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Rodrigues APDS, Batista SRR, Santos ASEA, Canheta ABDS, Nunes BP, de Oliveira Rezende AT, de Oliveira C, Silveira EA. Multimorbidity and complex multimorbidity in Brazilians with severe obesity. Sci Rep 2023; 13:16629. [PMID: 37789121 PMCID: PMC10547747 DOI: 10.1038/s41598-023-43545-5] [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: 09/22/2022] [Accepted: 09/25/2023] [Indexed: 10/05/2023] Open
Abstract
To investigate the prevalence of multimorbidity and complex multimorbidity and their association with sociodemographic and health variables in individuals with severe obesity. This is a baseline data analysis of 150 individuals with severe obesity (body mass index ≥ 35.0 kg/m2) aged 18-65 years. The outcomes were multimorbidity and complex multimorbidity. Sociodemographic, lifestyle, anthropometric and self-perceived health data were collected. Poisson multiple regression was conducted to identify multimorbidity risk factors. The frequency of two or more morbidities was 90.7%, three or more morbidities was 76.7%, and complex multimorbidity was 72.0%. Living with four or more household residents was associated with ≥ 3 morbidities and complex multimorbidity. Fair and very poor self-perceived health was associated with ≥ 2 morbidities, ≥ 3 morbidities and complex multimorbidity. A higher BMI range (45.0-65.0 kg/m2) was associated with ≥ 2 morbidities and ≥ 3 morbidities. Anxiety (82.7%), varicose veins of lower limbs (58.7%), hypertension (56.0%) were the most frequent morbidities, as well as the pairs and triads including them. The prevalence of multimorbidity and complex multimorbidity in individuals with severe obesity was higher and the risk for multimorbidity and complex multimorbidity increased in individuals living in households of four or more residents, with fair or poor/very poor self-perceived health and with a higher BMI.
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Affiliation(s)
| | - Sandro Rogério Rodrigues Batista
- Department of Internal Medicine, School of Medicine, Federal University of Goiás, Goiânia, Goiás, Brazil
- Primary Healthcare Office, Federal District State Health Department, Brasília, Distrito Federal, Brazil
| | | | | | | | | | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London, UK.
| | - Erika Aparecida Silveira
- Department of Internal Medicine, School of Medicine, Federal University of Goiás, Goiânia, Goiás, Brazil
- Department of Epidemiology & Public Health, University College London, London, UK
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Tan PY, Moore JB, Bai L, Tang G, Gong YY. In the context of the triple burden of malnutrition: A systematic review of gene-diet interactions and nutritional status. Crit Rev Food Sci Nutr 2022; 64:3235-3263. [PMID: 36222100 PMCID: PMC11000749 DOI: 10.1080/10408398.2022.2131727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Genetic background interacts with dietary components to modulate nutritional health status. This study aimed to review the evidence for gene-diet interactions in all forms of malnutrition. A comprehensive systematic literature search was conducted through April 2021 to identify observational and intervention studies reporting the effects of gene-diet interactions in over-nutrition, under-nutrition and micronutrient status. Risk of publication bias was assessed using the Quality Criteria Checklist and a tool specifically designed for gene-diet interaction research. 167 studies from 27 populations were included. The majority of studies investigated single nucleotide polymorphisms (SNPs) in overnutrition (n = 158). Diets rich in whole grains, vegetables, fruits and low in total and saturated fats, such as Mediterranean and DASH diets, showed promising effects for reducing obesity risk among individuals who had higher genetic risk scores for obesity, particularly the risk alleles carriers of FTO rs9939609, rs1121980 and rs1421085. Other SNPs in MC4R, PPARG and APOA5 genes were also commonly studied for interaction with diet on overnutrition though findings were inconclusive. Only limited data were found related to undernutrition (n = 1) and micronutrient status (n = 9). The findings on gene-diet interactions in this review highlight the importance of personalized nutrition, and more research on undernutrition and micronutrient status is warranted.
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Affiliation(s)
- Pui Yee Tan
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, United Kingdom
| | - J. Bernadette Moore
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, United Kingdom
| | - Ling Bai
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, United Kingdom
- School of Psychology, University of East Anglia, Norwich, United Kingdom
| | - GuYuan Tang
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, United Kingdom
| | - Yun Yun Gong
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, United Kingdom
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Personalized Nutrition in the Management of Female Infertility: New Insights on Chronic Low-Grade Inflammation. Nutrients 2022; 14:nu14091918. [PMID: 35565885 PMCID: PMC9105997 DOI: 10.3390/nu14091918] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/19/2022] [Accepted: 04/29/2022] [Indexed: 02/01/2023] Open
Abstract
Increasing evidence on the significance of nutrition in reproduction is emerging from both animal and human studies, suggesting a mutual association between nutrition and female fertility. Different “fertile” dietary patterns have been studied; however, in humans, conflicting results or weak correlations are often reported, probably because of the individual variations in genome, proteome, metabolome, and microbiome and the extent of exposure to different environmental conditions. In this scenario, “precision nutrition”, namely personalized dietary patterns based on deep phenotyping and on metabolomics, microbiome, and nutrigenetics of each case, might be more efficient for infertile patients than applying a generic nutritional approach. In this review, we report on new insights into the nutritional management of infertile patients, discussing the main nutrigenetic, nutrigenomic, and microbiomic aspects that should be investigated to achieve effective personalized nutritional interventions. Specifically, we will focus on the management of low-grade chronic inflammation, which is associated with several infertility-related diseases.
