Effects of long-term multidisciplinary inpatient therapy on body composition of severely obese adolescents

OBJECTIVE: To describe the effects of long-term multidisciplinary inpatient therapy on body composition of severely obese adolescents. METHODS: A total of 728 extremely obese adolescents, including 249 boys (aged 15.25±1.56 years) and 479 girls (aged 15.34±1.59 years) received multidisciplinary therapy during a period of 3 to 9 months. The therapy consisted of reduced energy intake, dietetic education, physical exercises and psychological therapy. Body composition was assessed by bioelectrical impedance analysis, and physical capacity was assessed by the multistage cycle ergometer test. Type and duration of each activity were recorded using a daily controlled activity diary. RESULTS: There was a significant decrease (p < 0.05) in body mass (27.84±12.49 kg for boys and 21.60±9.87 kg for girls), body mass index (9.19±3.88 kg/m² for boys and 7.72±3.98 kg/m² for girls) and fat mass. In addition, the percentage of fat free mass increased significantly (p < 0.05) in boys (from 58.8±6.41 to 69.98±7.43%) and in girls (from 51.86±4.96 to 60.04±5.65%). CONCLUSION: Long-term multidisciplinary approach allows significant reduction in severe obesity, preserving growth and percentage of fat free mass.OBJETIVO: Descrever os efeitos da terapia multidisciplinar de longo prazo sobre a composição corporal de adolescentes obesos severos internados. MÉTODOS: Um total de 728 adolescentes obesos extremos, incluindo 249 meninos (15,25±1,56 anos) e 479 meninas (15,34±1,59 anos), recebeu terapia multidisciplinar durante um período de 3 a 9 meses. A terapia consistiu de redução da ingestão energética, orientação dietética, exercícios físicos e terapia psicológica. A composição corporal foi analisada pela bioimpedância elétrica, e a aptidão física foi avaliada pelo teste em ciclo ergômetro multiestágios. O tipo e duração de cada atividade foram avaliados através de recordatório diário de atividade física. RESULTADOS: Foi verificada redução significante (p < 0,05) na massa corporal (27,84±12,49 kg para meninos e 21,60±9,87 kg para meninas), índice de massa corporal (9,19±3,88 kg/m² para meninos e 7,72±3,98 kg/m² para meninas) e da gordura corporal. Além disso, a porcentagem de massa magra aumentou significantemente (p < 0,05) nos meninos (de 58,8±6,41 para 69,98±7,43%) e nas meninas (de 51,86±4,96 para 60,04±5,65%). CONCLUSÃO: A terapia multidisciplinar de longo prazo permite reduzir acentuadamente a obesidade severa, preservando o crescimento e a porcentagem de massa magra.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Programa de Pós-Graduação em NutriçãoObesity Rehabilitation Centre INSULAUNIFESP Departamento de BiociênciasUNIFESP, EPM, Programa de Pós-Graduação em NutriçãoUNIFESP, Depto. de BiociênciasSciEL

Decomposition of oat straw and release of macronutrients in different managements

The present work was aimed in order to evaluate the decomposition process of remaining straw from oat cultivars submitted to different handling during the cultivation of corn for silage intercropped with Urochloa brizantha cv. MG13 Braúna. We considered nine oat cultivars named as follows: "IAPAR 61 IBIPORÃ" oat hay (61F), "IAPAR 61 IBIPORÃ" pasture (61P), "IAPAR 61 IBIPORÃ" cover crop (61SM), "Embrapa 139 (Fog)" oat hay (139F),"Embrapa 139 (Fog)" pasture (139P)," Embrapa 139 (Fog)" cover crop (139SM), "Emerald IPR 126" oat hay (EF), "Emerald IPR 126" grazed (EP) and "Emerald IPR 126" cover crop (ESM) from which we evaluated the decomposition of the remaining straw using the method of litter bags. The evaluations were carried out at 0, 15, 30, 60, 90 and 108 days after sowing corn for silage intercropped with Brizantha brachiaria cv. MG13 Braúna (Urochloa brizantha). Every oat cultivar had three repetitions arranged in a split-plot design. We took into account the quantity of straw, organic matter, carbon, nitrogen, carbon / nitrogen ratio, phosphorus and potassium. The results we got clarify that oat decomposition rate varied with the meteorological factors and initial mass, so that the greater the initial mass is, the longer the straw permanency and mulch effectiveness on the soil. The time the residual oat straw took to be decomposed depended on meteorological factors both during the cover crop developmental stage and the decomposition period itself. The higher the initial mass, the greater the time and effectiveness of mulching

