Exercício físico e fatores de risco cardiovasculares em mulheres obesas na pós-menopausa

Introduction: physical exercise has been recommended as a non-pharmacological, therapeutic strategy in the treatment of important cardiovascular risk factors. Objective: to analyze the impact of an exercise program, tailored to the reality of the Family Health Units (FHU), on body composition, cardiovascular risk factors and Framingham score in obese postmenopausal. Methods: 70 women between 50 and 79 years, sedentary, obese and without menstruating for at least twelve months, were randomly assigned to a trained group (TG) (n = 35) and an untrained (GnT) (n = 35). The GT took 20 weeks of a physical exercise program with three weekly sessions, consisting of monitoring activities and heating (10 minutes), 25 minutes of exercise flexibility and strength, 50 minute walk with intensity between 50-65% of VO2max and 5-minute cool-down. The GnT was instructed to maintain their normal activities. Results: TG showed significant reductions in body mass index (30,1+3,7 vs. 29,3+3,7; p=0,0001), waist circumference (93,3+10,3 vs. 89,1+10,4; p=0,0001), percentage of fat (54,2+2,9 vs. 53,2+3,3; p=0,0001), systolic blood pressure (128,0+14,6 vs. 119,2+10,3; p=0,0001), triglycerides (148,4+66,1 vs. 122,8+40,7; p=0,006), VLDL cholesterol (29,7+13,2 vs. 24,5+8,0; p=0,005) and Framingham score (13,08+4,0 vs. 11,77+4,1; p=0,010). In the untrained group were observed significant increases in the percentage of fat (55,0+4,0 vs. 57,0+3,8; p=0,0001), systolic blood pressure (128,6+10,5 vs. 133,7+12,0; p=0,001), fasting glucose (95,2+18,4 vs. 113,7+28,8; p=0,001) and Framingham score (12,82+3,2 vs. 13,91+4,0; p=0,043), but also decreases levels of HDL cholesterol (55,1+10,5 vs. 51,7+11,0; p=0,017). Conclusion: the exercise program, adapted to the conditions of FHU, was effective in reducing cardiovascular risk factors in obese postmenopausal women served by the SUS program.

Investigation of cytokines, oxidative stress, metabolic, and inflammatory biomarkers after orange juice consumption by normal and overweight subjects

Abdominal adiposity has been linked to metabolic abnormalities, including dyslipidemia, oxidative stress, and low-grade inflammation. To test the hypothesis that consumption of 100% orange juice (OJ) would improve metabolic, oxidative, and inflammatory biomarkers and cytokine levels in normal and overweight subjects with increased waist circumference. Subjects were divided into two groups in accordance with their body mass index: normal and overweight. Both groups of individuals consumed 750 mL of OJ daily for 8 weeks. Body composition (weight, height, percentage of fat mass, and waist circumference); metabolic biomarkers (total cholesterol, low-density lipoprotein-cholesterol [LDL-C], high-density lipoprotein-cholesterol [HDL-C], triglycerides, glucose, insulin, HOMA-IR, and glycated hemoglobin); oxidative biomarkers (malondialdehyde and DPPH(•)); inflammatory biomarkers (high-sensitivity C-reactive protein [hsCRP]); cytokines (IL-4, IL-10, IL-12, TNF-α, and IFN-γ); and diet were evaluated before and after consumption of OJ for 8 weeks. The major findings of this study were: 1) no alteration in body composition in either group; 2) improvement of the lipid profile, evidenced by a reduction in total cholesterol and LDL-C; 3) a potential stimulation of the immune response due to increase in IL-12; 4) anti-inflammatory effect as a result of a marked reduction in hsCRP; and 5) antioxidant action by the enhancement of total antioxidant capacity and the reduction of lipid peroxidation, in both normal and overweight subjects. OJ consumption has a positive effect on important biomarkers of health status in normal and overweight subjects, thereby supporting evidence that OJ acts as functional food and could be consumed as part of a healthy diet to prevent metabolic and chronic diseases.

Anthropometric indicators predict metabolic syndrome diagnosis in maintenance hemodialysis patients

Obesity has been considered the key in metabolic syndrome (MetS) development, and fat accumulation may be responsible for the occurrence of metabolic abnormalities in hemodialysis patients. The use of gold-standard methods to evaluate obesity is limited, and anthropometric measures may be the simplest methods. However, no study has investigated the association between anthropometric indexes and MetS in these patients. Therefore, the aim was to determine which anthropometric indexes had the best association and prediction for MetS in patients undergoing hemodialysis. Cross-sectional study that included patients older than 18 years, undergoing hemodialysis for at least 3 months. Patients with liver disease and cancer or those receiving corticosteroids or antiretroviral therapy were excluded. Diagnostic criteria from Harmonizing Metabolic Syndrome were used for the diagnosis of MetS. Anthropometric indexes evaluated were body mass index (BMI); percent standard of triceps skinfold thickness and of middle arm muscle circumference; waist circumference (WC); sagittal abdominal diameter; neck circumference; waist-to-hip, waist-to-thigh, and waist-to-height ratios; sagittal index; conicity index; and body fat percentage. Ninety-eight patients were included, 54.1% male, and mean age was 57.8 ± 12.9 years. The prevalence of MetS was 74.5%. Individuals with MetS had increased accumulation of abdominal fat and general obesity. Waist-to-height ratio was the variable independently associated with MetS diagnosis (odds ratio, 1.21; 95% confidence interval, 1.09-1.34; P < .01) and that better predicts MetS, followed by WC and BMI (area under the curve of 0.840, 0.836, and 0.798, respectively, P < .01). Waist-to-height ratio was the best anthropometric predictor of MetS in maintenance hemodialysis patients.

