PROGRAMA MULTIPROFISSIONAL DE TRATAMENTO DA OBESIDADE: AMPLIANDO A DISCUSSÃO

Objetivo: Avaliar aspectos positivos e negativos de um programa multiprofissional de tratamento da obesidade (PMTO) sob o ponto de vista dos seus participantes e seus responsáveis. Métodos: Pesquisa exploratória descritiva, realizada com adolescentes obesos participantes do PMTO e seus pais. Após 4 meses de intervenção ambos descreveram os aspectos positivos e negativos da participação no PMTO. As respostas foram categorizadas e apresentadas em gráficos com os valores de freqüência relativa. Resultados: Os resultados demonstraram melhoras no comportamento alimentar, condicionamento físico e aspectos psicológicos. Os aspectos negativos citados relacionam-se à adaptação ao exercício, dificuldades com transporte e choque de horários. Conclusões: Os resultados ressaltam o impacto positivo promovido pelo PTMO nos aspectos físicos, nutricionais e psicológicos de adolescentes obesos, e nos pontos negativos que devem ser reavaliados para aprimorar o programa. O estudo ainda possibilita uma nova perspectiva de avaliação dos resultados de programas de intervenção

The effects of partial sleep restriction and altered sleep timing on appetite and food reward.

We examined the effects of partial sleep restriction (PSR) with an advanced wake-time or delayed bedtime on measures of appetite, food reward and subsequent energy intake (EI). Twelve men and 6 women (age: 23 ± 4 years, body fat: 18.8 ± 10.1%) participated in 3 randomized crossover sessions: control (habitual bed- and wake-time), 50% PSR with an advanced wake-time and 50% PSR with a delayed bedtime. Outcome variables included sleep architecture (polysomnography), ad libitum EI (validated food menu), appetite sensations (visual analogue scales), the satiety quotient (SQ; mm/100 kcal) and food reward (Leeds Food Preference Questionnaire and the relative-reinforcing value (RRV) of preferred food task). Increased fasting and post-standard breakfast appetite ratings were noted following PSR with an advanced wake-time compared to the control and PSR with a delayed bedtime sessions (Fasting hunger ratings: 77 ± 16 vs. 65 ± 18 and 64 ± 16; P = 0.01; Post-meal hunger AUC: 5982 ± 1781 vs. 4508 ± 2136 and 5198 ± 2201; P = 0.03). Increased explicit wanting and liking for high-relative to low-fat foods were also noted during the advanced wake-time vs. control session (Explicit wanting: -3.5 ± 12.5 vs. -9.3 ± 8.9, P = 0.01; Explicit liking: -1.6 ± 8.5 vs. -7.8 ± 9.6, P = 0.002). No differences in the RRV of preferred food, the SQ and ad libitum lunch intake were noted between sessions. These findings suggest that appetite sensations and food reward are increased following PSR with an advanced wake-time, rather than delayed bedtime, vs. CONTROL: However, this did not translate into increased EI during a test meal. Given the increasing prevalence of shift workers and incidences of sleep disorders, additional studies are needed to evaluate the prolonged effects of voluntary sleep restriction with altered sleep timing on appetite and EI measurements

THE RELATIVE REINFORCING VALUE OF SNACK FOOD IS A SIGNIFICANT PREDICTOR OF FAT LOSS IN WOMEN WITH OVERWEIGHT OR OBESITY

Reinforcing Relative Value (RRV) of food and impulsivity are associated with energy intake and obesity. The study investigated the degree to which changes in RRV and impulsivity independently or interactively predict change in body weight and composition in women with overweight or obesity engaged in either a fast or in a slow weight loss programs. Body weight, body composition, Impulsivity (Barratt Impulsiveness Scale), RRV snack (computerized Behavioural Choice Task) were measured at baseline and post-intervention in 30 women with obesity undergoing either slow (n= 14 -500 kcal/day, 20 weeks) or fast n=16 (-1000kcal/day, 10 weeks) weight reduction. No group*time effects were noted on body composition, impulsivity or RRV, so participants from both groups were pooled for analysis. Multiple regression analyses indicated that none of the impulsivity variables predicted weight- or fat mass (FM) loss. However, Δ RRV snack predicted ΔFM (r=0.40, P=0.046), whereby greater increases in RRV snack were associated with less FM loss. Results indicate that different rates of weight loss do not differentially affect RRV snack or impulsivity traits. However, changes in RRV snack predicted FM loss, suggesting that dietary interventions that either mitigate increases or foster reductions in the RRV snack may yield greater reductions in adiposity. Trial Registration clinicaltrials.gov identifier: NCT04866875 NOVELTY POINTS • No differences in RRV of food were noted between fast and slow weight loss • Weight loss from combined fast and slow groups led to a moderate-sized reduction in the total impulsivity • Greater diet-induced increases in RRV snack was associated with less body fat-lossThe accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

<b>Multidisciplinary program for obesity treatment: Summary of results with adolescents</b> - doi 10.4025/actascihealthsci.v34i2.8934

