de Adiposidade Associados em Adolescentes Escolares do Distrito Federal. Arq Bras Cardiol 2021; 118:719-726. [PMID: 35137784 PMCID: PMC9007003 DOI: 10.36660/abc.20201240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 05/12/2021] [Indexed: 11/24/2022] Open
Abstract
Fundamento A prevalência de hipertensão arterial sistêmica (HAS) e de outros distúrbios metabólicos tem aumentado em indivíduos jovens. Entretanto, não há estudos representativos sobre esse assunto com a população do Distrito Federal (DF). Objetivo Estimar a prevalência de HAS e a sua associação com parâmetros lipídicos, glicídicos e de adiposidade em adolescentes do DF. Métodos Trata-se de um estudo observacional transversal com participantes do Estudo de Riscos Cardiovasculares em Adolescentes (ERICA). Foram avaliados pressão arterial, glicemia sanguínea, hemoglobina glicada, insulina, modelo de avaliação da homeostase da resistência à insulina (HOMA-IR), triglicerídeos, colesterol total, lipoproteína de alta densidade, lipoproteína de baixa densidade, índice de massa corporal (IMC) e perímetro da cintura, além de variáveis econômicas, demográficas e de maturação sexual. A análise de dados foi feita no software Stata e foi dividida nas seguintes etapas: análises descritiva, bruta e ajustada. Considerou-se p < 0,05. Resultados Foram incluídos 1.200 adolescentes com média de idade de 14,8 anos. A prevalência de HAS foi de 8% (intervalo de confiança de 95%: 6,3; 9,9). A maioria dos parâmetros se associou com a PA na análise bruta; na ajustada, os parâmetros glicídicos, lipídicos e de adiposidade mantiveram a associação, tendo IMC e HOMA-IR a maior magnitude na relação. Conclusão O estudo revelou elevada prevalência de HAS em adolescentes do DF, e os níveis pressóricos apresentaram-se associados a outros marcadores de perfil lipídico, glicídico e de adiposidade, evidenciando a relevância da vigilância em saúde para o planejamento de ações efetivas para a reversão do quadro e prevenção de novos casos.
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Berber LCL, Melendez-Araújo MS, Nakano EY, de Carvalho KMB, Dutra ES. Grazing Behavior Hinders Weight Loss in Long-Term Post Bariatric Surgery: a Cross-Sectional Study. Obes Surg 2021; 31:4076-4082. [PMID: 34215973 DOI: 10.1007/s11695-021-05533-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/13/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Grazing behavior is common in patients undergoing bariatric surgery (BS); however, little is known about grazing behavior in operated patients in the long term. We aimed to estimate grazing frequency and its association with weight loss and surgery response in patients who had undergone BS. METHODS This cross-sectional study included 109 patients who had undergone Roux-en-Y gastric bypass at least 5 years previously. They answered questions about socioeconomic factors, surgical information, and adherence to treatment/follow-up. The Rep(eat) questionnaire was used for grazing assessment. Student's t-test and Pearson's chi-square test were used to evaluate differences between groups. Analysis of covariance and partial correlation were used to investigate grazing behavior, and weight loss outcomes were controlled for the elapsed time since BS, healthcare service type, current psychologist care status, and the presence of a constriction ring. RESULTS The mean elapsed time since BS was 9.97 ± 2.39 years. Patients with grazing behavior (67%) comprised fewer surgery responders (p = 0.019), had lower total (%TWL, p = 0.005) and excess weight loss (%EWL, p = 0.029), and received less psychological counseling (45.5% vs. 54.5%, p = 0.042). Correlations were found between the presence of grazing and its subtypes and %EWL and %TWL (T = - 0.382, T = - 0.361, p < 0.001; compulsive grazing: T = - 0.358, T = - 0.342, p < 0.001, p = 0.001; non-compulsive grazing: T = - 0.333, T = - 0.311, p = 0.001, p = 0.003). No significant difference between patients with and without grazing behavior was found for previous/current diagnoses of psychological diseases or dietitian counseling. CONCLUSION Grazing behavior is common in the long-term among patients who have undergone BS and is negatively related to weight loss parameters.
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Affiliation(s)
- Larissa Cristina Lins Berber
- Graduate Program of Human Nutrition, Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Universitário, Darcy Ribeiro. Asa Norte, Brasília, Federal District, 70910-900, Brazil
| | - Mariana Silva Melendez-Araújo
- Graduate Program of Human Nutrition, Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Universitário, Darcy Ribeiro. Asa Norte, Brasília, Federal District, 70910-900, Brazil.
