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The aim of this study was to investigate the trend in the prevalence of overweight and obese adults in São Paulo, Brazil, between 2006 and 2019 across chronic diseases and the domains of physical activity. A descriptive retrospective study was carried out on the trend in the prevalence of 26.612 overweight and obese adults (10.150 men and 16.462 women). All data analyzed were based on information from the national system for monitoring risk factors called Protective and Risk Factors for Chronic Diseases by Telephone Survey-VIGITEL. The variables obese and overweight were analyzed in general and stratified by sex, age group, education level, each type of physical activity domain (yes or no), presence of hypertension and diabetes (yes or no), and smoking (yes or no). The prevalence of obesity significantly increased from 11.1% in 2006 to 19.8% in 2019, regardless of age, sex, physical activity practice, and presence of diabetes or hypertension, except for people aged 55-64 y, working people, and smokers. The total prevalence of overweight adults significantly increased overall (from 30.5% in 2006 to 33.4% in 2019) but it significantly increased only in females, in people aged 18-24 y, those who are non-white, those with an education level of 9-11 y, those who are not working, those who are non-smokers, those who did not have diabetes or hypertension, and those who were not physically active during leisure time but physically active at work and at home. There was a significant increase in the prevalence of overweight adults and especially of obese adults living in the city of São Paulo (Brazil) between 2006 and 2019, the latter being observed in nearly every analyzed sub-category, regardless of age, sex, physical activity practice, and presence of diabetes or hypertension.
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Obesidade , Sobrepeso , Humanos , Brasil/epidemiologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Prevalência , Sobrepeso/epidemiologia , Obesidade/epidemiologia , Adulto Jovem , Adolescente , Estudos Retrospectivos , Idoso , Exercício Físico , Hipertensão/epidemiologia , Fatores de RiscoRESUMO
Background: We aimed to identify and describe different types of lifestyle interventions primarily or secondarily focused on weight loss in SLE patients. Methods: A systematic search of controlled trials published until June 2021 that assigned adults patients after dietary or exercise intervention resulted in 248 studies initially screened. Results: Six studies with seven interventions (3 dietary and 4 exercise training programs) fulfilled the eligibility criteria and were included in the meta-analysis with a median of age 35.8 (31.3 to 49.0 years); median of BMI 26.6 (25.2 to 33.6 kg/m2). After six to twelve weeks of diet or exercise program, no differences were observed in body weight [-1.539 (-4.482 to 1.405) kg (CI 95%), p = 0.306]. Also, a subgroup analysis also revelated no body weight difference following dietary intervention [-3.561 (-9.604 to 2.481) kg (CI 95%), p = 0.248] or exercise intervention [-0.910 (-4.279 to 2.460) kg (CI 95%), p = 0.597]. Conclusion: The results showed that different protocols of exercise intervention or diets were not effective to reduce body weight in patients with SLE. However, only one of the selected trials had a specific study design and protocol focusing on weight loss management.
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AIM: The aim of this study was to analyze the association and susceptibility of Single Nucleotide Polymorphisms (SNPs) in the DRD2 and BDNF genes with BED in patients with weight regain in the postoperative period of bariatric surgery. METHODS: One hundred and seventy-seven individuals who underwent bariatric surgery with weight regain were evaluated and divided into two groups according to the BED diagnostic. The individuals were submitted to an anthropometric evaluation, analysis of the presence of BED using a validated questionnaire, and blood collection for genotyping of the polymorphisms rs6265 (BDNF) and rs1800497 (DRD2) by real-time polymerase chain reaction (RT-PCR). RESULTS: The presence of wild-type alleles for rs1800497 (CC) and rs6265 (GG) was more frequent in patients without BED. Nevertheless, the presence of one or two variant alleles for rs1800497 (CT + TT) and rs6265 (GA + AA) was more frequent in patients with BED. The combination of the two studied SNPs prevailed in patients with BED. CONCLUSIONS: The presence of allele frequency of rs1800497 SNP in the DRD2 gene and rs6265 SNP in the BDNF gene, isolated and/or combined, indicated an additional risk for the development of BED in patients with obesity, especially in the context of weight regain. LEVEL OF EVIDENCE: III (evidence obtained from the case-control analytic study).
