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Arsenault BJ, Carpentier AC, Poirier P, Després JP. Adiposity, type 2 diabetes and atherosclerotic cardiovascular disease risk: Use and abuse of the body mass index. Atherosclerosis 2024; 394:117546. [PMID: 38692978 DOI: 10.1016/j.atherosclerosis.2024.117546] [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: 12/18/2023] [Revised: 03/29/2024] [Accepted: 04/10/2024] [Indexed: 05/03/2024]
Abstract
The worldwide prevalence of individuals with an elevated body weight has increased steadily over the past five decades. Billions of research dollars have been invested to improve our understanding of the causes and consequences of having an elevated body weight. All this knowledge has, however, failed to influence populational body weight trajectories of most countries around the world. Research on the definition of "obesity" has also evolved. Body mass index (BMI), the most commonly used tool to make its diagnosis, has major limitations. In this review article, we will highlight evidence from observational studies, genetic association studies and randomized clinical trials that have shown the remarkable inter-individual differences in the way humans store energy as body fat. Increasing evidence also suggests that, as opposed to weight inclusive, lifestyle-based approaches, weight-centric approaches advising people to simply eat less and move more are not sustainable for most people for long-term weight loss and maintenance. It is time to recognize that this outdated approach may have produced more harm than good. On the basis of pathophysiological, genetic and clinical evidence presented in this review, we propose that it may be time to shift away from the traditional clinical approach, which is BMI-centric. Rather, emphasis should be placed on actionable lifestyle-related risk factors aiming at improving overall diet quality and increasing physical activity level in the general population.
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Affiliation(s)
- Benoit J Arsenault
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec (QC), Canada; Department of Medicine, Faculty of Medicine, Université Laval, Québec (QC), Canada
| | - André C Carpentier
- Division of Endocrinology, Department of Medicine, Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke (QC), Canada
| | - Paul Poirier
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec (QC), Canada; Faculté de pharmacie, Université Laval, Québec (QC), Canada
| | - Jean-Pierre Després
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec (QC), Canada; VITAM - Centre de recherche en santé durable, CIUSSS de la Capitale-Nationale, Québec (QC), Canada; Department of Kinesiology, Faculty of Medicine, Université Laval, Québec (QC), Canada.
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2
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Murphy-Després A, Chartrand DJ, Lemieux I, Tremblay A, Bergeron J, Poirier P, Alméras N, Després JP. Long-Term Improvement in Cardiorespiratory Fitness Ameliorates Insulin Sensitivity beyond Changes in Visceral/Ectopic Fat among Men with Visceral Obesity. Nutrients 2024; 16:1377. [PMID: 38732623 PMCID: PMC11085477 DOI: 10.3390/nu16091377] [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: 03/18/2024] [Revised: 04/27/2024] [Accepted: 04/29/2024] [Indexed: 05/13/2024] Open
Abstract
The SYNERGIE study documented the effects on cardiometabolic risk (CMR) indices of a 1-year lifestyle intervention targeting physical activity (PA) and diet followed by a 2-year maintenance period in men with visceral obesity. Improvements in CMR markers and a decrease in low-attenuation muscle (LAM) area were observed after 1 year. Despite a rebound in visceral adipose tissue (VAT) during the maintenance period, insulin resistance (IR) improved. We tested the hypothesis that variations in cardiorespiratory fitness (CRF) and LAM could explain the long-term improvement in IR. A health (n = 88; mean age 49.0 ± 8.2 years) and fitness (n = 72) evaluation was performed at 0, 1, and 3 years. Participants were classified into two groups based on their CRF response over the maintenance period (worsening: CRF- vs. maintenance/improvement: CRF+). During the maintenance period, changes in the psoas and core LAM areas correlated with changes in IR (r = 0.27; p < 0.05 and r = 0.34; p < 0.005) and changes in CRF (r = -0.31; p < 0.01 and r = -0.30; p < 0.05). IR improved in the CRF+ group (p < 0.05) but remained stable in the CRF- group. Men in the CRF+ group regained half of the changes in VAT volume and LAM at the psoas and mid-thigh compared to the CRF- group (p < 0.05). These results support the importance of targeting VAT and CRF/PA for the long-term management of CMR in men with visceral obesity.
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Affiliation(s)
- Adrien Murphy-Després
- Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec—Université Laval, Québec, QC G1V 4G5, Canada; (A.M.-D.); (D.J.C.); (I.L.); (A.T.); (P.P.); (N.A.)
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
| | - Dominic J. Chartrand
- Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec—Université Laval, Québec, QC G1V 4G5, Canada; (A.M.-D.); (D.J.C.); (I.L.); (A.T.); (P.P.); (N.A.)
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
| | - Isabelle Lemieux
- Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec—Université Laval, Québec, QC G1V 4G5, Canada; (A.M.-D.); (D.J.C.); (I.L.); (A.T.); (P.P.); (N.A.)
| | - Angelo Tremblay
- Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec—Université Laval, Québec, QC G1V 4G5, Canada; (A.M.-D.); (D.J.C.); (I.L.); (A.T.); (P.P.); (N.A.)
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
| | - Jean Bergeron
- Department of Molecular Biology, Medical Biochemistry, and Pathology, Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada;
- Centre de Recherche du CHU de Québec—Université Laval, Québec, QC G1V 4G2, Canada
| | - Paul Poirier
- Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec—Université Laval, Québec, QC G1V 4G5, Canada; (A.M.-D.); (D.J.C.); (I.L.); (A.T.); (P.P.); (N.A.)
- Faculty of Pharmacy, Université Laval, Québec, QC G1V 0A6, Canada
| | - Natalie Alméras
- Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec—Université Laval, Québec, QC G1V 4G5, Canada; (A.M.-D.); (D.J.C.); (I.L.); (A.T.); (P.P.); (N.A.)
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
| | - Jean-Pierre Després
- Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec—Université Laval, Québec, QC G1V 4G5, Canada; (A.M.-D.); (D.J.C.); (I.L.); (A.T.); (P.P.); (N.A.)
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
- VITAM—Centre de Recherche en Santé Durable, CIUSSS de la Capitale-Nationale, Québec, QC G1J 2G1, Canada
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3
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Overweight, Obesity, and CVD Risk: a Focus on Visceral/Ectopic Fat. Curr Atheroscler Rep 2022; 24:185-195. [PMID: 35235165 DOI: 10.1007/s11883-022-00996-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Despite its prevalence and well-documented impact on population health, obesity has not emerged as a strong independent risk factor for cardiovascular disease after control for intermediate risk factors. The purpose of this brief narrative review is to highlight results from imaging studies that have not only documented the remarkable heterogeneity of body fat topography but also the importance of visceral adiposity as a key body fat depot associated with cardiovascular disease risk and type 2 diabetes. RECENT FINDINGS Simple tools are also discussed in order to refine cardiometabolic risk assessment in persons with overweight/obesity. It is proposed that four lifestyle vital signs should be considered in clinical practice to improve discrimination of health risk in individuals with overweight/obesity: waist circumference as a simple marker of abdominal adiposity, cardiorespiratory fitness, overall diet quality, and level of reported physical activity. Heterogeneity of obesity is proposed as an example of a condition that would benefit from a precision lifestyle medicine approach.
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Silveira A, Gomes J, Roque F, Fernandes T, de Oliveira EM. MicroRNAs in Obesity-Associated Disorders: The Role of Exercise Training. Obes Facts 2022; 15:105-117. [PMID: 35051942 PMCID: PMC9021631 DOI: 10.1159/000517849] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 06/09/2021] [Indexed: 11/19/2022] Open
Abstract
Obesity is a worldwide epidemic affecting over 13% of the adult population and is defined by an excess of body fat that predisposes comorbidities. It is considered a multifactorial disease in which environmental and genetic factors interact, and it is a risk marker for cardiovascular disease. Lifestyle modifications remain the mainstay of treatment for obesity based on adequate diet and physical exercise. In addition, obesity is related to cardiovascular and skeletal muscle disorders, such as cardiac hypertrophy, microvascular rarefaction, and skeletal muscle atrophy. The discovery of obesity-involved molecular pathways is an important step to improve both the prevention and management of this disease. MicroRNAs (miRNAs) are a class of gene regulators which bind most commonly, but not exclusively, to the 3'-untranslated regions of messenger RNAs of protein-coding genes and negatively regulate their expression. Considerable effort has been made to identify miRNAs and target genes that predispose to obesity. Besides their intracellular function, recent studies have demonstrated that miRNAs can be exported or released by cells and circulate within the blood in a remarkably stable form. The discovery of circulating miRNAs opens up intriguing possibilities for the use of circulating miRNA patterns as biomarkers for obesity and cardiovascular diseases. The aim of this review is to provide an overview of the recent discoveries of the role played by miRNAs in the obese phenotype and associated comorbidities. Furthermore, we will discuss the role of exercise training on regulating miRNAs, indicating the mechanisms related to these alterations.
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Affiliation(s)
- Andre Silveira
- Laboratory of Biochemistry and Molecular Biology of Exercise, School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Brazil
- Endurance Performance Research Group (GEDAE-USP), School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Brazil
| | - João Gomes
- Laboratory of Biochemistry and Molecular Biology of Exercise, School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Brazil
| | - Fernanda Roque
- Laboratory of Biochemistry and Molecular Biology of Exercise, School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Brazil
| | - Tiago Fernandes
- Laboratory of Biochemistry and Molecular Biology of Exercise, School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Brazil
- *Tiago Fernandes,
| | - Edilamar Menezes de Oliveira
- Laboratory of Biochemistry and Molecular Biology of Exercise, School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Brazil
- **Edilamar Menezes de Oliveira,
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Després JP, Carpentier AC, Tchernof A, Neeland IJ, Poirier P. Management of Obesity in Cardiovascular Practice: JACC Focus Seminar. J Am Coll Cardiol 2021; 78:513-531. [PMID: 34325840 PMCID: PMC8609918 DOI: 10.1016/j.jacc.2021.05.035] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 12/14/2022]
Abstract
Obesity contributes to reduced life expectancy because of its link with type 2 diabetes and cardiovascular disease. Yet, targeting this poorly diagnosed, ill-defined, and underaddressed modifiable risk factor remains a challenge. In this review, we emphasize that the tendency among health care professionals to amalgam all forms of obesity altogether as a single entity may contribute to such difficulties and discrepancies. Obesity is a heterogeneous condition both in terms of causes and health consequences. Attention should be given to 2 prevalent subgroups of individuals: 1) patients who are overweight or moderately obese with excess visceral adipose tissue; and 2) patients with severe obesity, the latter group having distinct additional health issues related to their large body fat mass. The challenge of tackling high-cardiovascular-risk forms of obesity through a combination of personalized clinical approaches and population-based solutions is compounded by the current obesogenic environment and economy.
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Affiliation(s)
- Jean-Pierre Després
- VITAM-Centre de recherche en santé durable, CIUSSS de la Capitale-Nationale, Québec, Québec, Canada; Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Québec, Canada; Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Québec, Canada.
| | - André C Carpentier
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada; Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Québec, Canada. https://twitter.com/CarpentierAndr3
| | - André Tchernof
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Québec, Canada; School of Nutrition, Université Laval, Québec, Québec, Canada
| | - Ian J Neeland
- University Hospitals Harrington Heart and Vascular Institute and Case Western Reserve University, Cleveland, Ohio, USA
| | - Paul Poirier
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Québec, Canada; Faculty of Pharmacy, Université Laval, Québec, Québec, Canada
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6
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Khan NA, Edwards CG, Thompson SV, Hannon BA, Burke SK, Walk ADM, Mackenzie RWA, Reeser GE, Fiese BH, Burd NA, Holscher HD. Avocado Consumption, Abdominal Adiposity, and Oral Glucose Tolerance Among Persons with Overweight and Obesity. J Nutr 2021; 151:2513-2521. [PMID: 34191028 PMCID: PMC8417923 DOI: 10.1093/jn/nxab187] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/12/2021] [Accepted: 05/17/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Although intake of Hass avocado has been cross-sectionally linked to lower abdominal obesity, knowledge of the effects of avocado consumption on abdominal adiposity and glycemic outcomes remains limited. OBJECTIVE The effects of avocado consumption on abdominal adiposity, insulin resistance, oral-glucose-tolerance test (OGTT), and estimated β-cell function were evaluated. METHODS A total of 105 adults aged 25-45 y (61% female) with BMI ≥25 kg/m2 were randomly assigned to an intervention (N = 53) that received a daily meal with 1 fresh Hass avocado or a control (N = 52) that received an isocaloric meal with similar ingredients without avocado for 12 wk. DXA was used to assess the primary outcomes of abdominal adiposity [visceral adipose tissue (VAT), subcutaneous abdominal adipose tissue (SAAT), and the ratio of VAT to SAAT (VS Ratio)]. Fasted glucose and insulin were used to assess the primary outcomes of insulin resistance (HOMA-IR), and insulin sensitivity (Matsuda index) and β-cell function (Insulinogenic index) were estimated using an OGTT. Changes between groups were compared using an ANCOVA. Secondary analyses were conducted based on sex. RESULTS The control group exhibited a greater reduction in SAAT [-54.5 ± 155.8 g (control) compared with 17.4 ± 155.1 g (treatment), P = 0.017] and increase in VS Ratio [0.007 ± 0.047 (control) compared with -0.011 ± 0.044 (treatment), P = 0.024]. Among females, the treatment group exhibited a greater reduction in VAT [1.6 ± 89.8 g (control) compared with -32.9 ± 81.6 g (treatment), P = 0.021] and VS Ratio [0.01 ± 0.05 (control) compared with -0.01 ± 0.03 (treatment), P = 0.001]. Among males, there was no significant difference between groups in changes in abdominal adiposity or glycemic outcomes. CONCLUSIONS Daily consumption of 1 fresh Hass avocado changed abdominal adiposity distribution among females but did not facilitate improvements in peripheral insulin sensitivity or β-cell function among adults with overweight and obesity.This study was registered at clinicaltrials.gov as NCT02740439.