| | - Eduardo Yoshio Nakano
- Department of Statistics, Institute of Exact Sciences, University of Brasilia (UnB), Campus Universitário, Darcy Ribeiro. Asa Norte, Brasília, DF, 70910-900, Brazil
| | - Kênia Mara Baiocchi de Carvalho
- Graduate Program of Human Nutrition, Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Universitário, Darcy Ribeiro. Asa Norte, Brasília, Federal District, 70910-900, Brazil
| | - Eliane Said Dutra
- Graduate Program of Human Nutrition, Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Universitário, Darcy Ribeiro. Asa Norte, Brasília, Federal District, 70910-900, Brazil
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Rios INMS, Lamarca F, Vieira FT, de Melo HAB, Magalhães KG, de Carvalho KMB, Pizato N. The Positive Impact of Resistance Training on Muscle Mass and Serum Leptin Levels in Patients 2-7 Years Post-Roux-en-Y Gastric Bypass: A Controlled Clinical Trial. Obes Surg 2021; 31:3758-3767. [PMID: 34041699 DOI: 10.1007/s11695-021-05494-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE Resistance training program (RTP) assist the maintenance of optimal body composition and inflammatory response modulation in individuals in late Roux-en-Y gastric bypass (RYGB). This study aimed to investigate the effect of RTP on body composition and serum inflammatory profile in individuals 2-7 years post-RYGB. METHODS Volunteers were matched on body mass index (BMI), age, sex, and years after surgery, and they were allocated as control or RTP group. Body composition, visceral fat area (VFA), and inflammatory serum markers were measured at baseline and after 12 weeks of RTP. RESULTS The sample baseline characteristics (n = 63; BMI = 29.7 ± 5.3 kg/m2) were similar between the groups. After intervention, the RTP group presented higher fat-free mass (Δ 1.17 ± 1.12 kg, p = 0.003) and skeletal muscle mass (Δ 0.77 ± 0.66 kg, p = 0.002) and decreased leptin levels (Δ -0.15 ± 0.60 pg/mL, p = 0.028). Ultrasensitive C-reactive protein (CRPus), interleukin-6, adiponectin, and monocyte chemotactic protein-1 showed no significant time-by-group interaction. After the categorization of RTP group individuals by VFA median values (129.8 cm2, IQR 90.9; 152.5), participants with VFA values above the median presented a significant decrease in CRPus (Δ -0.20 mg/L, IQR -7.59; -0.03, p = 0.022) when compared to the participants with VFA values below the median. CONCLUSION The RTP improved individuals' body composition by a modest but significant enhancing muscle mass and decreasing serum leptin and CRPus levels, especially in individuals with VFA values above the median. RTPs assist in maintaining the adequate body composition as they contribute to a decrease in proinflammatory markers in long-term RYGB.
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Affiliation(s)
| | - Fernando Lamarca
- Graduate Program in Human Nutrition, University of Brasília (UnB), Brasília, Brazil
- Department of Applied Nutrition, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | | | | | - Kelly Grace Magalhães
- Laboratory of Immunology and Inflammation, Department of Cell Biology, University of Brasilia (UnB), Brasilia, Brazil
| | | | - Nathalia Pizato
- Graduate Program in Human Nutrition, University of Brasília (UnB), Brasília, Brazil.
- Faculty of Health Sciences, Graduate Program in Human Nutrition, University of Brasilia, Zip Code 70910-900, Asa Norte, Brasília, Federal District, Brazil.
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Ritter JDA, Cureau FV, Ronca DB, Blume CA, Teló GH, Camey SA, de Carvalho KMB, Schaan BD. Association between diet quality index and cardiometabolic risk factors in adolescents: Study of Cardiovascular Risks in Adolescents (ERICA). Nutrition 2021; 90:111216. [PMID: 33934056 DOI: 10.1016/j.nut.2021.111216] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study evaluated the association between diet quality, assessed by the Diet Quality Index for Adolescents adapted for Brazilians (DQIA-BR), and cardiometabolic markers in adolescents. METHODS The DQIA-BR and cardiometabolic markers were assessed in 36 956 Brazilian adolescents (12-17 y old) enrolled in the Study of Cardiovascular Risks in Adolescents (ERICA), a national school-based cross-sectional multicenter study in Brazil. For analyses, the sample was stratified by sex and nutritional status. Multiple linear regressions were used to investigate the association between DQIA-BR and cardiometabolic markers (total cholesterol, HDL-c, LDL-c, triglycerides, fasting glucose and HOMA-IR). Adjusted models were constructed with two input levels of covariates. The first model was adjusted for sex, age, and socioeconomic status; in the second model, total energy intake, physical activity, and sedentary behavior were included. RESULTS A higher DQIA-BR score was associated with a better cardiometabolic profile in girls with normal weight; however, no association was observed in those with overweight/obesity. In boys with overweight/obesity, a better quality of diet was associated with lower concentrations of total cholesterol (β = -0.338, 95% confidence interval [CI]: -0.611 to -0.066) and LDL-c (β = -0.227, 95% CI: -0.448 to -0.005), but only LDL-c remained significant in those with normal weight (β = -0.115, 95% CI: -0.224 to 0.005). CONCLUSION The effects of diet quality on cardiometabolic risk factors differ according to sex and the presence of overweight/obesity. Overall, DQIA-BR is a suitable tool to evaluate the association between diet quality and cardiometabolic markers in normal-weight adolescents, but not for adolescents, especially girls, with overweight/obesity.
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Affiliation(s)
- Julianna do Amaral Ritter
- Postgraduate Program in Medical Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Felipe Vogt Cureau
- Postgraduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Carina Andriatta Blume
- Postgraduate Program in Medical Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gabriela Heiden Teló
- School of Medicine and Postgraduate Program, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Suzi Alves Camey
- Postgraduate Program in Epidemiology, Department of Statistics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Beatriz D Schaan
- Postgraduate Program in Medical Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Postgraduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Lamarca F, Vieira FT, Lima RM, Nakano EY, da Costa THM, Pizato N, Dutra ES, de Carvalho KMB. Effects of Resistance Training With or Without Protein Supplementation on Body Composition and Resting Energy Expenditure in Patients 2-7 Years PostRoux-en-Y Gastric Bypass: a Controlled Clinical Trial. Obes Surg 2021; 31:1635-1646. [PMID: 33409971 DOI: 10.1007/s11695-020-05172-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Resistance training (RT) and adequate protein intake are recommended as strategies to preserve fat-free mass (FFM) and resting metabolic demand after bariatric surgery. However, the effect of both interventions combined in the late postoperative period is unclear. This study investigated the effects of RT, isolated and combined with protein supplementation, on body composition and resting energy expenditure (REE) in the late postoperative period of Roux-en-Y gastric bypass (RYGB). METHODS This controlled trial involved patients who were 2-7 years postRYGB. Participants were partially matched on body mass index (BMI), age, sex, and years after surgery, and divided into four groups, placebo maltodextrin (control [CON]; n = 17), whey protein supplementation (PRO; n = 18), RT combined with placebo (RTP; n = 13), and RT combined with whey protein supplementation (RTP + PRO; n = 15)-considering the participants who completed the protocol. REE was measured by indirect calorimetry and body composition by multifrequency electrical bioimpedance. RESULTS Participant characteristics (40.3 ± 8.3 years old; average BMI 29.7 ± 5.3 kg/m2; 88.9% females) were similar among groups. The RTP+PRO group showed an increase of 1.46 ± 1.02 kg in FFM and 0.91 ± 0.64 kg in skeletal muscle mass (SMM), which was greater than the equivalent values in the CON group (- 0.24 ± 1.64 kg, p = 0.006 and - 0.08 ± 0.96 kg, p = 0.008, respectively). There was no significant time-by-group interaction for absolute or relative REE. CONCLUSION Combined RT and adequate protein intake via supplementation can increase FFM and SMM in the late postoperative period without changing REE. These associated strategies were effective in improving muscle-related parameters and potentially in improving the patients' physical function.