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Silveira EA, Rosa LPDS, de Resende DP, Rodrigues APDS, da Costa AC, Rezende ATDO, Noll M, de Oliveira C, Junqueira-Kipnis AP. Positive Effects of Extra-Virgin Olive Oil Supplementation and DietBra on Inflammation and Glycemic Profiles in Adults With Type 2 Diabetes and Class II/III Obesity: A Randomized Clinical Trial. Front Endocrinol (Lausanne) 2022; 13:841971. [PMID: 35586621 PMCID: PMC9108866 DOI: 10.3389/fendo.2022.841971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background Evidence on the effects of dietary interventions on inflammatory markers in individuals with obesity and type 2 diabetes mellitus (T2DM) is scarce. Our study evaluated the effects of extra-virgin olive oil alone and in combination with a traditional Brazilian diet on inflammatory markers and glycemic profiles in adults with both T2DM and class II/III obesity. Methods Adults aged 18-64 years with T2DM and class II/III obesity were randomized into two intervention groups: 1) extra-virgin olive oil only and 2) extra-virgin olive oil + a traditional Brazilian diet (OliveOil+DietBra). Data on sociodemographic characteristics, lifestyle, anthropometry, biochemical markers and inflammatory markers were collected. The primary outcomes were glycemic parameters and inflammatory markers. The body mass index (BMI) and weight were the secondary outcomes. Results Forty individuals with T2DM and class II/III obesity were enrolled, and 34 (85%) completed the intervention course. The intake of olive oil was 37.88 ± 12.50 mL/day in the olive oil group and 37.71 ± 12.23 mL/day in the OliveOil+DietBra group, with no significant difference between groups (p = 0.484). Compared to the olive oil only group, the OliveOil+DietBra group had significantly lower levels of fasting insulin (p = 0.047) at the end of the intervention, whereas the other glycemic parameters were not altered. In the OliveOil+DietBra group, serum levels of inflammatory cytokines, IL-1α (p = 0.006) and adiponectin (p = 0.049) were lower and those of TNFα were higher (p = 0.037). There was a significant reduction in BMI and weight compared to the baseline values in the OliveOil+DietBra group (p = 0.015). Conclusions The intervention with OliveOil+DietBra effectively decreased the levels of fasting insulin, IL-1α and adiponectin, suggesting its beneficial role in improving the inflammatory profiles and fasting insulin levels in adults with class II/III obesity and T2DM. Clinical Trial Registration ClinicalTrials.gov, identifier: NCT02463435.
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Affiliation(s)
- Erika Aparecida Silveira
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiás, Brazil
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Lorena Pereira de Souza Rosa
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiás, Brazil
- Federal Institute of Goiás, Campus Goiânia, Goiás, Brazil
| | - Danilo Pires de Resende
- Department of Biosciences, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiás, Brazil
| | | | - Adeliane Castro da Costa
- Department of Biosciences, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiás, Brazil
| | | | - Matias Noll
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiás, Brazil
- Instituto Federal Goiano, Campus Ceres, Goiás, Brazil
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Ana Paula Junqueira-Kipnis
- Department of Biosciences, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiás, Brazil
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Longhi R, Santos ASEADC, López-Yerena A, Rodrigues APS, de Oliveira C, Silveira EA. The Effectiveness of Extra Virgin Olive Oil and the Traditional Brazilian Diet in Reducing the Inflammatory Profile of Individuals with Severe Obesity: A Randomized Clinical Trial. Nutrients 2021; 13:nu13114139. [PMID: 34836393 PMCID: PMC8624522 DOI: 10.3390/nu13114139] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/08/2021] [Accepted: 11/11/2021] [Indexed: 12/26/2022] Open
Abstract
We analyzed the effectiveness of two nutritional interventions alone and together, EVOO and the DieTBra, on the inflammatory profile of severely obese individuals. This study was an RCT with 149 individuals aged from 18 to 65 years, with a body mass index ≥ 35 kg/m2, randomized into three intervention groups: (1) 52 mL/day of EVOO (n = 50); (2) DieTBra (n = 49); and (3) DieTBra plus 52 mL/day of EVOO (DieTBra + EVOO, n = 50). The primary outcomes we measured were the-neutrophil-to-lymphocyte ratio (NLR) and the secondary outcomes we measured were the lymphocyte-to-monocyte ratio (LMR); leukocytes; and C reactive protein (CRP). After 12 weeks of intervention, DieTBra + EVOO significantly reduced the total leucocytes (p = 0.037) and LMR (p = 0.008). No statistically significant differences were found for the NLR in neither the intra-group and inter-group analyses, although a slight reduction was found in the DieTBra group (−0.22 ± 1.87). We observed reductions in the total leukocytes and LMR in the three groups, though without statistical difference between groups. In conclusion, nutritional intervention with DietBra + EVOO promotes a significant reduction in inflammatory biomarkers, namely leukocytes and LMR. CRP was reduced in EVOO and DieTBra groups and NLR reduced in the DieTBra group. This study was registered at ClinicalTrials.gov under NCT02463435.
