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Moriero M, Verzola D, Bertolotto M, Minetti S, Contini P, Ramoni D, Liberale L, Pontremoli R, Viazzi F, Pende A, Pisciotta L, Montecucco F, Carbone F. Baseline urinary osteopontin levels are associated with the improvement of metabolic syndrome. Nutr Metab Cardiovasc Dis 2024; 34:1874-1878. [PMID: 38664124 DOI: 10.1016/j.numecd.2024.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/19/2024] [Accepted: 03/26/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND AND AIMS While serum osteopontin (OPN)'s established role in cardiometabolic risk is recognized, its potential as a predictor of metabolic syndrome (MetS) improvement through a urine assay has not yet been demonstrated. In this study, we propose its potential predictive role over a 12-month period of standard care, with the ability to complement anthropometric measures. METHODS AND RESULTS Hierarchical clustering revealed a notable association of urinary OPN (uOPN) with MetS criteria and overcame anthropometric measures in predicting the improvement at 12 months (OR of 2.74 [95% CI 1.32 to 6.29]). uOPN significantly contributed to the homogeneity of the nodes in the random forest and ultimately enhanced the performance of anthropometric measures when assessed for accuracy and area under the curve (AUC). CONCLUSION Our findings offer insights into potential applications in cardiometabolic medicine for uOPN, which is easily detectable in non-invasive biological samples through an affordable assay.
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Affiliation(s)
- Margherita Moriero
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Daniela Verzola
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Maria Bertolotto
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Silvia Minetti
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Paola Contini
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Davide Ramoni
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Luca Liberale
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa - Italian Cardiovascular Network, Genoa, Italy
| | - Roberto Pontremoli
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Genoa, Italy
| | - Francesca Viazzi
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Genoa, Italy
| | - Aldo Pende
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Genoa, Italy
| | - Livia Pisciotta
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Genoa, Italy
| | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa - Italian Cardiovascular Network, Genoa, Italy
| | - Federico Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa - Italian Cardiovascular Network, Genoa, Italy.
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Bondyra-Wiśniewska B, Harton A. Effect of a Low-Glycemic Index Nutritional Intervention on Body Weight and Selected Cardiometabolic Parameters in Children and Adolescents with Excess Body Weight and Dyslipidemia. Nutrients 2024; 16:2127. [PMID: 38999875 PMCID: PMC11243242 DOI: 10.3390/nu16132127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 06/29/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024] Open
Abstract
Excess body weight in pediatric patients and the resulting dyslipidemia, if left untreated, are a serious risk factor for cardiovascular disease in young adults. Despite this, there is still no effective and validated nutritional strategy for the treatment of overweight/obesity and comorbid dyslipidemia in children and adolescents. A low-glycemic index (LGI) diet may be recommended, but evidence for its effectiveness in the pediatric population is limited. The aim of this study was to evaluate the effectiveness of nutritional intervention in children and adolescents with excess body weight and dyslipidemia. The study was conducted in patients aged 8-16 with overweight or obesity and lipid disorders (n = 64), of which 40 participants who completed the entire 8-week study were included in the analysis. Patients were randomly selected and allocated to one of the two dietary groups: the LGI diet or the standard therapy (ST) diet. Both diets were based on the principal recommendation of Cardiovascular Health Integrated Lifestyle Diet-2 (CHILD-2). This study showed that both LGI and ST diets were equally beneficial in reducing body weight, body fat, blood pressure, total cholesterol (TC), and triglyceride (TG) levels. The LGI diet, compared to the ST diet, was less effective in reducing blood TG levels but more effective in reducing diastolic blood pressure (DBP). Therefore, the choice of the type of diet in the treatment of children and adolescents with excess body weight and dyslipidemia may be individual. However, it should be based on the recommendation of CHILD-2. Further long-term, larger-scale studies are needed.
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Affiliation(s)
- Beata Bondyra-Wiśniewska
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS), 159C Nowoursynowska St, 02-776 Warsaw, Poland
| | - Anna Harton
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS), 159C Nowoursynowska St, 02-776 Warsaw, Poland
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Aguas-Ayesa M, Gómez-Ambrosi J, Frühbeck G. Comment on: "Pregnancy Outcomes After Bariatric Surgery: Importance of Maternal Ferritin on Birth Weight". Obes Surg 2024; 34:2315-2316. [PMID: 38842762 PMCID: PMC11217087 DOI: 10.1007/s11695-024-07286-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 06/07/2024]
Affiliation(s)
- Maite Aguas-Ayesa
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Avda. Pío XII 36, 31008, Pamplona, Spain
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), ISCIII, 31008, Pamplona, Spain
| | - Javier Gómez-Ambrosi
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), ISCIII, 31008, Pamplona, Spain
- Obesity and Adipobiology Group, IdiSNA, 31008, Pamplona, Spain
- Metabolic Research Laboratory, Clínica Universidad de Navarra, 31008, Pamplona, Spain
| | - Gema Frühbeck
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Avda. Pío XII 36, 31008, Pamplona, Spain.
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), ISCIII, 31008, Pamplona, Spain.
- Obesity and Adipobiology Group, IdiSNA, 31008, Pamplona, Spain.
- Metabolic Research Laboratory, Clínica Universidad de Navarra, 31008, Pamplona, Spain.
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4
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Aguas-Ayesa M, Yárnoz-Esquiroz P, Perdomo CM, Olazarán L, Vegas-Aguilar IM, García-Almeida JM, Gómez-Ambrosi J, Frühbeck G. Revisiting the beyond BMI paradigm in excess weight diagnosis and management: A call to action. Eur J Clin Invest 2024; 54:e14218. [PMID: 38629697 DOI: 10.1111/eci.14218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 06/06/2024]
Abstract
Adolphe Quételet, a 19th-century Belgian sociologist and statistician, pioneered the incorporation of statistics into social sciences. He initiated the development of anthropometry since he was interested in identifying the proportions of the 'ideal man'. He devised a ratio between weight and height, originally termed the Quételet Index, and today widely known and used as the body mass index or BMI. In 1835, he demonstrated that a normal curve accommodates the distribution of human traits articulating his reasoning on human variance around the average. Quételet's long-lasting legacy of the establishment of a simple measure to classify people's weight relative to an ideal for their height endures today with minor variations having dramatically influenced public health agendas. While being very useful, the limitations of the BMI are well known. Thus, revisiting the beyond BMI paradigm is a necessity in the era of precision medicine with morphofunctional assessment representing the way forward via incorporation of body composition and functionality appraisal. While healthcare systems were originally designed to address acute illnesses, today's demands require a radical rethinking together with an original reappraisal of our diagnosis and treatment approaches from a multidimensional perspective. Embracing new methodologies is the way forward to advance the field, gain a closer look at the underlying pathophysiology of excess weight, keep the spotlight on improving diagnostic performance and demonstrate its clinical validity. In order to provide every patient with the most accurate diagnosis together with the most appropriate management, a high degree of standardization and personalization is needed.
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Affiliation(s)
- Maite Aguas-Ayesa
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Pamplona, Spain
| | - Patricia Yárnoz-Esquiroz
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Carolina M Perdomo
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Pamplona, Spain
| | - Laura Olazarán
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Isabel M Vegas-Aguilar
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
- Institute of Biomedical Research in Malaga (IBIMA)-Bionand Platform, Málaga, Spain
| | - José Manuel García-Almeida
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Pamplona, Spain
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
- Institute of Biomedical Research in Malaga (IBIMA)-Bionand Platform, Málaga, Spain
- Department of Endocrinology and Nutrition, Quironsalud Málaga Hospital, Málaga, Spain
- Department of Medicine and Dermatology, Faculty of Medicine, University of Malaga, Málaga, Spain
| | - Javier Gómez-Ambrosi
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
| | - Gema Frühbeck
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
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Capoccia D, Leonetti F, Natali A, Tricò D, Perrini S, Sbraccia P, Guglielmi V. Remission of type 2 diabetes: position statement of the Italian society of diabetes (SID). Acta Diabetol 2024:10.1007/s00592-024-02317-x. [PMID: 38942960 DOI: 10.1007/s00592-024-02317-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 05/31/2024] [Indexed: 06/30/2024]
Abstract
The primary cause of the pandemic scale of type 2 diabetes (T2D) is the excessive and/or abnormal accumulation of adiposity resulting from a chronic positive energy balance. Any form of weight loss dramatically affects the natural history of T2D, favoring prevention, treatment, and even remission in the case of significant weight loss. However, weight regain, which is often accompanied by the recurrence or worsening of obesity complications such as T2D, is an inevitable biological phenomenon that is an integral part of the pathophysiology of obesity. This can occur not only after weight loss, but also during obesity treatment if it is not effective enough to counteract the physiological responses aimed at restoring adiposity to its pre-weight-loss equilibrium state. Over the past few years, many controlled and randomized studies have suggested a superior efficacy of bariatric surgery compared to conventional therapy in terms of weight loss, glycemic control, and rates of T2D remission. Recently, the therapeutic armamentarium in the field of diabetology has been enriched with new antihyperglycemic drugs with considerable efficacy in reducing body weight, which could play a pathogenetic role in the remission of T2D, not through the classical incretin effect, but by improving adipose tissue functions. All these concepts are discussed in this position statement, which aims to deepen the pathogenetic links between obesity and T2D, shift the paradigm from a "simple" interaction between insulin resistance and insulin deficiency, and evaluate the efficacy of different therapeutic interventions to improve T2D management and induce diabetes remission whenever still possible.
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Affiliation(s)
- Danila Capoccia
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Frida Leonetti
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.
| | - Andrea Natali
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Domenico Tricò
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sebastio Perrini
- Department of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Paolo Sbraccia
- Department of Systems Medicine, Unit of Internal Medicine - Obesity Center, Policlinico Tor Vergata, University of Rome Tor Vergata, Rome, Italy
| | - Valeria Guglielmi
- Department of Systems Medicine, Unit of Internal Medicine - Obesity Center, Policlinico Tor Vergata, University of Rome Tor Vergata, Rome, Italy
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6
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Gómez-Ambrosi J, Catalán V, Ramírez B, Salmón-Gómez L, Marugán-Pinos R, Rodríguez A, Becerril S, Aguas-Ayesa M, Yárnoz-Esquíroz P, Olazarán L, Perdomo CM, Silva C, Escalada J, Frühbeck G. Cardiometabolic risk stratification using a novel obesity phenotyping system based on body adiposity and waist circumference. Eur J Intern Med 2024; 124:54-60. [PMID: 38453570 DOI: 10.1016/j.ejim.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 02/15/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND The estimation of obesity-associated cardiometabolic risk does not usually take into account body composition or the distribution of adiposity. The aim of the present study was to assess the clinical usefulness of a novel obesity phenotyping system based on the combination of actual body fat percentage (BF%) and waist circumference (WC) according to the cardiometabolic risk estimation. METHODS A classification matrix combining BF% and WC as measures of both amount and distribution of adiposity establishing nine body phenotypes (3 BF% x 3 WC) was developed. Individuals were grouped in five different cardiometabolic risk phenotypes. We conducted a validation study in a large cohort of White subjects from both genders representing a wide range of ages and adiposity (n = 12,754; 65 % females, aged 18-88 years). RESULTS The five risk groups using the matrix combination of BF% and WC exhibited a robust linear distribution regarding cardiometabolic risk, estimated by the Metabolic Syndrome Severity Score, showing a continuous increase between groups with significant differences (P < 0.001) among them, as well as in other cardiometabolic risk factors. An additional 24 % of patients at very high risk was detected with the new classification system proposed (P < 0.001) as compared to an equivalent matrix using BMI and WC instead of BF% and WC. CONCLUSIONS A more detailed phenotyping should be a priority in the diagnosis and management of patients with obesity. Our classification system allows to gradually estimate the cardiometabolic risk according to BF% and WC, thus representing a novel and useful tool for both research and clinical practice.
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Affiliation(s)
- Javier Gómez-Ambrosi
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain.
| | - Victoria Catalán
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain
| | - Beatriz Ramírez
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain
| | - Laura Salmón-Gómez
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain
| | - Rocío Marugán-Pinos
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
| | - Amaia Rodríguez
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain
| | - Sara Becerril
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain
| | - Maite Aguas-Ayesa
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Patricia Yárnoz-Esquíroz
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain; Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Laura Olazarán
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain; Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Carolina M Perdomo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Camilo Silva
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain; Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Javier Escalada
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain; Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Gema Frühbeck
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain; Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
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Pucci M, Gammaldi V, Capece LM, Paoletta D, Iervolino A, Pontoriero M, Iacono M, Megaro P, Esposito R. Association between Obesity and Atrial Function in Patients with Non-Valvular Atrial Fibrillation: An Echocardiographic Study. J Clin Med 2024; 13:2895. [PMID: 38792436 PMCID: PMC11121835 DOI: 10.3390/jcm13102895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/19/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Obesity is a public health problem which prevalence has increased worldwide and is associated with different degrees of hemodynamic alterations and structural cardiac changes. The aim of the study is to investigate the impact of body mass index (BMI) on left atrial function using standard and advanced echocardiography in a population of patients with non-valvular atrial fibrillation (AF). Methods: 395 adult patients suffering from non-valvular AF, divided into three tertiles based on BMI value, carry out a cardiological examination with standard and advanced echocardiography. Results: Peak atrial longitudinal strain (PALS), a measure of left atrial function, is lower in the tertile with highest BMI (14.3 ± 8.2%) compared to both the first (19 ± 11.5%) and the second tertile (17.7 ± 10.6%) in a statistically significant manner (p < 0.002). Furthermore, BMI is significantly associated independent with the PALS by multilinear regression analysis, even after correction of the data for CHA2DS2-VASc score, left ventricular mass index, left ventricular ejection fraction, E/E' ratio and systolic pulmonary arterial pressure (coefficient standardized β = -0.127, p < 0.02; Cumulative R2 = 0.41, SEE = 0.8%, p < 0.0001). Conclusions: BMI could be considered an additional factor in assessing cardiovascular risk in patients with non-valvular atrial fibrillation, in addition to the well-known CHA2DS2-VASc score.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Roberta Esposito
- Department of Clinical Medicine and Surgery, Federico II University Hospital, 80131 Naples, Italy; (M.P.); (L.M.C.); (D.P.)