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Affiliation(s)
- Fernando Lamarca
- Graduate Program in Human Nutrition, University of Brasília, 70910-900, Asa Norte, Brasília, Federal District, Brazil.,Department of Applied Nutrition, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávio Teixeira Vieira
- Graduate Program in Human Nutrition, University of Brasília, 70910-900, Asa Norte, Brasília, Federal District, Brazil
| | - Ricardo Moreno Lima
- Graduate Program in Physical Education, University of Brasília, Brasília, Brazil
| | | | - Teresa Helena Macedo da Costa
- Graduate Program in Human Nutrition, University of Brasília, 70910-900, Asa Norte, Brasília, Federal District, Brazil
| | - Nathalia Pizato
- Graduate Program in Human Nutrition, University of Brasília, 70910-900, Asa Norte, Brasília, Federal District, Brazil
| | - Eliane Said Dutra
- Graduate Program in Human Nutrition, University of Brasília, 70910-900, Asa Norte, Brasília, Federal District, Brazil
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de Oliveira CL, Cureau FV, Cople-Rodrigues CDS, Giannini DT, Bloch KV, Kuschnir MCC, de Carvalho KMB, Schaan BD. Prevalence and factors associated with hypovitaminosis D in adolescents from a sunny country: Findings from the ERICA survey. J Steroid Biochem Mol Biol 2020; 199:105609. [PMID: 32006587 DOI: 10.1016/j.jsbmb.2020.105609] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 01/27/2020] [Accepted: 01/28/2020] [Indexed: 12/14/2022]
Abstract
Vitamin D plays a role in bone and metabolic health in life long, however hypovitaminosis D is common in different settings. The aim of this study was to describe vitamin D status among adolescents from a large sunny country and analyze associated factors. This was a multicenter, cross-sectional, school-based study. A total of 1152 adolescents age 12-17 from four Brazilian cities, Rio de Janeiro, Fortaleza, Brasília, and Porto Alegre, were included. Anthropometric variables, diet, type of school, race and season of data collection were evaluated. Serum concentrations of 25-hydroxyvitamin D [25(OH)D] were measured and categorized into three levels: ≤ 20 ng/mL, 21-29 ng/mL and ≥ 30 ng/mL. Ordered logistic regression models were used to explore the factors associated with hypovitaminosis D. The prevalence of vitamin D levels below 20 ng/mL, between 21 and 29 ng/mL and above 30 ng/mL was 21 % (95 %CI: 19 %-24 %), 42 % (95 %CI: 39 %-46 %) and 37 % (95 %CI: 33 %-40 %), respectively. In the final adjusted model, hypovitaminosis D was positively associated with gender, center (latitudes), data collected in winter or spring, non-whites, and private school students. A higher proportional odds ratio (POR) for hypovitaminosis D was found among obese boys (POR = 2.2, 95 %CI: 1.1-4.5), but not girls. Adequate dietary intake of vitamin D was a protective factor (POR = 0.4, 95 %CI: 0.2-0.6) against hypovitaminosis D. In conclusion, there is a high prevalence of Brazilian adolescents at risk of hypovitaminosis D, independent of region. Due to their potential benefits, lifestyle changes should be stimulated, including healthier food choices and spending more time outdoors (with sun protection).
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Affiliation(s)
| | - Felipe Vogt Cureau
- Faculty of Medicine, Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | | | - Denise Tavares Giannini
- Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Katia Vergetti Bloch
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Beatriz D Schaan
- Faculty of Medicine, Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Endocrine division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Faculty of Medicine, Graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Brazil
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Abstract
OBJECTIVE Validate the accuracy of the Screening Tool for Risk on Nutritional status and Growth (STRONGkids) and estimate the prevalence of malnutrition and nutritional risk in hospitalized children. METHODS Cross-sectional study of a representative sample of children admitted to ten public pediatric emergency rooms. The sample was randomly estimated in stages, including children older than 30 days and younger than 10 years of age, of both sexes, excluding syndromic children and those in whom it was impossible to directly measure anthropometry. Weight, height, and arm circumference were measured, as well as the Z-scores of the anthropometric indices weight-for-age, height-for-age, weight-for-height, body mass index for age, and arm circumference for age, classified according to the reference curves of the World Health Organization. After the tool was applied, its accuracy tests were performed in comparison with the anthropometric data, with the evaluation of sensitivity, specificity, and positive and negative predictive values. RESULTS A total of 271 children were evaluated, 56.46% males and 41.70% younger than 2 years of age. The prevalence rates of malnutrition, nutritional risk assessed by anthropometric measurements, and nutritional risk assessed by the tool were 12.18%, 33.95%, and 78.60%, respectively. Accuracy showed sensitivity of 84.8%, specificity of 26.7%, positive predictive value of 49.8%, and negative predictive value of 67.2%, when the patients at nutritional risk were identified by anthropometry. CONCLUSION Validation of the accuracy of STRONGkids was performed, showing high sensitivity, allowing the early identification of nutritional risk in similar populations.