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Cirurgia Bariátrica , Transtorno da Compulsão Alimentar , Transtorno da Compulsão Alimentar/genética , Fator Neurotrófico Derivado do Encéfalo/genética , Humanos , Polimorfismo de Nucleotídeo Único , Receptores de Dopamina D2/genética , Aumento de Peso/genéticaRESUMO
Changes in emotional state due to the COVID-19 pandemic may potentially modify eating habits, which may differ as a function of body mass index (BMI). Using a self-reported, questionnaire-based survey we evaluated Brazilian women during the pandemic for: (i) the influence of BMI on changes in eating habits, food choice determinants, and psychological symptoms; (ii) associations between eating habits, food choice determinants and psychological symptoms. General characteristics, anthropometric data, eating habits before and during the pandemic, food choice determinants and psychological symptoms during the pandemic were collected between June and September, 2020. Participants (n = 1,183) were normal weight (60.4%), overweight (26.2%) and obese (13.4%). A higher frequency of "cooking" (72.3-77.6%, p = 0.004) and "use of delivery service" (29.8-48.8%, p < 0.001) was reported during, in comparison to before the pandemic. Additionally, a higher prevalence of "snacking" (57.1-63.8%, p = 0.005) and "eating at table" (78.5-82.7%, p < 0.001) was reported during the pandemic, while the number of participants reporting "dieting" decreased (28.7-20.4%, p < 0.001). "Health", "natural concerns" and "need and hunger" were less important determinants for participants with overweight/obesity compared to normal weight. Regression analysis indicated that (i) "health", "natural concerns" and "affect regulation"; (ii) "health", "pleasure", "convenience", and "natural concerns"; and (iii) "visual appeal" and "pleasure" were the food choice determinants more associated with eating habits among women with normal weight, overweight, and obesity, respectively. In conclusion, eating habits were modified during the pandemic despite BMI, whereas food choice determinants differed between overweight/obesity and normal weight women.
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Background: The aim of this study was to investigate possible associations between food consumption and eating habits and food choice determinants in women during COVID-19 pandemic. Methods: This is a cross-sectional survey conducted in Brazil between June and September, 2020, during which time social distancing measures were in place. Results: Participants (n = 629) were aged 34.0 years and mostly within normal weight according to BMI (60.4%). "Snacking" and "liking" associated with increased energy (ß = 164.27 and ß = 110.24) and carbohydrate intake (ß = 1.97 and ß = 1.80), and with reduced protein intake (ß = -1.54 and ß = -1.18). In contrast, "dieting" and "weight control" associated with reduced energy (ß = -162.57 and ß = -111.49) and carbohydrate intake (ß = -2.78 and ß = -2.07), and with increased protein intake (ß = 3.78 and ß = 1.65). "Dieting" (ß = 7.27), "need and hunger" (ß = 3.34), and "health" (ß = 4.94) associated with an increased consumption of unprocessed and minimally processed foods, whereas "replacing main meals with snacks" (ß = -8.98), "snacking" (ß = -6.92) and binge eating symptoms (ß = -0.34) associated with reduced consumption of foods within this processing level. In contrast, "use of delivery services" (ß = 3.39), "replacing main meals with snacks" (ß = 5.49), "visual appeal" (ß = 2.17), "social norms" (ß = 2.19) and "affect regulation" (ß = 2.01) associated with increased ultraprocessed food consumption. Overall, associations were more frequent and pronounced when analyzing food consumption by processing level rather than by macronutrient intake. Conclusion: Some eating habits and food choice determinants ("snacking," "replacing meals with snacks," "use of delivery services") observed during the COVID-19 pandemic were associated with an unhealthy diet (high energy and carbohydrate consumption, increased ultraprocessed food consumption and reduced unprocessed/minimally processed foods consumption) in Brazilian women.
