Passive body heating improves sleep patterns in female patients with fibromyalgia

OBJECTIVE: To assess the effect of passive body heating on the sleep patterns of patients with fibromyalgia. METHODS: Six menopausal women diagnosed with fibromyalgia according to the criteria determined by the American College of Rheumatology were included. All women underwent passive immersion in a warm bath at a temperature of 36 ±1 °C for 15 sessions of 30 minutes each over a period of three weeks. Their sleep patterns were assessed by polysomnography at the following time-points: pre-intervention (baseline), the first day of the intervention (acute), the last day of the intervention (chronic), and three weeks after the end of the intervention (follow-up). Core body temperature was evaluated by a thermistor pill during the baseline, acute, chronic, and follow-up periods. The impact of this treatment on fibromyalgia was assessed via a specific questionnaire termed the Fibromyalgia Impact Questionnaire. RESULTS: Sleep latency, rapid eye movement sleep latency and slow wave sleep were significantly reduced in the chronic and acute conditions compared with baseline. Sleep efficiency was significantly increased during the chronic condition, and the awakening index was reduced at the chronic and follow-up time points relative to the baseline values. No significant differences were observed in total sleep time, time in sleep stages 1 or 2 or rapid eye movement sleep percentage. The core body temperature and Fibromyalgia Impact Questionnaire responses did not significantly change over the course of the study. CONCLUSION: Passive body heating had a positive effect on the sleep patterns of women with fibromyalgia.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo (UNIFESP) Departamento de PsicobiologiaCentro de Estudos em Psicobiologia e ExercícioUNIFESP, Depto. de Psicobiologia98/14303-3 e 07/56620-6 e 09/13881-0SciEL

A influência da gordura visceral e subcutânea na densidade mineral óssea de adolescentes obesos

OBJECTIVE: To verify the influence of visceral and subcutaneous fat, as well adipokines in bone mineral density (BMD) in obese adolescents. SUBJECTS AND METHODS: The study involved 125 postpubertal obese adolescents (45 boys and 80 girls). Anthropometric measurements, body composition, visceral and subcutaneous fat, and BMD were determined. Leptin, adiponectin, and insulin levels also analyzed. RESULTS: Data demonstrated a negative relationship between BMD with insulin resistance, visceral fat and leptin concentration; and bone mineral content with visceral/subcutaneous ratio. Positive association between BMD and subcutaneous fat was observed. CONCLUSIONS: Visceral fat and insulin resistance, as well as visceral/subcutaneous ratio and leptin concentration, were negative predictors of BMD in boys and girls, respectively. However, subcutaneous fat had a protective influence in BMD only in boys.OBJETIVO: Verificar a influência da gordura visceral e subcutânea, assim como das adipocinas na densidade mineral óssea (DMO) em adolescentes obesos. SUJEITOS E MÉTODOS: O estudo envolveu 125 adolescentes obesos pós-púberes. Medidas antropométricas, composição corporal, gordura visceral e subcutânea e DMO foram determinadas. Níveis de leptina, adiponectina e insulina foram analisados. RESULTADOS:Os dados demonstraram associação negativa entre DMO com resistência insulínica, gordura visceral e concentração de leptina; e conteúdo mineral ósseo com a razão visceral/subcutânea. Associação positiva entre DMO e gordura subcutânea foi observada. CONCLUSÕES: Gordura visceral, resistência insulínica, razão visceral/subcutânea e concentração de leptina foram preditores negativos da DMO em meninos e meninas, respectivamente. Entretanto, a gordura subcutânea demonstrou exercer influência positivamente na DMO somente nos meninos.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal de São Paulo (UNIFESP) Graduate Studies Program in NutritionUNIFESP Endocrinology DepartmentUNIFESP Psychobiology DepartmentUNIFESP Graduate Studies Program in Interdisciplinary Health SciencesUNIFESP Biosciences DepartmentUNIFESP, Graduate Studies Program in NutritionUNIFESP, Endocrinology DepartmentUNIFESP, Psychobiology DepartmentUNIFESP, Graduate Studies Program in Interdisciplinary Health SciencesUNIFESP, Biosciences DepartmentSciEL

Previous results of semipresential multiprofessional intervention, with an approach to a behavioral treatment in obesity / Resultados anteriores da intervenção multiprofissional semipresencial, com abordagem de tratamento comportamental na obesidade

AIM: Obesity is recognized as an important multifactorial disease and the Cognitive-Behavioural Therapy (CBT), based on reflection on conflicts with food, has been used in a way associated with interdisciplinary clinical therapies, aiming to promote greater understanding, self-efficacy and autonomy of treated individuals. In this context, the objective of this investigation was to analyse the impact of behavioural nutritional intervention using the MTT (Transtheoretical Model); associated with non-intensive interdisciplinary clinical therapy, including digital health education. METHODS: The research was approved by the Research Ethics Committee of University Federal of São Paulo (n º 0242/2017). The 60 selected volunteers (BMI ~34.7Kg/m2) were conducted to an interdisciplinary lifestyle therapy, with duration of 12 weeks. This therapy included clinical, nutritional and exercise physiology approach associated to digital health education. At the beginning (week 0) and after the 12 weeks an anthropometric evaluation was performed and a biochemical profile analysis as well as evaluation of the stage of behavior change according to Prochaska and Diclemente. Statistical analysis was performed adopting as significant values p ? 5%. RESULTS: there was an increased degree of motivation and a reduction in the frequency of volunteers in the Relapse and Pre-Contemplation stages, as well as an increase in the number of women classified in the Action stage.The decision-categorized group had a statistically significant reduction on body weight (p = 0.00), BMI (p = 0.00), Neck Circumference (p = 0.00), Waist Circumference (p = 0.02), Abdominal Circumference (p = 0.03), Hip Circumference (p = 0.02) Body Fat Percentage (p = 0.00), Total Cholesterol (p = 0.02) and Non-HDL Cholesterol (p = 0.04). In the Action and Maintenance group, there was a significant reduction in body weight (p = 0.00), BMI (p = 0.01), Neck Circumference (p=0.00), Waist Circumference (p= 0.00), Abdominal Circumference (p = 0.00) and Hip Circumference (p = 0.00). CONCLUSION: the semi-presential clinical approach was effective to promote improvements in the body composition, including body fat and lipid profile, as a dependent manner considering the identification of the stage of behavior change. 