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Affiliation(s)
- Juliana Rolim Vieira Maciel
- Universidade de Brasília, Departamento de Nutrição, Programa de Pós-Graduação em Nutrição Humana, Brasília, DF, Brazil.
| | | | | | - Eliane Said Dutra
- Universidade de Brasília, Departamento de Nutrição, Programa de Pós-Graduação em Nutrição Humana, Brasília, DF, Brazil
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Melendez-Araújo MS, Lemos KGE, Arruda SLM, Dutra ES, de Carvalho KMB. Weight Status of Brazilian's Mother-Son Dyad after Maternal Bariatric Surgery. Obes Surg 2020; 30:3508-3513. [PMID: 32314250 DOI: 10.1007/s11695-020-04605-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Pregnant women who have undergone bariatric surgery must be followed to ensure healthy mother-child nutritional status. This study aimed to compare weight status of mother-child dyad after maternal bariatric surgery in public and private Brazilian healthcare system units. MATERIALS AND METHODS This retrospective matched case-control included 19 women who underwent Roux-en-Y gastric bypass surgery performed by the same private clinical surgical team and 19 age- and preoperative body mass index (BMI) matched patients from a public hospital. All 38 female patients reported a postoperative spontaneous pregnancy. The T test of independent samples and Pearson chi-square test were used to investigate inter-group differences. RESULTS Patients in the private system were more frequently married (94.7% versus 68.4%, p = 0.036) and had a higher educational level (94.7% versus 36.8%, p = 0.01 for tertiary education) but lower BMI, compared with those in the public system (pre-gestational = 25.7 ± 3.2 versus 28.5 ± 5.0 kg/m2, p = 0.049; post-gestational = 24.6 ± 1.6 versus 29.0 ± 6.0 kg/m2, p = 0.040). The interval from bariatric surgery to conception was shorter among public system patients (21.1 ± 13.9 versus 43.4 ± 31.2 months, p = 0.009). In both groups, almost 90% of children were born at full term and with adequate weights. CONCLUSION Despite differences in the characteristics of public and private systems, the mother-child dyads in both groups achieved satisfactory post-bariatric surgery gestation outcomes. The type of medical system does not appear to influence pregnancy outcomes or neonatal weight status conditions.
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Affiliation(s)
- Mariana S Melendez-Araújo
- Graduate Program in Human Nutriton, Department of Nutrition, Faculty od Health Science, University of Brasília, Darcy Ribeiro University Campus, Asa Norte, Brasília, DF, 70910-900, Brazil
- Asa Norte Regional Hospital (HRAN), SMHN Qd 02, Asa Norte, Brasília, DF, 70710-100, Brazil
- Dr. Sérgio Arruda Clinic - Bariatric Surgery, SMHN Qd 02 Bloco C - Ed. Dr. Crispim, salas 1309-1313, Asa Norte, Brasília, DF, 70710-100, Brazil
| | - Kássia G E Lemos
- Graduate Program in Human Nutriton, Department of Nutrition, Faculty od Health Science, University of Brasília, Darcy Ribeiro University Campus, Asa Norte, Brasília, DF, 70910-900, Brazil
| | - Sérgio L M Arruda
- Asa Norte Regional Hospital (HRAN), SMHN Qd 02, Asa Norte, Brasília, DF, 70710-100, Brazil
- Dr. Sérgio Arruda Clinic - Bariatric Surgery, SMHN Qd 02 Bloco C - Ed. Dr. Crispim, salas 1309-1313, Asa Norte, Brasília, DF, 70710-100, Brazil
| | - Eliane S Dutra
- Graduate Program in Human Nutriton, Department of Nutrition, Faculty od Health Science, University of Brasília, Darcy Ribeiro University Campus, Asa Norte, Brasília, DF, 70910-900, Brazil
| | - Kênia Mara Baiocchi de Carvalho
- Graduate Program in Human Nutriton, Department of Nutrition, Faculty od Health Science, University of Brasília, Darcy Ribeiro University Campus, Asa Norte, Brasília, DF, 70910-900, Brazil.
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Vieira FT, Faria SLCM, Dutra ES, Ito MK, Reis CEG, da Costa THM, de Carvalho KMB. Perception of Hunger/Satiety and Nutrient Intake in Women Who Regain Weight in the Postoperative Period After Bariatric Surgery. Obes Surg 2020; 29:958-963. [PMID: 30565102 DOI: 10.1007/s11695-018-03628-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate the perception of hunger and satiety and its association with nutrient intake in women who regain weight in the postoperative period after bariatric surgery. METHODS Cross-sectional study of adult women divided into three groups: weight regain (n = 20), stable weight (n = 20) (both at least 24 months after Roux-en-Y gastric bypass surgery), and non-operated obesity (n = 20). A visual analogue scale measured hunger/satiety perception while fasting, immediately after finishing a test meal, and 180 min after finishing the test meal. The incremental area above or under the curve was calculated. Food intake was analyzed by 3 days of food recall and adjusted for intraindividual variation. To make between-group comparisons, Mann-Whitney, ANOVA, Kruskal-Wallis, and independent-samples T tests and Pearson's correlation were used. RESULTS There were no between-group differences in incremental areas of hunger/satiety, but protein intake was significantly lower among patients who regained weight compared with those who had stable body weight (0.99 ± 0.23 g/kg body weight vs. 1.17 ± 0.21 g/kg body weight, p = 0.047). In the group that regained weight, satiety was correlated positively with usual dietary protein density (r = 0.541; p = 0.017) and negatively with usual carbohydrate intake (r = - 0.663; p = 0.002). CONCLUSION Women who regained weight presented similar perceptions of hunger/satiety to those of patients without weight regain and with non-operated obesity. In patients who regained weight postoperatively, satiety perception was correlated positively with usual dietary protein density and inversely with usual carbohydrate intake.
