Auto-relato da frequência de consumo de álcool numa amostra representativa da população adulta portuguesa : associações com a obesidade e o perímetro da cintura

São vários, e ainda mal compreendidos, os factores que contribuem para a obesidade. Em Portugal, há simultaneamente uma elevada prevalência de obesidade e um elevado consumo de bebidas alcoólicas. A associação entre consumo de álcool e obesidade não é clara. Este artigo analisa a associação entre a frequência auto-relatada de consumo de bebidas alcoólicas (vinho, cerveja e bebidas brancas/espirituosas) e a prevalência de pré-obesidade e/ou obesidade na população adulta (entre os 18 e os 64 anos) em Portugal. Trata-se de um estudo observacional e transversal, representativo a nível de Portugal continental. No total, recolheram-se dados relativamente a 8116 portugueses. As frequências de consumo das várias bebidas estão fortemente correlacionadas entre si. Foi encontrada uma associação significativa entre as frequências auto-relatadas de consumo de álcool e o excesso de peso, a obesidade e as medidas do perímetro da cintura. A frequência auto-relatada de consumo para todas as bebidas aumenta com as categorias de índice de massa corporal. As categorias de perímetro da cintura associadas a risco cardiovascular estão associadas a maior frequência auto-relatada de consumo de todas as bebidas alcoólicas em estudo, à excepção das bebidas brancas/espirituosas. Embora a associação entre álcool e obesidade ainda esteja por clarificar, vários estudos revelaram associações positivas entre o consumo de álcool e a obesidade. Esta descoberta é apoiada pelos dados aqui descritos, recolhidos em Portugal continental, que sugerem um efeito sinergético do consumo (auto-relatado) do vinho e da cerveja tanto no IMC como no perímetro da cintura. Os resultados sugerem uma ligação importante entre a frequência autorelatada de consumo de álcool e o peso excessivo e a obesidade abdominal na população adulta portuguesa.

Alterações nas queixas subjetivas de memória e na escala de depressão geriátrica em adultos e idosos em Portugal estão associadas a um suplemento alimentar

A perda de memória é uma das principais queixas entre a população idosa. Reivindicada para melhorar a função cognitiva e de fácil obtenção em farmácias e dietéticas, a suplementação com fosfolípidos produziu resultados mistos em vários estudos. Um grupo de adultos e idosos saudáveis (n = 522) com idade 65,84 ± 10,74 anos, e com um nível de escolaridade de 7,90 ± 4,90 anos participaram do estudo. Os participantes foram submetidos a Avaliação Breve do Estado Mental (ABEM), Escala de Queixas de Memória (EQM) e Escala de Depressão Geriátrica (EDG). Três indivíduos apresentaram disfunção cognitiva, 505 queixas de memória apresentadas e 257 estavam acima do ponto de corte para a EDG. Subsequentemente, um grupo de mulheres (n = 17) utilizaram a suplementação com fosfolípidos durante 4 semanas. Após o período de suplementação, foi observada uma diminuição nos valores médios de EQM e EDG. A suplementação de fosfolípidos, ao longo de 4 semanas reduziu significativamente os valores EQM (p <0,05) neste grupo de mulheres.

Benefícios de uma intervenção com uma dieta do tipo mediterrânico e um programa de exercício físico em variáveis de composição corporal e factores de risco de doença cardiovascular

Introdução: Uma dieta do tipo mediterrânico associada a exercício físico pode ser uma estratégia eficaz na prevenção da obesidade e de co-morbilidades associadas. Objectivo: Este estudo pretendeu determinar a associação entre um programa de intervenção, constituído por uma dieta do tipo mediterrânico e exercício físico, com alterações em variáveis de composição corporal e metabólicas. Método: 12 mulheres e homens sedentários (32,5±8,74 anos, 1,69±0,11 cm), com excesso de peso (81,9±18,1 kg, 28,5±5,45 kg/m2, 36,1±8,56 % massa gorda) participaram num programa de intervenção de 12 semanas. Foi realizada avaliação da composição corporal, do dispêndio energético, da ingestão energética e de níveis séricos de lípidos em jejum. As sessões de nutrição foram realizadas semanalmente e a dieta apresentou uma distribuição de macronutrientes correspondente a 40-45% de hidratos de carbono, 15-20% de proteína e 30-35% de lípidos. As sessões de exercício foram realizadas 3 vezes por semana, com prescrição para as componentes cardiovascular e de força. Resultados: Os participantes tiveram alterações significativas nas variáveis de peso, perímetro da cintura, massa gorda, dispêndio energético e níveis séricos de colesterol e triglicéridos (p<0,05). A distribuição de macronutrientes da dieta não se alterou com a intervenção alimentar, contudo, o aumento significativo do consumo de PUFA’s revelou-se associado a menores valores de massa gorda e a maiores diferenças nos níveis de triglicéridos (p<0,05). Conclusão: O dispêndio calórico e o consumo de PUFA’s revelaram estar associados a melhorias da composição corporal (massa gorda). Este estudo também conduziu à melhoria das concentrações de colesterol e triglicéridos. No entanto, as melhorias nas concentrações de triglicéridos associaram-se apenas à dieta.

