Diet, cancer, and the lipidome.

International audienceThe potential for dietary fat to interfere with the development of breast cancer by delaying its occurrence makes the identification of defined molecules a mandatory step in cancer prevention. In order to circumvent the limitations and/or bias of dietary exposure assessment tools, biomarkers of past lipid intake such as the fatty acid composition of white adipose tissue have been used. When considered separately, candidate fatty acids identified as favorable on the basis of their association with breast cancer risk have usually led to inconsistent results in animal intervention studies. This inconsistency indicates that any approach based on a single fatty acid should be abandoned for an integrated view over the complex lipid interactions which finally determines the lipidome, the lipid profile that is found in individuals. This article presents a reappraisal of the role of the lipid profile through a comprehensive reanalysis of adipose tissue fatty acid composition obtained in patients with benign or malignant breast tumors as well as in experimental animals during dietary interventions. Rather than a single fatty acid, a composite indicator combining elevated monounsaturates and low omega6/omega3 fatty acid ratio was associated with breast cancer protection. This lipidome may become the template for identifying breast cancer risk related to diet, and for designing proper dietary modifications to delay the occurrence of breast cancer, although the universality of the findings cannot be assessed from a single study

Parent-Offspring Correlations in Pedometer-Assessed Physical Activity

Physical activity is a major component of a healthy lifestyle in youth and adults. To identify determinants of this complex behavior is an important research objective in the process of designing interventions to promote physical activity at population level. In addition to individual determinants, there is evidence documenting familial influences on physical activity. However, the few studies that have addressed this issue with objective measures did not provide data on parent-offspring physical activity relationships throughout childhood and adolescence. The purpose of this study was to assess familial correlations in pedometer-assessed physical activity.We measured ambulatory activity in 286 French nuclear families (283 mothers, 237 fathers, and 631 children aged 8-18 years) by pedometer recordings (Yamax Digiwalker DW 450) over a week. Correlations were computed with their 95% confidence intervals (CI) for spouse pairs, siblings, mother-offspring, and father-offspring. Data were expressed as steps per day and computed both for the full recording period and separately for weekdays and weekends.The correlations were the highest between siblings (r=0.28, 95%CI: 0.17-0.38). Parent-offspring correlations were significant in mothers (r=0.21, 95%CI: 0.12-0.30), especially between mothers and daughters (r=0.24, 95%CI: 0.12-0.36 vs. r=0.18, 95%CI: 0.05-0.31 for sons), but were almost nonexistent in fathers. Correlations were generally higher on weekend days compared to weekdays. Mother-offspring correlations did not decrease with increasing age of children (r=0.17, 95%CI: 0.00-0.34 in 8-11-year-olds, r=0.20, 95%CI: 0.07-0.33 in 12-15-year-olds, and r=0.25, 95%CI: 0.07-0.39 in ≥16-year-olds). Finally, between-spouse correlations were significant only during weekend days (r=0.14, 95%CI: 0.01-0.27).Ambulatory activity correlated within families, with a possible mother effect. Mother-offspring correlations remained significant through the transition from childhood to adolescence. Further studies are required to better understand the respective influences of shared activities, parental modeling and support as well as genetic factors on the familial aggregation of physical activity

Observations regarding 'quality of life' and 'comfort with food' after bariatric surgery: comparison between laparoscopic adjustable gastric banding and sleeve gastrectomy.

International audienceBACKGROUND: Although laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) are coexisting first-choice restrictive procedures for bariatric surgery candidates, it is possible, given their different modes of action, that these procedures have different effects on quality of life (QOL). We hypothesized that improvement of QOL and comfort with food could be better with LSG compared to LAGB. METHODS: This cohort study included 131 obese patients who had either LAGB (n = 102) or LSG (n = 29). Patients were assessed during preoperative and at 6- and 12-month postoperative visits. Five QOL dimensions were assessed using the 'Quality of Life, Obesity and Dietetics' rating scale: physical impact, psycho-social impact, impact on sex life, comfort with food and diet experience. We compared QOL evolution between LAGB and LSG using linear mixed models adjusted for gender and body mass index at each visit. RESULTS: Excess weight loss was 28.4 ± 14.7% and 34.8 ± 18.4% for LAGB and 35.7 ± 14.3% and 43.8 ± 17.8% for LSG at 6 and 12 months postoperatively, respectively. Both LAGB and LSG provided significant improvement in the physical, psycho-social, sexual and diet experience dimensions of QOL. LSG was associated with better improvement than LAGB in short-term (6-month) comfort with food. CONCLUSIONS: Our results add further evidence to the benefit of LSG and LAGB in obesity management. Within the first year of follow-up, there is no lasting difference in the comfort with food dimension between LSG and LABG