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Affiliation(s)
| | - Caitlyn G Edwards
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, USA
| | - Sharon V Thompson
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, USA
| | - Bridget A Hannon
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, USA
| | - Sarah K Burke
- Department of Physical Therapy, University of Florida, Gaineville, FL, USA
| | - Anne D M Walk
- Department of Psychology, Eastern Illinois University, Charleston, IL, USA
| | - Richard W A Mackenzie
- Department of Life Science, Whitelands College, University of Roehampton, London, UK
| | - Ginger E Reeser
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, USA
| | - Barbara H Fiese
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, USA,Family Resiliency Center, University of Illinois, Urbana, IL, USA
| | - Nicholas A Burd
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, USA,Division of Nutritional Sciences, University of Illinois, Urbana, IL, USA
| | - Hannah D Holscher
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, USA,Division of Nutritional Sciences, University of Illinois, Urbana, IL, USA,Department of Food Science and Human Nutrition, University of Illinois, Urbana, IL, USA
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7
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Goldenshluger A, Constantini K, Goldstein N, Shelef I, Schwarzfuchs D, Zelicha H, Yaskolka Meir A, Tsaban G, Chassidim Y, Gepner Y. Effect of Dietary Strategies on Respiratory Quotient and Its Association with Clinical Parameters and Organ Fat Loss: A Randomized Controlled Trial. Nutrients 2021; 13:nu13072230. [PMID: 34209600 PMCID: PMC8308467 DOI: 10.3390/nu13072230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 01/11/2023] Open
Abstract
The relation between changes in respiratory quotient (RQ) following dietary interventions and clinical parameters and body fat pools remains unknown. In this randomized controlled trial, participants with moderate abdominal obesity or/and dyslipidemia (n = 159) were randomly assigned to a Mediterranean/low carbohydrate (MED/LC, n = 80) or a low fat (LF, n = 79) isocaloric weight loss diet and completed a metabolic assessment. Changes in RQ (measured by indirect calorimeter), adipose-tissue pools (MRI), and clinical measurements were assessed at baseline and after 6 months of intervention. An elevated RQ at baseline was significantly associated with increased visceral adipose tissue, hepatic fat, higher levels of insulin and homeostatic insulin resistance. After 6 months, body weight had decreased similarly between the diet groups (−6 ± 6 kg). However, the MED/LC diet, which greatly improved metabolic health, decreased RQ significantly more than the LF diet (−0.022 ± 0.007 vs. −0.002 ± 0.008, p = 0.005). Total cholesterol and diastolic blood pressure were independently associated with RQ changes (p = 0.045). RQ was positively associated with increased superficial subcutaneous-adipose-tissue but decreased renal sinus, pancreatic, and intramuscular fats after adjusting for confounders. Fasting RQ may reflect differences in metabolic characteristics between subjects affecting their potential individual response to the diet.
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Affiliation(s)
- Ariela Goldenshluger
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, and Sylvan Adams Sports Institute, Tel-Aviv University, Tel-Aviv 96678, Israel; (A.G.); (K.C.); (N.G.)
| | - Keren Constantini
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, and Sylvan Adams Sports Institute, Tel-Aviv University, Tel-Aviv 96678, Israel; (A.G.); (K.C.); (N.G.)
| | - Nir Goldstein
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, and Sylvan Adams Sports Institute, Tel-Aviv University, Tel-Aviv 96678, Israel; (A.G.); (K.C.); (N.G.)
| | - Ilan Shelef
- Radiology Department, Soroka University Medical Center, Beer-Sheva 84101, Israel;
| | - Dan Schwarzfuchs
- Emergency Medicine Department, Soroka University Medical Center, Beer-Sheva 84101, Israel;
| | - Hila Zelicha
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel; (H.Z.); (A.Y.M.); (G.T.)
| | - Anat Yaskolka Meir
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel; (H.Z.); (A.Y.M.); (G.T.)
| | - Gal Tsaban
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel; (H.Z.); (A.Y.M.); (G.T.)
| | - Yoash Chassidim
- Industrial and Management Department, Sapir College, Sderot 79165, Israel;
| | - Yftach Gepner
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, and Sylvan Adams Sports Institute, Tel-Aviv University, Tel-Aviv 96678, Israel; (A.G.); (K.C.); (N.G.)
- Correspondence: ; Tel.: +972-733-804427
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8
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Maltais A, Lemieux I, Alméras N, Tremblay A, Bergeron J, Poirier P, Després JP. One-Year Lifestyle Intervention, Muscle Lipids, and Cardiometabolic Risk. Med Sci Sports Exerc 2020; 51:2156-2165. [PMID: 31525173 DOI: 10.1249/mss.0000000000002030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE Low-attenuation muscle (LAM) area at mid-thigh, a computed tomography (CT)-derived index of intramuscular lipids, is associated with insulin resistance, obesity, and type 2 diabetes. The present study aimed at testing the hypothesis that changes in LAM area in trunk muscles from a single abdominal scan could provide relevant information to evaluate the effects of a lifestyle intervention without the use of a mid-thigh CT scan. METHODS Cardiometabolic risk variables, including waist circumference, lipoprotein-lipid profile, glucose tolerance, and cardiorespiratory fitness, were assessed in a sample of 102 dyslipidemic viscerally obese men at baseline and after a 1-yr lifestyle intervention. Abdominal (L4-L5) and mid-thigh CT scans were performed and abdominal muscles classified as psoas and core muscles. Scans were segmented to calculate muscle areas, LAM areas, and mean attenuation values. RESULTS All muscle groups showed a decrease in LAM areas (P < 0.0001) in response to the lifestyle intervention. Changes in LAM areas were significantly associated with changes in triglycerides, high-density lipoprotein (HDL) cholesterol, cholesterol/HDL cholesterol ratio and log triglycerides/HDL cholesterol ratio (mid-thigh, 0.20 ≤ |r| ≤ 0.29; psoas, 0.28 ≤ |r| ≤ 0.38; core, 0.29 ≤ |r| ≤ 0.34, P < 0.05). Changes in core LAM area were significantly associated with changes in 2-h glucose levels, glucose area measured during the oral glucose tolerance test and homeostasis model assessment of insulin resistance (0.21 ≤ r ≤ 0.34, P < 0.05). Stepwise regression analyses showed that changes in LAM psoas area were associated with changes in HDL cholesterol and the cholesterol/HDL cholesterol ratio independently from changes in visceral adiposity. CONCLUSIONS Changes in trunk LAM areas are useful indices of changes in mid-thigh LAM area observed with a 1-yr lifestyle intervention. Thus, an additional mid-thigh scan is not necessary to evaluate muscle lipid content by CT when an abdominal CT scan is available.
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Affiliation(s)
- Alexandre Maltais
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, QC, CANADA.,Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC, CANADA
| | - Isabelle Lemieux
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, QC, CANADA
| | - Natalie Alméras
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, QC, CANADA.,Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC, CANADA
| | - Angelo Tremblay
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, QC, CANADA.,Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC, CANADA
| | - Jean Bergeron
- Endocrinology and Nephrology Unit, CHU de Québec, Université Laval Research Center, Québec, QC, CANADA
| | - Paul Poirier
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, QC, CANADA.,Faculty of Pharmacy, Université Laval, Québec, QC, CANADA
| | - Jean-Pierre Després
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, QC, CANADA.,Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC, CANADA
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9
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Adiposity, lifestyle and vitamin D levels: the quest for answers. Int J Obes (Lond) 2020; 44:1628-1629. [PMID: 32439910 DOI: 10.1038/s41366-020-0600-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/04/2020] [Accepted: 05/11/2020] [Indexed: 11/08/2022]
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10
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Gao X, Wang H, Bidulescu A. Lifestyle interventions along with vitamin D supplements on reducing leptinemia in obese man. Int J Obes (Lond) 2020; 44:1626-1627. [PMID: 32427980 DOI: 10.1038/s41366-020-0599-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 04/28/2020] [Accepted: 05/11/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Xiang Gao
- Department of Health and Exercise Science, College of Health and Human Sciences, Colorado State University, Fort Collins, CO, 80523-1582, USA.
| | - Haiping Wang
- Department of Epidemiology and Biostatistics, School of Public Health - Bloomington, Indiana University, Bloomington, IN, 47405, USA
| | - Aurelian Bidulescu
- Department of Epidemiology and Biostatistics, School of Public Health - Bloomington, Indiana University, Bloomington, IN, 47405, USA
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11
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Relationships between circulating 25(OH) vitamin D, leptin levels and visceral adipose tissue volume: results from a 1-year lifestyle intervention program in men with visceral obesity. Int J Obes (Lond) 2019. [DOI: 10.1038/s41366-019-0347-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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12
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Exercise Is Medicine: Primary Care Counseling on Aerobic Fitness and Muscle Strengthening. J Am Board Fam Med 2019; 32:103-107. [PMID: 30610148 PMCID: PMC6450080 DOI: 10.3122/jabfm.2019.01.180209] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 08/25/2018] [Accepted: 10/03/2018] [Indexed: 11/08/2022] Open
Abstract
Patient counseling on physical fitness remains underutilized in primary care, despite its clinical and cost effectiveness. Most counseling interventions have focused on aerobic activity and neglected another vital component of physical fitness, muscle strengthening, which has recently been shown to be independently protective against cardiometabolic diseases and premature mortality. This article reviews the latest scientific evidence and makes recommendations toward a more comprehensive approach for promoting physical fitness in primary care. Given the high prevalence and wide-ranging health impacts of physical inactivity, counseling on physical fitness should be a standard part of wellness promotion and disease prevention and treatment for all patients. Interventions that include muscle strengthening will have a significantly greater impact on health outcomes than those focused on aerobic fitness alone. Counseling to promote both aerobic fitness and muscle strengthening is indicated for all patients, irrespective of body weight, and should begin early in life and continue across the life course.
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Le Jemtel TH, Samson R, Milligan G, Jaiswal A, Oparil S. Visceral Adipose Tissue Accumulation and Residual Cardiovascular Risk. Curr Hypertens Rep 2018; 20:77. [PMID: 29992362 DOI: 10.1007/s11906-018-0880-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF THE REVIEW Low-grade systemic inflammation increases residual cardiovascular risk. The pathogenesis of low-grade systemic inflammation is not well understood. RECENT FINDINGS Visceral adipose tissue accumulates when the subcutaneous adipose tissue can no longer store excess nutrients. Visceral adipose tissue inflammation initially facilitates storage of nutrients but with time become maladaptive and responsible for low-grade systemic inflammation. Control of low-grade systemic inflammation requires reversal of visceral adipose tissue accumulation with intense and sustained aerobic exercise or bariatric surgery. Alternatively, pharmacologic inhibition of the inflammatory signaling pathway may be considered. Reversal visceral adipose tissue accumulation lowers residual cardiovascular risk.