“Alterações nas Queixas Subjetivas de Memória e na Escala de Depressão Geriátrica em adultos e idosos em Portugal estão associadas a um suplemento alimentar”: Revisitado

Para avaliar o efeito da suplementação de fosfatidilserina nos resultados obtidos na Escala de Queixas de Memória (EQM) e na Escala de Depressão Geriátrica (EDG), um grupo de adultos e idosos saudáveis (n= 915) com idade 65,65 ± 11,10 anos, e com um nível de scolaridade de 7,56 ± 4,56 anos participaram do estudo. Os participantes foram submetidos a Avaliação Breve do Estado Mental ABEM), Escala de Queixas de Memória (EQM) e Escala de Depressão Geriátrica (EDG). Quatro indivíduos apresentaram disfunção cognitiva, 874 queixas de memória apresentadas e 436 estavam acima do ponto de corte para a EDG. Subsequentemente, um grupo de mulheres (n= 48) utilizaram a suplementação de fosfatidilserina durante 4 semanas. A suplementação de fosfatidilserina, ao longo de 4 semanas reduziu significativamente os valores EQM (p=0,000) e de EDG (p=0,009) neste grupo de mulheres.

The counter-propagating Rossby-wave perspective on baroclinic instability. II: Application to the Charney model

The constant-density Charney model describes the simplest unstable basic state with a planetary-vorticity gradient, which is uniform and positive, and baroclinicity that is manifest as a negative contribution to the potential-vorticity (PV) gradient at the ground and positive vertical wind shear. Together, these ingredients satisfy the necessary conditions for baroclinic instability. In Part I it was shown how baroclinic growth on a general zonal basic state can be viewed as the interaction of pairs of ‘counter-propagating Rossby waves’ (CRWs) that can be constructed from a growing normal mode and its decaying complex conjugate. In this paper the normal-mode solutions for the Charney model are studied from the CRW perspective. Clear parallels can be drawn between the most unstable modes of the Charney model and the Eady model, in which the CRWs can be derived independently of the normal modes. However, the dispersion curves for the two models are very different; the Eady model has a short-wave cut-off, while the Charney model is unstable at short wavelengths. Beyond its maximum growth rate the Charney model has a neutral point at finite wavelength (r=1). Thereafter follows a succession of unstable branches, each with weaker growth than the last, separated by neutral points at integer r—the so-called ‘Green branches’. A separate branch of westward-propagating neutral modes also originates from each neutral point. By approximating the lower CRW as a Rossby edge wave and the upper CRW structure as a single PV peak with a spread proportional to the Rossby scale height, the main features of the ‘Charney branch’ (0

Linear amplification of marginally neutral baroclinic waves

Baroclinic wave development is investigated for unstable parallel shear flows in the limit of vanishing normal-mode growth rate. This development is described in terms of the propagation and interaction mechanisms of two coherent structures, called counter-propagating Rossby waves (CRWs). It is shown that, in this limit of vanishing normal-mode growth rate, arbitrary initial conditions produce sustained linear amplification of the marginally neutral normal mode (mNM). This linear excitation of the mNM is subsequently interpreted in terms of a resonance phenomenon. Moreover, while the mathematical character of the normal-mode problem changes abruptly as the bifurcation point in the dispersion diagram is encountered and crossed, it is shown that from an initial-value viewpoint, this transition is smooth. Consequently, the resonance interpretation remains relevant (albeit for a finite time) for wavenumbers slightly different from the ones defining cut-off points. The results are further applied to a two-layer version of the classic Eady model in which the upper rigid lid has been replaced by a simple stratosphere.