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Bennett R, Driessen C, Zorbas C, Sacks G, Gupta A, Cameron A, Gomez-Donoso C, Peeters A, Backholer K. ' Healthier options tend to get lost in the noise of online' - Australian shoppers' experiences with online grocery platforms. Public Health Nutr 2024; 27:e134. [PMID: 38742445 PMCID: PMC11148825 DOI: 10.1017/s1368980024001046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/30/2024] [Accepted: 04/24/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE We aimed to understand what influences parents' purchasing behaviours when shopping for groceries online and potential ways to improve the healthiness of online grocery platforms. DESIGN We conducted semi-structured interviews, guided by the Marketing Mix framework. Reflexive thematic analysis was used to analyse data. SETTING Online interviews were conducted with primary grocery shoppers. PARTICIPANTS Parents (n 14) or caregivers (n 2) using online grocery platforms at least every 2 weeks. RESULTS Most participants perceived purchasing healthy food when shopping for groceries online to be more challenging compared to in physical stores. They expressed concerns about the prominence of online marketing for unhealthy food. Participants from lower socio-economic backgrounds often depended on online supermarket catalogues to find price promotions, but healthy options at discounted prices were limited. Across socio-economic groups, fresh items like meat and fruit were preferred to be purchased instore due to concerns about online food quality.Participants believed online grocery platforms should make healthy foods more affordable and supported regulations on supermarket retailers to promote healthy options and limit unhealthy food promotion online. CONCLUSIONS Participants had varied experiences with online grocery shopping, with both positive and negative aspects. Efforts to improve population diets need to include mechanisms to create health-enabling online grocery retail platforms. Government interventions to restrict marketing of unhealthy foods and promote marketing of healthy options on these platforms warrant investigation.
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Affiliation(s)
- Rebecca Bennett
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Christine Driessen
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Christina Zorbas
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Adyya Gupta
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | | | - Clara Gomez-Donoso
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Anna Peeters
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
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Fiorotti AM, Gomes ACA, Bortoli AM, de Brito BB, Nunes KZ, Haraguchi FK, Bolsoni-Lopes A. Dynamic Changes in Adiponectin and Resistin Drive Remission of Cardiometabolic Risk Biomarkers in Individuals with Obesity Following Bariatric Surgery. Pharmaceuticals (Basel) 2024; 17:215. [PMID: 38399430 PMCID: PMC10893494 DOI: 10.3390/ph17020215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
The remission of obesity-related diseases following bariatric surgery appears to result from the reorganization of metabolic and hormonal pathways involving adipokines. This study aimed to investigate the relationship between changes in body adiposity and serum adipokine levels, as well as the association between variations in adiponectin or resistin levels and cardiometabolic risk blood biomarkers before and after Roux-en-Y gastric bypass. A longitudinal and prospective study was conducted with bariatric surgery patients. Anthropometric, body composition and blood biochemical parameters were measured before and at 2 and 6 months post-surgery. The data were analyzed using ANOVA, Pearson or Spearman correlation, and simple linear regression with a significance level of p < 0.05. Among 36 mostly female patients aged 30 to 39 years, significant reductions in body weight (-26.8%), fat mass (-50%), waist circumference (-18%) and waist-to-height ratio (-22%) were observed post-surgery. Serum adiponectin levels increased (+107%), while resistin (-12.2%), TNF-α (-35%), and PAI-1 (-11.1%) decreased. Glucose, insulin, CRP, cholesterol, LDL-c, triglycerides, and vitamin D also decreased. Waist circumference variation showed a positive correlation with PAI-1 and TNF-α and a negative correlation with adiponectin. The total fat mass showed a positive correlation with PAI-1. Adiponectin variation correlated negatively with glucose, resistin, and CRP but positively with HDL-c. Resistin showed a positive correlation with insulin and CRP. In conclusion, 6 months post-bariatric surgery, reducing abdominal adiposity had a more significant impact on serum adipokine levels than total fat mass. Adiponectin increase and resistin decrease acted as endocrine mediators driving the remission of cardiometabolic risk biomarkers in individuals with obesity following Roux-en-Y gastric bypass.
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Affiliation(s)
| | | | | | | | | | | | - Andressa Bolsoni-Lopes
- Postgraduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espirito Santo, Vitoria 29047-105, Brazil (A.C.A.G.); (A.M.B.); (B.B.d.B.); (K.Z.N.); (F.K.H.)
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10
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Foscolou A, Androutsos O, Kosti RI. Addressing a Growing Crisis: Exploring Novel Insights and Solutions in Research on Nutrition and Childhood and Adolescent Obesity. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1883. [PMID: 38136085 PMCID: PMC10741571 DOI: 10.3390/children10121883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023]
Abstract
Given the escalating global prevalence of non-communicable diseases (NCDs), it is consequently crucial to address childhood obesity by promoting lifestyle adjustments, as exemplified in the World Health Organization's Package of Essential Non-Communicable Disease Interventions for Primary Healthcare [...].
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Affiliation(s)
- Alexandra Foscolou
- Laboratory of Clinical Nutrition and Dietetics (CND-Lab), Department of Nutrition & Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece (O.A.)
- Institute of Preventive Medicine Environmental and Occupational Health Prolepsis, 15125 Athens, Greece
| | - Odysseas Androutsos
- Laboratory of Clinical Nutrition and Dietetics (CND-Lab), Department of Nutrition & Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece (O.A.)
| | - Rena I. Kosti
- Laboratory of Clinical Nutrition and Dietetics (CND-Lab), Department of Nutrition & Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece (O.A.)
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11
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Di Ciaula A, Bonfrate L, Khalil M, Garruti G, Portincasa P. Contribution of the microbiome for better phenotyping of people living with obesity. Rev Endocr Metab Disord 2023; 24:839-870. [PMID: 37119391 PMCID: PMC10148591 DOI: 10.1007/s11154-023-09798-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/10/2023] [Indexed: 05/01/2023]
Abstract
Obesity has reached epidemic proportion worldwide and in all ages. Available evidence points to a multifactorial pathogenesis involving gene predisposition and environmental factors. Gut microbiota plays a critical role as a major interface between external factors, i.e., diet, lifestyle, toxic chemicals, and internal mechanisms regulating energy and metabolic homeostasis, fat production and storage. A shift in microbiota composition is linked with overweight and obesity, with pathogenic mechanisms involving bacterial products and metabolites (mainly endocannabinoid-related mediators, short-chain fatty acids, bile acids, catabolites of tryptophan, lipopolysaccharides) and subsequent alterations in gut barrier, altered metabolic homeostasis, insulin resistance and chronic, low-grade inflammation. Although animal studies point to the links between an "obesogenic" microbiota and the development of different obesity phenotypes, the translational value of these results in humans is still limited by the heterogeneity among studies, the high variation of gut microbiota over time and the lack of robust longitudinal studies adequately considering inter-individual confounders. Nevertheless, available evidence underscores the existence of several genera predisposing to obesity or, conversely, to lean and metabolically health phenotype (e.g., Akkermansia muciniphila, species from genera Faecalibacterium, Alistipes, Roseburia). Further longitudinal studies using metagenomics, transcriptomics, proteomics, and metabolomics with exact characterization of confounders are needed in this field. Results must confirm that distinct genera and specific microbial-derived metabolites represent effective and precision interventions against overweight and obesity in the long-term.
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Affiliation(s)
- Agostino Di Ciaula
- Clinica Medica “A. Murri”, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari Medical School, 70124 Bari, Italy
| | - Leonilde Bonfrate
- Clinica Medica “A. Murri”, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari Medical School, 70124 Bari, Italy
| | - Mohamad Khalil
- Clinica Medica “A. Murri”, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari Medical School, 70124 Bari, Italy
| | - Gabriella Garruti
- Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari Medical School, 70124 Bari, Italy
| | - Piero Portincasa
- Clinica Medica “A. Murri”, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari Medical School, 70124 Bari, Italy
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12
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Abstract
In this thematic issue on phenotyping the obesities, prominent international experts offer an insightful and comprehensive collection of articles covering the current knowledge in the field. In order to actually capture all the polyhedral determinants of the diverse types of obesity, the granularity of the phenotypic information acquired must be expanded in the context of a personalized approach. Whilst the use of precision medicine has been successfully implemented in areas like cancer and other diseases, health care providers are more reluctant to embrace detailed phenotyping to guide diagnosis, treatment and prevention in obesity. Given its multiple complex layers, phenotyping necessarily needs to go beyond the multi-omics approach and incorporate all the diverse spheres that conform the reality of people living with obesity. Potential barriers, difficulties, roadblocks and opportunities together with their interaction in a syndemic context are analyzed. Plausible lacunae are also highlighted in addition to pointing to the need of redefining new conceptual frameworks. Therefore, this extraordinary collection of state-ofthe-art reviews provides useful information to both experienced clinicians and trainees as well as academics to steer clinical practice and research in the management of people living with obesity irrespective of practice setting or career stage.
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Affiliation(s)
- Piero Portincasa
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), Clinica Medica "A. Murri", University of Bari Medical School, 70124, Bari, Italy
| | - Gema Frühbeck
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, 31008, Pamplona, Spain.
- Metabolic Research Laboratory, Clínica Universidad de Navarra, 31008, Pamplona, Spain.
- Centro de Investigación Biomédica en Red Fisiopatología de La Obesidad Y Nutrición (CIBEROBN), 31008, Pamplona, Spain.
- Navarra Institute for Health Research, IdiSNA, 31008, Pamplona, Spain.
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13
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Gülü M, Yagin FH, Yapici H, Irandoust K, Dogan AA, Taheri M, Szura E, Barasinska M, Gabrys T. Is early or late biological maturation trigger obesity? A machine learning modeling research in Turkey boys and girls. Front Nutr 2023; 10:1139179. [PMID: 36866053 PMCID: PMC9971504 DOI: 10.3389/fnut.2023.1139179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 01/26/2023] [Indexed: 02/16/2023] Open
Abstract
Biological maturation status can affect individual differences, sex, height, body fat, and body weight in adolescents and thus may be associated with obesity. The primary aim of this study was to examine the relationship between biological maturation and obesity. Overall, 1,328 adolescents (792 boys and 536 girls) aged 12.00 ± 0.94-12.21 ± 0.99 years, respectively (measured for body mass, body stature, sitting stature). Body weights were deter-mined with Tanita body analysis system and adolescent obesity status was calculated according to the WHO classification. Biological maturation was determined according to the somatic maturation method. Our results showed that boys mature 3.077-fold later than girls. Obesity was an increasing effect on early maturation. It was determined that being obese, overweight and healthy-weight increased the risk of early maturation 9.80, 6.99 and 1.81-fold, respectively. The equation of the model predicting maturation is: Logit (P) = 1/(1 + exp. (- (-31.386 + sex-boy * (1.124) + [chronological age = 10] * (-7.031) + [chronological age = 11] * (-4.338) + [chronological age = 12] * (-1.677) + age * (-2.075) + weight * 0.093 + height * (-0.141) + obesity * (-2.282) + overweight * (-1.944) + healthy weight * (-0.592)))). Logistic regression model predicted maturity with 80.7% [95% CI: 77.2-84.1%] accuracy. In addition, the model had a high sensitivity value (81.7% [76.2-86.6%]), which indicates that the model can successfully distinguish adolescents with early maturation. In conclusion, sex and obesity are independent predictors of maturity, and the risk of early maturation is increased, especially in the case of obesity and in girls.