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Affiliation(s)
- Thierry H Le Jemtel
- Division of Cardiology, Tulane University School of Medicine, 1430 Tulane Avenue, SL-48, New Orleans, LA, 70112, USA.
| | - Rohan Samson
- Division of Cardiology, Tulane University School of Medicine, 1430 Tulane Avenue, SL-48, New Orleans, LA, 70112, USA
| | - Gregory Milligan
- Division of Cardiology, Tulane University School of Medicine, 1430 Tulane Avenue, SL-48, New Orleans, LA, 70112, USA
| | - Abhishek Jaiswal
- Department of Cardiology, Hartford Hospital, 85 Jefferson Street, Suite 208, Hartford, CT, 06106, USA
| | - Suzanne Oparil
- Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, USA
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14
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Shioya-Yamada M, Shimada K, Nishitani-Yokoyama M, Sai E, Takeno K, Tamura Y, Watada H, Kawamori R, Daida H, Kawai S. Association Between Visceral Fat Accumulation and Exercise Tolerance in Non-Obese Subjects Without Diabetes. J Clin Med Res 2018; 10:630-635. [PMID: 29977420 PMCID: PMC6031249 DOI: 10.14740/jocmr3403w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 06/04/2018] [Indexed: 12/21/2022] Open
Abstract
Background We examined the associations between visceral fat accumulation, presence of the components of metabolic syndrome (MetS), and exercise tolerance in non-obese subjects without diabetes. Methods Seventy-four non-obese, non-diabetic Japanese men were enrolled. The subjects were divided into the following two groups: non-obese subjects without any MetS risk factors (n = 38, Group A) and non-obese subjects with one or two MetS risk factors (n = 36, Group B). Anthropometric and metabolic parameters were measured. The response of heart rate (HR) and blood pressure (BP), and exercise tolerance were also evaluated with a cardiopulmonary exercise test using a bicycle ergometer. Results The body mass index, abdominal circumference, visceral fat area, and homeostasis model assessment-insulin resistance, were significantly higher, while levels of anaerobic threshold and maximal oxygen uptake were significantly lower in Group B than in Group A. The levels of resting HR, resting BP, and BP at maximal exercise were significantly higher in Group B than in Group A. There were no significant differences in the HR at maximal exercise as well as the HR and BP after exercise between the two groups. The visceral fat area was significantly and negatively correlated with exercise tolerance. Multivariate linear regression analyses demonstrated that visceral fat area, but not abdominal circumference, was significantly and independently associated with maximal oxygen uptake. Conclusions These data suggest that the visceral fat area is a significant determinant for exercise tolerance even in non-obese subjects without diabetes.
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Affiliation(s)
- Miki Shioya-Yamada
- Juntendo University Graduate School of Health and Sports Science, Chiba, Japan
| | - Kazunori Shimada
- Juntendo University Graduate School of Health and Sports Science, Chiba, Japan.,Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Miho Nishitani-Yokoyama
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Eiryu Sai
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kageumi Takeno
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yoshifumi Tamura
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hirotaka Watada
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ryuzo Kawamori
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Sachio Kawai
- Juntendo University Graduate School of Health and Sports Science, Chiba, Japan
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15
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Giovannucci E. An Integrative Approach for Deciphering the Causal Associations of Physical Activity and Cancer Risk: The Role of Adiposity. J Natl Cancer Inst 2018; 110:935-941. [DOI: 10.1093/jnci/djy091] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 04/17/2018] [Indexed: 12/30/2022] Open
Affiliation(s)
- Edward Giovannucci
- Department of Nutrition and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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16
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Neeland IJ, Poirier P, Després JP. Cardiovascular and Metabolic Heterogeneity of Obesity: Clinical Challenges and Implications for Management. Circulation 2018; 137:1391-1406. [PMID: 29581366 PMCID: PMC5875734 DOI: 10.1161/circulationaha.117.029617] [Citation(s) in RCA: 460] [Impact Index Per Article: 76.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The prevalence of obesity has increased globally over the last 2 decades. Although the body mass index has been a convenient and simple index of obesity at the population level, studies have shown that obesity defined by body mass index alone is a remarkably heterogeneous condition with varying cardiovascular and metabolic manifestations across individuals. Adipose tissue is an exquisitely active metabolic organ engaged in cross-talk between various systems; perturbation of adipose tissue results in a pathological response to positive caloric balance in susceptible individuals that directly and indirectly contributes to cardiovascular and metabolic disease. Inadequate subcutaneous adipose tissue expansion in the face of dietary triglycerides leads to visceral and ectopic fat deposition, inflammatory/adipokine dysregulation, and insulin resistance. Conversely, preferential fat storage in the lower body depot may act as a metabolic buffer and protect other tissues from lipotoxicity caused by lipid overflow and ectopic fat. Translational, epidemiological, and clinical studies over the past 30 years have clearly demonstrated a strong link between visceral and ectopic fat and the development of a clinical syndrome characterized by atherogenic dyslipidemia, hyperinsulinemia/glucose intolerance, hypertension, atherosclerosis, and adverse cardiac remodeling/heart failure. This relationship is even more nuanced when clinical entities such as metabolically healthy obesity phenotype and the obesity paradox are considered. Although it is clear that the accumulation of visceral/ectopic fat is a major contributor to cardiovascular and metabolic risk above and beyond the body mass index, implementation of fat distribution assessment into clinical practice remains a challenge. Anthropometric indexes of obesity are easily implemented, but newer imaging-based methods offer improved sensitivity and specificity for measuring specific depots. Lifestyle, pharmacological, and surgical interventions allow a multidisciplinary approach to overweight/obesity that may improve outcomes and align with a public health message to combat the growing epidemic of obesity worldwide and to build healthier lives free of cardiovascular diseases.
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Affiliation(s)
- Ian J Neeland
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (I.J.N.)
| | - Paul Poirier
- Québec Heart and Lung Institute, Université Laval, Canada (P.P., J.-P.D.)
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Wu B, Huang J, Fukuo K, Suzuki K, Yoshino G, Kazumi T. Different Associations of Trunk and Lower-Body Fat Mass Distribution with Cardiometabolic Risk Factors between Healthy Middle-Aged Men and Women. Int J Endocrinol 2018; 2018:1289485. [PMID: 29531527 PMCID: PMC5817354 DOI: 10.1155/2018/1289485] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The aim of this study was to assess whether the gender-specific pattern of fat mass (FM) distribution is related to gender differences in cardiometabolic risk factors. 207 healthy middle-aged Japanese were included in the study. We measured FM in the total body, trunk, and lower-body with dual-energy X-ray absorptiometry (DXA). The percentage of trunk FM (TFM) and lower-body FM (LFM) is noted as %TFM and %LFM, respectively. Other measurements included glucose and insulin during oral glucose tolerance test (OGTT), leptin, adiponectin, plasminogen activator inhibitor-1 (PAI-1), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and systemic oxidative stress marker. Arterial properties were indicated by cardio-ankle vascular index (CAVI) and intima-media thickness (IMT) of the common carotid artery. The results showed that %TFM is higher whereas %LFM is lower in men than in women and men have a more atherogenic cardiometabolic profile. In both genders, %TFM (%LFM) is related to an unfavorable (favorable) cardiometabolic profile. In particular, the relation between %LFM and OGTT-derived insulin sensitivity index is stronger in women than in men. These findings suggested that in relatively healthy adults, android and gynoid pattern of FM distribution contributes to gender differences in cardiometabolic risk factors.
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Affiliation(s)
- Bin Wu
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo 663-8558, Japan
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Jingshan Huang
- School of Computing, University of South Alabama, Mobile, AL 36688-0002, USA
| | - Keisuke Fukuo
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo 663-8558, Japan
- Department of Food Sciences and Nutrition, School of Human Environmental Science, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo 663-8558, Japan
- Research Institute for Nutrition Sciences, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo 663-8558, Japan
| | - Kazuhisa Suzuki
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo 663-8558, Japan
| | - Gen Yoshino
- Department of Diabetes and Endocrinology, Toho University Omori Medical Center, Omori-Ku, Omori-nishi 6-11-1, Tokyo 143-8541, Japan
| | - Tsutomu Kazumi
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo 663-8558, Japan
- Research Institute for Nutrition Sciences, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo 663-8558, Japan
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18
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Gepner Y, Shelef I, Schwarzfuchs D, Zelicha H, Tene L, Yaskolka Meir A, Tsaban G, Cohen N, Bril N, Rein M, Serfaty D, Kenigsbuch S, Komy O, Wolak A, Chassidim Y, Golan R, Avni-Hassid H, Bilitzky A, Sarusi B, Goshen E, Shemesh E, Henkin Y, Stumvoll M, Blüher M, Thiery J, Ceglarek U, Rudich A, Stampfer MJ, Shai I. Effect of Distinct Lifestyle Interventions on Mobilization of Fat Storage Pools: CENTRAL Magnetic Resonance Imaging Randomized Controlled Trial. Circulation 2017; 137:1143-1157. [PMID: 29142011 DOI: 10.1161/circulationaha.117.030501] [Citation(s) in RCA: 171] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 10/26/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND We aimed to assess whether distinct lifestyle strategies can differentially affect specific body adipose depots. METHODS We performed an 18-month randomized controlled trial among 278 sedentary adults with abdominal obesity (75%) or dyslipidemia in an isolated workplace with a monitored provided lunch. Participants were randomized to isocaloric low-fat or Mediterranean/low-carbohydrate (MED/LC) diet+28 g walnuts/day with/without added moderate physical activity (PA; 80% aerobic; supervised/free gym membership). Overall primary outcome was body fat redistribution, and the main specific end point was visceral adipose tissue (VAT). We further followed the dynamics of different fat depots (deep and superficial subcutaneous, liver, pericardial, muscle, pancreas, and renal sinus) by magnetic resonance imaging. RESULTS Of 278 participants (age, 48 years, 89% men, body mass index, 30.8 kg/m2), 86% completed the trial with good adherence. The low-fat group preferentially decreased reported fat intake (-21.0% versus -11.5% for the MED/LC; P<0.001), and the MED/LC group decreased reported carbohydrates intake (-39.5% versus -21.3% for the low-fat group; P<0.001). The PA+ groups significantly increased the metabolic equivalents per week versus the PA- groups (19.0 versus 2.1; P=0.009). Whereas final moderate weight loss was indifferent, exercise attenuated the waist circumference rebound with the greatest effect in the MED/LCPA+ group (P<0.05). VAT (-22%), intrahepatic (-29%), and intrapericardial (-11%) fats declines were higher than pancreatic and femur intermuscular fats (1% to 2%) loss. Independent of weight loss, PA+ with either diet had a significantly greater effect on decreasing VAT (mean of difference, -6.67cm2; 95% confidence interval, -14.8 to -0.45) compared with PA-. The MED/LC diet was superior to the low-fat diet in decreasing intrahepatic, intrapericardial, and pancreatic fats (P<0.05 for all). In contrast, renal sinus and femoral intermuscular fats were not differentially altered by lifestyle interventions but by weight loss per se. In multivariate models further adjusted for weight loss, losing VAT or intrahepatic fat was independently associated with improved lipid profile, losing deep subcutaneous adipose tissue with improved insulin sensitivity, and losing superficial subcutaneous adipose tissue remained neutral except for an association with decreased leptin. CONCLUSIONS Moderate weight loss alone inadequately reflects the significant lifestyle effects on atherogenic and diabetogenic fat depots. The MED/LC diet mobilizes specific ectopic fat depots, and exercise has an independent contribution to VAT loss. Fat depots exhibit diverse responsiveness and are differentially related to cardiometabolic markers. Distinct lifestyle protocols may uniquely induce fat mobilization from specific anatomic sites. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT01530724.
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Affiliation(s)
- Yftach Gepner
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | | | - Dan Schwarzfuchs
- Soroka University Medical Center, Beer-Sheva, Israel (I.S., D.S., G.T., Y.C., Y.H.)
| | - Hila Zelicha
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Lilac Tene
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Anat Yaskolka Meir
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Gal Tsaban
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.).,Soroka University Medical Center, Beer-Sheva, Israel (I.S., D.S., G.T., Y.C., Y.H.)
| | - Noa Cohen
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Nitzan Bril
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Michal Rein
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Dana Serfaty
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Shira Kenigsbuch
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Oded Komy
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Arik Wolak
- Department of Cardiology, Cardiac Imaging Unit, Shaare Zedek Medical Center, Jerusalem, Israel (A.W.)
| | - Yoash Chassidim
- Soroka University Medical Center, Beer-Sheva, Israel (I.S., D.S., G.T., Y.C., Y.H.)
| | - Rachel Golan
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Hila Avni-Hassid
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Avital Bilitzky
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | | | - Eyal Goshen
- Nuclear Research Center-Negev, Dimona, Israel (B.S., E.G.)
| | - Elad Shemesh
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Yaakov Henkin
- Soroka University Medical Center, Beer-Sheva, Israel (I.S., D.S., G.T., Y.C., Y.H.)
| | - Michael Stumvoll
- Department of Medicine, University of Leipzig, Germany (M.S., M.B., J.T., U.C.)
| | - Matthias Blüher
- Department of Medicine, University of Leipzig, Germany (M.S., M.B., J.T., U.C.)
| | - Joachim Thiery
- Department of Medicine, University of Leipzig, Germany (M.S., M.B., J.T., U.C.)
| | - Uta Ceglarek
- Department of Medicine, University of Leipzig, Germany (M.S., M.B., J.T., U.C.)
| | - Assaf Rudich
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Meir J Stampfer
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, and Harvard T.H. Chan School of Public Health, Boston, MA (M.J.S.).
| | - Iris Shai
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.). .,Soroka University Medical Center, Beer-Sheva, Israel (I.S., D.S., G.T., Y.C., Y.H.)