Atmospheric electricity coupling between earthquake regions and the ionosphere

We propose a mechanism to explain suggested links between seismic activity and ionospheric changes detected overhead. Specifically, we explain changes in the natural extremely low-frequency (ELF) radio noise recently observed in the topside ionosphere aboard the DEMETER satellite at night, before major earthquakes. Our mechanism utilises increased electrical conductivity of surface layer air before a major earthquake, which reduces the surface-ionosphere electrical resistance. This increases the vertical fair weather current, and (to maintain continuity of electron flow) lowers the ionosphere. Magnitudes of crucial parameters are estimated and found to be consistent with observations. Natural variability in ionospheric and atmospheric electrical properties is evaluated, and may be overcome using a hybrid detection approach. Suggested experiments to investigate the mechanism involve measuring the cut-off frequency of ELF “tweeks”, the amplitude and phase of very low frequency radio waves in the Earth–ionosphere waveguide, or medium frequency radar, incoherent scatter or rocket studies of the lower ionospheric electron density.

Dipole modes on open periodic structures — an experimental study

An experimental study is made of the lower pass-band of waveguides built as necklaces of oblate spheroids. Short lengths of guide are tested in open resonators. The dominant mode is found to be a glow-wave dipole type having no low-frequency cut off. High Q factors indicate low attenuations. Perturbation measurements demonstrate this energy to be concentrated in the vicinity of the guide.

Categorisation of synoptic environments associated with mesoscale convective systems over the UK

Mesoscale convective systems (MCSs) are relatively rare events in the UK but, when they do occur, can be associated with weather that is considered extreme with respect to climatology (as indicated by the number of such events that have been analysed as case studies). These case studies usually associate UK MCSs with a synoptic environment known as the Spanish plume. Here a previously published 17 year climatology of UK MCS events is extended to the present day (from 1998 to 2008) and these events classified according to the synoptic environment in which they form. Three distinct synoptic environments have been identified, here termed the classical Spanish plume, modified Spanish plume, and European easterly plume. Detailed case studies of the two latter, newly defined, environments are presented. Composites produced for each environment further reveal the differences between them. The classical Spanish plume is associated with an eastward propagating baroclinic cyclone that evolves according to idealised life cycle 1. Conditional instability is released from a warm moist plume of air advected northeastwards from Iberia that is capped by warmer, but very dry air, from the Spanish plateau. The modified Spanish plume is associated with a slowly moving mature frontal system associated with a forward tilting trough (and possibly cut-off low) at 500 hPa that evolves according to idealised life cycle 2. As in the classical Spanish plume, conditional instability is released from a warm plume of air advected northwards from Iberia. The less frequent European easterly plume is associated with an omega block centred over Scandinavia at upper levels. Conditional instability is released from a warm plume of air advected westwards across northern continental Europe. Unlike the Spanish plume environments, the European easterly plume is not a warm sector phenomena associated with a baroclinic cyclone. However, in all environments the organisation of convection is associated with the interaction of an upper-level disturbance with a low-level region of warm advection.

Revisiting youden’s index as a useful measure of the misclassification error in meta-analysis of diagnostic studies

The paper considers meta-analysis of diagnostic studies that use a continuous score for classification of study participants into healthy or diseased groups. Classification is often done on the basis of a threshold or cut-off value, which might vary between studies. Consequently, conventional meta-analysis methodology focusing solely on separate analysis of sensitivity and specificity might be confounded by a potentially unknown variation of the cut-off value. To cope with this phenomena it is suggested to use, instead, an overall estimate of the misclassification error previously suggested and used as Youden’s index and; furthermore, it is argued that this index is less prone to between-study variation of cut-off values. A simple Mantel–Haenszel estimator as a summary measure of the overall misclassification error is suggested, which adjusts for a potential study effect. The measure of the misclassification error based on Youden’s index is advantageous in that it easily allows an extension to a likelihood approach, which is then able to cope with unobserved heterogeneity via a nonparametric mixture model. All methods are illustrated at hand of an example on a diagnostic meta-analysis on duplex doppler ultrasound, with angiography as the standard for stroke prevention.