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BACKGROUND: Telomeres are structures located at the ends of chromosomes associated with a protein complex, known as the shelterin complex. In individuals with obesity, excess adipose tissue plays a key role in inducing a chronic and systemic inflammatory state, which can cause TL shortening. In this context, bariatric surgery is one of the most effective treatment modalities in improving metabolic control. AIM: Therefore, the present study aimed to evaluate how a short postoperative period of gastric bypass affects TL and expression of POT1, TRF1 and TRF2 genes. METHODS: Forty-eight women submitted to RYGB were evaluated before and after 6 months of the surgical procedure. Anthropometric measures of body weight and height (BMI), abdominal circumference (AC), body composition, food intake and blood collection for biochemical evaluation, TL analysis (DNA), and gene expression (RNA) were collected at each moment. RESULTS: There was a reduction of weight, BMI, AC, FM and FFM as well as of glycemia, total cholesterol, LDL-cholesterol, and triglycerides after gastric bypass. No difference in energy intake and macronutrients consumption was observed. There was no significant change in TL, but there was a significant increase of POT1 and TRF1 gene expression after surgery, while TRF2 expression did not change. CONCLUSIONS: Despite bariatric surgery is not capable of increasing telomere length in a short-term period, no reduction is observed; additionally, we found a correlation between serum triglycerides concentration and TL. The increase of POT1 and TRF1 gene expression may explain the maintenance of the TL after 6 months postoperative period.
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Derivação Gástrica , Obesidade Mórbida , Feminino , Expressão Gênica , Humanos , Obesidade Mórbida/cirurgia , Estudos Prospectivos , Telômero/genéticaRESUMO
Post bariatric control of food intake is influenced by psychological and behavioral factors. We investigated dietary habits and food intake during COVID-19 quarantine among recently operated patients. Patients were assessed for total and per meal energy and macronutrient intake as well as frequency of food consumption per processing level. Patients were also classified according to adherence to nutritional recommendations from our outpatient clinic. Main results are indicative of inappropriate nutritional intake during COVID-19 quarantine in postoperative bariatric patients. We observed that many patients failed to meet the recommended protein intake (89.2%) along a relatively high intake of ultra-processed foods (~1/4 of the diet). Our data suggest the need for the implementation of strategies to extend nutritional care to at-risk patients during social distancing.
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Bariatria , COVID-19 , Obesidade Mórbida , Brasil , Estudos Transversais , Dieta , Ingestão de Energia , Humanos , Obesidade Mórbida/cirurgia , Quarentena , SARS-CoV-2RESUMO
BACKGROUND: Telomere length is inversely associated with the senescence and aging process. Parallelly, obesity can promote telomere shortening. Evidence suggests that physical activity may promote telomere elongation. OBJECTIVE: This study's objective is to evaluate the effects of combined exercise training on telomere length in obese women. DESIGN AND METHODS: Twenty pre-menopausal women (BMI 30-40 kg/m2, 20-40 years) submitted to combined training (strength and aerobic exercises), but only 13 finished the protocol. Each exercise session lasted 55 min/day, three times a week, throughout 8 weeks. Anthropometric data, body composition, physical performance (Vo2max), and 8-h fasting blood samples were taken before and after 8 weeks of training. Leukocyte DNA was extracted for telomere length by RT-qPCR reaction, using the 2-ΔΔCt methodology. RESULTS: After the training intervention, significant differences (p < 0.05) were observed in telomere length (respectively before and after, 1.03 ± 0.04 to 1.07 ± 0.04 T/S ratio), fat-free mass (46 ± 7 to 48 ± 5 kg), Vo2max (35 ± 3 to 38 ± 3 ml/kg/min), and waist circumference (96 ± 8 to 90 ± 6 cm). In addition, an inverse correlation between waist circumference and telomere length was found, before (r = - 0.536, p = 0.017) and after (r = - 0.655, p = 0.015) exercise training. CONCLUSION: Combined exercise promoted leukocyte telomere elongation in obese women. Besides, the data suggested that greater waist circumference may predict shorter telomere length. CLINICAL TRIAL REGISTRATION: ClinicalTrails.gov, NCT03119350. Retrospectively registered on 18 April 2017.