High preoperative depression, phobic anxiety, and binge eating scores and low medium-term weight loss in sleeve gastrectomy obese patients: a preliminary cohort study.: Psychiatric factors and weight loss in obesity surgery

International audienceOBJECTIVE: Although depression, anxiety, and binge eating are prevalent in candidates for bariatric surgery, their impact on weight loss is unknown following sleeve gastrectomy. This study assesses the associations between weight loss and preoperative depression, anxiety, and binge eating scores in patients undergoing sleeve gastrectomy for morbid obesity. METHOD: This cohort study included 34 patients who underwent sleeve gastrectomy for morbid obesity between May 2006 and February 2010 in a French tertiary referral center. We assessed preoperative depression (using the Beck depression inventory and the SCL-90-R depression subscale), anxiety (using the Hamilton anxiety rating scale and the SCL-90-R anxiety subscales), and binge eating (using the bulimic investigatory test, Edinburgh). The primary outcome was the percentage of excess weight loss at 12 months (PEWL). RESULTS: The preoperative mean body mass index (BMI) was 55.3 kg/m2 ± 10.2 kg/m2 and 41.7 kg/m2 ± 8.7 kg/m2 at the 12-month follow-up visit. The mean PEWL was 46.8% ± 15.8%. After adjusting for the preoperative BMI, the PEWL was negatively associated with preoperative scores for depression (β= -0.357; P < 0.05), phobic anxiety (β = -0.340; P < 0.05), interpersonal sensitivity (β = -0.328; P < 0.05), and binge eating (β = -0.315; P = 0.05). Other forms of anxiety were not correlated with the PEWL. CONCLUSIONS: Higher preoperative depression, phobic anxiety, interpersonal sensitivity, and binge eating scores are associated with low postoperative weight loss in patients undergoing sleeve gastrectomy. Future studies should assess the preoperative prevalence of syndromal or subsyndromal atypical depression and its relationship to postoperative weight loss in bariatric surgery candidates

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National audienc

Lipides alimentaires et lipémie postprandiale (effets des repas successifs)

La contribution des lipides alimentaires à la lipémie postprandiale au cours de repas successifs a été peu explorée. Dans l'étude n1, six sujets sains ont ingéré 2 repas mixtes (déjeuner et dîner). Les lipides du déjeuner contribuaient à la lipémie post-dîner malgré l'intervalle de 7h entre les 2 repas. Dans l'étude n2, neuf sujets sains ont ingéré un petit déjeuner à 7h30 ainsi qu'un déjeuner (12h00). L'enrichissement en palmitate des TG montrait une participation des lipides du petit déjeuner (suivis par scintigraphie) étaient en partie retenus dans l'estomac et l'intestin grêle avant le déjeuner. Le déjeuner mobilisait ces lipides, par accélération de la vidange intestinale. En conclusion, les lipides ingérés au cours d'un repas contribuent à la lipémie du repas suivant même lorsque l'intervalle entre les deux repas est relativement long (7h). La vidange intestinale est un élément important de la régulation des flux d'entrée plasmatique des chylomicrons lors de repas successifs.Contribution of dietary fat to postprandial lipemia during sequential meals has not been extensively investigated. In the first study, six healthy subjects ingested 2 mixed meals (lunch and dinner). Lipids ingested at lunch contributed to post-dinner lipemia, despite the relatively long lasting interval between meals (7h). In the second study, nine healthy subjects ingested subsequently a breakfast (7:30 am) and a lunch (12:00 am). Dietary lipids ingested at breakfast were labelled with palmitate and Lipiodol. Palmitate enrichment confirmed the contribution of fat ingested at breakfast to post-lunch lipemia. Lipiodol dynamics, followed in vivo by scintigraphic imaging, showed that fat ingested at breakfast was retained in part within the gut at lunch time and mobilized following lunch ingestion. In conclusion, dietary lipids ingested at a first meal contribute to subsequent postprandial lipemia, despite a 7h interval between meals. Gastric emptying influences the rate of entry of lipids into the circulation during sequential meals.TOURS-BU Médecine (372612103) / SudocSudocFranceF

4.14. Alimentation et cancer

Alimentation et cancer : relations étroites et enjeux différents L’alimentation est un des plus importants facteurs environnementaux modificateurs du risque de cancer et pourrait rendre compte de 25 à 40 % des causes de cancer accessibles à la prévention. La cancérogenèse est un processus à étapes multiples provenant à l’origine d’altérations cellulaires. Celles-ci résultent de l’accumulation d’altérations acquises de gènes qui contrôlent les processus clés de la transformatio..