Long-Term Effects of Metformin and Lifestyle Modification on Nonalcoholic Fatty Liver Disease Obese Adolescents

Objective. To assess the long-term effects of metformin in combination with lifestyle intervention and its association between insulin levels and the degree of steatosis at ultrasonography (US) in obese adolescents. Methods. Thirty-five postpubertal obese boys were randomized into two groups: one receiving metformin in combination with a multidisciplinary lifestyle intervention versus a placebo group, which also received the same intervention. The visceral, subcutaneous fat and degree of steatosis were measured by ultrasonography. Fasting blood samples were collected to analyze glucose, insulin, insulin resistance, and aminotransferases. Repeated ANOVA measures were used to compare changes over time and between groups, and Spearman's correlations were used to identify an association between insulin and the degree of steatosis at US. Results. There was a positive correlation between the degree of steatosis at US with insulin concentrations and HOMA-IR. Long-term therapy plus metformin significantly reduced body weight, body mass index, insulin, HOMA-IR, and visceral fat. Conclusions. Metformin was more effective than the placebo in improving clinical parameters associated with obesity and steatosis

Improvement in HOMA-IR is an independent predictor of reduced carotid intima-media thickness in obese adolescents participating in an interdisciplinary weight-loss program

The aim of this study was to verify whether a 1-year interdisciplinary weight-loss program improved common carotid artery intima-media thickness (IMT) and whether insulin resistance and/or inflammation (as measured by the markers plasminogen activator inhibitor type-1 and adiponectin) might underlie obesity in adolescents. A group of 29 post-pubescent obese adolescents were submitted to an interdisciplinary intervention over the course of 1 year. Common carotid artery IMT was determined ultrasonographically. Body composition, blood pressure (BP), glycemia, insulinemia, homeostasis model assessment of insulin resistance (HOMA-IR), lipid profile and adipokine concentrations were analyzed before and after the intervention. the interdisciplinary weight-loss program promoted a significant improvement in body composition, insulin concentration, HOMA-IR, lipid profile, BP and inflammatory state, in addition to significantly decreasing the common carotid artery IMT. Furthermore, this study demonstrated that the difference between baseline and final values of HOMA-IR (Delta HOMA-IR) was negatively correlated with concomitant changes in the adiponectin concentration (Delta adiponectin; r=-0.42; P=0.02) and positively correlated with changes in common carotid artery IMT (Delta carotid IMT; r=0.41; P=0.03). Multiple regression analysis adjusted by age, cardiovascular risk factors and inflammatory markers showed that Delta HOMA-IR was an independent predictor of significant changes in common carotid artery IMT. This investigation demonstrated that an interdisciplinary weight-loss program promoted a reduction of the common carotid artery IMT in obese Brazilian adolescents, and the improvement of HOMA-IR was an independent predictor of carotid IMT changes in this population. Hypertension Research (2011) 34, 232-238; doi: 10.1038/hr.2010.225; published online 2 December 2010AFIPFundação 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)CENESPFADAUNIFESP-EPMUniversidade Federal de São Paulo, Postgrad Program Nutr, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychobiol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Med, Div Cardiol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Physiol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Biosci, São Paulo, BrazilUniversidade Federal de São Paulo, Postgrad Program Nutr, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychobiol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Med, Div Cardiol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Physiol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Biosci, São Paulo, BrazilFAPESP: 2006/00684-3FAPESP: 2008/53069-0FAPESP: 9814303-3 S.TWeb of Scienc

Quality of life in Brazilian obese adolescents: effects of a long-term multidisciplinary lifestyle therapy