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Affiliation(s)
- Mehmet Gülü
- Department of Coaching Education, Faculty of Sport Sciences, Kirikkale University, Kirikkale, Türkiye,*Correspondence: Mehmet Gülü, ✉
| | - Fatma Hilal Yagin
- Department of Biostatistics, and Medical Informatics, Faculty of Medicine, Inonu University, Malatya, Türkiye,Fatma Hilal Yagin, ✉
| | - Hakan Yapici
- Department of Coaching Education, Faculty of Sport Sciences, Kirikkale University, Kirikkale, Türkiye
| | - Khadijeh Irandoust
- Department of Sport Sciences, Imam Khomeini International University, Qazvin, Iran
| | - Ali Ahmet Dogan
- Department of Coaching Education, Faculty of Sport Sciences, Kirikkale University, Kirikkale, Türkiye
| | - Morteza Taheri
- Department of Sport Sciences, Imam Khomeini International University, Qazvin, Iran,Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Ewa Szura
- Department Health Sciences and Sport Sciences, University of Applied Sciences, Nysa, Poland
| | | | - Tomasz Gabrys
- Department of Physical Education and Sport, Faculty of Education, University of West Bohemia, Pilsen, Czechia
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14
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Boutelle KN, Rhee KE, Manzano MA, Bernard RS, Strong DR, Eichen DM, Anderson CCA, Marcus BH, Akshoomoff N, Crow SJ. Design of the FRESH-DOSE study: A randomized controlled noninferiority trial evaluating a guided self-help family-based treatment program for children with overweight or obesity. Contemp Clin Trials 2023; 124:106996. [PMID: 36343880 PMCID: PMC9968239 DOI: 10.1016/j.cct.2022.106996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022]
Abstract
Overweight and obesity affect 45% of children and increases the risk for several negative health sequelae. Family-Based Behavioral Treatment (FBT) is the most efficacious treatment for child weight management and consists of nutrition and physical activity education, behavior change skills and parenting skills training. FBT is time and staff intensive and can include 20, 60-min separate groups for parents and children, as well as 20-min behavior coaching sessions to help problem solve barriers to implementing the skills learned and individualize the program. Guided self-help (GSH) therapies involve providing families a manual to review independently and brief coaching sessions by an interventionist to facilitate adherence. We developed a GSH version of FBT (gshFBT) which provides a manual to both parents and children and includes 14, 20-min coaching sessions over 6-months. The current study randomized 150 children (mean age = 10.1 years (SD = 1.38); mean BMI% = 97.3% (SD = 2.84); mean BMIz = 2.09 (SD = 0.40); 49% female; 43% Hispanic) and one of their parents (mean age = 41.8 years (SD = 6.52); mean BMI = 32.0 (SD = 7.24); 87.3% female; 43% Hispanic) to either a group-based FBT program or a gshFBT program. Assessments are conducted at baseline, post-treatment (6 months), 6-month follow-up (12 months) and 12-month follow-up (18 months). Primary outcomes are child weight change (BMIz) and cost effectiveness. Recruitment occurred between May 2017 and October 2021 and follow-up assessments are underway. Given the public health concern for children with obesity and the low level of access to FBT, gshFBT could prove extremely useful to provide intervention to a greater proportion of the population.
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Affiliation(s)
- Kerri N Boutelle
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Kyung E Rhee
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Michael A Manzano
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court Suite 102, San Diego, CA 92120, USA
| | - Rebecca S Bernard
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - David R Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Dawn M Eichen
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Cheryl C A Anderson
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Bess H Marcus
- Department of Behavioral and Social Sciences, Brown University, School of Public Health, 121 South Main Street, box G-S121-3, Providence, RI 02912-G, USA
| | - Natacha Akshoomoff
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Scott J Crow
- Department of Psychiatry, University of Minnesota, F282/2A West 2450 Riverside Ave, Minneapolis, MN 55454, USA
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15
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Berman YE, Doherty DA, Mori TA, Beilin LJ, Ayonrinde OT, Adams LA, Huang RC, Olynyk JK, Keelan JA, Newnham JP, Hart RJ. Associations between Prenatal Exposure to Phthalates and Features of the Metabolic Syndrome in Males from Childhood into Adulthood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15244. [PMID: 36429961 PMCID: PMC9690816 DOI: 10.3390/ijerph192215244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/05/2022] [Accepted: 11/09/2022] [Indexed: 06/16/2023]
Abstract
Phthalate metabolites are detectable within the majority of the population. Evidence suggests that a prenatal exposure to phthalates may be associated with the subsequent risks of obesity and elevated blood pressure. We hypothesised that a prenatal exposure to phthalates would lead to an increase in adverse cardiometabolic parameters through childhood and adulthood. The maternal serum phthalate measurements from the stored samples taken from Gen1 mothers at 18 and 34 weeks gestation were examined in relation to the cardiometabolic measures in 387 male offspring from the Raine Study. Data from the Gen2 follow-ups between 3 and 27 years were used. The primary outcomes were analysed longitudinally using linear mixed models for the repeated measures. Non-alcoholic fatty liver disease (NAFLD) was assessed at 17 years using logistic regression. A consistent positive relationship was observed between a prenatal exposure to mono-carboxy-iso-octyl phthalate (MCiOP) through adolescence into adulthood with systolic blood pressure. There were no other consistent cardiovascular associations. Mid-levels of prenatal exposures to Mono-n-butyl phthalate (MnBP) were associated with a greater incidence of NAFLD. Detectable Mono-3-carboxypropyl phthalate (MCPP) was associated with a lower serum HDL-C through late childhood into adulthood, while a higher prenatal exposure to mono-iso-butyl phthalate (MiBP), was associated with a higher LDL-C at 22 years of age. A mid-level prenatal exposure to mono-2-ethylhexyl phthalate (MEHP) metabolites was associated with higher insulin in adulthood, while a higher prenatal exposure to the sum of the Di-(2-ethyl-hexyl) phthalate (DEHP) and Di-iso-nonyl phthalate (DiNP) metabolites was associated with higher fasting serum glucose in adulthood. In conclusion, our study demonstrated that higher prenatal phthalate exposures to some phthalate metabolites was associated with some adverse metabolic profiles through adolescence into adulthood, although the consistent themes were limited to a few metabolites and the outcomes of systolic blood pressure, fasting insulin and glucose.
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Affiliation(s)
- Ye’elah E. Berman
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth, WA 6008, Australia
| | - Dorota A. Doherty
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth, WA 6008, Australia
| | - Trevor A. Mori
- Medical School, University of Western Australia, Crawley, WA 6009, Australia
| | - Lawrence J. Beilin
- Medical School, University of Western Australia, Crawley, WA 6009, Australia
| | - Oyekoya T. Ayonrinde
- Medical School, University of Western Australia, Crawley, WA 6009, Australia
- Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
| | - Leon A. Adams
- Medical School, University of Western Australia, Crawley, WA 6009, Australia
- Department of Hepatology, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
| | - Rae-Chi Huang
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
- Telethon Kids Institute, University of Western Australia, Nedlands, WA 6009, Australia
| | - John K. Olynyk
- Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Jeffrey A. Keelan
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth, WA 6008, Australia
| | - John P. Newnham
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth, WA 6008, Australia
| | - Roger J. Hart
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth, WA 6008, Australia
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16
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Gender differences in the association between adverse events in childhood or adolescence and the risk of premature mortality. Sci Rep 2022; 12:19118. [PMID: 36352182 PMCID: PMC9646814 DOI: 10.1038/s41598-022-23443-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022] Open
Abstract
To examine, by gender, the relationship between adverse events in childhood or adolescence and the increased risk of early mortality (before 80 years). The study sample included 941 participants of the English Longitudinal Study of Aging who died between 2007 and 2018. Data on socioeconomic status, infectious diseases, and parental stress in childhood or adolescence were collected at baseline (2006). Logistic regression models were adjusted by socioeconomic, behavioral and clinical variables. Having lived with only one parent (OR 3.79; p = 0.01), overprotection from the father (OR 1.12; p = 0.04) and having had an infectious disease in childhood or adolescence (OR 2.05; p = 0.01) were risk factors for mortality before the age of 80 in men. In women, overprotection from the father (OR 1.22; p < 0.01) was the only risk factor for mortality before the age of 80, whereas a low occupation of the head of the family (OR 0.58; p = 0.04) and greater care from the mother in childhood or adolescence (OR 0.86; p = 0.03) were protective factors. Independently of one's current characteristics, having worse socioeconomic status and health in childhood or adolescence increased the risk of early mortality in men. Parental overprotection increased the risk of early mortality in both sexes, whereas maternal care favored longevity in women.
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Khalil M, Shanmugam H, Abdallah H, John Britto JS, Galerati I, Gómez-Ambrosi J, Frühbeck G, Portincasa P. The Potential of the Mediterranean Diet to Improve Mitochondrial Function in Experimental Models of Obesity and Metabolic Syndrome. Nutrients 2022; 14:nu14153112. [PMID: 35956289 PMCID: PMC9370259 DOI: 10.3390/nu14153112] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 01/27/2023] Open
Abstract
The abnormal expansion of body fat paves the way for several metabolic abnormalities including overweight, obesity, and diabetes, which ultimately cluster under the umbrella of metabolic syndrome (MetS). Patients with MetS are at an increased risk of cardiovascular disease, morbidity, and mortality. The coexistence of distinct metabolic abnormalities is associated with the release of pro-inflammatory adipocytokines, as components of low-to-medium grade systemic inflammation and increased oxidative stress. Adopting healthy lifestyles, by using appropriate dietary regimens, contributes to the prevention and treatment of MetS. Metabolic abnormalities can influence the function and energetic capacity of mitochondria, as observed in many obesity-related cardio-metabolic disorders. There are preclinical studies both in cellular and animal models, as well as clinical studies, dealing with distinct nutrients of the Mediterranean diet (MD) and dysfunctional mitochondria in obesity and MetS. The term “Mitochondria nutrients” has been adopted in recent years, and it depicts the adequate nutrients to keep proper mitochondrial function. Different experimental models show that components of the MD, including polyphenols, plant-derived compounds, and polyunsaturated fatty acids, can improve mitochondrial metabolism, biogenesis, and antioxidant capacity. Such effects are valuable to counteract the mitochondrial dysfunction associated with obesity-related abnormalities and can represent the beneficial feature of polyphenols-enriched olive oil, vegetables, nuts, fish, and plant-based foods, as the main components of the MD. Thus, developing mitochondria-targeting nutrients and natural agents for MetS treatment and/or prevention is a logical strategy to decrease the burden of disease and medications at a later stage. In this comprehensive review, we discuss the effects of the MD and its bioactive components on improving mitochondrial structure and activity.
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Affiliation(s)
- Mohamad Khalil
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.K.); (H.S.); (H.A.); (J.S.J.B.); (I.G.)
- Department of Soil, Plant and Food Sciences, University of Bari Aldo Moro, Via Amendola 165/a, 70126 Bari, Italy
| | - Harshitha Shanmugam
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.K.); (H.S.); (H.A.); (J.S.J.B.); (I.G.)
| | - Hala Abdallah
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.K.); (H.S.); (H.A.); (J.S.J.B.); (I.G.)
| | - Jerlin Stephy John Britto
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.K.); (H.S.); (H.A.); (J.S.J.B.); (I.G.)
| | - Ilaria Galerati
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.K.); (H.S.); (H.A.); (J.S.J.B.); (I.G.)
| | - Javier Gómez-Ambrosi
- Metabolic Research Laboratory, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (J.G.-A.); (G.F.)
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, 28029 Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Gema Frühbeck
- Metabolic Research Laboratory, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (J.G.-A.); (G.F.)
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, 28029 Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Piero Portincasa
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.K.); (H.S.); (H.A.); (J.S.J.B.); (I.G.)
- Correspondence: ; Tel.: +39-328-4687215
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18
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The Cardiovascular Disease (CVD) Risk Continuum from Prenatal Life to Adulthood: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148282. [PMID: 35886134 PMCID: PMC9317926 DOI: 10.3390/ijerph19148282] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 02/06/2023]
Abstract
The risk of developing cardiovascular diseases (CVDs) arises from the interaction of prenatal factors; epigenetic regulation; neonatal factors; and factors that affect childhood and adolescence, such as early adiposity rebound (AR) and social and environmental influences. Thus, CVD risk varies between the group of low-risk metabolically healthy normal-weight subjects (MHNW); the intermediate-risk group, which includes metabolically healthy obese (MHO) and metabolically unhealthy normal-weight subjects (MUHNW); and the high-risk group of metabolically unhealthy obese (MUHO) subjects. In this continuum, several risk factors come into play and contribute to endothelial damage, vascular and myocardial remodeling, and atherosclerotic processes. These pathologies can occur both in prenatal life and in early childhood and contribute to significantly increasing CVD risk in young adults over time. Early intervention in the pediatric MUHO population to reduce the CVD risk during adulthood remains a challenge. In this review, we focus on CVD risk factors arising at different stages of life by performing a search of the recent literature. It is urgent to focus on preventive or early therapeutic strategies to stop this disturbing negative metabolic trend, which manifests as a continuum from prenatal life to adulthood.
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Time to Consider the “Exposome Hypothesis” in the Development of the Obesity Pandemic. Nutrients 2022; 14:nu14081597. [PMID: 35458158 PMCID: PMC9032727 DOI: 10.3390/nu14081597] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/04/2022] [Accepted: 04/08/2022] [Indexed: 02/04/2023] Open
Abstract
The obesity epidemic shows no signs of abatement. Genetics and overnutrition together with a dramatic decline in physical activity are the alleged main causes for this pandemic. While they undoubtedly represent the main contributors to the obesity problem, they are not able to fully explain all cases and current trends. In this context, a body of knowledge related to exposure to as yet underappreciated obesogenic factors, which can be referred to as the “exposome”, merits detailed analysis. Contrarily to the genome, the “exposome” is subject to a great dynamism and variability, which unfolds throughout the individual’s lifetime. The development of precise ways of capturing the full exposure spectrum of a person is extraordinarily demanding. Data derived from epidemiological studies linking excess weight with elevated ambient temperatures, in utero, and intergenerational effects as well as epigenetics, microorganisms, microbiota, sleep curtailment, and endocrine disruptors, among others, suggests the possibility that they may work alone or synergistically as several alternative putative contributors to this global epidemic. This narrative review reports the available evidence on as yet underappreciated drivers of the obesity epidemic. Broadly based interventions are needed to better identify these drivers at the same time as stimulating reflection on the potential relevance of the “exposome” in the development and perpetuation of the obesity epidemic.