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BACKGROUND: : Bariatric surgery promotes significant weight loss and improvement of associated comorbidities; however, nutrients deficiencies and weight regain may occur in the middle-late postoperative period. AIM: To investigate nutritional status in 10 years follow-up. METHODS: : Longitudinal retrospective study in which anthropometric, biochemical indicators and nutritional intake were assessed before and after one, two, three, four, five and ten years of Roux-en Y gastric bypass through analysis of medical records. RESULTS: : After ten years there was a reduction of 29.2% of initial weight; however, 87.1% of patients had significant weight regain. Moreover, there was an increase of incidence of iron (9.2% to 18.5%), vitamin B12 (4.2% to 11.1%) and magnesium deficiency (14.1% to 14.8%). Folic acid concentrations increased and the percentage of individuals with glucose (40.4% to 3.7%), triglycerides (38% to 7.4%), HDL cholesterol (31 % to 7.4%) and uric acid (70.5% to 11.1%) abnormalities reduced. Also, there is a reduction of food intake at first year postoperative. After 10 years, there was an increase in energy, protein and lipid intake, also a reduction in folid acid intake. CONCLUSIONS: : Roux-en Y gastric bypass is an effective procedure to promote weight loss and improve comorbidities associated with obesity. However, comparison between postoperative period of five and 10 years showed a high prevalence of minerals deficiency and a significant weight regain, evidencing the need for nutritional follow-up in the postoperative period.
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Derivação Gástrica/reabilitação , Estado Nutricional/genética , Obesidade/cirurgia , Fenótipo , Adulto , Índice de Massa Corporal , Feminino , Ácido Fólico/sangue , Seguimentos , Humanos , Ferro/sangue , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Distúrbios Nutricionais/sangue , Distúrbios Nutricionais/etiologia , Obesidade/complicações , Período Pós-Operatório , Estudos Retrospectivos , Resultado do Tratamento , Vitamina B 12/sangue , Redução de PesoRESUMO
Telomeres are structures located at the ends of chromosomes associated with proteins, from the shelterin complex, which are responsible for the protection and preservation of the genetic material. The telomere length (TL) progressively decreases with each cell division, and recent evidence suggests that lifestyle can lead to telomere shortening. In individuals with obesity, excess adipose tissue plays a key role in inducing a chronic and systemic inflammatory state, which can cause TL shortening. Thus, the aim of the present review was to show the relationship between obesity and TL in addition to the possible risk factors for its shortening and how the different strategies for weight loss can modulate TL. As the crucial result, we can consider the association between TL and weight loss, and adiposity changes after different interventions, showing that TL may be used as a biomarker of responses to obesity treatment.
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Estado Nutricional , Obesidade/terapia , Encurtamento do Telômero , Redução de Peso , Humanos , TelômeroRESUMO
Human biological system provides innumerable neuroendocrine inputs for food intake control, with effects on appetite's modulation and the satiety signs. Its regulation is very complex, engaging several molecular interactions with many tissues, hormones, and neural circuits. Thus, signaling molecules that control food intake are critical for normal energy homeostasis and a deregulation of these pathways can lead to eating disorders and obesity. In line of this, genetic factors have a significantly influence of the regulation of neural circuits controlling the appetite and satiety pathways, as well as the regulation of brain reward systems. Single Nucleotide Polymorphisms (SNPs) in genes related to hypothalamic appetite and satiety mechanisms, further in multiple neurotransmitter systems may contribute to the development of major Eating Disorders (EDs) related to obesity, among them Binge Eating Disorder (BED) and Bulimia Nervosa (BN), which are discussed in this review.
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Transtorno da Compulsão Alimentar/genética , Transtornos da Alimentação e da Ingestão de Alimentos/genética , Obesidade/genética , Transtorno da Compulsão Alimentar/patologia , Bulimia Nervosa/genética , Bulimia Nervosa/patologia , Ingestão de Alimentos , Transtornos da Alimentação e da Ingestão de Alimentos/patologia , Humanos , Obesidade/patologiaRESUMO
ABSTRACT Background : Bariatric surgery promotes significant weight loss and improvement of associated comorbidities; however, nutrients deficiencies and weight regain may occur in the middle-late postoperative period. Aim: To investigate nutritional status in 10 years follow-up. Methods : Longitudinal retrospective study in which anthropometric, biochemical indicators and nutritional intake were assessed before and after one, two, three, four, five and ten years of Roux-en Y gastric bypass through analysis of medical records. Results : After ten years there was a reduction of 29.2% of initial weight; however, 87.1% of patients had significant weight regain. Moreover, there was an increase of incidence of iron (9.2% to 18.5%), vitamin B12 (4.2% to 11.1%) and magnesium deficiency (14.1% to 14.8%). Folic acid concentrations increased and the percentage of individuals with glucose (40.4% to 3.7%), triglycerides (38% to 7.4%), HDL cholesterol (31 % to 7.4%) and uric acid (70.5% to 11.1%) abnormalities reduced. Also, there is a reduction of food intake at first year postoperative. After 10 years, there was an increase in energy, protein and lipid intake, also a reduction in folid acid intake. Conclusions : Roux-en Y gastric bypass is an effective procedure to promote weight loss and improve comorbidities associated with obesity. However, comparison between postoperative period of five and 10 years showed a high prevalence of minerals deficiency and a significant weight regain, evidencing the need for nutritional follow-up in the postoperative period.