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Affiliation(s)
| | | | - Eliane Said Dutra
- Graduate Program in Human Nutrition of the University of Brasilia, Brasilia, Brazil
| | - Marina Kiyomi Ito
- Graduate Program in Human Nutrition of the University of Brasilia, Brasilia, Brazil
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Lamarca F, Melendez-Araújo MS, Porto de Toledo I, Dutra ES, de Carvalho KMB. Relative Energy Expenditure Decreases during the First Year after Bariatric Surgery: A Systematic Review and Meta-Analysis. Obes Surg 2019; 29:2648-2659. [DOI: 10.1007/s11695-019-03934-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Ronca DB, Blume CA, Cureau FV, Camey SA, Leotti VB, Drehmer M, Schaan BD, de Carvalho KMB. Diet quality index for Brazilian adolescents: the ERICA study. Eur J Nutr 2019; 59:539-556. [PMID: 30963230 DOI: 10.1007/s00394-019-01923-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 02/03/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aimed to assess the dietary patterns of adolescents using a food-based diet quality index and their compliance with a healthy dietary guideline METHODS: Participants included 71,553 Brazilian adolescents (12-17 years old) from the Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional school-based multicenter study.. Dietary intake was measured by one 24-h recall. A second recall was collected in a random subsample (~ 10%) to correct within-person variability. The Diet Quality Index for Adolescents adapted for Brazilians (DQIA-BR) was used to measure the overall quality of the dietary intake. The National Cancer Institute method was applied to estimate usual dietary intake. The DQIA-BR and the distribution of its components (quality, diversity, and equilibrium) were analyzed according to sex, geographical area, and type of school RESULTS: The mean (SD) DQIA-BR scores were 14.8% (6.1%) for females and 19.0% (6.3%) for males. All analyzed strata revealed low scores of DQIA-BR and its components. The median usual intake was five to sevenfold below the recommendations for vegetables and fruits and approximately twofold below the recommendations for dairy. The highest DQIA-BR mean scores were found in the northern region [17.0% (6.4%), females; 20.7% (6.3%), males]. Adolescents in both types of schools had relatively similar median intakes of snacks (~ 85 g) and sugared drinks (~ 600 ml) CONCLUSIONS: The overall diet quality of Brazilian adolescents is inadequate based on evaluated parameters in all regions and socioeconomic backgrounds.
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Affiliation(s)
- Débora Barbosa Ronca
- Graduate Program in Human Nutrition, Universidade de Brasília, Brasília, Brazil.
| | - Carina Andriatta Blume
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Vogt Cureau
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Suzi Alves Camey
- Postgraduate Program in Epidemiology, Department of Statistics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vanessa Bielefeldt Leotti
- Postgraduate Program in Epidemiology, Department of Statistics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Michele Drehmer
- Postgraduate Program in Epidemiology, Department of Nutrition and Food and Nutrition Research Center, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Beatriz D Schaan
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Schaan CW, Cureau FV, Bloch KV, de Carvalho KMB, Ekelund U, Schaan BD. Prevalence and correlates of screen time among Brazilian adolescents: findings from a country-wide survey. Appl Physiol Nutr Metab 2018; 43:684-690. [DOI: 10.1139/apnm-2017-0630] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The purpose of this study was to evaluate the distribution, prevalence, and correlates of excessive screen time (>2 h/day) among Brazilian adolescents. The Study of Cardiovascular Risks in Adolescents (ERICA) is a national, school-based, cross-sectional multicenter study. Information about time spent in front of screens was assessed by questionnaire. Poisson regression models were used to examine the associations between following correlates (region, sex, age, skin color, income, Internet access, and number of TVs at home) and excessive screen time. A total of 66 706 Brazilian adolescents (aged 12–17 years) were included. The overall mean time in front of screens was 3.25 h/day (95% confidence interval (95%CI): 3.20–3.31) and the prevalence of excessive screen time was 57.3% (95%CI: 55.9–58.6). Moreover, excessive screen time also differs across Brazilian regions, being higher in Southeast and South, respectively. In adjusted models stratified by region, the socioeconomic status was associated with excessive screen time in North, Northeast, and Midwest. In all regions, having a computer with Internet access was associated with higher prevalence of excessive screen time. In conclusion, prevalence of excessive screen time in Brazilian adolescents is high. It presents regional variations and facility for Internet access.
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Affiliation(s)
- Camila Wohlgemuth Schaan
- Post-graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul – Hospital de Clínicas de Porto Alegre. 2350, Ramiro Barcelos Street, building 21. Porto Alegre 90035-003, RS, Brazil
| | - Felipe Vogt Cureau
- Post-graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, Brazil
| | - Katia Vergetti Bloch
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-598, Brazil
| | | | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sports Science, Ullevål Stadion, 0806, Oslo, Norway
| | - Beatriz D. Schaan
- Post-graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, Brazil and Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-903, Brazil
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Ito MK, Gonçalves VSS, Faria SLCM, Moizé V, Porporatti AL, Guerra ENS, De Luca Canto G, de Carvalho KMB. Effect of Protein Intake on the Protein Status and Lean Mass of Post-Bariatric Surgery Patients: a Systematic Review. Obes Surg 2017; 27:502-512. [PMID: 27844254 DOI: 10.1007/s11695-016-2453-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Post-bariatric surgery may compromise nutritional status due to energy and protein intake restriction. METHODS Systematic review was performed to synthesize evidence on the amount of protein intake and its association with lean mass and serum proteins during at least 6 months following Roux-en-Y gastric bypass or sleeve gastrectomy. RESULTS Twelve studies (n = 739) were identified in the search. Protein intake below 60 g/day and significant lean mass loss were observed in majority of these studies. Of the four studies that measured association between protein intake and lean mass retention, only two supported this hypothesis. CONCLUSION There is insufficient evidence of the effect of dietary protein on serum protein levels. Further studies are needed to better estimate the protein intake that supports a healthy nutritional status in this population.