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da Costa N, Silveira JFDC, Schneiders LDB, Sehn AP, Reuter ÉM, Hobkirk JP, Carroll S, Reuter CP. Moderating Role of Physical Fitness in the Association Between TV Time and Adiposity Parameters in Adolescents. Am J Health Promot 2022; 36:1104-1111. [PMID: 35414246 DOI: 10.1177/08901171221086951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE To identify whether physical fitness (PF) components play a moderating role in the relationship between TV time and adiposity levels. DESIGN Cross-sectional study. SETTING Few studies have examined if different PF levels modify the association between TV time and adiposity in adolescents. Studies often focus on the isolated relationships between obesity and TV time, or obesity and PF levels. SUBJECTS 1071 adolescents (617 girls), aged 12 to 17 years. MEASURES Cardiorespiratory fitness (CRF), abdominal muscular endurance, and lower limb strength were evaluated using the protocols of the Projeto Esporte Brasil fitness testing battery. TV time was obtained using a self-reported questionnaire. Body mass index (BMI) and waist circumference (WC) were also assessed. Moderation analyses were conducted through multiple linear regression models with the following associations tested in different models: PF components, TV time, and interaction (PF component x TV time) with adiposity parameters (BMI and WC). RESULTS A significant interaction term was found for CRF and TV time in the association with both WC (β: -.005; 95% CI: -.009; -.001; P = .012) and BMI (β: -.002; 95% CI: -.004; -.001; P = .009). CONCLUSION CRF moderates the relationship between TV time and adiposity measures in this cross-sectional analysis. These data support strategies looking at increasing physical activity levels to improve CRF and avoid the development of excess abdominal obesity and excess weight.
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Affiliation(s)
- Náthalie da Costa
- Department of Health Sciences, 67889University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - João F de C Silveira
- Graduate Program in Health Promotion, 4019University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil.,School of Life Sciences, University of Hull, Kingston upon Hull, UK
| | - Letícia de B Schneiders
- Graduate Program in Health Promotion, 4019University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Ana P Sehn
- Graduate Program in Health Promotion, 4019University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Éboni M Reuter
- Department of Health Sciences, 67889University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - James P Hobkirk
- School of Life Sciences, University of Hull, Kingston upon Hull, UK.,Department of Sport, Health and Exercise Science, University of Hull, Kingston upon Hull, UK
| | - Sean Carroll
- School of Life Sciences, University of Hull, Kingston upon Hull, UK.,Department of Sport, Health and Exercise Science, University of Hull, Kingston upon Hull, UK
| | - Cézane P Reuter
- Department of Health Sciences, 67889University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil.,Graduate Program in Health Promotion, 4019University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
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21
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Chylińska-Frątczak A, Pietrzak I, Michalak A, Wyka K, Szadkowska A. Autoimmune reaction against pancreatic beta cells in children and adolescents with simple obesity. Front Endocrinol (Lausanne) 2022; 13:1061671. [PMID: 36589801 PMCID: PMC9794760 DOI: 10.3389/fendo.2022.1061671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION One of the most important complications of obesity is insulin resistance, which leads to carbohydrate metabolism disorders such as type 2 diabetes. However, obesity is also associated with development of an autoimmune response against various organs, including pancreatic beta cells. The prevalence of such autoimmune processes in children and their possible contribution to the increased incidence of type 1 diabetes is currently unclear. Therefore, the present study assessed the prevalence of autoantibodies against pancreatic islet beta cell's antigens in children and adolescents with simple obesity. MATERIAL AND METHODS This prospective observational study included pediatric patients (up to 18 years of age) with simple obesity hospitalized between 2011 and 2016 at the Department of Pediatrics, Diabetology, Endocrinology and Nephrology of the Medical University of Lodz. Children with acute or chronic conditions that might additionally affect insulin resistance or glucose metabolism were excluded. Collected clinical data included sex, age, sexual maturity ratings (Tanner`s scale), body height and weight, waist and hip circumference, amount of body fat and lean body mass. Each participant underwent a 2-hour oral glucose tolerance test with simultaneous measurements of glycaemia and insulinemia at 0`, 60` and 120`. In addition, glycated hemoglobin HbA1c, fasting and stimulated c-peptide, total cholesterol, as well as high- and low-density cholesterol and triglycerides were measured. Insulin resistance was assessed by calculating HOMA-IR index. The following autoantibodies against pancreatic islet beta cells were determined in each child: ICA - antibodies against cytoplasmic antigens of pancreatic islets, GAD - antibodies against glutamic acid decarboxylase, ZnT8 - antibodies against zinc transporter, IA2 - antibodies against tyrosine phosphatase, IAA - antibodies against insulin. RESULTS The study group included 161 children (57.4% boys, mean age 13.1 ± 2.9 years) with simple obesity (mean BMI z-score +2.2 ± 1.6). Among them, 28 (17.4%) were diagnosed with impaired glucose metabolism during OGTT [23 (82.2%) - isolated impaired glucose tolerance (IGT), 3 (10.7%) - isolated impaired fasting glucose (IFG), 2 (7.1%) - IFG and IGT]. Of the children tested, 28 (17.4%) were tested positive for at least one islet-specific autoantibody [with similar percentages in boys (15, 17.4%) and girls (13, 17.3%), p=0.9855], with ICA being the most common (positive in 18, 11.2%), followed by IAA (7, 4.3%), ZnT8 (5, 3.1%), GADA (3, 1.9%) and IA2 (1, 0.6%). There was no association between the presence of the tested antibodies and age, sex, stage of puberty, parameters assessing the degree of obesity, HbA1c, lipid levels and basal metabolic rate. However, autoantibody-positive subjects were more likely to present IFG or IGT in OGTT compared to those who tested completely negative (9, 32.1% vs 19, 14.3%, p=0.0280). Their HOMA-IR was also significantly higher (HOMA-IR: 4.3 ± 1.9 vs 3.4 ± 1.9, p=0.0203) and this difference remained statistically significant after adjusting for sex and age (p=0.0340). CONCLUSIONS Children and adolescents with simple obesity presented a higher prevalence of markers of autoimmune response against pancreatic beta cells than the general population. Most often, they had only one type of antibody - ICA. The presence of autoimmune response indicators against pancreatic islet antigens is more common in obese patients with impaired carbohydrate metabolism and is associated with lower insulin sensitivity.
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Affiliation(s)
- Aneta Chylińska-Frątczak
- Department of Pediatrics, Endocrinology, Diabetology and Nephrology, Maria Konopnicka University Pediatrics Center, Lodz, Poland
| | - Iwona Pietrzak
- Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Lodz, Poland
- *Correspondence: Iwona Pietrzak,
| | - Arkadiusz Michalak
- Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Lodz, Poland
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland
| | - Krystyna Wyka
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
| | - Agnieszka Szadkowska
- Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Lodz, Poland
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22
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Portincasa P, Bonfrate L, Khalil M, Angelis MD, Calabrese FM, D’Amato M, Wang DQH, Di Ciaula A. Intestinal Barrier and Permeability in Health, Obesity and NAFLD. Biomedicines 2021; 10:83. [PMID: 35052763 PMCID: PMC8773010 DOI: 10.3390/biomedicines10010083] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/20/2021] [Accepted: 12/28/2021] [Indexed: 02/07/2023] Open
Abstract
The largest surface of the human body exposed to the external environment is the gut. At this level, the intestinal barrier includes luminal microbes, the mucin layer, gastrointestinal motility and secretion, enterocytes, immune cells, gut vascular barrier, and liver barrier. A healthy intestinal barrier is characterized by the selective permeability of nutrients, metabolites, water, and bacterial products, and processes are governed by cellular, neural, immune, and hormonal factors. Disrupted gut permeability (leaky gut syndrome) can represent a predisposing or aggravating condition in obesity and the metabolically associated liver steatosis (nonalcoholic fatty liver disease, NAFLD). In what follows, we describe the morphological-functional features of the intestinal barrier, the role of major modifiers of the intestinal barrier, and discuss the recent evidence pointing to the key role of intestinal permeability in obesity/NAFLD.
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Affiliation(s)
- Piero Portincasa
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (L.B.); (M.K.); (A.D.C.)
| | - Leonilde Bonfrate
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (L.B.); (M.K.); (A.D.C.)
| | - Mohamad Khalil
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (L.B.); (M.K.); (A.D.C.)
- Department of Soil, Plant and Food Sciences, University of Bari Aldo Moro, Via Amendola 165/a, 70126 Bari, Italy; (M.D.A.); (F.M.C.)
| | - Maria De Angelis
- Department of Soil, Plant and Food Sciences, University of Bari Aldo Moro, Via Amendola 165/a, 70126 Bari, Italy; (M.D.A.); (F.M.C.)
| | - Francesco Maria Calabrese
- Department of Soil, Plant and Food Sciences, University of Bari Aldo Moro, Via Amendola 165/a, 70126 Bari, Italy; (M.D.A.); (F.M.C.)
| | - Mauro D’Amato
- Gastrointestinal Genetics Lab, CIC bioGUNE-BRTA, 48160 Derio, Spain;
- Ikerbasque, Basque Foundation for Science, 48009 Bilbao, Spain
| | - David Q.-H. Wang
- Department of Medicine and Genetics, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Einstein-Mount Sinai Diabetes Research Center, Albert Einstein College of Medicine, New York, NY 10461, USA;
| | - Agostino Di Ciaula
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (L.B.); (M.K.); (A.D.C.)
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23
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Li K, Yin R, Wang Y, Zhao D. Associations between exposure to polycyclic aromatic hydrocarbons and metabolic syndrome in U.S. adolescents: Cross-sectional results from the National Health and Nutrition Examination Survey (2003-2016) data. ENVIRONMENTAL RESEARCH 2021; 202:111747. [PMID: 34333007 DOI: 10.1016/j.envres.2021.111747] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 07/13/2021] [Accepted: 07/21/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The metabolic syndrome is a constellation of risk factors, including abdominal obesity, hypertension, dyslipidemia, and hyperglycemia. Polycyclic aromatic hydrocarbons (PAHs) constitute a group of chemicals that are formed during the incomplete combustion of coal, oil and gas, garbage, and other organic substances. In the occupational exposure population, PAHs exposure increased the prevalence ratio of metabolic syndrome. However, the effect of PAHs on prevalence of metabolic syndrome in adolescents has not been reported. Because of the propensity for childhood metabolic risk to track into adulthood, there is a great need to identify risk factors for childhood metabolic syndrome. METHOD Using data from the 2003-2016 National Health and Nutrition Examination Survey. We defined metabolic syndrome using a modified version of the National Cholesterol Education Program Adult Treatment Panel Ⅲ definition for adolescents. Weighted logistic regression was used to calculate the odds ratio and 95 % confidence intervals for each biomarker. In addition, we applied the weighted quantile sum (WQS) regressions to adolescent metabolic syndrome to reveal the multiple exposure effects and relative weights of each PAH. RESULTS Among the 827 adolescents, 183 (22.13 %) had metabolic syndrome. The levels of 2-hydroxynaphthalene (2-NAP), 2-hydroxyphenanthrene (2-PHE), 2-hydroxyfluorene (2-FLU), 1-hydroxynaphthalene (1-NAP), 3-hydroxyfluorene (3-FLU) and 1-hydroxypyrene (1-PYR) were higher in the group of adolescents with metabolic syndrome. There were positive associations between higher concentrations of 2-NAP, 2-FLU and odds of metabolic syndrome after adjustment, which odds ratios (ORs) in the 3rd tertile were 2.22 (95%CI:1.45-3.44) and 2.09 (95%CI:1.36-3.10), respectively. In subgroups analysis, the ORs between the 3 tertile concentrations of 2-NAP, 2-PHE and high fasting blood glucose (FBG) were 2.20 (95%CI:1.37-3.57) and 1.99 (95%CI:1.16-3.48). CONCLUSION The present study suggested that PAHs may be associated with odds of metabolic syndrome as well as individual metabolic syndrome components among adolescents. A cohort study should be designed to clarify the cause and effect between PAHs and metabolic syndrome in future research.
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Affiliation(s)
- Kun Li
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China; Beijing Key Laboratory of Diabetes Research and Care, Beijing, 101149, China
| | - Ruili Yin
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China; Beijing Key Laboratory of Diabetes Research and Care, Beijing, 101149, China
| | - Yan Wang
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China; Beijing Key Laboratory of Diabetes Research and Care, Beijing, 101149, China
| | - Dong Zhao
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China; Beijing Key Laboratory of Diabetes Research and Care, Beijing, 101149, China.
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Beetch M, Alejandro EU. Placental mTOR Signaling and Sexual Dimorphism in Metabolic Health across the Lifespan of Offspring. CHILDREN 2021; 8:children8110970. [PMID: 34828683 PMCID: PMC8619510 DOI: 10.3390/children8110970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/23/2021] [Accepted: 10/24/2021] [Indexed: 11/17/2022]
Abstract
Robust evidence of fetal programming of adult disease has surfaced in the last several decades. Human and preclinical investigations of intrauterine insults report perturbations in placental nutrient sensing by the mechanistic target of rapamycin (mTOR). This review focuses on pregnancy complications associated with placental mTOR regulation, such as fetal growth restriction (FGR), fetal overgrowth, gestational diabetes mellitus (GDM), polycystic ovarian syndrome (PCOS), maternal nutrient restriction (MNR), preeclampsia (PE), maternal smoking, and related effects on offspring birthweight. The link between mTOR-associated birthweight outcomes and offspring metabolic health trajectory with a focus on sexual dimorphism are discussed. Both human physiology and animal models are summarized to facilitate in depth understanding. GDM, PCOS and fetal overgrowth are associated with increased placental mTOR, whereas FGR, MNR and maternal smoking are linked to decreased placental mTOR activity. Generally, birth weight is reduced in complications with decreased mTOR (i.e., FGR, MNR, maternal smoking) and higher with increased mTOR (GDM, PCOS). Offspring display obesity or a higher body mass index in childhood and adulthood, impaired glucose and insulin tolerance in adulthood, and deficiencies in pancreatic beta-cell mass and function compared to offspring from uncomplicated pregnancies. Defining causal players in the fetal programming of offspring metabolic health across the lifespan will aid in stopping the vicious cycle of obesity and type II diabetes.