RESUMO Racional: A cirurgia bariátrica promove importante perda ponderal e melhora das comorbidades associadas; entretanto, deficiências nutricionais e reganho de peso podem ocorrer no pós-operatório médio e tardio. Objetivo: Investigar a evolução do estado nutricional de pacientes após cinco e 10 anos de pós-operatório. Método: Estudo retrospectivo longitudinal, no qual indicadores antropométricos, bioquímicos e a ingestão alimentar foram avaliados no período pré-operatório e após um, dois, três, quatro, cinco e dez anos da operação, por meio de revisão de prontuários. Resultados: Após 10 anos observou-se redução de 29,2% do peso inicial; no entanto, 87,1% dos pacientes tiveram reganho significativo de peso. Além disso, houve aumento da incidência de deficiência de ferro (9,2% para 18,5%), vitamina B12 (4,2% para 11,1%) e magnésio (14,1% para 14,8%). As concentrações de ácido fólico aumentaram e a porcentagem de indivíduos com alterações na glicemia (40,4% a 3,7%), triglicérides (38% a 7,4%), colesterol HDL (31% a 7,4%) e ácido úrico (70,5% a 11,1%) diminuiu. Além disso, houve redução na ingestão alimentar no primeiro ano de pós-operatório. Após 10 anos, houve aumento na ingestão de energia, proteína e lipídios, e redução na de ácido fólico. Conclusões: A derivação gástrica em Y-de-Roux é procedimento eficaz para promover perda de peso e melhorar as comorbidades associadas à obesidade. Entretanto, a comparação entre os períodos pós-operatórios de cinco e 10 anos mostrou que uma porcentagem de pacientes apresenta deficiências de vitaminas e minerais e reganho de peso significativo, evidenciando a necessidade do acompanho nutricional no período pós-operatório.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Fenótipo , Derivação Gástrica/reabilitação , Estado Nutricional/genética , Obesidade/cirurgia , Período Pós-Operatório , Vitamina B 12/sangue , Redução de Peso , Índice de Massa Corporal , Estudos Retrospectivos , Seguimentos , Estudos Longitudinais , Resultado do Tratamento , Ácido Fólico/sangue , Ferro/sangue , Distúrbios Nutricionais/etiologia , Distúrbios Nutricionais/sangue , Obesidade/complicaçõesRESUMO
OBJECTIVES: After bariatric surgery, modifications to signaling pathway networks including those of the metabolic regulator called mammalian or mechanistic target of rapamycin (mTOR) may lead to molecular alterations related to energy source availability, systemic nutrients, and catabolic and anabolic cellular processes. This study aimed to identify gene expression changes with regard to the mTOR complex 2 subunit signaling pathway in obese patients before and after bariatric surgery. METHODS: The experimental group included 13 obese women who were examined before (preoperative) and 6 mo after (postoperative) Roux-en-Y gastric bypass (RYGB) surgery. The control group included nine apparently eutrophic women matched by age and without any other metabolic diseases (i.e., no diabetes and no liver or kidney diseases). Peripheral blood mononuclear cell samples were collected for RNA extraction and subsequent microarray analysis. RESULTS: After this methodological procedure, we identified 47 000 differentially expressed genes. A subsequent bioinformatic analysis showed that three diferentially expressed genes (rapamycin-insensitive companion of mTOR [RICTOR], phosphoinositide-3-kinase regulatory subunit 1 [PIK3 R1], and hypoxia inducible factor 1 alpha subunit 1A [HIF1 A]) participated in the mTOR signaling pathway. Real-time quantitative polymerase chain reaction revealed that RICTOR, PIK3 R1, and HIF1 A were upregulated 6 mo after RYGB surgery (P <0.05). In addition, patients in the experimental group lost weight significantly and presented significant improvement in biochemical/metabolic variables. CONCLUSIONS: The weight loss that was induced by RYGB surgery alters the mTOR signaling pathway and specifically the mTOR complex 2 subunit. The increased expression of genes that act in this pathway such as RICTOR, PIK3 R1, and HIF1 A reflects the induced weight loss and improved metabolic indicators (e.g., insulin resistance and lipolysis) that are evidenced in this study.