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19
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Borel JC, Borel AL, Piper AJ. NERO: a pilot study but important step towards comprehensive management of obesity hypoventilation syndrome. Thorax 2017; 73:5-6. [DOI: 10.1136/thoraxjnl-2017-211032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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20
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Influence on Adiposity and Atherogenic Lipaemia of Fatty Meals and Snacks in Daily Life. J Lipids 2017; 2017:1375342. [PMID: 28706738 PMCID: PMC5494570 DOI: 10.1155/2017/1375342] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 05/02/2017] [Accepted: 05/09/2017] [Indexed: 11/18/2022] Open
Abstract
The present work reviewed the connections of changes in consumption of high-fat food with changes in adiposity and lipaemia in adults with overweight or obesity. Hyperlipaemia from higher fat meals and excessive adiposity contributes to atherogenic process. Low-fat diet interventions decrease body fat, lipaemia, and atherosclerosis markers. Inaccuracy of physical estimates of dietary fat intake remains, however, a limit to establishing causal connections. To fill this gap, tracking fat-rich eating episodes at short intervals quantifies the behavioural frequency suggested to measure (by regression of changes in real time) direct effects of this eating pattern on adiposity and atherogenic lipaemia. Such evidence will provide the basis for an approach focused on a sustained decrease in frequency of fatty meals or snacks to reduce obesity, hyperlipaemia, and atherosclerosis.
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21
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Munoz AJ, Bonhomme K, Lara-Castro C. Liraglutide effect on epicardial fat: Missing the forest for the trees. Obesity (Silver Spring) 2017; 25:979. [PMID: 28429872 DOI: 10.1002/oby.21844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 03/01/2017] [Indexed: 11/06/2022]
Affiliation(s)
- A Julian Munoz
- Department of Internal Medicine, Division of Endocrinology, University of South Carolina School of Medicine Columbia, South Carolina, USA
| | - Keisha Bonhomme
- Department of Internal Medicine, Division of Endocrinology, University of South Carolina School of Medicine Columbia, South Carolina, USA
| | - Cristina Lara-Castro
- USC-Palmetto Richland Medical Group, Department of Internal Medicine, Columbia, South Carolina, USA
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22
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Sanguankeo A, Lazo M, Upala S, Brancati FL, Bonekamp S, Pownall HJ, Balasubramanyam A, Clark JM. Effects of visceral adipose tissue reduction on CVD risk factors independent of weight loss: The Look AHEAD study. Endocr Res 2017; 42:86-95. [PMID: 27351077 PMCID: PMC5573136 DOI: 10.1080/07435800.2016.1194856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To determine if the reduction of visceral adipose tissue (VAT) volume by lifestyle intervention improved risk factors for cardiovascular disease (CVD) independent of weight loss amount. DESIGN Ancillary study of randomized-controlled trial. SETTING Data analysis using multivariable regression models. PARTICIPANTS Participants of the Look AHEAD (Action for HEAlth in Diabetes) Fatty Liver Ancillary Study. MAIN OUTCOME MEASURES Correlations between changes in VAT and in CVD risk factors, while adjusting for weight loss and treatment (intensive lifestyle intervention [ILI] vs. diabetes support and education [DSE]). RESULTS Of 100 participants analyzed, 52% were women, and 36% were black, with a mean age of 61.1 years. In the DSE group, mean weight and VAT changed by 0.1 % (p=0.90) and 4.3% (p=0.39), respectively. In the ILI group, mean weight and VAT decreased by 8.0% (p<0.001) and 7.7% (p=0.01), respectively. Across both groups, mean weight decreased by 3.6% (p<0.001), and mean VAT decreased by 1.2% (p=0.22); the decrease in VAT was correlated with the increase in HDL-cholesterol (HDL-C; R=-0.37; p=0.03). There were no correlations between changes in VAT and blood pressure, triglycerides, LDL-C, glucose, or HbA1c. After adjusting for age, race, gender, baseline metabolic values, fitness, and treatment group, changes in HDL-C were not associated with changes in VAT, while weight changes were independently associated with decrease in glucose, HbA1c, and increase in HDL-C. CONCLUSIONS VAT reduction was not correlated with improvements of CVD risk factors in a sample of overweight and obese adults with type 2 diabetes after adjusting for weight loss.
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Affiliation(s)
- Anawin Sanguankeo
- a Department of Preventive and Social Medicine , Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok , Thailand
- b Department of Internal Medicine , Bassett Medical Center and Columbia University College of Physicians and Surgeons , Cooperstown , NY , USA
- c The Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - Mariana Lazo
- d Division of General Internal Medicine, Department of Medicine , The Johns Hopkins University , Baltimore , MD , USA
- e The Welch Center for Prevention, Epidemiology, Prevention, and Clinical Research , Baltimore , MD , USA
| | - Sikarin Upala
- a Department of Preventive and Social Medicine , Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok , Thailand
- b Department of Internal Medicine , Bassett Medical Center and Columbia University College of Physicians and Surgeons , Cooperstown , NY , USA
| | | | - Susanne Bonekamp
- g The Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | | | - Ashok Balasubramanyam
- i Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine , Houston , TX , USA
| | - Jeanne M Clark
- c The Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
- e The Welch Center for Prevention, Epidemiology, Prevention, and Clinical Research , Baltimore , MD , USA
- g The Johns Hopkins University School of Medicine , Baltimore , MD , USA
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23
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Han E, Lee YH, Lee BW, Kang ES, Lee IK, Cha BS. Anatomic fat depots and cardiovascular risk: a focus on the leg fat using nationwide surveys (KNHANES 2008-2011). Cardiovasc Diabetol 2017; 16:54. [PMID: 28441953 PMCID: PMC5405479 DOI: 10.1186/s12933-017-0536-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 04/18/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Although central fat is a well-known risk factor for cardiovascular disease (CVD) and cardiometabolic disorders, the effect of other regional fats or muscle distribution on CVD risk has not been fully investigated. METHODS This was a cross-sectional study using nationally representative samples of 15,686 subjects from the 2008-2011 Korea National Health and Nutrition Examination Survey. Individual CVD risk was evaluated in adults aged ≥20 without prior CVD, using atherosclerotic cardiovascular disease (ASCVD) risk equations according to the 2013 ACC/AHA guidelines. Body composition was assessed by dual X-ray absorptiometry. RESULTS Ratio of leg fat to total fat (LF/TF ratio) was the most predictive for CVD among body fat or muscle distribution parameters (AUC = 0.748, 95% CI 0.741-0.755). ASCVD risk score was gradually increased with decreased LF/TF ratio (P < 0.001), and individuals whose LF/TF ratio in lowest tertile tended to belong to the high-risk (10-year risk >10%) group compared to those in the highest tertile (OR = 6.25, 95% CI 5.60-6.98). Subjects in the lowest tertile showed increased risk of cardiometabolic risk factor components including obesity, hypertension, diabetes, dyslipidemia, chronic kidney disease, and albuminuria (OR range 2.57-11.24, all P < 0.001). In addition, a higher LF/TF ratio was associated with decreased ASCVD risk, even in subjects with multiple CVD risk factors. Multiple logistic regression analyses also demonstrated this association (OR = 1.85, 95% CI 1.36-2.52). CONCLUSIONS Among various body composition parameters, LF/TF ratio was superior in predicting higher CVD risk and a higher LF/TF ratio was independently associated with decreased risk of CVD and each cardiometabolic risk factor.
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Affiliation(s)
- Eugene Han
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.,Graduate School, Yonsei University College of Medicine, Seoul, South Korea.,Division of Endocrinology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Yong-Ho Lee
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea. .,Graduate School, Yonsei University College of Medicine, Seoul, South Korea. .,Institue of Endocrine Research, Yonsei University College of Medicine, Seoul, South Korea.
| | - Byung-Wan Lee
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.,Graduate School, Yonsei University College of Medicine, Seoul, South Korea.,Institue of Endocrine Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Seok Kang
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.,Graduate School, Yonsei University College of Medicine, Seoul, South Korea.,Institue of Endocrine Research, Yonsei University College of Medicine, Seoul, South Korea
| | - In-Kyu Lee
- Division of Endocrinology, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea
| | - Bong-Soo Cha
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.,Graduate School, Yonsei University College of Medicine, Seoul, South Korea.,Institue of Endocrine Research, Yonsei University College of Medicine, Seoul, South Korea
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24
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Rosqvist F, Bjermo H, Kullberg J, Johansson L, Michaëlsson K, Ahlström H, Lind L, Risérus U. Fatty acid composition in serum cholesterol esters and phospholipids is linked to visceral and subcutaneous adipose tissue content in elderly individuals: a cross-sectional study. Lipids Health Dis 2017; 16:68. [PMID: 28372558 PMCID: PMC5379570 DOI: 10.1186/s12944-017-0445-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 03/07/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Visceral adipose tissue (VAT) and truncal fat predict cardiometabolic disease. Intervention trials suggest that saturated fatty acids (SFA), e.g. palmitic acid, promote abdominal and liver fat storage whereas polyunsaturated fatty acids (PUFA), e.g. linoleic acid, prevent fat accumulation. Such findings require investigation in population-based studies of older individuals. We aimed to investigate the relationships of serum biomarkers of PUFA intake as well as serum levels of palmitic acid, with abdominal and total adipose tissue content. METHODS In a population-based sample of 287 elderly subjects in the PIVUS cohort, we assessed fatty acid composition in serum cholesterol esters (CE) and phospholipids (PL) by gas chromatography and the amount of VAT and abdominal subcutaneous (SAT) adipose tissue by magnetic resonance imaging (MRI), liver fat by MR spectroscopy (MRS), and total body fat, trunk fat and leg fat by dual-energy X-ray absorptiometry (DXA). Insulin resistance was estimated by HOMA-IR. RESULTS VAT and trunk fat showed the strongest correlation with insulin resistance (r = 0.49, P < 0.001). Linoleic acid in both CE and PL was inversely related to all body fat depots (r = -0.24 to -0.33, P < 0.001) including liver fat measured in a sub-group (r = -0.26, P < 0.05, n = 73), whereas n-3 PUFA showed weak inverse (18:3n-3) or positive (20:5n-3) associations. Palmitic acid in CE, but not in PL, was directly correlated with VAT (r = 0.19, P < 0.001) and trunk fat (r = 0.18, P = 0.003). Overall, the significant associations remained after adjusting for energy intake, height, alcohol, sex, smoking, education and physical activity. The inverse correlation between linoleic acid and VAT remained significant after further adjustment for total body fat. CONCLUSIONS Serum linoleic acid is inversely related to body fat storage including VAT and trunk fat whereas palmitic acid was less consistently but directly associated, in line with recent feeding studies. Considering the close link between VAT and insulin resistance, a potential preventive role of plant-based PUFA in VAT accumulation warrants further study.