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Affiliation(s)
- Marina Kiyomi Ito
- Department of Nutrition, Graduate Program in Human Nutrition, University of Brasilia, Brasilia, DF, Brazil
| | | | - Silvia Leite Campos Martins Faria
- Department of Nutrition, Graduate Program in Human Nutrition, University of Brasilia, Brasilia, DF, Brazil. .,Gastrocirurgia de Brasilia, Brasilia, DF, Brazil.
| | - Violeta Moizé
- Obesity Unit, Hospital Clinic Universitari, Barcelona, Spain
| | - André Luís Porporatti
- Brazilian Centre for Evidence-based Research, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Eliete Neves Silva Guerra
- Laboratory of Oral Histopathology, Health Science Faculty, University of Brasilia, Brasília, DF, Brazil
| | - Graziela De Luca Canto
- Brazilian Centre for Evidence-based Research, Federal University of Santa Catarina, Florianopolis, Brazil
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Novelli IR, Fonseca LG, Gomes DL, Dutra ES, Baiocchi de Carvalho KM. Emotional eating behavior hinders body weight loss in women after Roux-en-Y gastric bypass surgery. Nutrition 2017; 49:13-16. [PMID: 29571605 DOI: 10.1016/j.nut.2017.11.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 10/17/2017] [Accepted: 11/04/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Successful weight loss and maintenance after Roux-en-Y gastric bypass (RYGB) may be related to eating behavior. The aim of this study was to assess the eating behavior domains that prevail in women during the RYGB postoperative period and their associations with surgery outcome. METHODS This cross-sectional study investigated eating behavior in 95 women (47.3 ± 9.8 y old) ≥ 2 y after Roux-en-Y gastric bypass. Patients were grouped according to surgery outcome: successful group (SG; n = 67), defined as having lost ≥ 50% of the preoperative excess weight loss (EWL), and an unsuccessful group (UG; n = 28). Mean postoperative time was 59.5 ± 21.2 mo (55.7 ± 19.9 in the SG and 68.6 ± 21.9 in the UG). The short version of the Three-Factor Eating Questionnaire was used to assess cognitive restraint, emotional eating, and uncontrolled eating behaviors. Multivariate analysis was used to investigate associations between eating behavior scores and EWL. RESULTS The highest score in both groups was for the cognitive restraint domain, followed by emotional and uncontrolled eating. Emotional eating was negatively associated with percentage of EWL (β = -0.286; P = 0.033), regardless of age, educational attainment, and postoperative time. CONCLUSION The cognitive restraint domain was the main type of eating behavior observed, and patients with higher emotional eating score were at a higher risk for having insufficient weight loss after RYGB. These results indicate the relevance of monitoring emotional components during the long-term nutritional follow-up of bariatric patients to achieve better surgery outcomes.
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Affiliation(s)
- Isabelle Romero Novelli
- Graduate Program of Human Nutrition, Faculty of Health Sciences, University of Brasília, Brasília, Federal District, Brazil
| | - Laís Gomes Fonseca
- Graduate Program of Human Nutrition, Faculty of Health Sciences, University of Brasília, Brasília, Federal District, Brazil
| | | | - Eliane Said Dutra
- Graduate Program of Human Nutrition, Faculty of Health Sciences, University of Brasília, Brasília, Federal District, Brazil
| | - Kênia Mara Baiocchi de Carvalho
- Graduate Program of Human Nutrition, Faculty of Health Sciences, University of Brasília, Brasília, Federal District, Brazil.
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Cureau FV, Bloch KV, Henz A, Schaan CW, Klein CH, Oliveira CLD, Giannini DT, Leon EBD, Abreu GDA, Telo GH, Dias GM, Carvalho KMBD, Barufaldi LA, Kuschnir MCC, Szklo M, Montenegro Jr. R, Silva TLND, Ekelund U, Schaan BD. Challenges for conducting blood collection and biochemical analysis in a large multicenter school-based study with adolescents: lessons from ERICA in Brazil. CAD SAUDE PUBLICA 2017; 33:e00122816. [DOI: 10.1590/0102-311x00122816] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 01/06/2017] [Indexed: 11/21/2022] Open
Abstract
Abstract: The Study of Cardiovascular Risk in Adolescents (ERICA) is a pioneering study that aimed to assess the prevalence of cardiovascular risk factors, including metabolic syndrome components in Brazilian adolescents. This study aims to describe the methodological aspects related to blood collection as well as to report pertaining results of the preparation, transport, storage, and exams in ERICA. Exams in ERICA were performed in a single laboratory and blood samples were collected in schools in a standardized manner. Logistics involved air transportation of samples to the reference laboratory with controlled temperature since sample collection. The serum was stored in local biorepositories in four centers to be used in future analyses. During the study, 284,247 exams were performed and rate of participation in exams was 56.2%, thus involving 40,732 adolescents. From the total, 92.6% of the samples reached the reference laboratory maintaining the temperature between 0-10°C. No clinical significant changes in results due to temperature changes were identified. External quality control recorded satisfactory results in 98.7% of the evaluations. Four biorepositories with samples of 7,785 adolescents were created. Thus, we can consider that the logistics adopted in ERICA was fairly successful and description of this as well as the difficulties experienced in Brazil can inform and facilitate the planning of future studies, especially in developing countries.