© 2009 Lofrano-Prado et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

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

Coacervate whey protein improves inflammatory milieu in mice fed with high-fat diet

Background: Functional foods with bioactive properties may help in treat obesity, as they can lead to a decreased risks of inflammatory diseases. the aim of this study was to investigate the effects of chitosan coacervate whey protein on the proinflammatory processes in mice fed with high-fat diet.Methods: Mice were divided into two groups receiving either a normolipidic or high-fat diet; the animals in each of the two diet groups were given a diet supplement of either coacervate (gavage, 36 mg protein/kg of body weight) or tap water for four weeks [groups: normolipidic diet plus water (C); normolipidic diet and coacervate (CC); high-fat diet and water (H); and high-fat diet and coacervate (HC)].Results: the high-fat diet promoted inflammation, possibly by decreased adiponectin/sum of adipose tissues ratio and increased phosphorylation of NF-kappa B p50. in HC we observed a positive correlation between IL-10 and TNF-alpha in mesenteric adipose tissue, retroperitoneal adipose tissue and liver tissue. We also observed a positive correlation between lipopolisaccharide with IL-10 in the liver tissue.Conclusions: High-fat diet treatment promoted metabolic alterations and inflammation, and chitosan coacervate whey protein modulated inflammatory milieu.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, Dept Fisiol, Disciplina Fisiol Nutr, São Paulo, BrazilUniversidade Federal de São Paulo, Inst Ciencias & Tecnol, Sao Jose Dos Campos, SP, BrazilUniversidade Federal de São Paulo, Dept Fisiol, Disciplina Fisiol Nutr, São Paulo, BrazilUniversidade Federal de São Paulo, Inst Ciencias & Tecnol, Sao Jose Dos Campos, SP, BrazilFAPESP: 2011/04310-9Web of Scienc

Long-term interdisciplinary therapy reduces endotoxin level and insulin resistance in obese adolescents

Aim: the purpose of the present study was to assess the dietary fat intake, glucose, insulin, Homeostasis model assessment for insulin resistance HOMA-IR, and endotoxin levels and correlate them with adipokine serum concentrations in obese adolescents who had been admitted to long-term interdisciplinary weight-loss therapy.Design: the present study was a longitudinal clinical intervention of interdisciplinary therapy. Adolescents (n = 18, aged 15-19 y) with a body mass index >95th percentile were admitted and evaluated at baseline and again after 1 year of interdisciplinary therapy. We collected blood samples, and IL-6, adiponectin, and endotoxin concentrations were measured by ELISA. Food intake was measured using 3-day diet records. in addition, we assessed glucose and insulin levels as well as the homeostasis model assessment for insulin resistance (HOMA-IR).Results: the most important finding from the present investigation was that the long-term interdisciplinary lifestyle therapy decreased dietary fat intake and endotoxin levels and improved HOMA-IR. We observed positive correlations between dietary fat intake and endotoxin levels, insulin levels, and the HOMA-IR. in addition, endotoxin levels showed positive correlations with IL-6 levels, insulin levels and the HOMA-IR. Interestingly, we observed a negative correlation between serum adiponectin and both dietary fat intake and endotoxin levels.Conclusions: the present results indicate an association between dietary fat intake and endotoxin level, which was highly correlated with a decreased pro-inflammatory state and an improvement in HOMA-IR. in addition, this benefits effect may be associated with an increased adiponectin level, which suggests that the interdisciplinary therapy was effective in improving inflammatory pathways.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Dept Fisiol, São Paulo, BrazilDept Biociencias, São Paulo, BrazilDept Psicobiol, São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, São Paulo, BrazilICB Univ São Paulo USP, Grp Metab & Canc, São Paulo, BrazilUniv So Santa Catarina, Hlth Sci Unit, Lab Exercise Biochem & Physiol, Criciuma, SC, BrazilUniversidade Federal de São Paulo UNIFESP, São Paulo, BrazilFAPESP: 2011/50356-0FAPESP: 2011/50414-0Web of Scienc