Revisiting Youden's index as a useful measure of the misclassification error in meta-analysis of diagnostic studies

The paper considers meta-analysis of diagnostic studies that use a continuous Score for classification of study participants into healthy, or diseased groups. Classification is often done on the basis of a threshold or cut-off value, which might vary between Studies. Consequently, conventional meta-analysis methodology focusing solely on separate analysis of sensitivity and specificity might he confounded by a potentially unknown variation of the cut-off Value. To cope with this phenomena it is suggested to use, instead an overall estimate of the misclassification error previously suggested and used as Youden's index and; furthermore, it is argued that this index is less prone to between-study variation of cut-off values. A simple Mantel-Haenszel estimator as a summary measure of the overall misclassification error is suggested, which adjusts for a potential study effect. The measure of the misclassification error based on Youden's index is advantageous in that it easily allows an extension to a likelihood approach, which is then able to cope with unobserved heterogeneity via a nonparametric mixture model. All methods are illustrated at hand of an example on a diagnostic meta-analysis on duplex doppler ultrasound, with angiography as the standard for stroke prevention.

The measurement of maternal plasma corticotropin-releasing factor (CRF) and CRF-binding protein improves the early prediction of preeclampsia

In the present study we measured maternal plasma concentrations of two placental neurohormones, corticotropin-releasing factor (CRF) and CRF-binding protein (CRF-BP), in 58 at-risk pregnant women consecutively enrolled between 28 and 29 wk of pregnancy to evaluate whether their evaluation may predict third trimester-onset preeclampsia ( PE). The statistical significance was assessed by t test. The cut-off points for defining altered CRF and CRF-BP levels for prediction of PE were chosen by receiving operator characteristics curve analysis, and the probability of developing PE was calculated for several combinations of hormone testing results. CRF and CRF-BP levels were significantly ( both P < 0.0001) higher and lower, respectively, in the patients (n = 20) who later developed PE than in those who did not present PE at follow-up. CRF at the cut-off 425.95 pmol/liter achieved a sensitivity of 94.8% and a specificity of 96.9%, whereas CRF-BP at the cut-off 125.8 nmol/liter combined a sensitivity of 92.5% and a specificity of 82.5% as single markers for prediction of PE. The probability of PE was 34.5% in the whole study population, 93.75% when both CRF and CRF-BP levels were changed, and 0% if both hormone markers were unaltered. The measurement of CRF and CRF-BP levels may add significant prognostic information for predicting PE in at-risk pregnant women.

Lack of association between central adiposity and lipaemia in UK Sikh men

OBJECTIVE: To determine whether the positive statistical associations between measures of total and regional adiposity and measures of glucose, insulin and triacylglycerol ( TAG) metabolism reported in Caucasian men, are also observed in UK Sikhs. DESIGN: A matched cross-sectional study in which each volunteer provided a blood sample after a 12-h overnight fast and had anthropometric measurements taken. SUBJECTS: A total of 55 healthy Caucasian and 55 healthy UK Sikh men were recruited. The Caucasian and Sikh men were matched for age ( 48.7 +/- 10.9 and 48.3 +/- 10.0 y, respectively) and body mass index (BMI) ( 26.1 +/- 2.8 and 26.3 +/- 3.2 kg/m(2), respectively). MEASUREMENTS: Anthropometric measurements were performed to assess total and regional fat depots. The concentrations of plasma total cholesterol, high-density cholesterol (HDL- C), low-density cholesterol (LDL-C) and small dense LDL (LDL3), TAG, glucose, fasting insulin (ins) and nonesterified fatty acids (NEFA) were analysed in fasted plasma. Surrogate measures of insulin resistance (HOMA-IR) and insulin sensitivity (RQUICKI) were calculated from insulin and glucose (HOMA-IR) and insulin, glucose and NEFA ( RQUICKI) measurements. RESULTS: The Sikh men had significantly higher body fat, with the sum of the four skinfold measurements (Ssk) ( P = 0.0001) and subscapular skinfold value (P = 0.009) higher compared with the Caucasian men. The Sikh volunteers also had characteristics of the metabolic syndrome: lower HDL-C (P = 0.07), higher TAG (P = 0.004), higher % LDL3 (P = 0.0001) and insulin resistance (P = 0.05). Both ethnic groups demonstrated positive correlations between insulin and waist circumference (Caucasian: r = 0.661, P = 0.0001; Sikh: r = 0.477, P = 0.0001). The Caucasian men also demonstrated significant positive correlations between central adiposity (r = 0.275, P = 0.04), other measures of adiposity (BMI and suprailiac skinfold) and plasma TAG, whereas the Sikh men showed no correlation for central adiposity (r = 0.019, ns) and TAG with a trend to a negative relationship between other measures ( Ssk and suprailiac) which reached near significance for subscapular skinfold and TAG (r = - 0.246, P = 0.007). The expected positive association between insulin and TAG was observed in the Caucasian men (r = 0.318, P = 0.04) but not in the Sikh men (r = 0.011, ns). CONCLUSIONS: In the Caucasian men, the expected positive association between plasma TAG and centralized body fat was observed. However, a lack of association between centralized, or any other measure of adiposity, and plasma TAG was observed in the matched Sikh men, although both ethnic groups showed the positive association between centralized body fat and insulin resistance, which was less strong for Sikhs. These findings in the Sikh men were not consistent with the hypothesis that there is a clear causal relationship between body fat and its distribution, insulin resistance, and lipid abnormalities associated with the metabolic syndrome, in this ethnic group.