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Affiliation(s)
- Rafael Longhi
- Department of Nutrition, Federal University of Minas Gerais, Belo Horizonte 30130-100, Brazil;
| | - Annelisa Silva e Alves de Carvalho Santos
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia, Rua 235 c/1ª s/n, Setor Universitário, Goiânia 74650-050, Brazil; (A.S.e.A.d.C.S.); (A.P.S.R.)
| | - Anallely López-Yerena
- Department of Nutrition, Food Science and Gastronomy, XIA, Faculty of Pharmacy and Food Sciences, Institute of Nutrition and Food Safety (INSA-UB), University of Barcelona, 08028 Barcelona, Spain;
| | - Ana Paula Santos Rodrigues
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia, Rua 235 c/1ª s/n, Setor Universitário, Goiânia 74650-050, Brazil; (A.S.e.A.d.C.S.); (A.P.S.R.)
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, London University College, London WC1E 6BT, UK;
| | - Erika Aparecida Silveira
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia, Rua 235 c/1ª s/n, Setor Universitário, Goiânia 74650-050, Brazil; (A.S.e.A.d.C.S.); (A.P.S.R.)
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, London University College, London WC1E 6BT, UK;
- Correspondence: ; Tel.: +55-62-3209-6151
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Mendonça CR, Noll M, Cardoso CKDS, Santos ASADC, Rodrigues APDS, Silveira EA. Reduction in Pain and Pain Intensity with Nonpharmacological Treatment in Severely Obese Patients: A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11112. [PMID: 34769633 PMCID: PMC8582684 DOI: 10.3390/ijerph182111112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 12/26/2022]
Abstract
The objective of this study was to analyze the effectiveness of two nonpharmacological interventions-traditional Brazilian diet (DieTBra), and extra-virgin olive oil (EVOO)-in terms of the reduction in pain and pain intensity in individuals with severe obesity. We conducted a 12-week parallel randomized clinical trial with 149 individuals (body mass index (BMI) ≥ 35 kg/m2) who were randomized into three groups: supplementation with EVOO (n = 50), DieTBra (n = 49), and EVOO + DieTBra (n = 50). Of the total, 133 individuals with a mean BMI of 46.04 kg/m2 completed the study. By the end of the follow-up, there was a reduction in severe pain in the EVOO + DieTBra group (p = 0.003). There was a significant reduction in severe pain in the EVOO + DieTBra group (-22.7%); pain in the wrist and hand (-14.1%), upper back (-26.9%), and knees (-18.4%) in the DieTBra group; and reduction in hip pain (-11.1%) with EVOO consumption. We conclude that EVOO and DieTBra, either alone or in combination, are effective interventions to reduce pain intensity and pain in different regions in individuals with severe obesity, and have great potential for clinical application.
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Affiliation(s)
- Carolina Rodrigues Mendonça
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74650-050, GO, Brazil; (M.N.); (C.K.d.S.C.); (A.S.A.d.C.S.); (A.P.d.S.R.); (E.A.S.)
| | - Matias Noll
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74650-050, GO, Brazil; (M.N.); (C.K.d.S.C.); (A.S.A.d.C.S.); (A.P.d.S.R.); (E.A.S.)
- Instituto Federal Goiano, Rodovia Go-154, Km 03, s/n, Ceres 76300-000, GO, Brazil
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark
| | - Camila Kellen de Souza Cardoso
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74650-050, GO, Brazil; (M.N.); (C.K.d.S.C.); (A.S.A.d.C.S.); (A.P.d.S.R.); (E.A.S.)
| | - Annelisa Silva Alves de Carvalho Santos
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74650-050, GO, Brazil; (M.N.); (C.K.d.S.C.); (A.S.A.d.C.S.); (A.P.d.S.R.); (E.A.S.)
| | - Ana Paula dos Santos Rodrigues
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74650-050, GO, Brazil; (M.N.); (C.K.d.S.C.); (A.S.A.d.C.S.); (A.P.d.S.R.); (E.A.S.)
| | - Erika Aparecida Silveira
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74650-050, GO, Brazil; (M.N.); (C.K.d.S.C.); (A.S.A.d.C.S.); (A.P.d.S.R.); (E.A.S.)