Avaliação do estado nutricional, ingestão proteica e qualidade de vida de indivúduos cirróticos com encefalopatia hepática

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

O consumo de laticínios está associado à redução de triglicerídios e alterações na composição corporal de mulheres com sobrepeso e obesidade: um estudo de intervenção de 12 semanas

Pós-graduação em Saúde Coletiva - FMB

Avaliação dos marcadores prognósticos de pacientes com DPOC no período de nove anos

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Avaliação e monitoramento da obesidade em adultos residentes do município de Rio Claro - SP

Obesity is characterized by an excess of fat on the body and can results several problems on the individual health. As an epidemic of modern times, the prevalence started to increase at an accelerated rate from the 90's in worldwide. Data on the epidemic in Brazil and medium-sized cities are scarce, and the monitoring of obesity is essential for development public policy. So, the objective was to analyze the individual factors associated with obesity such as age, gender, education, marital status, economic class and level of physical activity and make a monitoring of obesity in adults in the city of Rio Claro - SP. To do this, the survey was conducted longitudinally, consists of two times at an interval of seven years. At first (2008) were interviewed 1588 adults in the city of Rio Claro distributed throughout the city. At the second phase (2014/2015) was conducted a new interview with the same subject in 1588. In 2008, personal information collected and applied some questionnaires with the physical activity level, food intake and quality of life. To assess obesity in adults was calculated the body mass index (BMI) proposed by the World Health Organization (WHO) from the high reported weight and height. For older people it used a specific BMI. The prevalence was used percentages and their respective confidence intervals of 95%. For the incidence, was calculated by the formula of cumulative incidence, both stratified by personal characteristics (gender, economic class, education, marital status and age). Thus it was observed that there was an increase in the prevalence of obesity in 2008 (19.0%), increasing to 26.7% in 2015. The cumulative incidence was 14.4% in the range of 7 years. As for the groups, we observed a significant difference between economic class and obesity being less prevalent among people of class D / E. Regarding marital status, it was observed that married / cohabiting have a higher prevalence. Therefore, we can conclude...

Nutritional and metabolic risk factors for insulin resistance in adults

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Avaliação da composição corporal e consumo de macronutrientes de mulheres atletas do judô

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Correlação entre os resultados pré-operatórios de testes cardiopulmonares e a evolução pós-operatória em cirurgia bariátrica

Pós-graduação em Bases Gerais da Cirurgia - FMB

O impacto do excesso de gordura corporal sobre a remodelação óssea de adolescentes

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Juvenile onset systemic lupus erythematosus: a possible role for vitamin D in disease status and bone health

Purpose: In juvenile onset systemic lupus erythematosus (JoSLE), evidence for the association between vitamin D status, lupus activity, and bone health is very limited and not conclusive. The aim of this study was, therefore, to assess in JoSLE patients the possible relevance of vitamin D deficiency in disease and bone parameters. Methods: Fifty-seven JoSLE patients were initially compared to 37 age, race and body mass index (BMI) -matched healthy controls. The serum concentration of 25 hydroxyvitamin D (25OHD) was determined by radioimmunoassay. Patients with 25OHD deficiency (acurrency sign20 ng/mL) were compared to those with levels > 20 ng/mL. Disease activity was evaluated by SLE Disease Activity Index (SLEDAI). Bone mineral density (BMD) and body composition (BC) were measured using dual-energy X-ray absorptiometry (DXA). Results: 25OHD levels were similar in patients and controls (21.44 +/- 7.91 vs 22.54 +/- 8.25 ng/mL, p = 0.519), regardless of supplementation (65% of patients and none in controls). Thirty-one patients with 25OHD deficiency (acurrency sign20 ng/mL) were further compared to the 26 JoSLE patients with levels > 20 ng/mL. These two groups were well-balanced regarding vitamin D confounding variables: age (p = 0.100), ethnicity (p = 1.000), BMI (p = 0.911), season (p = 0.502), frequency of vitamin D supplementation (p = 0.587), creatinine (p = 0.751), renal involvement (p = 0.597), fat mass (p = 0.764), lean mass (p = 0.549), previous/current use of glucocorticoids(GC) (p = 1.0), immunosuppressors (p = 0.765), and mean current daily dose of GC (p = 0.345). Patients with vitamin D deficiency had higher SLEDAI (3.35 +/- 4.35 vs 1.00 +/- 2.48, p = 0.018), lower C4 levels (12.79 +/- 6.78 vs 18.38 +/- 12.24 mg/dL, p = 0.038), lower spine BMD (0.798 +/- 0.148 vs 0.880 +/- 0.127 g/cm2, p = 0.037) and whole body BMD (0.962 +/- 0.109 vs 1.027 +/- 0.098 g/cm2, p = 0.024). Conclusion: JoSLE vitamin D deficiency, in spite of conventional vitamin D supplementation, affects bone and disease activity status independent of therapy and fat mass reinforcing the recommendation to achieve adequate levels. Lupus (2012) 21, 1335-1342.