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Affiliation(s)
- Fredrik Rosqvist
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Helena Bjermo
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Joel Kullberg
- Department of Radiology, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Lars Johansson
- Department of Radiology, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Karl Michaëlsson
- Department of Surgical Sciences, Section of Orthopaedics, Uppsala University, Uppsala, Sweden
| | - Håkan Ahlström
- Department of Radiology, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Lars Lind
- Department of Medical Sciences, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
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Borel AL, Nazare JA, Baillot A, Alméras N, Tremblay A, Bergeron J, Poirier P, Després JP. Cardiometabolic risk improvement in response to a 3-yr lifestyle modification program in men: contribution of improved cardiorespiratory fitness vs. weight loss. Am J Physiol Endocrinol Metab 2017; 312:E273-E281. [PMID: 28028035 DOI: 10.1152/ajpendo.00278.2016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 12/06/2016] [Accepted: 12/27/2016] [Indexed: 12/16/2022]
Abstract
Our objective was to examine the respective contributions of changes in visceral adiposity, subcutaneous adiposity, liver fat, and cardiorespiratory fitness (CRF) to the improvements in cardiometabolic risk markers in response to a 3-yr healthy eating/physical activity lifestyle intervention. Ninety-four out of 144 viscerally obese healthy men completed a 3-yr lifestyle intervention. Body weight, body composition, and fat distribution were assessed by anthropometry and DEXA/computed tomography. CRF, adipokines, lipoprotein/lipid profile, and 75 g of oral glucose tolerance were assessed. CRF and visceral and subcutaneous adiposity significantly improved over the 3-yr intervention, with a nadir in year 1 and a partial regain in year 3 Liver fat (estimated by insulin hepatic extraction) stabilized from year 1 to year 3, whereas HOMA-IR, ISI-Matsuda index, and adiponectin continued to improve. Multivariate analysis revealed that both visceral adiposity and estimated liver fat reductions contributed to the improved ISI-Matsuda index observed over 3 yr (r2 = 0.28, P < 0.001). Three-year changes in fat mass and CRF were independently associated with changes in visceral fat (adjusted r2 = 0.40, P < 0.001), whereas only changes in CRF were associated with changes in estimated liver fat (adjusted r2 = 0.18, P < 0.001). A long-term (3 yr) healthy eating/physical activity intervention in men improves several cardiometabolic risk markers over the long term (3 yr) despite a partial body weight regain observed between year 1 and year 3 The improvement in CRF contributes to visceral and estimated liver fat losses over the long term, which in turn explain the benefits of the lifestyle intervention on cardiometabolic risk profile.
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Affiliation(s)
- Anne-Laure Borel
- Grenoble Alpes University Hospital, Endocrinology Department, Grenoble, France
- Grenoble Alpes University, Hypoxia Physiopathology (HP2), Laboratory Institut National de la Santé et de la Recherche Médicale (INSERM) U1042, Grenoble, France
| | - Julie-Anne Nazare
- Centre de Recherche en Nutrition Humaine Rhône-Alpes, Centre Européen de Nutrition pour la Santé, Cardiovasculaire, Métabolisme, Diabétologie et Nutrition INSERM U1060 U060, University of Lyon, Lyon, France
| | - Aurélie Baillot
- Nursing Department, Université du Québec en Outaouais, Gatineau, Quebec, Canada
| | - Natalie Alméras
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
| | - Angelo Tremblay
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
| | - Jean Bergeron
- Endocrinology and Nephrology Unit, Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec City, Quebec, Canada; and
| | - Paul Poirier
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
- Faculty of Pharmacy, Université Laval, Quebec City, Quebec, Canada
| | - Jean-Pierre Després
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada;
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
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26
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Associations between physical activity and BMI, body fatness, and visceral adiposity in overweight or obese Latino and non-Latino adults. Int J Obes (Lond) 2017; 41:873-877. [PMID: 28220040 PMCID: PMC5461184 DOI: 10.1038/ijo.2017.49] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 02/01/2017] [Accepted: 02/10/2017] [Indexed: 01/11/2023]
Abstract
Background/Objectives Although several studies have reported associations between moderate to vigorous physical activity (MVPA), body fatness, and visceral adipose tissue (VAT), the extent to which associations differ among Latinos and non-Latinos remains unclear. The present study evaluated the associations between body composition and MVPA in Latino and non-Latino adults. Subjects/Methods An exploratory, cross-sectional analysis was conducted using baseline data collected from 298 overweight adults enrolled in a 12-month randomized controlled trial that tested the efficacy of text messaging to improve weight loss. MVPA, body fatness and VAT were assessed by waist-worn accelerometry, DXA, and DXA-derived software (GE CoreScan GE, Madison, WI) respectively. Participants with less than 5 days of accelerometry data or missing DXA data were excluded; 236 participants had complete data. Multivariable linear regression assessed associations between body composition and MVPA per day, defined as time in MVPA, bouts of MVPA (time per bout ≥10 min), non-bouts of MVPA (time per bout <10 min), and meeting the 150-minute MVPA guideline. The modifying influence of ethnicity was modeled with a multiplicative interaction term. Results The interaction between ethnicity and MVPA in predicting percent body fat was significant (p = 0.01, 95% CI [0.58, 4.43]) such that a given increase in MVPA was associated with a greater decline in total body fat in non-Latinos compared to Latinos (adjusted for age, sex and accelerometer wear time). There was no interaction between ethnicity and MVPA in predicting VAT (g) (p = 0.78, 95% CI [−205.74, 273.17]) and BMI (p = 0.18, 95% CI [−0.49, 2.26]). Conclusions An increase in MVPA was associated with a larger decrease in body fat, but neither BMI nor VAT, in non-Latinos compared to Latinos. This suggests that changes in VAT and BMI in response to MVPA may be less influenced by ethnicity than is total body fatness.
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27
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Karimian S, Stein J, Bauer B, Teupe C. Improvement of impaired diastolic left ventricular function after diet-induced weight reduction in severe obesity. Diabetes Metab Syndr Obes 2017; 10:19-25. [PMID: 28123309 PMCID: PMC5229165 DOI: 10.2147/dmso.s124541] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND/OBJECTIVES Obesity is independently associated with left ventricular (LV) diastolic dysfunction and altered cardiac morphology. Morbidity and mortality in patients with diastolic dysfunction are similar to values observed in patients with systolic heart failure. We hypothesized that dysfunctional cardiac responses in people with obesity are reversible after weight loss. Thus, we studied the effect of dietary weight reduction on LV diastolic function as well as on cardiac structure using transthoracic echocardiography and tissue Doppler imaging (TDI). SUBJECTS/METHODS Thirty-two subjects with obesity underwent a 12-week low-calorie fasting phase of a formula diet. Echocardiographic tissue Doppler indices of diastolic function and measurements of cardiac size were obtained prior to and after the fasting phase. RESULTS A 12-week diet significantly reduced body mass index from 40.3 ± 6.6 kg/m2 to 33.2 ± 6.1 kg/m2 (p < 0.01). Weight loss was associated with a significant reduction in blood pressure and heart rate. Echocardiography revealed diastolic dysfunction in subjects with obesity, which was improved by dieting. After weight loss, trans-mitral Doppler echocardiography showed a significant reduction in A-wave velocity, from 65.8 ± 19.2 cm/s to 57.0 ± 16.8 cm/s, and an increase in E/A ratio from 1.2 ± 0.4 to 1.4 ± 0.5 (p < 0.01). TDI displayed a significantly lower a'-wave velocity (10.3 ± 2.3 cm/s and 8.9 ± 1.7 cm/s; p < 0.01). Left atrial and LV dimensions were normal and remained unchanged after weight loss. CONCLUSION Obesity is associated with diastolic dysfunction. A 12-week low-calorie diet with successful weight loss can reduce blood pressure and heart rate and partially normalize diastolic dysfunction.
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Affiliation(s)
| | | | - Boris Bauer
- Department of Radiology, Krankenhaus Sachsenhausen, Teaching Hospital of Goethe University Frankfurt, Frankfurt, Germany
| | - Claudius Teupe
- Department of Medicine – Cardiology
- Correspondence: Claudius Teupe, Department of Internal Medicine – Cardiology, Krankenhaus Sachsenhausen, Teaching Hospital of Goethe University Frankfurt, Schulstrasse 31, D-60594 Frankfurt, Germany, Tel +49 69 6605 1100, Fax +49 69 6605 29 1100, Email
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28
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Takagawa Y, Yagi S, Ise T, Ishii A, Nishikawa K, Fukuda D, Kusunose K, Matsuura T, Tobiume T, Yamaguchi K, Yamada H, Soeki T, Wakatsuki T, Shimabukuro M, Katoh S, Aihara KI, Akaike M, Sata M. Improved Exercise Capacity After Cardiac Rehabilitation Is Associated with Reduced Visceral Fat in Patients with Chronic Heart Failure. Int Heart J 2017; 58:746-751. [DOI: 10.1536/ihj.16-454] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Yuriko Takagawa
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
- Department of Community Medicine and Human Resource Development, Tokushima University Graduate School of Biomedical Sciences
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Ayumi Ishii
- Department of Rehabilitation, Tokushima University Hospital
| | - Koji Nishikawa
- Department of Rehabilitation, Tokushima University Hospital
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
- Departments of Cardio-Diabetes Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Tomomi Matsuura
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takeshi Tobiume
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Michio Shimabukuro
- Departments of Cardio-Diabetes Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Shinsuke Katoh
- Department of Rehabilitation, Tokushima University Hospital
| | - Ken-ichi Aihara
- Departments of Medical Education Community Medicine for Diabetes and Metabolic Disorders, Tokushima University Graduate School of Biomedical Sciences
| | - Masashi Akaike
- Departments of Medical Education, Tokushima University Graduate School of Biomedical Sciences
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
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Boudet G, Walther G, Courteix D, Obert P, Lesourd B, Pereira B, Chapier R, Vinet A, Chamoux A, Naughton G, Poirier P, Dutheil F. Paradoxical dissociation between heart rate and heart rate variability following different modalities of exercise in individuals with metabolic syndrome: The RESOLVE study. Eur J Prev Cardiol 2016; 24:281-296. [PMID: 27856807 DOI: 10.1177/2047487316679523] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Aims To analyse the effects of different modalities of exercise training on heart rate variability (HRV) in individuals with metabolic syndrome (MetS). Methods and results Eighty MetS participants (aged 50-70 years) were housed and managed in an inpatient medical centre for 21 days, including weekends. Physical activity and food intake/diet were intensively monitored. Participants were randomly assigned into three training groups, differing only by intensity of exercise: moderate-endurance-moderate-resistance ( re), high-resistance-moderate-endurance ( Re), and moderate-resistance-high-endurance ( rE). HRV was recorded before and after the intervention by 24-hour Holter electrocardiogram. Although mean 24-hour heart rate decreased more in Re than re (-11.6 ± 1.6 vs. -4.8 ± 2.1%; P = 0.010), low frequency/high frequency decreased more in re than Re (-20.4 ± 5.5% vs. + 20.4 ± 9.1%; P = 0.002) and rE (-20.4 ± 5.5% vs. -0.3 ± 11.1%; P = 0.003). Very low frequency increased more in Re than re (+121.2 ± 35.7 vs. 42.9 ± 11.3%; P = 0.004). For all HRV parameters, rE ranged between re and Re values. Low frequency/high frequency changes were linked with visceral fat loss only in re (coefficient 5.9, 95% CI 1.9-10.0; P = 0.004). By day 21, HRV parameters of MetS groups (heart rate -8.6 ± 1.0%, standard deviation of R-R intervals + 34.0 ± 6.6%, total power + 63.3 ± 11.1%; P < 0.001) became closer to values of 50 aged-matched healthy controls. Conclusions A 3-week residential programme with intensive volumes of physical activity (15-20 hours per week) enhanced HRV in individuals with MetS. Participants with moderate intensity of training had greater improvements in sympathovagal balance, whereas those with high intensity in resistance training had greater decreases in heart rate and greater increases in very low frequency. Modality-specific relationships were observed between enhanced HRV and visceral fat loss. Clinical Trial Registration URL: http://www.clinicaltrials.gov . Unique identifier: NCT00917917.
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Affiliation(s)
- Gil Boudet
- 1 University Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), France.,2 University Hospital of Clermont Ferrand (CHU), Preventive and Occupational Medicine, France
| | | | - Daniel Courteix
- 1 University Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), France
| | | | - Bruno Lesourd
- 1 University Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), France
| | - Bruno Pereira
- 4 University Hospital of Clermont Ferrand (CHU), Clinical Research and Innovation Direction, France
| | - Robert Chapier
- 1 University Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), France
| | - Agnès Vinet
- 3 University of Avignon, LaPEC EA4278, France
| | - Alain Chamoux
- 2 University Hospital of Clermont Ferrand (CHU), Preventive and Occupational Medicine, France
| | - Geraldine Naughton
- 5 Australian Catholic University, School of Exercise Science, Faculty of Health, Australia
| | - Paul Poirier
- 6 Centre de recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Canada.,7 Faculté de Pharmacie, Université Laval, Canada
| | - Frédéric Dutheil
- 1 University Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), France.,2 University Hospital of Clermont Ferrand (CHU), Preventive and Occupational Medicine, France.,5 Australian Catholic University, School of Exercise Science, Faculty of Health, Australia.,8 CNRS, UMR 6024, Physiological and Psychosocial Stress, University Clermont Auvergne, France
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Gangloff A, Bergeron J, Lemieux I, Després JP. Changes in circulating vitamin D levels with loss of adipose tissue. Curr Opin Clin Nutr Metab Care 2016; 19:464-470. [PMID: 27537278 DOI: 10.1097/mco.0000000000000315] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW Low vitamin D levels have been extensively reported in obesity. Thus, the pandemic of obesity has been paralleled by a high prevalence of low vitamin D status. Given the well documented associations linking poor vitamin D status to adverse health outcomes (diabetes, cardiovascular disease, cancers, all-cause mortality), a proper understanding of the mechanisms linking excess adiposity to low vitamin D status is key to identify and implement effective interventions to replenish vitamin D levels in obese individuals. In this review, we will discuss recent literature investigating the effects of adipose tissue volume loss through energy restriction and/or physical activity on circulating 25-hydroxyvitamin D [25(OH)D] levels. RECENT FINDINGS Improvements of circulating 25(OH)D levels with adiposity loss through lifestyle interventions without supplementation is being reported by a growing number of studies, including recent randomized controlled trials. SUMMARY Low 25(OH)D is one of the metabolic disturbances associated with excess adiposity, particularly visceral adiposity. Recommendations for the treatment of obesity-related vitamin D deficiency should emphasize the role of visceral adiposity loss through healthy lifestyle habits, in conjunction with weight-adjusted vitamin D supplementation, not only to replenish 25(OH)D levels but also to address other visceral adiposity-related disturbances, such as insulin resistance, inflammation, hypertension, and dyslipidemia.