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Silveira EA, Noll PRES, Mohammadifard N, Rodrigues APS, Sarrafzadegan N, de Oliveira C. Which Diets Are Effective in Reducing Cardiovascular and Cancer Risk in Women with Obesity? An Integrative Review. Nutrients 2021; 13:3504. [PMID: 34684505 PMCID: PMC8541423 DOI: 10.3390/nu13103504] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 09/24/2021] [Accepted: 09/28/2021] [Indexed: 12/22/2022] Open
Abstract
Women are more affected by obesity than men which increases their risk of cancer and cardiovascular disease (CVD). Therefore, it is important to understand the effectiveness of different types of diet in the context of women's health. This review aims to summarize the scientific evidence on the effects of different types of diet for women with obesity and their impact on CVD and cancer risk. This review included epidemiological and clinical studies on adult women and different types of diets, such as the Mediterranean (MED) diet, the Traditional Brazilian Diet, the Dietary Approach to Stop Hypertension (DASH), intermittent fasting (IF), calorie (energy) restriction, food re-education, low-carbohydrate diet (LCD) and a very low-carbohydrate diet (VLCD). Our main findings showed that although LCDs, VLCD and IF are difficult to adhere to over an extended period, they can be good options for achieving improvements in body weight and cardiometabolic parameters. MED, DASH and the Traditional Brazilian Diet are based on natural foods and reduced processed foods. These diets have been associated with better women's health outcomes, including lower risk of CVD and cancer and the prevention and treatment of obesity.
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Affiliation(s)
- Erika Aparecida Silveira
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia 74690-900, Brazil
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK;
| | | | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran;
| | | | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran;
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK;
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Gharipour M, Mani A, Amini Baghbahadorani M, de Souza Cardoso CK, Jahanfar S, Sarrafzadegan N, de Oliveira C, Silveira EA. How Are Epigenetic Modifications Related to Cardiovascular Disease in Older Adults? Int J Mol Sci 2021; 22:9949. [PMID: 34576113 PMCID: PMC8470616 DOI: 10.3390/ijms22189949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 12/16/2022] Open
Abstract
The rate of aging has increased globally during recent decades and has led to a rising burden of age-related diseases such as cardiovascular disease (CVD). At the molecular level, epigenetic modifications have been shown recently to alter gene expression during the life course and impair cellular function. In this regard, several CVD risk factors, such as lifestyle and environmental factors, have emerged as key factors in epigenetic modifications within the cardiovascular system. In this study, we attempted to summarized recent evidence related to epigenetic modification, inflammation response, and CVD in older adults as well as the effect of lifestyle modification as a preventive strategy in this age group. Recent evidence showed that lifestyle and environmental factors may affect epigenetic mechanisms, such as DNA methylation, histone acetylation, and miRNA expression. Several substances or nutrients such as selenium, magnesium, curcumin, and caffeine (present in coffee and some teas) could regulate epigenetics. Similarly, physical inactivity, alcohol consumption, air pollutants, psychological stress, and shift working are well-known modifiers of epigenetic patterns. Understanding the exact ways that lifestyle and environmental factors could affect the expression of genes could help to influence the time of incidence and severity of aging-associated diseases. This review highlighted that a healthy lifestyle throughout the life course, such as a healthy diet rich in fibers, vitamins, and essential elements, and specific fatty acids, adequate physical activity and sleep, smoking cessation, and stress control, could be useful tools in preventing epigenetic changes that lead to impaired cardiovascular function.
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Affiliation(s)
- Mojgan Gharipour
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 8158388994, Iran;
| | - Arya Mani
- Cardiovascular Research Center, Department of Internal Medicine, and Department of Genetics, Yale University School of Medicine, New Haven, CT 06520, USA;
| | - Mona Amini Baghbahadorani
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 8158388994, Iran;
| | - Camila Kellen de Souza Cardoso
- School of Social Sciences and Health, Nutrition Course, Pontifical Catholic University of Goias, Goiânia 74605-010, Brazil;
| | - Shayesteh Jahanfar
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MI 02111, USA;
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 8158388994, Iran;
- Faculty of Medicine, School of Population and Public Health, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK;
| | - Erika Aparecida Silveira
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK;
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia 74690-900, Brazil
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Canheta ABDS, Santos ASEADC, de Souza JD, Silveira EA. Adequate statistical analyses and inferences of Randomized Clinical Trial. Clin Nutr 2020; 40:334-335. [PMID: 33257013 DOI: 10.1016/j.clnu.2020.11.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 11/12/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Andrea Batista de Sousa Canheta
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias (UFG), Brazil; Faculty of Education, Federal University of Goias (UFG), Brazil
| | | | | | - Erika Aparecida Silveira
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias (UFG), Brazil.
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Kellen de Souza Cardoso C, Gondim Peixoto MDR, dos Santos Rodrigues AP, Rodrigues Mendonça C, de Oliveira C, Aparecida Silveira E. Bone Mineral Density in Severely Obese Women: Health Risk and Health Protective Risk Factors in Three Different Bone Sites. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7017. [PMID: 32992832 PMCID: PMC7579229 DOI: 10.3390/ijerph17197017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 11/21/2022]
Abstract
Factors associated with bone mineral density (BMD) are poorly known in severely obese individuals i.e., a body mass index (BMI) > 35 kg/m2. The objectives of this study were to describe the bone health profile of severely obese Brazilian women, to identify the health risk and health protective factors for BMD in this group and to assess whether these factors vary according to three different bone sites. BMD was assessed using dual-energy X-ray absorptiometry (DXA). This study analyzed baseline data from 104 women who had an average BMI of 43.7 ± 4.5 kg/m2 and presented the following BMD status: 1.283 ± 0.094 g/cm2 for total body, 1.062 ± 0.159 g/cm2 for vertebral column and 1.195 ± 0.134 g/cm2 for hip. They took part in the "Effect of nutritional intervention and olive oil in severe obesity" randomized clinical trial (DieTBra Trial). The risk factors negatively associated with lower BMD were age ≥50 years for the three bone sites i.e., total body, vertebral column and hip. Smoking for total body BMD (p = 0.045); BMI ≥ 50kg/m2 for vertebral column and hip; menopause for hip; high C-reactive protein (CRP) levels (p = 0.049), insufficient zinc (p = 0.010) and previous fracture for vertebral column (p = 0.007). The protective factors positively associated with BMD were physical activity (≥150 min/week (p = 0.001)) for hip; type 2 diabetes mellitus (DM2) (p < 0.0001) total body and adequate vitamin D levels from food consumption (p = 0.039) for vertebral column. A BMI ≥ 50 kg/m2 was a risk factor for lower BMD. The findings showed that protective and risk factors varied by bone site. The original study is registered with ClinicalTrials.gov. (protocol number: NCT02463435).