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25
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Bim MA, Pinto ADA, Claumann GS, Pelegrini A. High waist-to-height ratio and associated factors in adolescents from a city in Southern Brazil: a cross-sectional study. ACTA ACUST UNITED AC 2021; 40:e2020468. [PMID: 34614141 PMCID: PMC8543829 DOI: 10.1590/1984-0462/2022/40/2020468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/25/2021] [Indexed: 11/22/2022]
Abstract
Objective: To verify the prevalence of abdominal obesity with the waist-to-height ratio (WHtR) and associated factors in adolescents from a city in Southern Brazil. Methods: A total of 960 adolescents (494 boys) aged 15–18 years old participated in this study. The dependent variable was WHtR; independent variables were self-reported age, economic level, sexual maturation, physical activity level, screen time, and body fat. Data were analyzed using descriptive statistics and logistic regression. Results: It was observed that 36.7% of the adolescents presented high WHtR (50.2% in girls and 23.9% in boys). Regardless of sex, adolescents with high body fat were more likely of having high WHtR (boys: Odds Ratio [OR] 29.79; 95% confidence interval [95%CI] 16.87–52.62; girls: OR 19.43; 95%CI 10.51–35.94). In girls, high WHtR was associated with age (OR 1.83; 95%CI 1.17–2.87), and in boys, with economic level (OR 2.34; 95%CI 1.01–5.45). Conclusions: One in each three adolescents has abdominal obesity. Among adolescents with high body fat, girls aged 15–16 and boys with high-income are the groups most exposed to abdominal obesity.
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Pucci G, Bisogni V, Battista F, D'Abbondanza M, Anastasio F, Crapa ME, Sanesi L, Desantis F, Troiani L, Papi F, Vaudo G. Association between Ideal Cardiovascular Health and aortic stiffness in Italian adolescents. The MACISTE study. Nutr Metab Cardiovasc Dis 2021; 31:2724-2732. [PMID: 34334290 DOI: 10.1016/j.numecd.2021.05.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 05/17/2021] [Accepted: 05/31/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Ideal Cardiovascular Health (ICH), defined as optimal levels of cardiovascular (CV) health factors and behaviors, has been reported to be very low in adults and children, with consequent several negative health outcomes and higher CV risk. The present study investigated the burden of ICH among Italian adolescents and its association with carotid-femoral pulse wave velocity (cf-PWV). METHODS AND RESULTS 387 healthy adolescents (mean age 17.1 ± 1.4 years) attending the "G. Donatelli" High School in Terni, Italy, were evaluated. ICH was assessed through clinical evaluation, laboratory measures and interviewer-administered questionnaires. Cf-PWV was measured by arterial tonometry (SphygmoCor). For each ICH metric, a score of 2 was assigned for ideal levels, 1 for intermediate, and 0 for poor. All subjects showed at least one ICH metric, whereas none showed all ICH 7 metrics. The average number of ICH metrics was 4.3 ± 1.1. The highest rates were observed for fasting blood glucose (98%), whereas an ideal healthy diet was achieved only by 8% of subjects. The Cf-PWV was inversely and linearly associated with the sum of ICH metrics (p = 0.03) and the ICH score (p < 0.01). At the multivariate analysis, the association between ICH score and cf-PWV remained significant after adjustment for age, sex, heart rate, mean arterial pressure and other confounders (p = 0.04). CONCLUSION ICH is relatively uncommon among Italian adolescents and inversely related to cf-PWV. Our results showed a detrimental association between CV unhealthy factors and behaviors with increased aortic stiffness, which starts developing at an early stage of the lifespan.
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Affiliation(s)
- Giacomo Pucci
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, Terni University Hospital, Terni, Italy.
| | - Valeria Bisogni
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, Terni University Hospital, Terni, Italy
| | - Francesca Battista
- Department of Medicine, Sports and Exercise Medicine Division, University of Padua, Padua, Italy
| | - Marco D'Abbondanza
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, Terni University Hospital, Terni, Italy
| | - Fabio Anastasio
- Unit of Cardiology, ASST-VAL Hospital of Sondrio, Sondrio, Italy
| | - Mariano E Crapa
- U.O. Medicina Interna, Asl Taranto, Presidio Ospedaliero Occidentale, Castellaneta, Italy
| | - Leandro Sanesi
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, Terni University Hospital, Terni, Italy
| | | | - Lucas Troiani
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Francesco Papi
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, Terni University Hospital, Terni, Italy
| | - Gaetano Vaudo
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, Terni University Hospital, Terni, Italy
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Andreassen SM, Ekelund U, Bernhardsen GP. No association between maternal exercise during pregnancy and the child's weight status at age 7 years: The MoBa study. Scand J Med Sci Sports 2021; 31:1991-2001. [PMID: 34228833 DOI: 10.1111/sms.14015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/29/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Maternal lifestyle during pregnancy may affect the development of overweight and obesity in the child. We examined whether maternal exercise during pregnancy is associated with offspring overweight and obesity in childhood. A secondary aim was to examine whether the association is affected by the child's physical activity level. MATERIALS AND METHODS This study is based on data from the Norwegian Mother, Father and Child Cohort Study (MoBa), including 44 352 pregnancies and children (n = 32 304 in week 17 and n = 32 419 in week 30 in the final adjusted model). Maternal exercise during pregnancy was self-reported in gestational weeks 17 and 30. We conducted linear and logistic regression separately for girls and boys, and outcomes were the child's body mass index (BMI) and weight status (overweight/obese) at age 7 years. We further examined the additive joint association between maternal exercise during pregnancy and the child's leisure time physical activity on weight status at age 7 years. RESULTS In total, 12.4% of the children were classified as overweight or obese, and 1.7% as obese. The results suggest no association between maternal exercise in both gestational weeks 17 and 30 and the weight status of the child at age 7 years. The association between maternal exercise and the child's weight status at age 7 years appears not to be affected by the child's physical activity level. CONCLUSION Maternal exercise level during pregnancy does not appear to be associated with the child's BMI or odds of being overweight or obese in childhood.
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Affiliation(s)
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.,Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Guro Pauck Bernhardsen
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.,Department of Research and Development, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
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Kim K, Joyce BT, Zheng Y, Schreiner PJ, Jacobs DR, Catov JM, Shikany JM, Carnethon MR, Greenland P, Van Horn LV, Allen NB, Lloyd-Jones DM, Gunderson EP, Hou L. DNA Methylation GrimAge and Incident Diabetes: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. Diabetes 2021; 70:1404-1413. [PMID: 33820761 PMCID: PMC8275890 DOI: 10.2337/db20-1167] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 03/27/2021] [Indexed: 12/21/2022]
Abstract
DNA methylation (DNAm)-based biological age (epigenetic age) has been suggested as a useful biomarker of age-related conditions including type 2 diabetes (T2D), and its newest iterations (GrimAge measurements) have shown early promise. In this study, we explored the association between epigenetic age and incident T2D in the context of their relationships with obesity. A total of 1,057 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study were included in the current analyses. We stratified the participants into three groups: normal weight, overweight, and obese. A 1-year increase of GrimAge was associated with higher 10-year (study years 15-25) incidence of T2D (odds ratio [OR] 1.06, 95% CI 1.01-1.11). GrimAge acceleration, which represents the deviation of GrimAge from chronological age, was derived from the residuals of a model of GrimAge and chronological age, and any GrimAge acceleration (positive GrimAA: having GrimAge older than chronological age) was associated with significantly higher odds of 10-year incidence of T2D in obese participants (OR 2.57, 95% CI 1.61-4.11). Cumulative obesity was estimated by years since obesity onset, and GrimAge partially mediated the statistical association between cumulative obesity and incident diabetes or prediabetes (proportion mediated = 8.0%). In conclusion, both older and accelerated GrimAge were associated with higher risk of T2D, particularly among obese participants. GrimAge also statistically mediated the associations between cumulative obesity and T2D. Our findings suggest that epigenetic age measurements with DNAm can potentially be used as a risk factor or biomarker associated with T2D development.
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Affiliation(s)
- Kyeezu Kim
- Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL
| | - Brian T Joyce
- Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Yinan Zheng
- Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Janet M Catov
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - James M Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Linda V Van Horn
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Norrina B Allen
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Donald M Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Erica P Gunderson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Lifang Hou
- Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
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Di Sessa A, Grandone A, Marzuillo P, Umano GR, Cirillo G, Miraglia Del Giudice E. Early menarche is associated with insulin-resistance and non-alcoholic fatty liver disease in adolescents with obesity. J Pediatr Endocrinol Metab 2021; 34:607-612. [PMID: 33823088 DOI: 10.1515/jpem-2020-0684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/12/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Recent evidence linked early menarche to a higher risk of insulin-resistance (IR) and nonalcoholic fatty liver disease (NAFLD) in adulthood. We aimed to evaluate the impact of early menarche on glucose derangements and NAFLD in a sample of Italian adolescents with obesity. METHODS Anthropometric and biochemical evaluations were conducted in all the enrolled 318 obese patients (mean age 12.31 ± 2.95 years). NAFLD was defined by the presence of ultrasound detected liver steatosis and/or alanine transaminase (ALT) levels >40 IU/L. RESULTS Patients with early menarche showed both higher homeostasis model assessment of insulin-resistance (HOMA-IR) (p=0.008) and ALT (p=0.02) values, an increased prevalence of NAFLD (p=0.001), and lower Matsuda and Insulinogenic Index (IGI) values than the other obese patients. The association between early menarche and both ALT and Matsuda Index remained significant in General Linear Models (GLMs) in which respectively body mass index standard deviation score (BMI-SDS) and Matsuda Index, and BMI-SDS were included as covariates. Patients with early menarche also showed a higher risk of both HOMA-IR>3 (OR 1.69, CI 1.05-2.70, p=0.02) and NAFLD (OR 1.10, CI 1.01-1.21, p=0.03). CONCLUSIONS Girls with obesity presenting early menarche showed higher HOMA-IR levels, lower Matsuda Index and IGI values, and higher risk of NAFLD compared to girls without early menarche.
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Affiliation(s)
- Anna Di Sessa
- Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Anna Grandone
- Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Pierluigi Marzuillo
- Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppina Rosaria Umano
- Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Grazia Cirillo
- Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Emanuele Miraglia Del Giudice
- Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
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Development and Pilot Testing of a Food Literacy Curriculum for High School-Aged Adolescents. Nutrients 2021; 13:nu13051532. [PMID: 34062865 PMCID: PMC8147294 DOI: 10.3390/nu13051532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 01/16/2023] Open
Abstract
Adolescent obesity and poor diet quality are increasingly prevalent and could be mitigated with attainment of food literacy. However, as these programs for adolescents are lacking, the purpose of this project was to develop a food literacy curriculum for high school-aged adolescents. The curriculum was designed in accordance with food literacy attributes and components utilizing Backward Design, Social Cognitive Theory, and Constructivism. After expert committee review, pilot testing was completed in two low-income communities by a trained facilitator and observer. Detailed observations were collected during pilot testing to assess achievement of learning objectives. Modifications were made to lesson procedures as required. The resulting curriculum, Teens CAN: Comprehensive Food Literacy in Cooking, Agriculture, and Nutrition, contains 12 modules of experiential lessons and application activities within three topics. Agriculture lessons concentrate on the food supply chain and food environments; nutrition lessons include food groups while focusing on nutrients of concern for underconsumption; and cooking lessons include food safety, budgeting, and preparation. Teens CAN provides a comprehensive and necessary approach to advancing food literacy in adolescents. Future directions include assessing dietary implications after participating in Teens CAN lessons and employment of an innovative two-tiered cross-age teaching model.
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Associations between Prenatal Exposure to Phthalates and Timing of Menarche and Growth and Adiposity into Adulthood: A Twenty-Years Birth Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094725. [PMID: 33946657 PMCID: PMC8125681 DOI: 10.3390/ijerph18094725] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/24/2021] [Accepted: 04/25/2021] [Indexed: 12/12/2022]
Abstract
Phthalates are ubiquitous environmental chemicals with endocrine disrupting properties and potentially obesogenic effects. We hypothesised that antenatal phthalate exposure may influence growth and adiposity patterns in girls through childhood into adolescence. Among 1342 Raine Study singleton females, 462 had maternal serum and at least one outcome available up to 20 years of age. Individuals’ maternal serum collected at 18 and 34 weeks gestation was pooled and analyzed for concentrations of 32 metabolites of 15 phthalate diesters. Cox regression and linear models were used to determine associations between maternal phthalate levels and age at menarche, change in height and weight z-scores between birth and two years, height from birth to 20 years, BMI from two to 20 years, deviation from mid-parental height at age 20 and DEXA scan measures at age 20. Weak negative associations were detected with some phthalate metabolites and change in height and weight z-score during infancy. Weak positive associations between some of the high molecular weight phthalate metabolites and height z-score were detected during childhood. While still within the normal range, age at menarche was slightly delayed in girls with higher prenatal exposure to the higher molecular weight phthalate metabolites. We derived some associations between prenatal phthalate exposure with early growth patterns and age at menarche.