<p class="aTitulodoArtigo">This study aimed to evaluate the effects of a multidisciplinary intervention program on the factors: stage of behavior change (SBC), physical self-description (PSD), blood pressure (BP) and physical fitness in obese adolescents. The study was characterized as quasi-experimental type, with 33 adolescents who were evaluated before and after 16 weeks of intervention. The anthropometric and fitness variables, BP were assessed, and we also applied the Stage of Change instrument and PSDQ (Physical Self-Description Questionnaire), in order to measure the SBC and the PSD, respectively. The statistical analysis involved measures of central tendency and dispersion, and the comparison between the initial and final periods was performed by Student’s t-test. The comparison between the periods before and after-intervention presented significant differences (p < 0.05) for almost all variables, except for the hip circumference, waist to hip ratio and pull-ups in the adapted bar. The program promoted effective changes in the fat consumption, and habitual physical activity and PSD of habitual physical activity, body fat and appearance. The results are quite promising and evidence the needto expand programs like this, in order to lead to the behavioral change. In this way, the physical education professional has a decisive role on this process.</p> <br /><br /

Multidisciplinary program for obesity treatment: Summary of results with adolescents = Programa multiprofissional de tratamento da obesidade: síntese de resultados com adolescentes

This study aimed to evaluate the effects of a multidisciplinary intervention program on the factors: stage of behavior change (SBC), physical self-description (PSD), blood pressure (BP) and physical fitness in obese adolescents. The study was characterized as quasi-experimental type, with 33 adolescents who were evaluated before and after 16 weeks of intervention. The anthropometric and fitness variables, BP were assessed, and we also applied the Stage of Change instrument and PSDQ (Physical Self-Description Questionnaire), in order to measure the SBC and the PSD, respectively. The statistical analysis involved measures of central tendency and dispersion, and the comparison between the initial and final periods was performed by Student’s t-test. The comparison between the periods before and after-intervention presented significant differences (p O objetivo do estudo foi Avaliar os efeitos de um programa de intervenção multiprofissional sobre: estágio de mudança de comportamento (EMC), autodescrição física (ADF), pressão arterial (PA) e aptidão física em adolescentes obesos. O Estudo foi classificado como quase experimental realizado com 33 adolescentes que foram avaliados antes e após 16 semanas de intervenção. Foram avaliadas variáveis antropométricas, de aptidão física, PA e aplicados os instrumentos SOC (Stage of Change) e PSDQ (Physical Self-Description Questionnaire), a fim de mensurar EMC e ADF, respectivamente. A análise estatística envolveu medidas de tendência central e dispersão e a comparação entre os períodos inicial e final foi realizada pelo teste t de Student. A comparação entre os momentos pré e pós-intervenção apresentou diferenças significativas (p < 0,05) para quase todas as variáveis, com exceção da circunferência do quadril, relação cintura quadril e teste de barra adaptada. Com o estudo, foi possível considerar que o programa mostrou interferir no EMC de consumo de gorduras na dieta e atividade física habitual e na ADF de atividade física habitual, gordura corporal e aparência. Os resultados são bastante promissores e apontam para a necessidade de ampliação na abrangência de programas de intervenção com enfoque na mudança do comportamento, tendo o profissional de educação física um papel decisivo nesse processo

PROGRAMA MULTIPROFISSIONAL DE TRATAMENTO DA OBESIDADE: AMPLIANDO A DISCUSSÃO

The aim of this study was to assess positive and negative aspects of a multidisciplinary treatment program of the obesity (MTPO) from the perspective of its participants and their parents. This study is characterized as a descriptive survey, conducted in the city of Maringá-PR, with obese adolescents who participated in the MTPO and their parents. After four months of intervention both describe the positive and negative aspects of the program. The responses was categorized, and presented in figures with the relative frequency values. The results presented improvements related to eating behavior and fitness; there were also significant improvements in psychological aspects. The negative aspects cited are related to the adaptation to exercise, difficulties with transport costs and schedules problems to participate in the program. The results highlight the positive impact promoted by MTPO in the physical, nutritional and psychological aspects of obese adolescents, as well as negative aspects that should be reassessed in order to improve the program. Furthermore, this study opens the possibility of a new perspective for evaluating the results of similar programs

<b> Factors associated with bone mineral density in women who underwent bariatric surgery </b>

http://dx.doi.org/10.4025/actascihealthsci.v36i1.14930 To analyze factors associated with bone mineral density (BMD) of candidates and patients admitted to Bariatric Surgery (BS). This study included 61 women who had done or were waiting for BS. Anthropometric variables, body composition and BMD from the femur, femoral neck, lumbar spine and the whole body were measured. The factors associated with changes in BMD, such as smoking, alcohol ingestion, sedentary lifestyle, BS, nutritional supplementation and age were evaluated. The statistical significance was set at 5%. Age and BS were associated with changes in BMD. Among the individuals who had  BS done, the rates of osteopenia/osteoporosis were greater in the femur (OR 3.34; CI [1.52 - 1.83]) and femoral neck (OR 3.69; CI [1.34 – 2.08]). Subjects older than 50 years also had greater rates of BMD in the lumbar spine (OR 4.12; CI [2.09 – 22.33]), the whole body (OR 4.77; CI [1.34 – 28.14]), femur (OR 16.94; CI [2.16 - 124.32]) and femoral neck (OR 14.95; CI [1.86 - 110.66]). Patients who have had BS and are over 50 years of age showed higher rates of osteopenia/osteoporosis, which demonstrate the necessity of further studies exploring the effects of BS and its impact on bone metabolism