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Affiliation(s)
| | - Maria do Rosário Gondim Peixoto
- Postgraduate Program in Nutrition and Health, Faculty of Nutrition, Federal University of Goias, Goiânia 74605-220, Goiás, Brazil;
| | - Ana Paula dos Santos Rodrigues
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goiás, Brazil; (A.P.d.S.R.); (C.R.M.)
| | - Carolina Rodrigues Mendonça
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goiás, Brazil; (A.P.d.S.R.); (C.R.M.)
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK;
| | - Erika Aparecida Silveira
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goiás, Brazil; (A.P.d.S.R.); (C.R.M.)
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK;
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AlKhattaf NF, Alraddadi AM, Aljarbou MA, Arnauti MA, Alfaleh AM, Hammouda SA. Determining the correlation between olive oil consumption, BMI, and waist circumference in the adult Saudi population. J Taibah Univ Med Sci 2020; 15:380-386. [PMID: 33132810 PMCID: PMC7564903 DOI: 10.1016/j.jtumed.2020.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/08/2020] [Accepted: 07/14/2020] [Indexed: 02/03/2023] Open
Abstract
Objective This study aimed to explore the correlation between dietary intake of olive oil, body mass index (BMI), and waist circumference (WC). Methods In this cross-sectional study, we recruited 200 participants aged 20–30 years using pre-determined inclusion and exclusion criteria. Demographic data was collected via a questionnaire, while dietary data was collected for two days using a 24-hour dietary recall. Anthropometric data such as BMI and WC were collected, and all the information was entered into the Diet Organizer software and statistical package for social sciences (SPSS) software for statistical analysis. The test results were assessed on the basis of a significance level of 95% (p < 0.05). Results We did not find a significant difference in BMI and WC between high and low olive oil consumers. Carbohydrate intake was significantly higher among low olive oil consumers. Although high olive oil consumers had a significantly higher caloric intake, they had a similar BMI compared to low olive oil consumers. Conclusion This study provides baseline data on the intake of olive oil in a Saudi cohort aged 20–30 years. This study suggests that high olive oil intake may have a role in maintaining body weight.
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Affiliation(s)
| | | | | | | | | | - Sahar A Hammouda
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah, KSA
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12
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Silveira EA, Souza JDD, Santos ASEADC, Canheta ABDS, Pagotto V, Noll M. What are the factors associated with sarcopenia-related variables in adult women with severe obesity? Arch Public Health 2020; 78:71. [PMID: 32774854 PMCID: PMC7398193 DOI: 10.1186/s13690-020-00454-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/28/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Understanding the association between sarcopenia-related variables and several risk factors may help to implement interventions aimed at preventing its occurrence by reducing or controlling the identified risk factors. Although changes in body composition occur in both sexes, in women, muscle loss is accentuated due to decreased estrogen levels following menopause. This study aims to determine the factors associated with sarcopenia-related parameters in middle-aged women identified with class II/III obesity (body mass index [BMI] ≥ 35 kg/m2). METHODS The study included 104 women with severe obesity (40.23 ± 8.49 years) with an average body fat percentage of 52.45 ± 4.14%. Sarcopenia was assessed using total appendicular skeletal muscle mass (ASMM), appendicular skeletal muscle mass index (ASMMI), and appendicular skeletal muscle mass adjusted by BMI (ASMM/BMI) as evaluated using dual energy X-ray absorptiometry (DXA). Hand grip strength (HGS) and HGS adjusted by BMI (HGS/BMI) were evaluated using dynamometry. Functional performance was assessed using the walking speed test (WS). The explanatory variables were age, lifestyle, comorbidities, food consumption, and metabolic parameters. A multivariate linear regression was performed. RESULTS Factors associated with sarcopenia-related variables in 104 severely obese women with a mean BMI of 43.85 kg/m2 were as follows: ASMMI negatively correlated with serum levels of tetraiodothyronine (T4) and tobacco use; ASMM/BMI negatively correlated with age, serum T4 levels, and diabetes; ASMM negatively correlated with T4 serum levels and diabetes; HGS negatively correlated with age and hypercholesterolemia, and positively correlated with low-density lipoprotein cholesterol (LDL-c); HGS/BMI negatively correlated with age and hypercholesterolemia and positively correlated with LDL-c; and WS negatively correlated with hypothyroidism and diabetes. CONCLUSION In severely obese women, muscle mass and function were inversely associated with age, smoking status, endocrine parameters, hypercholesterolemia, and comorbidities such as diabetes. Thus, the results of this investigation are relevant in supporting the development of clinical interventions to aid in the prevention of sarcopenia in adult women with severe obesity.