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Abstract
PURPOSE OF REVIEW The childhood obesity epidemic is widely considered to have reached pandemic proportions. Across the world, children with obesity are facing numerous psychological and physiological issues that follow them into adulthood, frequently leading to chronic illness and early death. In an effort to combat the compounding effects of childhood overweight, researchers are attempting to identify biological and environmental contributors to child weight. Parenting styles are one recognized influence on child diet and body mass index (BMI). This review is a comprehensive examination of the literature on the influence of parenting style on childhood diet and BMI over the past 5 years. RECENT FINDINGS Current research continues to support the use of traditional parenting style categories (i.e., authoritative, authoritarian, permissive, uninvolved/neglectful): however, newer subcategories of Baumrind's styles and the inclusion of previously underrepresented groups (e.g., fathers, cross cultural comparison studies) are shedding more light on the nuance of parenting's relationship with child weight. Parenting styles that focus on the balance of warmth and control (e.g., authoritative) in contrast to the styles dedicated to only one of these constructs (e.g., permissive, authoritarian) seem to promote the healthiest dietary habits and may be protective of child BMI.
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D'Amico EJ, Palimaru AI, Dickerson DL, Dong L, Brown RA, Johnson CL, Klein DJ, Troxel WM. Risk and Resilience Factors in Urban American Indian and Alaska Native Youth during the Coronavirus Pandemic. AMERICAN INDIAN CULTURE AND RESEARCH JOURNAL 2021; 44:21-48. [PMID: 35719739 PMCID: PMC9205322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
American Indians and Alaska Natives suffer disproportionately from poverty and other inequities and are vulnerable to adverse health and socioeconomic effects of COVID-19. Using surveys and interviews (May - July 2020), we examined urban American Indian/Alaska Native adolescents' (N=50) health and behaviors, family dynamics, community cohesion, and traditional practice participation during COVID-19. About 20% of teens reported clinically significant anxiety and depression, 25% reported food insecurity, and 40% reported poor sleep. Teens also reported high family and community cohesion, and many engaged in traditional practices during this time. Although many teens reported problems, they also emphasized resilience strategies.
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Affiliation(s)
| | | | - Daniel L Dickerson
- UCLA Integrated Substance Abuse Programs; Semel Institute for Neuroscience and Human Behavior David Geffen School of Medicine; 1640 Sepulveda Blvd., Suite 200; Los Angeles, CA
| | - Lu Dong
- RAND Corporation; 1776 Main St., Santa Monica, CA 90401
| | - Ryan A Brown
- RAND Corporation; 1776 Main St., Santa Monica, CA 90401
| | | | - David J Klein
- RAND Corporation; 1776 Main St., Santa Monica, CA 90401
| | - Wendy M Troxel
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, Pennsylvania 15213
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Mann JK, Lutzker L, Holm SM, Margolis HG, Neophytou AM, Eisen EA, Costello S, Tyner T, Holland N, Tindula G, Prunicki M, Nadeau K, Noth EM, Lurmann F, Hammond SK, Balmes JR. Traffic-related air pollution is associated with glucose dysregulation, blood pressure, and oxidative stress in children. ENVIRONMENTAL RESEARCH 2021; 195:110870. [PMID: 33587949 PMCID: PMC8520413 DOI: 10.1016/j.envres.2021.110870] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 12/30/2020] [Accepted: 02/07/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND Metabolic syndrome increases the risk of cardiovascular disease in adults. Antecedents likely begin in childhood and whether childhood exposure to air pollution plays a contributory role is not well understood. OBJECTIVES To assess whether children's exposure to air pollution is associated with markers of risk for metabolic syndrome and oxidative stress, a hypothesized mediator of air pollution-related health effects. METHODS We studied 299 children (ages 6-8) living in the Fresno, CA area. At a study center visit, questionnaire and biomarker data were collected. Outcomes included hemoglobin A1c (HbA1c), urinary 8-isoprostane, systolic blood pressure (SBP), and BMI. Individual-level exposure estimates for a set of four pollutants that are constituents of traffic-related air pollution (TRAP) - the sum of 4-, 5-, and 6-ring polycyclic aromatic hydrocarbon compounds (PAH456), NO2, elemental carbon, and fine particulate matter (PM2.5) - were modeled at the primary residential location for 1-day lag, and 1-week, 1-month, 3-month, 6-month, and 1-year averages prior to each participant's visit date. Generalized additive models were used to estimate associations between each air pollutant exposure and outcome. RESULTS The study population was 53% male, 80% Latinx, 11% Black and largely low-income (6% were White and 3% were Asian/Pacific Islander). HbA1c percentage was associated with longer-term increases in TRAP; for example a 4.42 ng/m3 increase in 6-month average PAH456 was associated with a 0.07% increase (95% CI: 0.01, 0.14) and a 3.62 μg/m3 increase in 6-month average PM2.5 was associated with a 0.06% increase (95% CI: 0.01, 0.10). The influence of air pollutants on blood pressure was strongest at 3 months; for example, a 6.2 ppb increase in 3-month average NO2 was associated with a 9.4 mmHg increase in SBP (95% CI: 2.8, 15.9). TRAP concentrations were not significantly associated with anthropometric or adipokine measures. Short-term TRAP exposure averages were significantly associated with creatinine-adjusted urinary 8-isoprostane. DISCUSSION Our results suggest that both short- and longer-term estimated individual-level outdoor residential exposures to several traffic-related air pollutants, including ambient PAHs, are associated with biomarkers of risk for metabolic syndrome and oxidative stress in children.
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Affiliation(s)
- Jennifer K Mann
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Liza Lutzker
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Stephanie M Holm
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Helene G Margolis
- Department of Internal Medicine, University of California, Davis, Davis, CA, USA
| | - Andreas M Neophytou
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA; Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Ellen A Eisen
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Sadie Costello
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Tim Tyner
- University of California, San Francisco-Fresno, Fresno, CA, USA; Central California Asthma Collaborative, USA
| | - Nina Holland
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Gwen Tindula
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Mary Prunicki
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Palo Alto, CA, USA
| | - Kari Nadeau
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Palo Alto, CA, USA
| | - Elizabeth M Noth
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | | | - S Katharine Hammond
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - John R Balmes
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
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Berman YE, Doherty DA, Main KM, Frederiksen H, Keelan JA, Newnham JP, Hart RJ. The influence of prenatal exposure to phthalates on subsequent male growth and body composition in adolescence. ENVIRONMENTAL RESEARCH 2021; 195:110313. [PMID: 33069699 DOI: 10.1016/j.envres.2020.110313] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/29/2020] [Accepted: 10/02/2020] [Indexed: 05/13/2023]
Abstract
Phthalates are ubiquitous environmental chemicals with predominantly anti-androgenic, and potentially obesogenic effects. We hypothesised that antenatal phthalate exposure may influence subsequent boy's growth and body composition through childhood and adolescence. Among 1399 singleton males from the Raine Study, 410 had maternal serum and at least one height, BMI or DEXA outcome available after birth and up to 20 years of age. Maternal serum collected at 18 and 34 weeks' gestation was pooled, and analyzed for concentrations of 32 metabolites of 15 phthalate diesters. Their serum concentrations were categorized into undetectable/detectable levels or tertiles. Linear mixed models were used to determine associations between maternal serum phthalate levels and longitudinal height and body mass index (BMI) z-scores in boys from birth to 20 years of age (n = 250 and n = 295 respectively). Linear regression was used to determine associations between maternal phthalate levels and deviation from mid-parental height (n = 177) and DEXA scan outcomes (n = 191) at the 20 year follow-up. Weak positive associations of participants height z-score increase were detected with exposure to some phthalate metabolites in particular to the lower molecular weight phthalate metabolites. Less consistent findings, by mixed model analyses, were detected for BMI and body composition, by dual energy X-ray absorptiometry (DEXA), with some positive associations of phthalate metabolites with BMI and some negative associations with DEXA fat tissue measures, although no consistent findings were evident. In conclusion, we derived some associations of childhood growth with prenatal phthalate exposure, particularly with respect to the lower molecular weight phthalate metabolites.
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Affiliation(s)
- Ye'elah E Berman
- Women and Infants Research Foundation, Carson House, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Perth, Australia
| | - Dorota A Doherty
- Women and Infants Research Foundation, Carson House, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Perth, Australia; Division of Obstetrics and Gynaecology, University of Western Australia, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Perth, WA, Australia, 6008
| | - Katharina M Main
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Hanne Frederiksen
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Jeffrey A Keelan
- Women and Infants Research Foundation, Carson House, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Perth, Australia; Division of Obstetrics and Gynaecology, University of Western Australia, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Perth, WA, Australia, 6008
| | - John P Newnham
- Women and Infants Research Foundation, Carson House, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Perth, Australia; Division of Obstetrics and Gynaecology, University of Western Australia, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Perth, WA, Australia, 6008
| | - Roger J Hart
- Women and Infants Research Foundation, Carson House, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Perth, Australia.
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Pearson K, Jordan KC, Metos J, Holubkov R, Nanjee MN, Mihalopoulos NL. Association of Prepregnancy BMI, Gestational Weight Gain, and Child Birth Weight with Metabolic Dysfunction in Children and Adolescents with Obesity. South Med J 2021; 113:482-487. [PMID: 33005961 DOI: 10.14423/smj.0000000000001161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Previous studies have reported that maternal prepregnancy body mass index (BMI), gestational weight gain (GWG), and child birth weight are positively associated with metabolic dysfunction (a broader term than metabolic syndrome) in children and adolescents. Physical activity habits may play a role in reducing these risk factors. The objectives of this study were to investigate the association of prepregnancy BMI, GWG, child birth weight, physical activity, and sedentary time with metabolic dysfunction in a cohort of children and adolescents with obesity. METHODS Participants (N = 117; 53% Hispanic) were children and adolescents, aged 8 to 17 years, with obesity. Fasting serum glucose, insulin, and a complete lipid profile were obtained. Body weight, height, waist circumference, and blood pressure were measured. A self-reported survey assessed prepregnancy BMI, GWG, child birth weight, physical activity, and sedentary time. The χ2 test and the Mantel-Haenzel test statistic were used to examine the differences in proportions for the outcome of metabolic dysfunction. RESULTS In this sample, 76.9% of children and adolescents had metabolic dysfunction. Prepregnancy BMI and GWG were not associated with metabolic dysfunction. Child birth weight and sedentary behavior were positively correlated (P = 0.033 and P = 0.015, respectively) with a diagnosis of metabolic dysfunction. Physical activity levels were not associated with metabolic dysfunction. Hispanic and non-Hispanic youth were similar for all risk factors. CONCLUSIONS Contrary to previous studies, prepregnancy BMI and GWG were not correlated with metabolic dysfunction. These findings support the need for lifestyle interventions, particularly in reducing sedentary behaviors, in obese children and adolescents.
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Affiliation(s)
- Kelsey Pearson
- From the Departments of Nutrition and Integrative Physiology, Pediatrics, and Cardiovascular Genetics, University of Utah, Salt Lake City
| | - Kristine C Jordan
- From the Departments of Nutrition and Integrative Physiology, Pediatrics, and Cardiovascular Genetics, University of Utah, Salt Lake City
| | - Julie Metos
- From the Departments of Nutrition and Integrative Physiology, Pediatrics, and Cardiovascular Genetics, University of Utah, Salt Lake City
| | - Richard Holubkov
- From the Departments of Nutrition and Integrative Physiology, Pediatrics, and Cardiovascular Genetics, University of Utah, Salt Lake City
| | - M Nazeem Nanjee
- From the Departments of Nutrition and Integrative Physiology, Pediatrics, and Cardiovascular Genetics, University of Utah, Salt Lake City
| | - Nicole L Mihalopoulos
- From the Departments of Nutrition and Integrative Physiology, Pediatrics, and Cardiovascular Genetics, University of Utah, Salt Lake City
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Park J, Ten Hoor GA, Baek S, Baek S, Lee JY, Lee H. Social Ecological Barriers for Healthy Eating of Obese Children and Their Caregivers in Low-income Families in South Korea. Ecol Food Nutr 2021; 60:525-541. [PMID: 33459056 DOI: 10.1080/03670244.2021.1875454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In this qualitative study, the focus is on healthy eating in children from low-income families who visit a Community Child Care center (CCC) in South Korea. Barriers for healthy eating were identified using focus group interviews with low-income overweight and obese children and their caregivers and applying a social ecological model as well as the framework analysis for qualitative data. The need for theory- and evidence-based health promotion interventions is indicated, at the level of the family, but also at the level of collaboration among all stakeholders, as well as multi-level policy changes.
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Affiliation(s)
- Jiyoung Park
- College of Nursing, Institute for Health Science Research, Inje University, Busan, South Korea
| | - Gill A Ten Hoor
- Department of Work & Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Suyon Baek
- Department of Nursing, Kongju National University, Gongju, South Korea
| | - Seolhyang Baek
- Department of Nursing, College of Medicine, Dongguk University, Gyeongju, South Korea
| | - Ja-Yin Lee
- College of Nursing, Yonsei University, Seoul, South Korea
| | - Hyunju Lee
- Korea Disease Control and Prevention Agency (KDCA), Osong, South Korea
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Portincasa P, Di Ciaula A, Garruti G, Vacca M, De Angelis M, Wang DQH. Bile Acids and GPBAR-1: Dynamic Interaction Involving Genes, Environment and Gut Microbiome. Nutrients 2020; 12:E3709. [PMID: 33266235 PMCID: PMC7760347 DOI: 10.3390/nu12123709] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/25/2020] [Accepted: 11/26/2020] [Indexed: 02/06/2023] Open
Abstract
Bile acids (BA) are amphiphilic molecules synthesized in the liver from cholesterol. BA undergo continuous enterohepatic recycling through intestinal biotransformation by gut microbiome and reabsorption into the portal tract for uptake by hepatocytes. BA are detergent molecules aiding the digestion and absorption of dietary fat and fat-soluble vitamins, but also act as important signaling molecules via the nuclear receptor, farnesoid X receptor (FXR), and the membrane-associated G protein-coupled bile acid receptor 1 (GPBAR-1) in the distal intestine, liver and extra hepatic tissues. The hydrophilic-hydrophobic balance of the BA pool is finely regulated to prevent BA overload and liver injury. By contrast, hydrophilic BA can be hepatoprotective. The ultimate effects of BA-mediated activation of GPBAR-1 is poorly understood, but this receptor may play a role in protecting the remnant liver and in maintaining biliary homeostasis. In addition, GPBAR-1 acts on pathways involved in inflammation, biliary epithelial barrier permeability, BA pool hydrophobicity, and sinusoidal blood flow. Recent evidence suggests that environmental factors influence GPBAR-1 gene expression. Thus, targeting GPBAR-1 might improve liver protection, facilitating beneficial metabolic effects through primary prevention measures. Here, we discuss the complex pathways linked to BA effects, signaling properties of the GPBAR-1, mechanisms of liver damage, gene-environment interactions, and therapeutic aspects.