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Affiliation(s)
- Anne Gangloff
- aQuébec Heart and Lung Institute Research Centre bLipid Clinic, CHU de Québec-Université Laval cEndocrinology and Nephrology Unit, CHU de Québec Research Centre dFaculty of Medicine, Department of Kinesiology, Université Laval, Québec City, Québec, Canada
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Abdelbadee AY, Paspulati RM, McFarland HD, Bedaiwy MA, Ciancibello L, Anderson G, Zanotti KM. Computed Tomography Morphometrics and Pulmonary Intolerance in Endometrial Cancer Robotic Surgery. J Minim Invasive Gynecol 2016; 23:1075-1082. [PMID: 27449691 DOI: 10.1016/j.jmig.2016.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 07/06/2016] [Accepted: 07/11/2016] [Indexed: 10/21/2022]
Abstract
STUDY OBJECTIVES To identify morphometric characteristics of obese patients that best predict pulmonary intolerance to robotic pelvic surgery using a novel method for quantifying adipose distribution. DESIGN Retrospective study (Canadian Task Force classification II-2). SETTING University hospital. PATIENTS Fifty-nine patients with endometrial cancer who underwent robotic hysterectomy and lymphadenectomy between April 2008 and May 2014 and also underwent perioperative computed tomography (CT) imaging within 1 year. INTERVENTION Visceral fat volume (VFV) and subcutaneous fat volume (SFV) were quantified through waist circumference measurements along with average volume estimation of slices taken at 3 levels: mid-waist, L2-L3, and L4-L5. Mean and maximum values were obtained for intraoperative physiological data. MEASUREMENTS AND MAIN RESULTS The patients' mean body mass index (BMI) was 34 (range, 20-59). Along with waist circumference, VFV and SFV quantified by CT at the mid-waist, L2-L3, and L4-L5 levels were all significant independent predictors for peak airway pressure (PAP; average and maximum) and plateau airway pressure (Pplat; average and maximum) on multivariate regression analysis after adjustment for age, ethnicity, diabetes, hypertension, pulmonary disease, smoking, obstructive sleep apnea, American Society of Anesthesiologists classification, and duration of anesthesia. Compared with the other CT parameters, L2-L3 VFV was the best predictor of average PAP (β = 0.398; p = .002), maximum PAP (β = 0.493; p < .001), average Pplat (β = 0.536; p < .001), and maximum Pplat (β = 0.573; p < .001). CONCLUSION These novel CT morphometric measurements represent valid predictors of pulmonary intolerance to robotic surgery in obese patients. Of the measures analyzed, VFV at L2-L3 best predicts pulmonary tolerance in obese patients.
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Affiliation(s)
- Ahmed Y Abdelbadee
- Department of Reproductive Biology, University Hospitals Case Medical Center, Cleveland, OH; Department of Obstetrics and Gynecology, Women's Health Hospital, Assiut University, Assiut, Egypt
| | - Raj M Paspulati
- Radiology Department, University Hospitals Case Medical Center, Cleveland, OH
| | - Heather D McFarland
- Department of Anesthesiology and Perioperative Medicine, University Hospitals Case Medical Center, Cleveland, OH
| | - Mohamed A Bedaiwy
- Department of Obstetrics and Gynecology, Women's Health Hospital, Assiut University, Assiut, Egypt; Department of Obstetrics and Gynecology, Faculty of Medicine, University of British Colombia, Vancouver, BC, Canada
| | - Leslie Ciancibello
- Radiology Department, University Hospitals Case Medical Center, Cleveland, OH
| | - Gina Anderson
- Radiology Department, University Hospitals Case Medical Center, Cleveland, OH
| | - Kristine M Zanotti
- Department of Reproductive Biology, University Hospitals Case Medical Center, Cleveland, OH.
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Leclerc J, Arsenault M, Després JP, Brassard P, Gaudreault V, Bergeron J, Alméras N, Tremblay A, Auclair A, Ross MK, Denault-Bissonnette S, Poirier P. Determinants of Improvement In Left Ventricular Diastolic Function Following a 1-Year Lifestyle Modification Program in Abdominally Obese Men with Features of the Metabolic Syndrome. Metab Syndr Relat Disord 2016; 14:483-491. [PMID: 27754772 DOI: 10.1089/met.2016.0021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Abdominal obesity and presence of the metabolic syndrome (MetS) are associated with cardiac abnormalities. Among those, left ventricular diastolic dysfunction (LVDD) is the most frequently encountered in clinical practice. Few studies evaluated the reversibility of LVDD by an approach promoting lifestyle modifications in abdominally obese subjects with MetS. METHODS We assessed the impact of a 1-year lifestyle modification program combining nutritional and physical activity counseling on LVDD and metabolic profile of abdominally obese men with MetS. Echocardiograms, oral glucose tolerance test, lipids profile, dual energy X-ray absorptiometry, computed tomography scans (visceral obesity assessment), heart rate variability (HRV), as well as maximal and submaximal exercise tests were performed in participants before and after a 1-year program combining healthy eating and a physical activity/exercise program. RESULTS Fifty-one abdominally obese men participated in this study. At baseline, 86% of the participants had LVDD (n = 44). After the 1-year program, LVDD improved in 57% of participants (n = 29, P < 0.0001). All metabolic, adiposity, and exercise tolerance measures improved from baseline (P < 0.0001), but were not associated with improvement in LVDD. Participants who improved LVDD had better exercise performance at baseline. Exercise tolerance during the submaximal exercise test, parasympathetic cardiac autonomic activity, and fasting insulin predicted 50% of LVDD improvements. CONCLUSIONS There was a significant improvement in LVDD after a 1-year lifestyle intervention program in abdominally obese men with MetS, such an improvement being associated with increased exercise tolerance, enhanced HRV, and reduced insulin levels.
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Affiliation(s)
- Jacinthe Leclerc
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,2 Faculté de Pharmacie, Université Laval , Québec, Canada
| | - Marie Arsenault
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,3 Faculté de médecine, Université Laval , Québec, Canada
| | - Jean-Pierre Després
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,4 Département de kinésiologie, Faculté de médecine, Université Laval , Québec, Canada
| | - Patrice Brassard
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,4 Département de kinésiologie, Faculté de médecine, Université Laval , Québec, Canada
| | - Valérie Gaudreault
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,2 Faculté de Pharmacie, Université Laval , Québec, Canada
| | - Jean Bergeron
- 3 Faculté de médecine, Université Laval , Québec, Canada .,5 Centre Hospitalier Universitaire de Québec-Université Laval , Québec, Canada
| | - Natalie Alméras
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,3 Faculté de médecine, Université Laval , Québec, Canada
| | - Angelo Tremblay
- 4 Département de kinésiologie, Faculté de médecine, Université Laval , Québec, Canada
| | - Audrey Auclair
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,2 Faculté de Pharmacie, Université Laval , Québec, Canada
| | - Marie-Kristelle Ross
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,3 Faculté de médecine, Université Laval , Québec, Canada .,6 Centre Hospitalier de Lévis , Québec, Québec, Canada
| | - Stéphanie Denault-Bissonnette
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,3 Faculté de médecine, Université Laval , Québec, Canada .,5 Centre Hospitalier Universitaire de Québec-Université Laval , Québec, Canada
| | - Paul Poirier
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,2 Faculté de Pharmacie, Université Laval , Québec, Canada
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Lipid accumulation product (LAP) as a criterion for the identification of the healthy obesity phenotype in postmenopausal women. Exp Gerontol 2016; 82:81-7. [DOI: 10.1016/j.exger.2016.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 06/16/2016] [Accepted: 06/17/2016] [Indexed: 01/11/2023]
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Abstract
Epidemiological studies have illustrated convincingly that fat distribution is associated with cardiometabolic risk. Fat deposition preferentially in the lower body, commonly seen in premenopausal women, is associated with lower risk, while central obesity in men and postmenopausal women is associated with higher risk. Studies of the physiology and the tissue and cellular characteristics of different adipose tissue depots, visceral and abdominal, gluteal, and femoral subcutaneous, corroborate this idea. In this report, we chose to focus on interventions-surgical, hormonal, lifestyle, and pharmacological-that directly or indirectly affect fat distribution, seeking further evidence for its pathophysiological significance.
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Affiliation(s)
- Pornpoj Pramyothin
- Division of Nutrition, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Asadang building, 8th floor, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand
| | - Kalypso Karastergiou
- Department of Medicine, Evans Biomedical Research Center, Boston University School of Medicine, 650 Albany St, Rm 810, Boston, MA, 02118, USA.
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Bottorff JL, Seaton CL, Johnson ST, Caperchione CM, Oliffe JL, More K, Jaffer-Hirji H, Tillotson SM. An Updated Review of Interventions that Include Promotion of Physical Activity for Adult Men. Sports Med 2016; 45:775-800. [PMID: 25430599 PMCID: PMC4440891 DOI: 10.1007/s40279-014-0286-3] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The marked disparity in life expectancy between men and women suggests men are a vulnerable group requiring targeted health promotion programs. As such, there is an increasing need for health promotion strategies that effectively engage men with their health and/or illness management. Programs that promote physical activity could significantly improve the health of men. Although George et al. (Sports Med 42(3):281, 30) reviewed physical activity programs involving adult males published between 1990 and 2010, developments in men's health have prompted the emergence of new sex- and gender-specific approaches targeting men. The purpose of this review was to: (1) extend and update the review undertaken by George et al. (Sports Med 42(3):281, 30) concerning the effectiveness of physical activity programs in males, and (2) evaluate the integration of gender-specific influences in the content, design, and delivery of men's health promotion programs. A search of MEDLINE, CINAHL, ScienceDirect, Web of Science, PsycINFO, the Cochrane Library, and the SPORTDiscus databases for articles published between January 2010 and August 2014 was conducted. In total, 35 studies, involving evaluations of 31 programs, were identified. Findings revealed that a variety of techniques and modes of delivery could effectively promote physical activity among men. Though the majority of programs were offered exclusively to men, 12 programs explicitly integrated gender-related influences in male-specific programs in ways that recognized men's interests and preferences. Innovations in male-only programs that focus on masculine ideals and gender influences to engage men in increasing their physical activity hold potential for informing strategies to promote other areas of men's health.
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Affiliation(s)
- Joan L Bottorff
- Institute for Healthy Living and Chronic Disease Prevention, and School of Nursing, University of British Columbia, ART223, 3333 University Way, Kelowna, BC, V1V 1V7, Canada,
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Wu FZ, Huang YL, Wu CC, Wang YC, Pan HJ, Huang CK, Yeh LR, Wu MT. Differential Effects of Bariatric Surgery Versus Exercise on Excessive Visceral Fat Deposits. Medicine (Baltimore) 2016; 95:e2616. [PMID: 26844473 PMCID: PMC4748890 DOI: 10.1097/md.0000000000002616] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The aim of the present study was to compare differential impacts of bariatric surgery and exercise-induced weight loss on excessive abdominal and cardiac fat deposition.Excessive fat accumulation around the heart may play an important role in the pathogenesis of cardiovascular disease. Recent evidences have suggested that bariatric surgery results in relatively less decrease in epicardial fat compared with abdominal visceral fat and paracardial fat.Sixty-four consecutive overweight or obese subjects were enrolled in the study. Clinical characteristics and metabolic profiles were recorded. The volumes of abdominal visceral adipose tissue (AVAT), abdominal subcutaneous adipose tissue (ASAT), epicardial (EAT), and paracardial adipose tissue (PAT) were measured by computed tomography in the bariatric surgery group (N = 25) and the exercise group (N = 39) at baseline and 3 months after intervention. Subjects in both the surgery and exercise groups showed significant reduction in body mass index (15.97%, 7.47%), AVAT (40.52%, 15.24%), ASAT (31.40, 17.34%), PAT (34.40%, 12.05%), and PAT + EAT (22.31%, 17.72%) (all P < 0.001) after intervention compared with baseline. In both the groups, the decrease in EAT was small compared with the other compartments (P < 0.01 in both groups). Compared with the exercise group, the surgery group had greater loss in abdominal and cardiac visceral adipose tissue (AVAT, ASAT, PAT, EAT+PAT) (P < 0.001), but lesser loss in EAT (P = 0.037).Compared with the exercise group, bariatric surgery results in significantly greater percentage loss of excessive fat deposits except for EAT. EAT, but not PAT, was relatively preserved despite weight reduction in both the groups. The physiological impact of persistent EAT deserves further investigation.