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Affiliation(s)
| | | | - Aline Henz
- Universidade Federal do Rio Grande do Sul, Brazil
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Beatriz D. Schaan
- Universidade Federal do Rio Grande do Sul, Brazil; Universidade Federal do Rio Grande do Sul, Brazil
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Cureau FV, da Silva TLN, Bloch KV, Fujimori E, Belfort DR, de Carvalho KMB, de Leon EB, de Vasconcellos MTL, Ekelund U, Schaan BD. ERICA: leisure-time physical inactivity in Brazilian adolescents. Rev Saude Publica 2016; 50 Suppl 1:4s. [PMID: 26910541 PMCID: PMC4767040 DOI: 10.1590/s01518-8787.2016050006683] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 10/28/2015] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To evaluate the prevalence of leisure-time physical inactivity in Brazilian adolescents and their association with geographical and sociodemographic variables. METHODS The sample was composed by 74,589 adolescents participating in the Study of Cardiovascular Risks in Adolescents (ERICA). This cross-sectional study of school basis with national scope involved adolescents aged from 12 to 17 years in Brazilian cities with more than 100 thousand inhabitants. The prevalence of leisure-time physical inactivity was categorized according to the volume of weekly practice (< 300; 0 min). The prevalences were estimated for the total sample and by sex. Poisson regression models were used to assess associated factors. RESULTS The prevalence of leisure-time physical inactivity was 54.3% (95%CI 53.4-55.2), and higher for the female sex (70.7%, 95%CI 69.5-71.9) compared to the male (38.0%, 95%CI 36.7-39.4). More than a quarter of adolescents (26.5%, 95%CI 25.8-27.3) reported not practicing physical activity in the leisure time, a condition more prevalent for girls (39.8%, 95%CI 38.8-40.9) than boys (13.4%, 95%CI 12.4-14.4). For girls, the variables that were associated with physical inactivity were: reside in the Northeast (RP = 1.13, 95%CI 1.08-1.19), Southeast (RP = 1.16, 95%CI 1.11-1.22) and South (RP = 1.12, 95%CI 1.06-1.18); have 16-17 years (RP = 1.06, 95%CI 1.12-1.15); and belong to the lower economic class (RP = 1.33, 95%CI 1.20-1.48). The same factors, except reside in the Southeast and South, were also associated with not practicing physical activity in the leisure time for the same group. In males, as well as the region, being older (p < 0.001) and declaring to be indigenous (RP = 0.37, 95%CI 0.19-0.73) were also associated with not practicing physical activities in the leisure time. CONCLUSIONS The prevalence of leisure-time physical inactivity in Brazilian adolescents is high. It presents regional variations and is associated with age and low socioeconomic status. Special attention should be given to girls and to those who do not engage in any physical activity during the leisure time, so that they can adopt a more active lifestyle.
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Affiliation(s)
| | | | - Katia Vergetti Bloch
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Elizabeth Fujimori
- Departamento de Enfermagem em Saúde Coletiva, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brasil
| | | | | | - Elisa Brosina de Leon
- Faculdade de Educação Física e Fisioterapia, Universidade Federal do Amazonas, Manaus, AM, Brasil
| | | | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sports Science, Oslo, Norway
| | - Beatriz D Schaan
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
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da Silva FBL, Gomes DL, de Carvalho KMB. Poor diet quality and postoperative time are independent risk factors for weight regain after Roux-en-Y gastric bypass. Nutrition 2016; 32:1250-3. [PMID: 27544005 DOI: 10.1016/j.nut.2016.01.018] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 12/28/2015] [Accepted: 01/27/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE In this study, multivariate analyses was used to investigate factors associated with weight regain long after Roux-en-Y gastric bypass. METHODS This retrospective study comprised 80 patients (88.8% female) with at least 24 mo of postoperative time. Weight regain was defined as an increase of at least 10% of the lowest postoperative weight. The following data were collected: demographic characteristics, eating behavior, food intake, diet quality measured by the Healthy Eating Index, level of physical activity, follow-up visit attendance, anthropometric history, and postoperative time. Multivariate logistic regression generated a controlled analysis, followed by calculation of the odds ratio (OR). RESULTS The mean postoperative time was 47.0 ± 18.0 mo. The mean pre- and postoperative body mass indexes were 49.8 ± 9.3 kg/m(2) and 33.6 ± 7.2 kg/m(2), respectively. Despite satisfactory postoperative weight loss, 23.7% of the patients regained weight. After controlling for confounders, only postoperative time (OR 1.08; P < 0.01) and Healthy Eating Index (OR 0.95; P = 0.04) remained associated with weight regain. CONCLUSION Patients with long-term obesity and poor diet quality were at high risk of weight regain. These results suggest the need of nutritional monitoring during the late postoperative period, paying special attention to eating patterns.
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Abstract
Various indices and scores based on admittedly healthy dietary patterns or food guides for the general population, or aiming at the prevention of diet-related diseases have been developed to assess diet quality. The four indices preferred by most studies are: the Diet Quality Index; the Healthy Eating Index; the Mediterranean Diet Score; and the Overall Nutritional Quality Index. Other instruments based on these indices have been developed and the words 'adapted', 'revised', or 'new version I, II or III' added to their names. Even validated indices usually find only modest associations between diet and risk of disease or death, raising questions about their limitations and the complexity associated with measuring the causal relationship between diet and health parameters. The objective of this review is to describe the main instruments used for assessing diet quality, and the applications and limitations related to their use and interpretation.