Gene-nutrient interactions in the metabolic syndrome: single nucleotide polymorphisms in ADIPOQ and ADIPOR1 interact with plasma saturated fatty acids to modulate insulin resistance

Background: Progression of the metabolic syndrome (MetS) is determined by genetic and environmental factors. Gene-environment interactions may be important in modulating the susceptibility to the development of MetS traits. Objective: Gene-nutrient interactions were examined in MetS subjects to determine interactions between single nucleotide polymorphisms (SNPs) in the adiponectin gene (ADIPOQ) and its receptors (ADIPOR1 and ADIPOR2) and plasma fatty acid composition and their effects on MetS characteristics. Design: Plasma fatty acid composition, insulin sensitivity, plasma adiponectin and lipid concentrations, and ADIPOQ, ADIPOR1, and ADIPOR2 SNP genotypes were determined in a cross-sectional analysis of 451 subjects with the MetS who participated in the LIPGENE (Diet, Genomics, and the Metabolic Syndrome: an Integrated Nutrition, Agro-food, Social, and Economic Analysis) dietary intervention study and were repeated in 1754 subjects from the LIPGENE-SU.VI.MAX (SUpplementation en VItamines et Mineraux AntioXydants) case-control study (http://www.ucd.ie/lipgene). Results: Single SNP effects were detected in the cohort. Triacylglycerols, nonesterified fatty acids, and waist circumference were significantly different between genotypes for 2 SNPs (rs266729 in ADIPOQ and rs10920533 in ADIPOR1). Minor allele homozygotes for both of these SNPs were identified as having degrees of insulin resistance, as measured by the homeostasis model assessment of insulin resistance, that were highly responsive to differences in plasma saturated fatty acids (SFAs). The SFA-dependent association between ADIPOR1 rs10920533 and insulin resistance was replicated in cases with MetS from a separate independent study, which was an association not present in controls. Conclusions: A reduction in plasma SFAs could be expected to lower insulin resistance in MetS subjects who are minor allele carriers of rs266729 in ADIPOQ and rs10920533 in ADIPOR1. Personalized dietary advice to decrease SFA consumption in these individuals may be recommended as a possible therapeutic measure to improve insulin sensitivity. This trial was registered at clinicaltrials.

Detection of neural correlates of self-paced motor activity using empirical mode decomposition phase locking analysis

Transient episodes of synchronisation of neuronal activity in particular frequency ranges are thought to underlie cognition. Empirical mode decomposition phase locking (EMDPL) analysis is a method for determining the frequency and timing of phase synchrony that is adaptive to intrinsic oscillations within data, alleviating the need for arbitrary bandpass filter cut-off selection. It is extended here to address the choice of reference electrode and removal of spurious synchrony resulting from volume conduction. Spline Laplacian transformation and independent component analysis (ICA) are performed as pre-processing steps, and preservation of phase synchrony between synthetic signals. combined using a simple forward model, is demonstrated. The method is contrasted with use of bandpass filtering following the same preprocessing steps, and filter cut-offs are shown to influence synchrony detection markedly. Furthermore, an approach to the assessment of multiple EEG trials using the method is introduced, and the assessment of statistical significance of phase locking episodes is extended to render it adaptive to local phase synchrony levels. EMDPL is validated in the analysis of real EEG data, during finger tapping. The time course of event-related (de)synchronisation (ERD/ERS) is shown to differ from that of longer range phase locking episodes, implying different roles for these different types of synchronisation. It is suggested that the increase in phase locking which occurs just prior to movement, coinciding with a reduction in power (or ERD) may result from selection of the neural assembly relevant to the particular movement. (C) 2009 Elsevier B.V. All rights reserved.