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Affiliation(s)
- Erika Aparecida Silveira
- Health Science Post-Graduation Program, Faculty of Medicine, Universidade Federal de Goiás, 1a. s/n - Setor Leste Universitário, Goiânia, Goiás CEP 74605-020 Brazil
| | - Jacqueline Danesio de Souza
- University North of Paraná, Londrina, Brazil
- Faculty of Nursing, Universidade Federal de Goiás, Goiânia, Brazil
| | - Annelisa Silva e Alves de Carvalho Santos
- Health Science Post-Graduation Program, Faculty of Medicine, Universidade Federal de Goiás, 1a. s/n - Setor Leste Universitário, Goiânia, Goiás CEP 74605-020 Brazil
| | - Andrea Batista de Souza Canheta
- Health Science Post-Graduation Program, Faculty of Medicine, Universidade Federal de Goiás, 1a. s/n - Setor Leste Universitário, Goiânia, Goiás CEP 74605-020 Brazil
| | - Valéria Pagotto
- Health Science Post-Graduation Program, Faculty of Medicine, Universidade Federal de Goiás, 1a. s/n - Setor Leste Universitário, Goiânia, Goiás CEP 74605-020 Brazil
| | - Matias Noll
- Health Science Post-Graduation Program, Faculty of Medicine, Universidade Federal de Goiás, 1a. s/n - Setor Leste Universitário, Goiânia, Goiás CEP 74605-020 Brazil
- Instituto Federal Goiano, Goiânia, Brazil
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13
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Mendonça CR, Noll M, de Carvalho Santos ASEA, Rodrigues APDS, Silveira EA. High prevalence of musculoskeletal pain in individuals with severe obesity: sites, intensity, and associated factors. Korean J Pain 2020; 33:245-257. [PMID: 32606269 PMCID: PMC7336341 DOI: 10.3344/kjp.2020.33.3.245] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/08/2020] [Accepted: 05/09/2020] [Indexed: 12/21/2022] Open
Abstract
Background Musculoskeletal pain is associated with obesity; however, information on factors associated with pain in adults with obesity and severe obesity is limited. The purpose of this study was to assess the prevalence of musculoskeletal pain by site and intensity of pain and associated factors in individuals with severe obesity (body mass index ≥ 35.0 kg/m2). Methods Baseline data from the DieTBra Trial study evaluating pain symptoms in nine body regions over the last seven days using the Nordic Questionnaire on Musculoskeletal Symptoms and Numerical Pain Scale. The variables analyzed using multiple Poisson regression with hierarchical analysis were: sociodemographic, lifestyle, food consumption, clinical, and anthropometric, and the outcome was moderate and intense pain. Results In 150 participants, there was a high prevalence of ankle and foot pain (68.7%), lower back pain (62.7%), pain in the knees (53.3%) and upper back pain (52.0%), with a predominance of intense pain. Factors associated with pain according to specific sites were: type 2 diabetes with hand/wrist pain; sedentary time with hip pain; insomnia with pain in the hip and knee; edema in the lower limbs with pain in the lower back and ankles/feet; degree of obesity with ankle/foot pain; and percentage of total fat with ankle/foot pain. Conclusions There was a high prevalence of pain and intense pain in individuals with severe obesity and an association with clinical variables, the degree of obesity, and sedentary lifestyle.
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Affiliation(s)
| | - Matias Noll
- Instituto Federal Goiano, Campus Ceres, Goiás, Brazil
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14
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Mendonça CR, Noll M, Rodrigues APDS, Vitorino PVDO, Mendes MDA, Silveira EA. Association of Pain, Severe Pain, and Multisite Pain with the Level of Physical Activity and Sedentary Behavior in Severely Obese Adults: Baseline Data from the DieTBra Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4478. [PMID: 32580400 PMCID: PMC7345744 DOI: 10.3390/ijerph17124478] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 12/16/2022]
Abstract
The study aimed to assess the prevalence of pain, severe pain, and pain in four or more regions associated with physical activity and sedentary behavior, as well as other associated factors in severely obese adults (Body Mass Index ≥ 35 kg/m2). Baseline data from the DieTBra Trial were analyzed. The outcome variables were pain (yes/no) and pain in four or more sites (yes/no), as identified by the Brazilian version of the Nordic Musculoskeletal Questionnaire, along with the presence of severe pain (yes/no), identified based on the Numerical Pain Rating Scale (≥8). The main independent variables were moderate to vigorous physical activity (MVPA), light physical activity, and sedentary behavior, assessed by triaxial accelerometry. The variables were analyzed using multiple hierarchical Poisson regression. In 150 individuals (men, 14.67%; and women, 85.33%), with a mean age of 39.6 ± 0.7 years, there was a high prevalence of pain (89.33%), severe pain (69.33%), and pain in four or more regions (53.33%). The associated factors were shorter MVPA time with pain (p = 0.010); arthritis/arthrosis (p = 0.007) and the use of muscle relaxants (p = 0.026) with severe pain; and economic class C (p = 0.033), and economic class D (p = 0.003), along with arthritis and arthrosis (p = 0.025) with pain in four or more sites. There were no significant associations between sedentary behavior and any of the three outcomes analyzed. These findings indicate that, in severely obese individuals, shorter MVPA time is associated with a higher prevalence of pain. Future studies on physical activity intervention may contribute to the reduction in the prevalence and severity of pain in adults with severe obesity.