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Affiliation(s)
- Fu-Zong Wu
- From the Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan (F-ZW, Y-LH, Y-CW, M-TW); Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan (F-ZW, Y-LH, M-TW); Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan (F-ZW, Y-LH, M-TW); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX (CCW); Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan (H-JP); Bariatric & Metabolic International Surgery Center, E-Da Hospital, Kaohsiung, Taiwan (C-KH); and Department of Radiology, E-Da Hospital, Kaohsiung, Taiwan (L-RY)
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Auclair A, Martin J, Bastien M, Bonneville N, Biertho L, Marceau S, Hould FS, Biron S, Lebel S, Lescelleur O, Després JP, Poirier P. Is There a Role for Visceral Adiposity in Inducing Type 2 Diabetes Remission in Severely Obese Patients Following Biliopancreatic Diversion with Duodenal Switch Surgery? Obes Surg 2015; 26:1717-27. [DOI: 10.1007/s11695-015-1973-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Després JP. Exercise and energy balance: going to extremes to show that body weight is not the best outcome. Am J Clin Nutr 2015; 102:1303-4. [PMID: 26561630 DOI: 10.3945/ajcn.115.124560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jean-Pierre Després
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Québec City, Québec, Canada; and Department of Kinesiology, Faculty of Medicine, Université Laval, Québec City, Québec, Canada
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Kim CS, Kim SK, Araneta MRG, Lee EJ, Barrett-Connor E, Huh KB. Can increased visceral adiposity without body weight changes accelerate carotid atherosclerosis in South Korean participants with type 2 diabetes? J Diabetes Complications 2015; 29:1085-91. [PMID: 26231803 DOI: 10.1016/j.jdiacomp.2015.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 06/10/2015] [Accepted: 06/12/2015] [Indexed: 11/25/2022]
Abstract
AIMS Type 2 diabetes mellitus (T2DM) and visceral obesity are associated with each other and with cardiovascular diseases. We determined whether increased visceral adiposity without weight gain was associated with sex-specific accelerated carotid atherosclerosis in South Koreans with T2DM. METHODS From 2003 to 2012, we recruited 280 participants with T2DM for the Seoul Metabolic Syndrome cohort who had body weight, visceral fat thickness (VFT), and carotid intima-media thickness (CIMT) measured at intervals of 2years. According to VFT change, sex-specific quartiles of clinical characteristics and changes of CIMT were determined. Logistic regression models predicted the odds of the progression of CIMTs in each quartile. RESULTS During 2years of observation, VFTs fell by 5.2±13.5mm in men (P<0.001) and 3.4±10.5mm in women (P<0.001). Progression of CIMT was only significant for women's maximal CIMT (0.031±0.145mm, P=0.012), while significant improvements in HbA1c were found (0.9%; P<0.001 in both sexes). There were no significant differences in clinical characteristics, or in progression of CIMT in men or women according to 2-year quartiles of VFT change. CONCLUSIONS Our results do not suggest that increased visceral adiposity without body weight changes impacts the CIMT progression in South Korean men or women with T2DM.
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Affiliation(s)
- Chul Sik Kim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea; Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, U.S
| | - Soo-Kyung Kim
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Maria Rosario G Araneta
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, U.S
| | - Eun Jig Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
| | - Elizabeth Barrett-Connor
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, U.S..
| | - Kab Bum Huh
- Huh's Diabetes Center and the 21st Century Diabetes and Vascular Research Institute, Seoul, Korea.
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Moslehi N, Ehsani B, Mirmiran P, Hojjat P, Azizi F. Association of Dietary Proportions of Macronutrients with Visceral Adiposity Index: Non-Substitution and Iso-Energetic Substitution Models in a Prospective Study. Nutrients 2015; 7:8859-70. [PMID: 26516906 PMCID: PMC4632456 DOI: 10.3390/nu7105436] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 09/14/2015] [Accepted: 10/13/2015] [Indexed: 12/15/2022] Open
Abstract
We aimed to investigate associations between dietary macronutrient proportions and prospective visceral adiposity index changes (ΔVAI). The study included 1254 adults (18–74 years), from the Tehran Lipid and Glucose Study (TLGS), who were followed for three years. Dietary intakes were assessed twice using food frequency questionnaires. Associations of dietary macronutrient with ΔVAI and risk of visceral adiposity dysfunction (VAD) after three years were investigated. The percentage of energy intake from protein in the total population, and from fat in women, were associated with higher increases in VAI. A 5% higher energy intake from protein substituted for carbohydrate, monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs) was associated with higher ΔVAI. Higher energy intake from animal protein substituted for PUFAs was positively associated with ΔVAI. Substituting protein and PUFAs with MUFAs were related to higher ΔVAI. The associations were similar in men and women, but reached significance mostly among women. Risk of VAD was increased when 1% of energy from protein was replaced with MUFAs. Substituting protein for carbohydrate and fat, and fat for carbohydrate, resulted in increased risk of VAD in women. Higher dietary proportions of protein and animal-derived MUFA may be positively associated with ΔVAI and risk of VAD.
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Affiliation(s)
- Nazanin Moslehi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran 19395-4763, Iran.
| | - Behnaz Ehsani
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 19395-4741, Iran.
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 19395-4741, Iran.
| | - Parvane Hojjat
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran 19395-4763, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran 19395-4763, Iran.
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Effect of adipose tissue volume loss on circulating 25-hydroxyvitamin D levels: results from a 1-year lifestyle intervention in viscerally obese men. Int J Obes (Lond) 2015; 39:1638-43. [PMID: 26095245 DOI: 10.1038/ijo.2015.118] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 05/21/2015] [Accepted: 06/12/2015] [Indexed: 01/02/2023]
Abstract
BACKGROUND/OBJECTIVES Although weight loss has been associated with changes in circulating 25-hydroxyvitamin D (25(OH)D) levels, the quantification of the increase in 25(OH)D levels as a function of adipose tissue volume loss precisely assessed by imaging has not been reported before. The objective of this substudy was to describe the effects of a 1-year lifestyle intervention on plasma 25(OH)D levels. The relationships between changes in 25(OH)D levels and changes in adiposity volume (total and by adipose tissue compartment) were studied. SUBJECTS/METHODS This intervention study was performed between 2004 and 2006 and participants were recruited from the general community. Sedentary, abdominally obese and dyslipidemic men (n=103) were involved in a 1-year lifestyle modification program. Subjects were individually counseled by a kinesiologist and a nutritionist once every 2 weeks during the first 4 months with subsequent monthly visits in order to elicit a 500-kcal daily energy deficit and to increase physical activity/exercise habits. Body weight, body composition and fat distribution were assessed by dual-energy X-ray absorptiometry and computed tomography, whereas the 25(OH)D levels were measured with an automated assay. RESULTS The 1-year intervention resulted in a 26% increase in circulating 25(OH)D (from 48±2 nmol l(-1) or 19±0.8 ng ml(-1) (±s.e.m.) to 58±2 nmol l(-1) or 23±0.8 ng ml(-1), P<0.0001) along with a 26% decrease in visceral adiposity volume (from 1947±458 to 1459±532 cm3). One-year increases in 25(OH)D levels correlated inversely with changes in all adiposity indices, especially Δvisceral (r=-0.36, P<0.0005) and Δtotal abdominal (r=-0.37, P<0.0005) adipose tissue volumes. CONCLUSIONS These results indicate that there is a linear increase in circulating 25(OH)D levels as a function of adiposity volume loss, and therefore suggest a role of adiposity reduction in the management of obesity-associated vitamin D insufficiency.
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Glueck CJ, Wang P, Woo JG, Morrison JA, Khoury PR, Daniels SR. Adolescent and young adult female determinants of visceral adipose tissue at ages 26-28 years. J Pediatr 2015; 166:936-46.e1-3. [PMID: 25641236 DOI: 10.1016/j.jpeds.2014.12.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 10/17/2014] [Accepted: 12/12/2014] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To assess adolescent and young adult determinants of visceral adipose tissue (VAT) at ages 26-28 years. STUDY DESIGN Prospective study (ages 9-28 years) of cardiometabolic measures, menarche age, menses irregularities, metabolic syndrome, impaired fasting glucose-type 2 diabetes mellitus, and VAT in 400 girls (248 black, 152 white). RESULTS Adolescent (age 14-19) independent variables for greater VAT at ages 26-28 included larger mean waist circumference (partial R(2) = 30.8%), earlier age at menarche (0.9%), and white race (1.8%). Young adult (ages 20-28 years) independent variables for greater VAT included larger mean waist circumference (partial R(2) = 61.7%), greater triglyceride levels (3.3%), lower high-density lipoprotein cholesterol (1.0%), and greater insulin resistance (homeostasis model assessment-estimated insulin resistance; 0.4%). Independent variables for greater VAT when both adolescent and young adult variables were used included waist (tertile rank change from adolescence to young adulthood, partial R(2) = 58.3%), greater young adult triglyceride levels (4.4%), white race (1.8%), greater young adult homeostasis model assessment-estimated insulin resistance (age 20-28, 2.4%), and earlier menarche age (0.7%). Menses irregularities were not independently associated with young adult VAT. CONCLUSIONS Adolescent girls with early menarche and larger waist circumference should be targets for primary prevention of accretion of VAT. In young adulthood, VAT is associated with dysregulated cardiometabolic profiles, which is greater for those with waist circumference increases from adolescence to adulthood. Waist circumference during young adulthood, and to a lesser degree during adolescence, is an inexpensive surrogate for VAT at ages 26-28 years.
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Affiliation(s)
- Charles J Glueck
- Cholesterol Center, Jewish Hospital of Cincinnati, Cincinnati, OH.
| | - Ping Wang
- Cholesterol Center, Jewish Hospital of Cincinnati, Cincinnati, OH
| | - Jessica G Woo
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - John A Morrison
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Philip R Khoury
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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Bongers M, Stefan N, Fritsche A, Häring HU, Nikolaou K, Schick F, Machann J. Lebervolumen, Leberfettanteil und Körpergewicht im Verlauf einer Lebensstilinterventionsstudie. Radiologe 2015; 55:323-8. [DOI: 10.1007/s00117-014-2722-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Tchernof A, Mansour MF, Pelletier M, Boulet MM, Nadeau M, Luu-The V. Updated survey of the steroid-converting enzymes in human adipose tissues. J Steroid Biochem Mol Biol 2015; 147:56-69. [PMID: 25448733 DOI: 10.1016/j.jsbmb.2014.11.011] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 11/10/2014] [Accepted: 11/12/2014] [Indexed: 12/26/2022]
Abstract
Over the past decade, adipose tissues have been increasingly known for their endocrine properties, that is, their ability to secrete a number of adipocytokines that may exert local and/or systemic effects. In addition, adipose tissues have long been recognized as significant sites for steroid hormone transformation and action. We hereby provide an updated survey of the many steroid-converting enzymes that may be detected in human adipose tissues, their activities and potential roles. In addition to the now well-established role of aromatase and 11β-hydroxysteroid dehydrogenase (HSD) type 1, many enzymes have been reported in adipocyte cell lines, isolated mature cells and/or preadipocytes. These include 11β-HSD type 2, 17β-HSDs, 3β-HSD, 5α-reductases, sulfatases and glucuronosyltransferases. Some of these enzymes are postulated to bear relevance for adipose tissue physiology and perhaps for the pathophysiology of obesity. This elaborate set of steroid-converting enzymes in the cell types of adipose tissue deserves further scientific attention. Our work on 20α-HSD (AKR1C1), 3α-HSD type 3 (AKR1C2) and 17β-HSD type 5 (AKR1C3) allowed us to clarify the relevance of these enzymes for some aspects of adipose tissue function. For example, down-regulation of AKR1C2 expression in preadipocytes seems to potentiate the inhibitory action of dihydrotestosterone on adipogenesis in this model. Many additional studies are warranted to assess the impact of intra-adipose steroid hormone conversions on adipose tissue functions and chronic conditions such as obesity, diabetes and cancer.