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Affiliation(s)
- Piero Portincasa
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, 70124 Bari, Italy;
| | - Agostino Di Ciaula
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, 70124 Bari, Italy;
| | - Gabriella Garruti
- Section of Endocrinology, Department of Emergency and Organ Transplantations, University of Bari “Aldo Moro” Medical School, Piazza G. Cesare 11, 70124 Bari, Italy;
| | - Mirco Vacca
- Dipartimento di Scienze del Suolo, Della Pianta e Degli Alimenti, Università degli Studi di Bari Aldo Moro, 70124 Bari, Italy; (M.V.); (M.D.A.)
| | - Maria De Angelis
- Dipartimento di Scienze del Suolo, Della Pianta e Degli Alimenti, Università degli Studi di Bari Aldo Moro, 70124 Bari, Italy; (M.V.); (M.D.A.)
| | - David Q.-H. Wang
- Department of Medicine and Genetics, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Einstein-Mount Sinai Diabetes Research Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
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Hou M, Zhou W, Sun L, Wang B, Shen J, Cao L, Lv H. Effect of Fish Oil on Insulin Sensitivity in Children: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials. Can J Diabetes 2020; 45:531-538.e1. [PMID: 33388274 DOI: 10.1016/j.jcjd.2020.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/18/2020] [Accepted: 11/13/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Fish oil has been shown to reduce the risk of metabolic disorders. However, the effects of fish oil intervention on glucose metabolism and insulin sensitivity are still controversial, especially in children. The current meta-analysis aimed to evaluate the effects of fish oil intervention on insulin sensitivity in children. METHODS The Cochrane Library, PubMed, Embase, Web of Science, ClinicalTrials.gov and China National Knowledge Infrastructure databases were searched up to August 2020 for relevant studies evaluating fish oil intake compared with placebo on insulin sensitivity indications (Homeostatic Model for Insulin Resistance). A fixed-effects model was used to calculate the pooled effect. RESULTS A total of 13 studies with 1,132 participants (567 in placebo group and 565 in fish oil group) were included in the meta-analysis. Compared with the placebo group, fish oil intervention had beneficial effects on insulin sensitivity in the pooled analysis (weighted mean difference, -0.219; 95% confidence interval, -0.392 to -0.046; p=0.013). In subgroup analyses, when the fish oil intervention period was short-term (≤6 months), low dose (eicosapentaenoic acid + docosahexaenoic acid dose <1.5 g/day) and high ratio (eicosapentaenoic acid to docosahexaenoic acid ≥1), it could improve insulin sensitivity. No heterogeneity was found for the pooled and subgroup analyses. CONCLUSION Fish oil intervention has a beneficial effect on insulin sensitivity in children.
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Affiliation(s)
- Miao Hou
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Wanping Zhou
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Ling Sun
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Bo Wang
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jie Shen
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Lei Cao
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Haitao Lv
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China.
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Yin C, Zhang H, Zhang M, Xiao Y. Adropin and apelin-12 efficiently predict metabolic syndrome in obese children. Pediatr Diabetes 2020; 21:1132-1139. [PMID: 32749012 DOI: 10.1111/pedi.13101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/09/2020] [Accepted: 07/28/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Metabolic syndrome (MetS) is the most common condition associated with childhood and adolescent obesity and is a challenging public health issue. Very few studies have described the specificity and sensitivity of serum levels of adropin and apelin-12 as predictors of MetS. The aim of this study was to evaluate the association between serum levels of adropin and apelin-12 and MetS, and their sensitivity as predictors of MetS in obese children. METHODS This study involved 138 children. The study group included obese subjects with MetS, and the two control groups included obese subjects without MetS and normal weight subjects. Anthropometric parameters and clinical data were collected. Plasma levels of apelin-12, adropin, leptin, adiponectin, and TNF-α were also measured. RESULTS Obese children with MetS had significantly higher levels of apelin-12 and significantly lower levels of adropin when compared with those in children without MetS. In logistic regressions, we identified that apelin-12 was a risk factor for metabolic syndrome, and adropin was a protecting factor of having MetS after adjusting for age, sex, and puberty. Furthermore, ROC analysis revealed that adropin and apelin-12 are more sensitive predictors of metabolic syndrome than leptin and adiponectin. CONCLUSION Serum adropin and apelin-12 levels can be useful biomarkers for predicting MetS in obese children. Our findings could provide a novel approach for the treatment and prevention of MetS.
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Affiliation(s)
- Chunyan Yin
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shan Xi, China
| | - Hongai Zhang
- Department of Pediatrics, The First People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Meizheng Zhang
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shan Xi, China
| | - Yanfeng Xiao
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shan Xi, China
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Öncel HF, Salar R, Özbay E, Elkan H. Changes in the sexual functions of male patients and their partners after obesity surgery. Andrologia 2020; 53:e13873. [PMID: 33108823 DOI: 10.1111/and.13873] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/09/2020] [Accepted: 09/15/2020] [Indexed: 11/30/2022] Open
Abstract
Sexual functionality significantly contributes to health-related quality of life and can decrease with obesity. In this study, we aimed to prospectively evaluate the changes that occur in the erection function, sexual function and testosterone level of male patients scheduled to undergo bariatric surgery, as well as the changes in the sexual function of their partner. A total of 40 patients and their partners were included. International Index of Erectile Function-5 (IIEF-5) questionnaire and the Arizona Sexual Experience Scale (ASEX) were filled before and 6 months after surgery by the male patients. The ASEX form was also completed by the partners before and 6 months after the procedure. The height and weight measurements and testosterone values were measured before and after surgery. A statistically significant difference was found between the preoperative and post-operative IIEF-5 scores of the patients (p = 0.000 < 0.01). There was also a statistically significant difference between the patients and their partners' preoperative and post-operative ASEX scores. We can conclude that the partners of men with preoperative erection complaints also experience sexual dysfunction, and with the post-operative decrease in or disappearance of erection complaints, the sexual function of both male patients and their partners improves.
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Affiliation(s)
- Halil F Öncel
- Urology Department, Mehmet Akif İnan Training & Research Hospital, Şanlıurfa, Turkey
| | - Remzi Salar
- Urology Department, Mehmet Akif İnan Training & Research Hospital, Şanlıurfa, Turkey
| | - Engin Özbay
- Urology Department, Mehmet Akif İnan Training & Research Hospital, Şanlıurfa, Turkey
| | - Hasan Elkan
- General Surgery Department, Şanlıurfa Training & Research Hospital, Şanlıurfa, Turkey
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Evaluate the effects of metabolic syndrome in adolescents and children. FRONTIERS OF NURSING 2020. [DOI: 10.2478/fon-2020-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Abstract
The metabolic syndrome (MS) in adolescents and children can cause serious consequences that lead researchers to pay efforts to study in such area. Presently, MS definition is still not standardized. Different versions of MS definition have been used by numerous studies, which may be a problem to identify MS and then to predict and prevent clinical diseases. The pediatric literature shows that insulin resistance and obesity might be the key underlying pathophysiology of MS to cause many related diseases. High prevalence of MS is in overweight and obese children and adolescents. This article focuses on such above issues and also effects of MS on two main disease outcomes: cardiovascular disease and type 2 diabetes.
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Rapson J, Conlon C, Ali A. Nutrition Knowledge and Perspectives of Physical Activity for Pre-Schoolers amongst Early Childhood Education and Care Teachers. Nutrients 2020; 12:nu12071984. [PMID: 32635381 PMCID: PMC7400386 DOI: 10.3390/nu12071984] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 12/14/2022] Open
Abstract
Caregivers’ nutrition and physical activity knowledge is recognised as being important for children’s health and body size. Identifying knowledge gaps amongst caregivers may inform professional development and obesity-prevention strategies in childcare settings. This cross-sectional validated online questionnaire aimed to measure current early childhood education and care (ECEC) teachers’ nutrition knowledge for pre-schoolers (2–5-year-olds) and related perspectives. Teachers’ (n = 386) knowledge of nutrition was lacking: The overall score was 22.56 ± 2.83 (mean ± SD), or 61% correct. Increased years of experience significantly predicted an increase in knowing that national nutrition and physical activity guidelines exist (B = 0.02 [95% CI, 0.00–0.03], r2 = 0.13, p = 0.033). Teachers’ increased agreement in feeling they were confident talking about nutrition to parents significantly predicted an increase in overall nutrition knowledge scores (B = 0.34 [95% CI, 0.06–0.63], r2 = 0.15, p = 0.019). The belief that ECEC teachers play a vital role in promoting pre-schoolers’ healthy eating and physical activity was widespread. Common knowledge barriers included a lack of staff training, confidence, and resources. ECEC teachers may lack nutrition knowledge for pre-schoolers, particularly in regard to basic nutrition recommendations (servings, food/beverage choices, and portion sizes).
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Affiliation(s)
| | | | - Ajmol Ali
- Correspondence: ; Tel.: +64-9-213-6414
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Brunetti G, Faienza MF, Piacente L, Storlino G, Oranger A, D’Amato G, De Filippo G, Colucci S, Grano M. Shedding "LIGHT" on the Link between Bone and Fat in Obese Children and Adolescents. Int J Mol Sci 2020; 21:E4739. [PMID: 32635185 PMCID: PMC7370129 DOI: 10.3390/ijms21134739] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 12/15/2022] Open
Abstract
Obesity may affect bone health, but literature reports are contradictory about the correlation of body mass index (BMI) and bone markers. LIGHT, one of the immunostimulatory cytokines regulating the homeostasis of bone and adipose tissue, could be involved in obesity. The study involved 111 obese subjects (12.21 ± 3.71 years) and 45 controls. Patients underwent the evaluation of bone status by quantitative ultrasonography (QUS). LIGHT amounts were evaluated in sera by ELISA, whereas its expression on peripheral blood cells was evaluated by flow cytometry. Osteoclastogenesis was performed by culturing peripheral blood mononuclear cells (PBMCs) with or without anti-LIGHT antibodies. Obese patients showed significant high BMI-standard deviation score (SDS), weight-SDS, and Homeostatic model assessment for insulin resistance (HOMA-IR) that negatively correlated with the reduced Amplitude Dependent Speed of Sound (AD-SoS)-Z-score and Bone Transmission Time (BTT-Z)-score. They displayed significantly higher serum levels of LIGHT compared with controls (497.30 ± 363.45 pg/mL vs. 186.06 ± 101.41 pg/mL, p < 0.001). LIGHT expression on monocytes, CD3+-T-cells, and neutrophils was also higher in obese patients than in the controls. Finally, in PBMC cultures, the addition of anti-LIGHT antibodies induced a significant osteoclastogenesis inhibition. Our study highlighted the high serum levels of LIGHT in obese children and adolescents, and its relationship with both the grade of obesity and bone impairment.
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Affiliation(s)
- Giacomina Brunetti
- Department of Basic and Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University of Bari, 70124 Bari, Italy;
| | - Maria Felicia Faienza
- Department of Biomedical Science and Human Oncology, Paediatric Unit, University of Bari, 70100 Bari, Italy; (M.F.F.); (L.P.)
| | - Laura Piacente
- Department of Biomedical Science and Human Oncology, Paediatric Unit, University of Bari, 70100 Bari, Italy; (M.F.F.); (L.P.)
| | - Giuseppina Storlino
- Department of Emergency and Organ Transplantation, Section of Human Anatomy and Histology, University of Bari, 70124 Bari, Italy; (G.S.); (A.O.); (M.G.)
| | - Angela Oranger
- Department of Emergency and Organ Transplantation, Section of Human Anatomy and Histology, University of Bari, 70124 Bari, Italy; (G.S.); (A.O.); (M.G.)
| | - Gabriele D’Amato
- Neonatal Intensive Care Unit, Di Venere Hospital, 70131 Bari, Italy;
| | - Gianpaolo De Filippo
- Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Service d’Endocrinologie Diabétologie Pédiatrique, 75019 Paris, France;
| | - Silvia Colucci
- Department of Basic and Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University of Bari, 70124 Bari, Italy;
| | - Maria Grano
- Department of Emergency and Organ Transplantation, Section of Human Anatomy and Histology, University of Bari, 70124 Bari, Italy; (G.S.); (A.O.); (M.G.)