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Affiliation(s)
- Carolina Rodrigues Mendonça
- Postgraduate Program in Health Sciences, Faculdade de Medicina, Universidade Federal de Goiás, Goiás 74605-050, Brazil; (A.P.d.S.R.); (E.A.S.)
| | - Matias Noll
- Instituto Federal Goiano (IF Goiano), Goiás 74270-040, Brazil;
| | - Ana Paula dos Santos Rodrigues
- Postgraduate Program in Health Sciences, Faculdade de Medicina, Universidade Federal de Goiás, Goiás 74605-050, Brazil; (A.P.d.S.R.); (E.A.S.)
| | - Priscila Valverde de Oliveira Vitorino
- Postgraduate Program in Health Sciences, Professor of the School of Social Sciences and Health, Pontifical Catholic University of Goiás, Goiânia, Goiás 74605-010, Brazil;
| | | | - Erika Aparecida Silveira
- Postgraduate Program in Health Sciences, Faculdade de Medicina, Universidade Federal de Goiás, Goiás 74605-050, Brazil; (A.P.d.S.R.); (E.A.S.)
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15
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Silveira EA, de Souza Rosa LP, de Carvalho Santos ASEA, de Souza Cardoso CK, Noll M. Type 2 Diabetes Mellitus in Class II and III Obesity: Prevalence, Associated Factors, and Correlation between Glycemic Parameters and Body Mass Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3930. [PMID: 32498226 PMCID: PMC7312992 DOI: 10.3390/ijerph17113930] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/24/2020] [Accepted: 05/27/2020] [Indexed: 12/20/2022]
Abstract
Despite the worldwide growth of class II and III obesity, the factors associated with type 2 diabetes mellitus (T2DM) in these obese individuals are not widely understood. Moreover, no study has investigated these associations in South America. Our study aimed to investigate the prevalence of T2DM and its associated factors, with an emphasis on biochemical parameters and eating habits, in class II and III obese individuals. We also aimed to analyze the correlation between glycemic parameters and body mass index (BMI). Baseline data from a randomized clinical trial (DieTBra Trial) of 150 class II and III obese individuals (BMI > 35 kg/m2) was used. An accelerometer, Food Frequency Questionnaire, and bioimpedance analysis were used to assess physical activity levels, eating habits, and body composition, respectively. Blood was collected after 12 h of fasting. Hierarchical multivariate Poisson regression was performed, and prevalence ratios (PRs) were calculated. Correlations between glycemic parameters (fasting blood glucose, glycosylated hemoglobin, homeostasis model assessment of insulin resistance (HOMA-IR), and insulin) and BMI were also analyzed. The prevalence of T2DM was 40.0% (95% CI, 32.1-48.3), high fasting blood glucose level was 19.33% (95% CI, 13.3-26.6), and high glycosylated hemoglobin was 32.67% (95% CI, 25.2-40.8). Age ≥ 50 years (PR = 3.17, 95% CI, 1.26-7.98) was significantly associated with T2DM; there was a positive linear trend between age and T2DM (p = 0.011). Multivariate analysis showed an association with educational level (PR = 1.49, 1.07-2.09, p = 0.018), nonconsumption of whole grains daily (PR = 1.67, 1.00-2.80, p = 0.049), and high HOMA-IR (PR = 1.54, 1.08-2.18, p = 0.016). We found a high prevalence of T2DM and no significant correlations between BMI and glycemic parameters.
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Affiliation(s)
- Erika Aparecida Silveira
- Post-Graduate Program in Health Sciences, School of Medicine, Federal University of Goiás, Goiás 74605-050, Brazil; (L.P.d.S.R.); (A.S.e.A.d.C.S.); (C.K.d.S.C.); (M.N.)
| | - Lorena Pereira de Souza Rosa
- Post-Graduate Program in Health Sciences, School of Medicine, Federal University of Goiás, Goiás 74605-050, Brazil; (L.P.d.S.R.); (A.S.e.A.d.C.S.); (C.K.d.S.C.); (M.N.)
- Federal Institute of Goiás, Goiânia Oeste Campus, Goiás 74270-040, Brazil
| | - Annelisa Silva e Alves de Carvalho Santos
- Post-Graduate Program in Health Sciences, School of Medicine, Federal University of Goiás, Goiás 74605-050, Brazil; (L.P.d.S.R.); (A.S.e.A.d.C.S.); (C.K.d.S.C.); (M.N.)