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Abstract
OBJECTIVE: The objective of this study was to identify the factors associated with exclusive breastfeeding in children aged less than six months from the Brazilian Legal Amazon and Northeast regions. METHODS: The study used data from a survey that assessed prenatal and infant (<1 year) care in 2010. Sociodemographic, prenatal, delivery, and puerperium care factors with p<0.05 in multivariate analysis were associated with exclusive breastfeeding. RESULTS: For both regions, the prevalence of exclusive breastfeeding decreased with age, which was the main variable associated with early weaning. In the Legal Amazon, exclusive breastfeeding prevailed among: mothers aged 35 years or more; mothers living in state capitals; and mothers who breastfed on the first hour of life. In the Northeast, the probability of exclusive breastfeeding was greater for mothers aged 35 years or more. CONCLUSION: The factors associated with exclusive breastfeeding were child's and mother's age in both regions; and residence location and breastfeeding in the first hour of life in the Legal Amazon, suggesting the need of differentiated strategies for the promotion of exclusive breastfeeding.
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Abstract
OBJECTIVE: To evaluate the results of a multidisciplinary program to promote healthy habits on anthropometric and biochemical parameters on participants of the Family Health Strategy of the Distrito Federal. METHODS: The sample consisted of 279 overweight and obese adults of both sexes divided into two groups: intervention (IG, n=198) and control group (CG, n=89). The IG received standard Family Health Strategy care plus a multidisciplinary health promoting program that included dietary interventions and physical activity, called Set Waist Program. The control group received only standard ESF care. Data were collected at baseline and after 4 and 8 months of follow up. Body mass index, waist circumference, fasting blood glucose and lipid profile were assessed. RESULTS: Prevalence of obesity (63.3% to 49.4%, p=0.027) and waist circumference (102.2cm to 94.8cm, p<0.0001) were significantly reduced in IG. Total cholesterol, LDL and HDL-cholesterol were reduced in both groups. CONCLUSION: Reductions in anthropometric measures were maximized through simple interventions that stimulated lifestyle changes. These results suggest that multidisciplinary initiatives such the Set Waist Program can be incorporated into other Family Health Strategy teams to optimize the control of obesity and health promotion. Participant compliance is an issue that deserves further investigation.
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Melendez-Araújo MS, de Matos Arruda SL, de Oliveira Kelly E, de Carvalho KMB. Preoperative nutritional interventions in morbid obesity: impact on body weight, energy intake, and eating quality. Obes Surg 2013; 22:1848-54. [PMID: 23054569 DOI: 10.1007/s11695-012-0737-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Although the benefits of preoperative weight loss and adequacy of dietary patterns in bariatric surgery is well-recognized, the nutritional strategies in the preoperative period have been scarcely investigated. We aimed to evaluate the impact of intensive and standard nutritional interventions on body weight, energy intake, and eating quality. METHODS This is a retrospective study in which 32 patients undergoing intensive nutritional intervention, with low-calorie diet (10 kcal/kg) and biweekly visits, were pair-matched by age, sex, and body mass index with 32 patients under a standard nutritional intervention, based on a general dietary counseling. Twenty-four-hour food recall was used to assess energy intake and to derive healthy eating index (HEI). The follow-up preoperative period varied from 8 to 16 weeks. RESULTS Weight loss was observed in 72% of the patients from the intensive intervention group and 75% of the patients from the standard intervention group. According to the mixed model analysis, time effect on weight loss in both groups was significant (P = 0.0002); however, no difference was found between the intervention groups (P = 0.71). The time effect was significant in both groups for energy intake reduction as well (P < 0.0001), but no difference was found between the intervention groups (P = 0.25). Improvement of eating quality was expressed by the nutrient score of the HEI that increased significantly overtime (P = 0.02), also without distinction between the groups (P = 0.61). CONCLUSION Both intensive and standard nutritional interventions promoted weight loss, energy intake reduction, and improvement of eating quality in morbidly obese patients during preoperative period.
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Affiliation(s)
- Mariana Silva Melendez-Araújo
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Ciências da Saúde, Universidade de Brasília, Campus Darcy Ribeiro, Brasília, DF, 70910-900, Brazil
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Pinto KADC, Priore SE, de Carvalho KMB. [Metabolic parameters and risk factors associated with abdominal obesity among female adolescents in public schools in the Distrito Federal (Brazil)]. Arch Latinoam Nutr 2011; 61:55-65. [PMID: 22097290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study aimed to estimate the prevalence of abdominal obesity and investigate their association with parameters markers of metabolic syndrome (MS) and its risk factors in female adolescents. It is a cross-sectional study with 150 adolescents from 10 public schools in the Federal District, Brazil. The presence of abdominal obesity was considered by measuring waist circumference above the 80th percentile, according to Taylor et al. (2000). The associated factors included sociodemographic characteristics, health status of adolescents and their parents, physical activity, eating habits, blood pressure and biochemical profile. The abdominal obesity prevalence ratio (PR) was estimated by Poisson regression model, with 95% CI. Among the adolescents studied (age= 15.6 +/- 0.8 years; BMI = 21.0 +/- 3.0 kg/m2), prevalence of abdominal obesity was 20%, and this condition was not associated with sociodemographic variables, physical activity and diet. However, abdominal obesity was significantly associated with intake of less than 4 meals a day (PR = 2.27; IC95% 1.27-4.10), previous obesity (PR = 2.36; IC95% 1.31-4.01), history of parental chronic disease (PR = 3.55; IC 95% 1.63-7.75), fasting insulin = 15 uUi/mL (PR = 3.05; IC 95% 1.36-6.82) e HDL-c > 40 mg/dL (PR = 0.39; IC95% 0.23-0.67). In this population, modifiable factors, family history and determinants of MS, such as insulin and HDL-c were associated with abdominal obesity, which points to the need for effective health promotion among adolescents.
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Affiliation(s)
- Karina Alves de Castro Pinto
- Faculdade de Ciências da Saúde, Universidade de Brasília, Universidade Federal de Viçosa, Centro de Ciências Biológicas e da Saúde, Minas Gerais, Brasil
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