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Affiliation(s)
- André Tchernof
- Institut Universitaire de Cardiologie et Pneumologie de Québec, Québec, Canada; École de Nutrition, Université Laval, Québec, Canada; Endocrinologe et Néphrologie, Centre Hospitalier Universitaire de Québec, Québec, Canada.
| | - Mohamed Fouad Mansour
- Institut Universitaire de Cardiologie et Pneumologie de Québec, Québec, Canada; Endocrinologe et Néphrologie, Centre Hospitalier Universitaire de Québec, Québec, Canada
| | - Mélissa Pelletier
- Endocrinologe et Néphrologie, Centre Hospitalier Universitaire de Québec, Québec, Canada
| | - Marie-Michèle Boulet
- Institut Universitaire de Cardiologie et Pneumologie de Québec, Québec, Canada; École de Nutrition, Université Laval, Québec, Canada
| | - Mélanie Nadeau
- Institut Universitaire de Cardiologie et Pneumologie de Québec, Québec, Canada
| | - Van Luu-The
- Endocrinologe et Néphrologie, Centre Hospitalier Universitaire de Québec, Québec, Canada
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Lévesque V, Poirier P, Després JP, Alméras N. Assessing and targeting key lifestyle cardiovascular risk factors at the workplace: Effect on hemoglobin A1c levels. Ann Med 2015; 47:605-14. [PMID: 26542534 DOI: 10.3109/07853890.2015.1091943] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
PURPOSE Despite the key role played by lifestyle habits in the epidemic of type 2 diabetes (T2D), nutritional quality and physical activity are not systematically considered in clinical practice. The project was conducted to verify whether assessing/targeting lifestyle habits could reduce hemoglobin A1c (HbA1c) levels of employees. METHODS The intervention consisted of a 3-month competition among teams of five employees to favor peer-based support in the adoption of healthier lifestyle habits (Eat better, Move more, and Quit smoking) (n = 900). A comprehensive cardiometabolic/cardiorespiratory health assessment was conducted before and after the contest (nutrition/physical activity questionnaires, blood pressure, anthropometric measurements, lipid profile, HbA1c, fitness). HbA1c levels were used to identify individuals with prediabetes (5.7%-6.4%) or T2D (≥6.5%). RESULTS At baseline, 51% of the employees had increased HbA1c levels (≥5.7%). The HbA1c levels were associated with waist circumference, independently of body mass index. Subjects with prediabetes showed a higher waist circumference as well as a more deteriorated cardiometabolic profile compared to workers with normal HbA1c levels. After the intervention, employees with elevated HbA1c significantly reduced their HbA1c levels. CONCLUSION Results suggest that assessing/targeting key lifestyle correlates of the cardiometabolic profile represents a relevant approach to target abdominal obesity and fitness with a significant impact on HbA1c levels.
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Affiliation(s)
- Valérie Lévesque
- a Quebec Heart and Lung Institute , Québec , QC , Canada.,b Department of Kinesiology , Faculty of Medicine, Université Laval , Québec , QC , Canada
| | - Paul Poirier
- a Quebec Heart and Lung Institute , Québec , QC , Canada.,c Faculty of Pharmacy, Université Laval , Québec , QC , Canada
| | - Jean-Pierre Després
- a Quebec Heart and Lung Institute , Québec , QC , Canada.,b Department of Kinesiology , Faculty of Medicine, Université Laval , Québec , QC , Canada
| | - Natalie Alméras
- a Quebec Heart and Lung Institute , Québec , QC , Canada.,b Department of Kinesiology , Faculty of Medicine, Université Laval , Québec , QC , Canada
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Abstract
Androgens are regulators of important adipocyte functions such as adipogenesis, lipid storage, and lipolysis. Through depot-specific impact on the cells of each fat compartment, androgens could modulate body fat distribution patterns in humans. Testosterone and dihydrotestosterone have been shown to inhibit the differentiation of preadipocytes to lipid-storing adipocytes in several models including primary cultures of human adipocytes from both men and women. Androgen effects have also been observed on some markers of lipid metabolism such as LPL activity, fatty acid uptake, and lipolysis. Possible depot-specific and sex-specific effects have been observed in some but not all models. Transformation of androgen precursors to active androgens or their inactivation by enzymes that are expressed and functional in adipose tissue may contribute to modulate the local availability of active hormones. These phenomena, along with putative depot-specific interactions with glucocorticoids may contribute to human body fat distribution patterns.
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Affiliation(s)
- Mouna Zerradi
- Endocrinology and Nephrology, CHU de Quebec Research Center, 2705 Laurier Blvd. R-4779, Quebec City, PQ, Canada, G1V 4G2
- Department of Nutrition, Laval University, Québec City, Canada, G1V 4G2
| | - Julie Dereumetz
- Endocrinology and Nephrology, CHU de Quebec Research Center, 2705 Laurier Blvd. R-4779, Quebec City, PQ, Canada, G1V 4G2
- Department of Nutrition, Laval University, Québec City, Canada, G1V 4G2
| | - Marie-Michèle Boulet
- Endocrinology and Nephrology, CHU de Quebec Research Center, 2705 Laurier Blvd. R-4779, Quebec City, PQ, Canada, G1V 4G2
- Department of Nutrition, Laval University, Québec City, Canada, G1V 4G2
| | - André Tchernof
- Endocrinology and Nephrology, CHU de Quebec Research Center, 2705 Laurier Blvd. R-4779, Quebec City, PQ, Canada, G1V 4G2.
- Department of Nutrition, Laval University, Québec City, Canada, G1V 4G2.
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Abstract
A clustering of metabolic abnormalities such as dyslipidemia, hypertension, and diabetes mellitus, all of which are major risk factors for cardiovascular disease (CVD), occurs more often than by chance. Numerous epidemiological studies, as well as basic researches, have revealed that visceral fat accumulation is closely involved in this risk clustering. This morbid condition is now well recognized as the metabolic syndrome. The concept of the metabolic syndrome, i.e., the involvement of visceral adiposity in the clustering of CVD risk factors, implies that an effective CVD risk reduction will be accomplished by an intervention to reduce visceral fat deposits. The primary strategy of the intervention is lifestyle modification, which can be put into practice in healthcare fields, without necessity of medical treatment. Now that CVD is a leading global health burden, the metabolic syndrome attracts increasing attention in the world. To take global action against the syndrome, several working groups developed its internationally unified diagnostic criteria. Most recently, the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) jointly proposed the criteria, although some cautions will be needed in their practical use. In this review, we mainly focus on the findings observed in clinical and epidemiological studies, to discuss a practical strategy of the management of the metabolic syndrome in healthcare fields.
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Affiliation(s)
- Mitsuyoshi Takahara
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
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Chondronikola M, Volpi E, Børsheim E, Porter C, Annamalai P, Enerbäck S, Lidell ME, Saraf MK, Labbe SM, Hurren NM, Yfanti C, Chao T, Andersen CR, Cesani F, Hawkins H, Sidossis LS. Brown adipose tissue improves whole-body glucose homeostasis and insulin sensitivity in humans. Diabetes 2014; 63:4089-99. [PMID: 25056438 PMCID: PMC4238005 DOI: 10.2337/db14-0746] [Citation(s) in RCA: 563] [Impact Index Per Article: 56.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Brown adipose tissue (BAT) has attracted scientific interest as an antidiabetic tissue owing to its ability to dissipate energy as heat. Despite a plethora of data concerning the role of BAT in glucose metabolism in rodents, the role of BAT (if any) in glucose metabolism in humans remains unclear. To investigate whether BAT activation alters whole-body glucose homeostasis and insulin sensitivity in humans, we studied seven BAT-positive (BAT(+)) men and five BAT-negative (BAT(-)) men under thermoneutral conditions and after prolonged (5-8 h) cold exposure (CE). The two groups were similar in age, BMI, and adiposity. CE significantly increased resting energy expenditure, whole-body glucose disposal, plasma glucose oxidation, and insulin sensitivity in the BAT(+) group only. These results demonstrate a physiologically significant role of BAT in whole-body energy expenditure, glucose homeostasis, and insulin sensitivity in humans, and support the notion that BAT may function as an antidiabetic tissue in humans.
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Affiliation(s)
- Maria Chondronikola
- Metabolism Unit, Shriners Hospital for Children, Galveston, TX Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX Department of Nutrition and Metabolism, Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Elena Volpi
- Department of Nutrition and Metabolism, Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX Institute for Translational Sciences, University of Texas Medical Branch, Galveston, TX Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX
| | - Elisabet Børsheim
- Metabolism Unit, Shriners Hospital for Children, Galveston, TX Department of Surgery, University of Texas Medical Branch, Galveston, TX
| | - Craig Porter
- Metabolism Unit, Shriners Hospital for Children, Galveston, TX Department of Surgery, University of Texas Medical Branch, Galveston, TX
| | - Palam Annamalai
- Department of Interventional Radiology, University of Texas Medical Branch, Galveston, TX
| | - Sven Enerbäck
- Department of Medical and Clinical Genetics, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Martin E Lidell
- Department of Medical and Clinical Genetics, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Manish K Saraf
- Metabolism Unit, Shriners Hospital for Children, Galveston, TX Department of Surgery, University of Texas Medical Branch, Galveston, TX
| | - Sebastien M Labbe
- Quebec Heart and Lung Research Institute Centre, Quebec City, Quebec, Canada
| | - Nicholas M Hurren
- Metabolism Unit, Shriners Hospital for Children, Galveston, TX Department of Surgery, University of Texas Medical Branch, Galveston, TX
| | - Christina Yfanti
- Metabolism Unit, Shriners Hospital for Children, Galveston, TX Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX
| | - Tony Chao
- Metabolism Unit, Shriners Hospital for Children, Galveston, TX Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX Department of Nutrition and Metabolism, Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX
| | - Clark R Andersen
- Metabolism Unit, Shriners Hospital for Children, Galveston, TX Department of Surgery, University of Texas Medical Branch, Galveston, TX
| | - Fernando Cesani
- Department of Nuclear Medicine, University of Texas Medical Branch, Galveston, TX
| | - Hal Hawkins
- Department of Pathology, University of Texas Medical Branch, Galveston, TX Department of Pathology, Shriners Hospital for Children, Galveston, TX
| | - Labros S Sidossis
- Metabolism Unit, Shriners Hospital for Children, Galveston, TX Department of Nutrition and Metabolism, Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece Institute for Translational Sciences, University of Texas Medical Branch, Galveston, TX Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX
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Visceral, subcutaneous abdominal adiposity and liver fat content distribution in normal glucose tolerance, impaired fasting glucose and/or impaired glucose tolerance. Int J Obes (Lond) 2014. [DOI: 10.1038/ijo.2014.163] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Response to statin therapy in obstructive sleep apnea syndrome: a multicenter randomized controlled trial. Mediators Inflamm 2014; 2014:423120. [PMID: 25221387 PMCID: PMC4158472 DOI: 10.1155/2014/423120] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 07/23/2014] [Accepted: 07/25/2014] [Indexed: 01/12/2023] Open
Abstract
Rationale. Accumulated evidence implicates sympathetic activation as inducing oxidative stress and systemic inflammation, which in turn lead to hypertension, endothelial dysfunction, and atherosclerosis in obstructive sleep apnea (OSA). Statins through their pleiotropic properties may modify inflammation, lipid profile, and cardiovascular outcomes in OSA. Methods. This multicenter, randomized, double-blind study compared the effects of atorvastatin 40 mg/day versus placebo over 12 weeks on endothelial function (the primary endpoint) measured by peripheral arterial tone (PAT). Secondary endpoints included office blood pressure (BP), early carotid atherosclerosis, arterial stiffness measured by pulse wave velocity (PWV), and metabolic parameters. Results. 51 severe OSA patients were randomized. Key demographics for the study population were age 54 ± 11 years, 21.6% female, and BMI 28.5 ± 4.5 kg/m2. In intention to treat analysis, mean PAT difference between atorvastatin and placebo groups was 0.008 (−0.29; 0.28), P = 0.979. Total and LDL cholesterol significantly improved with atorvastatin. Systolic BP significantly decreased with atorvastatin (mean difference: −6.34 mmHg (−12.68; −0.01), P = 0.050) whereas carotid atherosclerosis and PWV were unchanged compared to the placebo group. Conclusion. In OSA patients, 3 months of atorvastatin neither improved endothelial function nor reduced early signs of atherosclerosis although it lowered blood pressure and improved lipid profile. This trial is registered with NCT00669695.
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