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Faienza MF, Corbo F, Carocci A, Catalano A, Clodoveo ML, Grano M, Wang DQH, D’Amato G, Muraglia M, Franchini C, Brunetti G, Portincasa P. Novel insights in health-promoting properties of sweet cherries. J Funct Foods 2020; 69:103945. [PMID: 34422115 PMCID: PMC8376227 DOI: 10.1016/j.jff.2020.103945] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Sweet cherry (Prunus avium L.) is one of the most popular and appreciated temperate fruit not only for its sensory and nutritional properties, but also for its content in bioactive compounds. Consumption of sweet cherries brings beneficial effects on to health, which include prevention and modulatory effects in several chronic diseases such as (diabetes mellitus, cancer, cardiovascular and other inflammatory diseases). The presence of natural polyphenolic compounds with high antioxidant potential might drive and partly explain such beneficial effects, but more translational and clinical studies should address this topic. Here, we review the health-promoting properties of cherries and their bioactive compounds against human diseases.
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Affiliation(s)
- Maria Felicia Faienza
- Department of Biomedical Sciences and Human Oncology, Paediatric Section, University of Bari “A. Moro”, Bari, Italy
| | - Filomena Corbo
- Department of Pharmacy-Drug Sciences, University of Bari “Aldo Moro”, Bari, Italy
| | - Alessia Carocci
- Department of Pharmacy-Drug Sciences, University of Bari “Aldo Moro”, Bari, Italy
| | - Alessia Catalano
- Department of Pharmacy-Drug Sciences, University of Bari “Aldo Moro”, Bari, Italy
| | - Maria Lisa Clodoveo
- Interdisciplinary Department of Medicine, University of Bari “A. Moro”, Bari, Italy
| | - Maria Grano
- Department of Emergency and Organ Transplantation, Section of Human Anatomy and Histology, University of Bari “Aldo Moro”, Bari, Italy
| | - David Q.-H. Wang
- Department of Medicine, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | | | - Marilena Muraglia
- Department of Pharmacy-Drug Sciences, University of Bari “Aldo Moro”, Bari, Italy
| | - Carlo Franchini
- Department of Pharmacy-Drug Sciences, University of Bari “Aldo Moro”, Bari, Italy
| | - Giacomina Brunetti
- Department of Basic and Medical Sciences, Neurosciences and Sense Organs, section of Human Anatomy and Histology, University of Bari “A. Moro”, Bari, Italy
| | - Piero Portincasa
- Clinica Medica “A. Murri”, Department of Biomedical Sciences and Human Oncology, Paediatric Section, University of Bari “A. Moro”, Bari, Italy
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Stefania DS, Clodoveo ML, Cariello M, D'Amato G, Franchini C, Faienza MF, Corbo F. Polyphenols and obesity prevention: critical insights on molecular regulation, bioavailability and dose in preclinical and clinical settings. Crit Rev Food Sci Nutr 2020; 61:1804-1826. [PMID: 32436425 DOI: 10.1080/10408398.2020.1765736] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Obesity represents one of the most important public health challenges of the 21st century and is characterized by a multifactorial etiology in which environmental, behavioral, metabolic, and genetic factors work together. Despite the rapid increase in prevalence of obesity in the last decades, especially in children, it remains a preventable disease. To battle obesity a multisector approach promoting healthier lifestyle in terms of physical activity and nutrition is needed. Specifically, biologically active dietary compounds, as polyphenols, are able to modulate the expression of genes involved in the development and progression of obesity and its comorbidities as demonstrated by multiple studies using different obesity models. However, human studies focusing on the transcriptomic modulation by polyphenols in obese patients are still limited and do not often recapitulate the results obtained in preclinical setting likely due to the underestimation of some variables such as bioavailability, dose and form (native vs. metabolized) of polyphenols used. The aim of this review is to summarize the state-of-art of nutrigenomic in vitro, in vivo and ex vivo studies as well as clinical trials based on dietary polyphenols to fight obesity. We also critical discuss the variables to be considered to fill the gap between preclinical and clinical settings.
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Affiliation(s)
- De Santis Stefania
- Department of Pharmacy-Drug Science, University of Bari Aldo Moro, Bari, Italy
| | - M L Clodoveo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - M Cariello
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - G D'Amato
- Neonatal Intensive Care Unit, Di Venere Hospital, Bari, Italy
| | - C Franchini
- Department of Pharmacy-Drug Science, University of Bari Aldo Moro, Bari, Italy
| | - M F Faienza
- Pediatric Unit, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - F Corbo
- Department of Pharmacy-Drug Science, University of Bari Aldo Moro, Bari, Italy
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Wang HH, Lee DK, Liu M, Portincasa P, Wang DQH. Novel Insights into the Pathogenesis and Management of the Metabolic Syndrome. Pediatr Gastroenterol Hepatol Nutr 2020; 23:189-230. [PMID: 32483543 PMCID: PMC7231748 DOI: 10.5223/pghn.2020.23.3.189] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/17/2020] [Accepted: 04/21/2020] [Indexed: 02/06/2023] Open
Abstract
The metabolic syndrome, by definition, is not a disease but is a clustering of individual metabolic risk factors including abdominal obesity, hyperglycemia, hypertriglyceridemia, hypertension, and low high-density lipoprotein cholesterol levels. These risk factors could dramatically increase the prevalence of type 2 diabetes and cardiovascular disease. The reported prevalence of the metabolic syndrome varies, greatly depending on the definition used, gender, age, socioeconomic status, and the ethnic background of study cohorts. Clinical and epidemiological studies have clearly demonstrated that the metabolic syndrome starts with central obesity. Because the prevalence of obesity has doubly increased worldwide over the past 30 years, the prevalence of the metabolic syndrome has markedly boosted in parallel. Therefore, obesity has been recognized as the leading cause for the metabolic syndrome since it is strongly associated with all metabolic risk factors. High prevalence of the metabolic syndrome is not unique to the USA and Europe and it is also increasing in most Asian countries. Insulin resistance has elucidated most, if not all, of the pathophysiology of the metabolic syndrome because it contributes to hyperglycemia. Furthermore, a major contributor to the development of insulin resistance is an overabundance of circulating fatty acids. Plasma fatty acids are derived mainly from the triglycerides stored in adipose tissues, which are released through the action of the cyclic AMP-dependent enzyme, hormone sensitive lipase. This review summarizes the latest concepts in the definition, pathogenesis, pathophysiology, and diagnosis of the metabolic syndrome, as well as its preventive measures and therapeutic strategies in children and adolescents.
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Affiliation(s)
- Helen H. Wang
- Department of Medicine and Genetics, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Einstein-Mount Sinai Diabetes Research Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Dong Ki Lee
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Min Liu
- Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Piero Portincasa
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari Medical School, Bari, Italy
| | - David Q.-H. Wang
- Department of Medicine and Genetics, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Einstein-Mount Sinai Diabetes Research Center, Albert Einstein College of Medicine, Bronx, NY, USA
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Baghersalimi M, Fathi R, Kazemi S. The effect of eight-week walking program on plasma levels of amino acids in early/mid pubertal obese girls. Med J Islam Repub Iran 2020; 33:128. [PMID: 32280634 PMCID: PMC7137814 DOI: 10.34171/mjiri.33.128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Indexed: 01/17/2023] Open
Abstract
Background: Altered circulating amino acids levels have been observed in metabolic disorders, like obesity, type-2 diabetes, and other insulin-resistant states. This study aimed to investigate the effect of 8-week walking on plasma amino acids (PAAs) in obese girls. Methods: This clinical trial study (IRCT20180928041160N1) was conducted on 32 early/mid pubertal obese girls which they divided into interval-walking (IWG, n=12), continuous-walking (CWG, n=11) and control (CG, n=9) groups. The walking program (3- sessions/week for 8-weeks) consists of 30-min walking with 70-85%HRmax and 60-75%HRmax, respectively in the IWG (2-min walking and 1-min active rest) and CWG. The concentration of PAAs was measured at baseline and 72-hours after the last session in fasting state, using high-performance liquid chromatography. A repeated measures ANCOVA (group (3) * time (2)) with post hoc Bonferroni was used to analyze the data. Results: More the PAAs were not affected by interval or continuous walking training. A significant increase in lysine (p=0.003, 95%CI 24.08, 108.97) was observed only in the CG, and there was a significant difference between the CG and CWG (p=0.032). Global arginine bioavailability (GABA) significantly decreased in the CG (P<0.001, 95%CI -0.65, -0.21) and the IWG (p=0.004, 95%CI -0.60, -0.21). A significant increase in weight (p=0.043, 95%CI 0.27, 1.46), insulin (p=0.046, 95%CI -0.91, 9.01), and HOMA-IR (p=0.007, 95%CI 0.26, 2.63) were found only in the CG, and both insulin and HOMA-IR tended to decline in the CWG. Conclusion: Except for lysine and GABA, all groups roughly showed similar changes in more amino acids. Continuous-walking could improve the plasma level of lysine and GABA, which along with an improvement of fasting insulin levels and HOMA-IR.
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Affiliation(s)
- Masoumeh Baghersalimi
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Mazandaran, Babolsar, Iran
| | - Rozita Fathi
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Mazandaran, Babolsar, Iran
| | - Sohrab Kazemi
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Eyler AA, Valko CR, Curoe KA, Ramadas R, Chriqui JF. Adherence to Updated Childcare Nutrition Regulations in Colorado, United States. Front Public Health 2020; 8:102. [PMID: 32322568 PMCID: PMC7156549 DOI: 10.3389/fpubh.2020.00102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 03/16/2020] [Indexed: 12/03/2022] Open
Abstract
Background: Preschool years are an important time for shaping healthy eating behaviors. Childcare centers can be a venue for policy change for broad and sustained positive impact on healthy eating environment. The objectives of this study were to assess how self-reported current practices align with updated statewide childcare center licensing regulations in Colorado, US, and to explore correlates of adherence. Methods: Using a post-test only study design, a survey was sent to all full-day, licensed childcare centers in Colorado (N = 1,398) with a valid street or email address. The survey included questions on allowable food and beverages, mealtime practices, and perceptions of the updated regulations. Frequencies were calculated and logistic regression models computed for a composite score of each of these factors. Results: Respondents (N = 344) were mostly center directors, with over 8 years of experience, from urban areas. Compliance was high for most food and beverage criteria (over 90%) and all meal practices. One third participated in the federal Child and Adult Care Food Program (CACFP), and were more likely to comply with the state meal regulations than non-CACFP centers. Conclusion: Although our results show high self-reported compliance, a more thorough study of the policy process would provide comprehensive evidence on effective development, enactment, and implementation of these regulations.
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Affiliation(s)
- Amy A. Eyler
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Cheryl R. Valko
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Katherine A. Curoe
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Ramya Ramadas
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Jamie F. Chriqui
- Division of Health Policy and Administration and Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, IL, United States
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Hsia DS, Gosselin NH, Williams J, Farhat N, Marier JF, Shih W, Peterson C, Siegel R. A randomized, double-blind, placebo-controlled, pharmacokinetic and pharmacodynamic study of a fixed-dose combination of phentermine/topiramate in adolescents with obesity. Diabetes Obes Metab 2020; 22:480-491. [PMID: 31696603 DOI: 10.1111/dom.13910] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/19/2019] [Accepted: 10/31/2019] [Indexed: 01/16/2023]
Abstract
AIMS To assess the pharmacokinetic (PK) and pharmacodynamic characteristics of VI-0521, a fixed-dose combination of immediate-release phentermine (PHEN) and extended-release topiramate (TPM) in adolescents aged 12 to 17 years with obesity, and to report weight loss and adverse events using this drug combination. MATERIALS AND METHODS This was a multicentre, randomized, double-blind, parallel-design, placebo-controlled study in adolescents with obesity. A total of 42 adolescents were randomly assigned in a 1:1:1 ratio to placebo, or to a mid-dose (PHEN/TPM 7.5 mg/46 mg), or a top-dose (PHEN/TPM 15 mg/92 mg) of VI-0521. A total of 26 adolescents were included in the PK analysis (14 from the mid-dose group and 12 from the top-dose group). RESULTS On day 56, arithmetic means of terminal elimination half-life, apparent clearance (CL/F) and apparent central volume of distribution (Vc/F) were consistent across dose levels for both PHEN and TPM. Arithmetic means of CL/F and Vc/F for PHEN and TPM administered as a combination in adolescents with obesity were within 10% to 30% of those previously assessed in adults with obesity enrolled in phase II and III studies. A higher proportion of adolescents in both the mid- and top-dose groups (13.3% and 50.0%, respectively) compared with placebo (0.0%) reached ≥5% weight loss at day 56. The least squares (LS) mean change in systolic blood pressure from baseline to day 56 was -5.2 mmHg for the placebo group, -2.5 mmHg for the mid-dose group, and - 5.5 mmHg for the top-dose group. The LS mean change in diastolic blood pressure from baseline to day 56 was -2.4 mmHg for the placebo group, +3.8 mmHg for the mid-dose group, and + 2.0 mmHg for the top-dose group. Participants in the top-dose group had increases in heart rate from baseline of 4.1 bpm, while participants in the mid-dose group experienced a mean decrease in heart rate of 4.5 bpm at day 56. Both PHEN/TPM dose combinations were safe and well tolerated. CONCLUSIONS Treatment of adolescents with obesity using a fixed-dose combination of PHEN/TPM for 8 weeks resulted in exposure to PHEN and TPM that was comparable to that observed in adults, statistically significant weight loss, and a tolerable safety profile. These data indicate that both mid- and top-dose levels are appropriate for longer-term safety and efficacy studies in adolescents.
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Affiliation(s)
- Daniel S Hsia
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States
| | | | - Jenna Williams
- Cincinnati Children's Hospital/University of Cincinnati, Cincinnati, Ohio, United States
| | | | | | | | | | - Robert Siegel
- Cincinnati Children's Hospital/University of Cincinnati, Cincinnati, Ohio, United States
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