Perinatal and early adulthood factors associated with adiposity

We used body mass index (BMI) and waist circumference (WC) as fat indicators to assess whether perinatal and early adulthood factors are associated with adiposity in early adulthood. We hypothesized that risk factors differ between men and women and are also different when WC is used for measuring adiposity as opposed to BMI. We conducted a longitudinal study based on a sample of 2,063 adults from the 1978/1979 Ribeirao Preto birth cohort. Adjustment was performed using four sequential multiple linear regression models stratified by sex. Both perinatal and early adulthood variables influenced adulthood BMI and WC. The associations differed between men and women and depending on the measure of abdominal adiposity (BMI or WC). Living with a partner, for both men and women, and high fat and alcohol intake in men were factors that were consistently associated with higher adulthood BMI and WC levels. The differences observed between sexes may point to different lifestyles of men and women, suggesting that prevention policies should consider gender specific strategies.

Glutamate-induced obesity leads to decreased sperm reserves and acceleration of transit time in the epididymis of adult male rats

Background: Given the established fact that obesity interferes with male reproductive functions, the present study aimed to evaluate sperm production in the testis and storage in the epididymis in a glutamate-induced model of obesity. Methods: Male rats were treated neonatally with monosodium glutamate (MSG) at doses of 4 mg/kg subcutaneously, or with saline solution (control group), on postnatal days 2, 4, 6, 8 and 10. On day 120, obesity was confirmed by the Lee index in all MSG-treated rats. After this, all animals from the two experimental groups were anesthetized and killed to evaluate body and reproductive organ weights, sperm parameters, plasma hormone levels (FSH, LH and testosterone), testicular and epididymal histo-morphometry and histopathology. Results: Significant reductions in absolute and relative weights of testis, epididymis, prostate and seminal vesicle were noted in MSG-treated animals. In these same animals plasma testosterone and follicle-stimulating hormone (FSH) concentrations were decreased, as well as sperm counts in the testis and epididymis and seminiferous epithelium height and tubular diameter. The sperm transit time was accelerated in obese rats. However, the number of Sertoli cells per seminiferous tubule and stereological findings on the epididymis were not markedly changed by obesity. Conclusions: Neonatal MSG-administered model of obesity lowers sperm production and leads to a reduction in sperm storage in the epididymis of adult male rats. The acceleration of sperm transit time can have implications for the sperm quality of these rats.

Effects of circuit-based exercise programs on the body composition of elderly obese women

Aim: The aim of this study was to investigate the impact of circuit-based exercise on the body composition in obese older women by focusing on physical exercise and body weight (BW) gain control in older people. Methods: Seventy older women (>60 years old) voluntarily took part in the study. Participants were randomized into six different groups according to body mass index (BMI): appropriate weight (AW) control (AWC) and trained (AWT) groups, overweight (OW) control (OWC) and trained (OWT) groups, and obesity (O) control (OC) and trained (OT) groups. The exercise program consisted of 50 minutes of exercise three times per week for 12 weeks. The exercises were alternated between upper and lower body using rest between sets for 40 seconds with intensity controlled by heart rate (70% of work). The contraction time established was 5 seconds to eccentric and concentric muscular action phase. The following anthropometric parameters were evaluated: height (m), body weight (BW, kg), body fat (BF, %), fat mass (FM, kg), lean mass (LM, kg), and BMI (kg/m(2)). Results: The values (mean +/- standard deviation [SD]) of relative changes to BW (-8.0% +/- 0.8%), BF (-21.4% +/- 2.1%), LM (3.0% +/- 0.3%), and FM (-31.2% +/- 3.0%) to the OT group were higher (P < .05) than in the AWT (BW: -2.0% +/- 1.1%; BF: -4.6% +/- 1.8%; FM: -7.0% +/- 2.8%; LM: 0.2% +/- 1.1%) and OWT (BW: -4.5% +/- 1.0%; BF: -11.0% +/- 2.2%; FM: -16.1% +/- 3.2%; LM: -0.2% +/- 1.0%) groups; additionally, no differences were found for C groups. While reduction (P < .03) in BMI according to absolute values was observed for all trained groups (AWT: 22 +/- 1 versus 21 +/- 1; OWT: 27 +/- 1 versus 25 +/- 1, OT: 34 +/- 1 versus 30 +/- 1) after training, no differences were found for C groups. Conclusion: In summary, circuit-based exercise is an effective method for promoting reduction in anthropometrics parameters in obese older women.