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Derivação Gástrica , Alvo Mecanístico do Complexo 2 de Rapamicina/metabolismo , Obesidade/genética , Transdução de Sinais/genética , Redução de Peso/genética , Adulto , Feminino , Humanos , Leucócitos Mononucleares/metabolismo , Estudos Longitudinais , Pessoa de Meia-Idade , Obesidade/cirurgia , Período Pós-Operatório , Período Pré-Operatório , Resultado do TratamentoRESUMO
OBJECTIVE: Resting metabolic rate (RMR) is an important parameter to guide the nutritional therapy of class III obese patients. The aims of the present study were to develop a predictive equation for RMR estimation in class III obese women using anthropometric indicators and to compare indirect calorimetry with other predictive equations. METHODS: This was a cross-sectional study on women with class III obesity (body mass index >40 kg/m2). Weight, height, fat-free mass, fat mass, and RMR of all individuals were measured. Multiple linear regression was used to determine the new RMR equation and the Bland-Altman plot was used to analyze the agreement between indirect calorimetry and the results of predictive equations. RESULTS: We evaluated 101 women with obesity class III and a mean age of 36.3 ± 10 y. The anthropometric and body composition variables used in the new equation had a coefficient of determination of 0.80, and a significant influence on RMR (P = 0.01). Harris-Benedict and World Health Organization equations showed similar bias and limits (181.6, +2 SD = 765.5, -2 SD = -402.2; 156.4, +2 SD = 799.4, -2 SD = -486.6, respectively). The Mifflin-St Jeor and Owen equations showed large clinical bias (mean, 239.2 and 463.9, respectively), and a tendency to overestimate RMR. CONCLUSION: The prediction equations tested in the study had low accuracy in estimating RMR of women with class III obesity. However, our equation was developed specifically for this population, using variables known to influence their energy expenditure.
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Antropometria/métodos , Metabolismo Basal , Calorimetria Indireta/estatística & dados numéricos , Indicadores Básicos de Saúde , Obesidade/diagnóstico , Adulto , Composição Corporal , Índice de Massa Corporal , Peso Corporal , Estudos Transversais , Metabolismo Energético , Feminino , Humanos , Modelos Lineares , Pessoa de Meia-Idade , Obesidade/classificação , Valor Preditivo dos Testes , Valores de Referência , Reprodutibilidade dos TestesRESUMO
This study aims (i) to verify expression of the UCPs, PLIN1, PPARG2, and ADRB3 genes in the abdominal subcutaneous adipose tissue of obese women at baseline and after 8 weeks of supplementation with decaffeinated green tea extract, and (ii) to associate findings with clinical parameters. This is a longitudinal study during which 11 women with obesity grade III were submitted to supplementation with 450 mg of (-)-epigallocatechin gallate (EGCG) (intervention group); the control group consisted of 10 eutrophic women. Anthropometric parameters [weight, height, and body mass index (BMI)], resting metabolic rate (RMR, measured by indirect calorimetry), and gene expression (measured by real-time PCR, RT-qPCR) were determined before and after supplementation. After 8 weeks, clinical parameters and UCP1, PLIN1, PPARG2, and ADRB3 expression remained unaltered in the intervention group (p > .05). Genetic analysis also showed that the UCP3 gene was upregulated (p = .026), but its upregulation did not promote weight loss.