Altérations du métabolisme des acides gras dans l'hyperthrophie et l'insuffisance cardiaque (conséquences et évaluation)

L hypertrophie et l insuffisance cardiaque (IC) s accompagnent de perturbations du métabolisme énergétique. Des cœurs hypertrophiques de rats SHR ont été perfusés au travail avec divers acides gras (AG), puis soumis à une épreuve de stress adrénergique. Nos résultats suggèrent l existence d un niveau minimum critique d utilisation des AG exogènes à respecter pour maintenir des fonctions cardiaques optimales et soulignent l intérêt potentiel des AG à chaîne moyenne dans les situations d utilisation restreinte des AG à chaîne longue. Les altérations du métabolisme des AG ont été ensuite étudiées par le profil des acylcarnitines sanguins chez des patients atteints d IC. Les résultats démontrent une augmentation globale de la carnitine et ses dérivés circulants chez ces patients et suggèrent de multiples sites de perturbations du métabolisme énergétique. L ensemble de ces résultats souligne l importance de la contribution énergétique des AG pour la fonction cardiaque dans le cœur malade.Left ventricular hypertrophy and heart failure (HF) are associated with cardiac energy metabolism alterations. Hypertrophied SHR hearts have been perfused in a working mode with different fatty acid (FA) concentrations and subjected to an adrenergic stimulation. Results suggest that a critical threshold of exogenous FA contribution should be preserved for optimal cardiac functions and highlight the potential beneficial effect of a medium-chain FA administration in situations of reduced long-chain FA contribution. The consequences of FA metabolism alterations have been studied in HF patients, using blood acylcarnitine profiles. Results demonstrate a global increase in circulating carnitine and its derivatives in HF patients, suggesting multiple perturbation sites of energy metabolism. Collectively, results from these studies highligth the impact of FA contribution to energy production for cardiac functions of the diseased heart.TOURS-BU Médecine (372612103) / SudocPARIS-BIUP (751062107) / SudocSudocFranceF

Mesures de l'activité physique en conditions de vie courante (validité et applications chez des sujets peu actifs)

L inactivité physique, facteur de risque de pathologies chroniques, est un problème majeur de santé publique. Des méthodes validées sont essentielles pour mesurer l activité physique (AP). Le 1er objectif de cette thèse était de préciser la validité des techniques de mesure de l AP. Le 2nd objectif visait à comparer les résultats de questionnaires de rappel évaluant le contexte aux mesures objectives de l AP. Le 3ème objectif était d évaluer l intérêt des méthodes objectives pour l étude de certains déterminants de l AP. Nous avons mesuré par différentes méthodes (calorimétrie indirecte, actimètres, questionnaires de rappel) l AP, en vie libre, de sujets peu actifs (personnes obèses, diabétiques ou sédentaires). Nos résultats illustrent l intérêt des méthodes objectives mais aussi leurs limites, ainsi que l intérêt des données déclaratives pour évaluer le contexte. Le choix des méthodes influence le résultat des études et doit tenir compte des caractéristiques de l AP des sujets les moins actifs. Ce choix participe à l amélioration des connaissances des liens entre AP et santé pour guider la promotion de l AP des segments peu actifs de la population.Physical inactivity is a risk factor for chronic diseases and is recognized as a major public health issue. Validated methods are essential to describe accurately physical activity (PA). The 1st aim of this work was to assess the validity of PA assessment techniques. The 2nd was to compare the results of recall questionnaires evaluating PA context with objective PA measures. The 3rd was to assess the usefulness of objective methods in the assessment of some determinants of PA. We measured free-living PA with different methods (indirect calorimetry, actimetry, recall questionnaire assessing PA context) in individuals with low PA levels (obese subjects, type 2 diabetic patients, inactive subjects). The results highlight the usefulness but also the limits of the methods of PA measurement in daily life conditions. The choice of an assessment method will influence the study results and must be adapted to the unique ways in which the least active individuals engage in PA. Selecting the appropriate method is a pre-requisite for improving our knowledge on the relations between PA and health in order to guide PA promotion in the least active segments of the population.TOURS-Bibl.électronique (372610011) / SudocSudocFranceF