Uso de tecnologia digital interativa como coadjuvante à terapia interdisciplinar no controle de risco cardiometabólico e inflamação em mulheres com obesidade / Use of interactive digital technology as an adjunct to interdisciplinary therapy in the control of cardiometabolic risk and inflammation in women with obesity

Introdução:  A obesidade é uma doença complexa associada ao desequilíbrio entre adipocinas pró e anti-inflamatórias, o que pode levar ao risco cardiometabólico. O uso da tecnologia digital interativa como ferramenta coadjuvante à prática clínica interdisciplinar na terapia de perda de peso surge como uma estratégia inovadora complementar. Objetivo:Avaliar o efeito da abordagem clínica associada ao uso de meios eletrônicos em marcadores de risco cardiometabólico e inflamatórios em mulheres com obesidade. Métodos: A terapia interdisciplinar consistiu em acompanhamento com endocrinologista, nutricionista e profissional da educação física, associado ao suporte de mídia digital pelo Facebook®, Instagram® e WhatsApp®, com duração de 12 semanas. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de São Paulo (0305/2017). A terapia foi realizada por meio de consultas presenciais mensais e por informações virtuais semanais utilizando vídeos educacionais sobre exercícios físicos e orientações alimentares na plataforma digital, com intuito de promover mudanças de estilo de vida (#12semanas®). Foram selecionadas mulheres com obesidade (n = 28), com idade de 32 ± 6,26 anos e IMC de 34.01 ± 4.58 kg/m². No encontro inicial e final, foram realizadas avaliações antropométricas, composição corporal por bioimpedância elétrica, bioquímica (perfil lipídico, glicemia) e análise do perfil inflamatório (leptina e adiponectina). Resultados: No final da intervenção, houve redução significativa nos parâmetros antropométricos, incluindo massa corporal, circunferência da cintura, pescoço, abdômen e quadril; e relação cintura/quadril. Houve redução estatística de biomarcadores do risco cardiometabólico e fatores inflamatórios, incluindo melhora no perfil lipídico, glicemia, triglicerídeos e concentração de leptina. Verificou-se que a adiponectina apresentou correlação negativa com razão cintura/quadril. A adiponectina se correlacionou positivamente com o HDL-colesterol e negativamente com a fração LDL-colesterol e triacilglicerol. Conclusão:  A abordagem clínica interdisciplinar associada à educação em saúde com recursos digitais foi efetiva em reduzir o risco cardiometabólico e o estado inflamatório em mulheres com obesidade

An Interdisciplinary Weight Loss Program Improves Body Composition and Metabolic Profile in Adolescents With Obesity: Associations With the Dietary Inflammatory Index

Background and Aims: The prevalence of overweight and obesity consitutes a global epidemic and it is growing around the world. Food and nutrition are essential requirements for promoting health and protecting against non-communicable chronic diseases, such as obesity and cardiovascular disease. Specific dietary components may modulate inflammation and oxidative stress in obese individuals. The Dietary Inflammatory Index (DII®) was developed to characterize the anti- and pro-inflammatory effects of individuals\u27 diet. Few studies have investigated the role of diet-associated inflammation in adolescents with obesity. The present study aims to investigate the effects of an interdisciplinary weight loss therapy on DII scores and cardiometabolic risk in obese adolescents and possibles correlations. Methods: A total of 45 volunteers (14–19 years old) were recruited and enrolled for long-term interdisciplinary therapy including clinical, nutritional, psychological counseling, and exercise training. Adolescents had access to videos about health education weekly. Body composition and inflammatory and serum profiles were evaluated at baseline and after intervention. The food intake was obtained by 24-h food recall. Data was used to calculate energy-adjusted DII (E-DII) scores. Negative scores indicate an anti-inflammatory diet and positive scores indicates a pro-inflammatory diet. The sample was divided according to whether individuals increased or decreased E-DII scores after therapy. Results: After therapy the body mass index (BMI), body weight, body fat, abdominal, waist, neck, and hip circumferences decreased significantly. The mean of high-density lipoprotein cholesterol (HDL-c) increased after the therapy. There was found an improvement of inflammatory and cardiometabolic parameters. In exploratory analyses, this occurred mainly when the EDII improved. Conclusion: Long-term interdisciplinary therapy combined with a health education website improved inflammatory serum markers in obese adolescents. Reduction in DII scores was associated with reduction of cardiometabolic parameters, suggesting that an anti-inflammatory diet may be an effective strategy to prevent and treat obesity and related comorbidities. Trial: http://www.ensaiosclinicos.gov.br/rg/RBR-6txv3v/, Register Number: RBR-6txv3