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Tecido Adiposo/metabolismo , Obesidade/terapia , Chá/química , Proteína Desacopladora 3/metabolismo , Redução de Peso , Adolescente , Adulto , Metabolismo Basal , Índice de Massa Corporal , Catequina/análogos & derivados , Catequina/farmacologia , Suplementos Nutricionais , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Obesidade/genética , PPAR gama/genética , PPAR gama/metabolismo , Perilipina-1/genética , Perilipina-1/metabolismo , Extratos Vegetais/farmacologia , Receptores Adrenérgicos beta 3/genética , Receptores Adrenérgicos beta 3/metabolismo , Proteína Desacopladora 1/genética , Proteína Desacopladora 1/metabolismo , Proteína Desacopladora 3/genética , Regulação para Cima , Adulto JovemRESUMO
BACKGROUND: Number of pregnancies has been increasing in women of childbearing age after the gastric bypass. OBJECTIVE: The objective of this study was to evaluate the nutritional status of children of women submitted to gastric bypass. METHODS: We evaluated anthropometric, breastfeeding and biochemical profile, body composition, and dietary intake indicators of children of both sexes who were born alive after the surgery. For statistical analysis, were performed Shapiro-Wilk and ANOVA test (p < 0.05). RESULTS: The sample consisted of 13 children (61.6% female, mean age of 46 ± 22.3 months, BMI of 18.9 ± 3.3 kg/m2). The classification of BMI index by age showed that 46.1% of the children were normal weight and 30.8% obese. We observed a large percentage of children with deficiency of iron and vitamin A. 7.6 and 30.7% of children presented carbohydrate and lipid, respectively, lower than the recommendation. Fiber intake was inadequate in all children, calcium in 61.5%, vitamin A in 30.7%, and folate in 76.9% of them. Also, 84.6% presented sodium intake higher than the recommendations. The blood glucose levels were lower in children with maternal breastfeeding (65.5 ± 2.1 mg/dL, p < 0.05); furthermore, children breastfed with artificial and breast milk presented lower fat mass (3.8 ± 1.9 kg; p < 0.05). CONCLUSION: Children from women with previously gastric bypass presented low birth weight; however, they are currently underweight or overweight and present important deficiency of iron and vitamin A and inadequate alimentary intake mainly of sodium and fibers. Breastfeeding may play a protective role in the development of obesity in these children.
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Cirurgia Bariátrica/reabilitação , Filho de Pais com Deficiência , Estado Nutricional , Obesidade Mórbida , Adulto , Cirurgia Bariátrica/estatística & dados numéricos , Composição Corporal , Índice de Massa Corporal , Pesos e Medidas Corporais , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Filho de Pais com Deficiência/estatística & dados numéricos , Pré-Escolar , Estudos Transversais , Feminino , Derivação Gástrica/reabilitação , Derivação Gástrica/estatística & dados numéricos , Humanos , Lactente , Masculino , Exposição Materna/estatística & dados numéricos , Pessoa de Meia-Idade , Sobrepeso/epidemiologia , Sobrepeso/etiologia , Gravidez , Adulto JovemRESUMO
BACKGROUND: Differential gene expression in peripheral blood mononuclear cells (PBMCs) after Roux-en-Y gastric bypass (RYGB) is poorly characterized. Markers of these processes may provide a deeper understanding of the mechanisms that underlie these events. The main goal of this study was to identify changes in PBMC gene expression in women with obesity before and 6 months after RYGB-induced weight loss. METHODS: The ribonucleic acid (RNA) of PBMCs from 13 obese women was analyzed before and 6 months after RYGB; the RNA of PBMCs from nine healthy women served as control. The gene expression levels were determined by microarray analysis. Significant differences in gene expression were validated by real-time quantitative polymerase chain reaction (RT-qPCR). RESULTS: Microarray analysis for comparison of the pre- and postoperative periods showed that 1366 genes were differentially expressed genes (DEGs). The main pathways were related to gene transcription; lipid, energy, and glycide metabolism; inflammatory and immunological response; cell differentiation; oxidative stress regulation; response to endogenous and exogenous stimuli; substrate oxidation; mTOR signaling pathway; interferon signaling; mitogen-activated protein kinases (MAPK), cAMP response element binding protein (CREB1), heat shock factor 1 (HSF1), and sterol regulatory element binding protein 1c (SREBP-1c) gene expression; adipocyte differentiation; and methylation. CONCLUSIONS: Six months after bariatric surgery and significant weight loss, many molecular pathways involved in obesity and metabolic diseases change. These findings are an important tool to identify potential targets for therapeutic intervention and clinical practice of nutritional genomics in obesity.
Assuntos
Cirurgia Bariátrica , Leucócitos Mononucleares/metabolismo , Obesidade Mórbida/genética , Obesidade Mórbida/cirurgia , Transcriptoma , Redução de Peso/genética , Adulto , Cirurgia Bariátrica/reabilitação , Estudos de Casos e Controles , Feminino , Derivação Gástrica/reabilitação , Expressão Gênica , Perfilação da Expressão Gênica , Humanos , Análise em Microsséries , Pessoa de Meia-Idade , Proteínas Quinases Ativadas por Mitógeno/genética , Obesidade Mórbida/sangueRESUMO
INTRODUCTION: Although pregnancy after bariatric surgery is related to risk reduction, nutritional complications may occur. This study aimed to evaluate nutritional and biochemical indicators of women who became pregnant after Roux en Y gastric bypass (RYGB). MATERIALS AND METHODS: We carried out a retrospective study with women who became pregnant after RYGB. We evaluated anthropometric, biochemical, and dietary intake indicators in the preoperative period and before, during, and after pregnancy by analysis of medical records. Shapiro-Wilk test and ANOVA for repeated measures were performed (p < 0.05). RESULTS: The study included 25 patients (35.7 ± 3.8 years), who became pregnant 31.3 ± 21.7 months after RYGB. Weight loss until the beginning of pregnancy was 32.4%, and the gestational weight gain was 3.8 ± 12 kg. There was a higher frequency of patients with hypertension in the preoperative time when compared to that during the pregnancy period. Total cholesterol (180.9 ± 24.8 versus 148.5 ± 30.4 mg/dL), LDL-cholesterol (103.5 ± 19.2 versus 85.8 ± 23.1 mg/dL), HDL-cholesterol (56.4 ± 8 versus 46.9 ± 8.7 mg/dL), and latent iron-binding capacity (337.6 ± 95.8 versus 277.8 ± 65 µg/dL) were higher during the pregnancy compared to that before the pregnancy, while hemoglobin values (11.2 ± 1 versus 12.3 ± 1.2 g/dL) and sodium (138.8 ± 2.9 versus 141 ± 3 mmol/L) were lower. No differences of food intake were found among times. There is no difference on gestational weight gain between women who became pregnant before or after the first year. CONCLUSION: During pregnancy, there was an expected weight gain and maintenance of the lipid profile within the normal range; however, there was a reduction of hemoglobin levels. These findings show the need for individualized follow-up with adequate nutritional intervention in the event of deficiencies.
Assuntos
Ingestão de Alimentos , Derivação Gástrica/efeitos adversos , Desnutrição/sangue , Estado Nutricional , Obesidade/cirurgia , Complicações na Gravidez/sangue , Adolescente , Adulto , Antropometria , Biomarcadores/sangue , Feminino , Humanos , Desnutrição/etiologia , Pessoa de Meia-Idade , Obesidade/sangue , Gravidez , Complicações na Gravidez/etiologia , Estudos Retrospectivos , Aumento de Peso , Redução de Peso , Adulto JovemRESUMO
BACKGROUND: Analysis of the expression of genes related to the energy metabolism can elucidate the understanding of physiological and genetic factors that contribute to obesity. This study aimed to evaluate the expression of genes and its influence on resting metabolic rate and weight loss in obese patients before and after bariatric surgery. METHODS: This study was conducted on 23 women, who were divided into two groups: bariatric surgery (preoperative and 6 months after surgery) and control. Abdominal subcutaneous adipose tissue samples were collected to analyze the gene expression, and the resting metabolic rate (RMR) was measured by indirect calorimetry. RESULTS: Significant differences were observed in weight reduction (22 %, p = 0.01), BMI (22.5 %, p = 0.01), and RMR values (10.5 %, p = 0.01) after the bariatric surgery, while the weight-adjusted RMR increased (15.8 %, p = 0.01). Increased UCP2 expression after 6 months of Roux-en-Y gastric bypass (RYGB) as compared to preoperative period (0.764 to 1.268, p = 0.01) was observed. Analysis with weight-adjusted RMR as dependent variable revealed that UCP2 (r 2 = 0.517, p = 0.01) and PLIN1 (r 2 = 0.420, p = 0.04) expression determine the RMR values in preoperative period. Moreover, UCP2 and PLIN1 expression in preoperative period influenced the percentage of weight loss, even when adjusted for age and BMI. CONCLUSIONS: We have demonstrated that after 6 months of bariatric surgery, there is significant increase in the UCP2 expression. Additionally, the expression of UCP2 and PLIN1 genes influences the resting metabolic rate in obese individuals and could predict the weight loss after bariatric surgery.