- United College of Campinas, Goiás 74535-040, Brazil
| | - Camila Kellen de Souza Cardoso
- Post-Graduate Program in Health Sciences, School of Medicine, Federal University of Goiás, Goiás 74605-050, Brazil; (L.P.d.S.R.); (A.S.e.A.d.C.S.); (C.K.d.S.C.); (M.N.)
- Nutrition Course, School of Social and Health Sciences, Pontifical Catholic University of Goiás, Goiás 74605-010, Brazil
| | - Matias Noll
- Post-Graduate Program in Health Sciences, School of Medicine, Federal University of Goiás, Goiás 74605-050, Brazil; (L.P.d.S.R.); (A.S.e.A.d.C.S.); (C.K.d.S.C.); (M.N.)
- Instituto Federal Goiano, Ceres Campus, Goiás 76310-000, Brazil
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16
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Aparecida Silveira E, Danésio de Souza J, dos Santos Rodrigues AP, Lima RM, de Souza Cardoso CK, de Oliveira C. Effects of Extra Virgin Olive Oil (EVOO) and the Traditional Brazilian Diet on Sarcopenia in Severe Obesity: A Randomized Clinical Trial. Nutrients 2020; 12:E1498. [PMID: 32455620 PMCID: PMC7284637 DOI: 10.3390/nu12051498] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Nutritional interventions may have positive effects on sarcopenia and body composition. OBJECTIVE to evaluate the effectiveness of extra virgin olive oil (EVOO) consumption and a healthy traditional Brazilian diet (DieTBra) on improving sarcopenia indicators and reducing total body fat in severe obesity. METHODS A randomized controlled trial registered at ClinicalTrials.gov (NCT02463435) conducted with 111 severely obese participants randomized into three treatment groups-(1) EVOO (52 mL/day), (2) DieTBra, (3) DieTBra + EVOO (52 mL/day)-for 12 weeks. Body composition was assessed by dual-energy X-ray absorptiometry and sarcopenia by walking speed and handgrip strength. RESULTS Significant reductions in total body fat (p = 0.041) and body weight (p = 0.003) were observed in the DieTBra group. In the DietBra + olive oil group there was also a significant reduction in body weight (0.001) compared to the olive oil-only group. ANCOVA analyses showed reductions in total body fat in the DieTBra (p = 0.016) and DieTBra + olive oil (p = 0.004) groups. Individuals in the DieTBra group had significant improvements in their walking speed (p = 0.042) and handgrip strength (p = 0.044). CONCLUSIONS DieTBra contributes to improvements in handgrip strength, walking speed, and total body fat in severely obese adults. The major study was registered at ClinicalTrials.gov (NCT02463435).
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Affiliation(s)
- Erika Aparecida Silveira
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goias, Brazil; (J.D.d.S.); (A.P.d.S.R.)
- Affiliate Academic at the Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK
| | - Jacqueline Danésio de Souza
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goias, Brazil; (J.D.d.S.); (A.P.d.S.R.)
| | - Ana Paula dos Santos Rodrigues
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goias, Brazil; (J.D.d.S.); (A.P.d.S.R.)
| | - Ricardo M. Lima
- Faculty of Physical Education, University of Brasília, Darcy Ribeiro University Campus, Brasília CEP 70910-900, Distrito Federal, Brazil;
| | - Camila Kellen de Souza Cardoso
- School of Social Sciences and Health, Nutrition Course, Pontifical Catholic University of Goias, Goiânia 74605-020, Brazil;
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London WC1E 6BT, UK;
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17
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Santos ASEADC, Rodrigues APDS, Rosa LPDS, Noll M, Silveira EA. Traditional Brazilian Diet and Olive Oil Reduce Cardiometabolic Risk Factors in Severely Obese Individuals: A Randomized Trial. Nutrients 2020; 12:nu12051413. [PMID: 32422956 PMCID: PMC7284483 DOI: 10.3390/nu12051413] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/03/2020] [Accepted: 05/11/2020] [Indexed: 01/14/2023] Open
Abstract
Cardioprotective effects associated with extra virgin olive oil (EVOO) have been studied within the Mediterranean diet. However, little is known about its consumption in the traditional Brazilian diet (DieTBra) or without any dietary prescription, particularly in severely obese individuals. This study aimed to assess the effectiveness of DieTBra and EVOO in cardiometabolic risk factor (CMRF) reduction in severely obese individuals. We conducted a parallel randomized clinical trial with 149 severely obese individuals (body mass index ≥ 35.0 kg/m2) aged 18–65 years, assigned to three groups: 52 mL/day of EVOO (n = 50), DieTBra (n = 49), and DieTBra + 52 mL/day of EVOO (n = 50). Participants were followed up for 12 weeks. Low-density lipoprotein cholesterol (LDL-c) was the primary endpoint and several cardiometabolic parameters were secondary endpoints. Endpoints were compared at baseline and at the end of the study using analysis of variance, the Kruskal–Wallis test, and Student’s t-test. The TC/High-density lipoprotein (HDL) ratio (−0.33 ± 0.68, p = 0.002) and LDL/HDL ratio (−0.26 ± 0.59, p = 0.005) decreased in the EVOO group. Delta values for all variables showed no significant statistical difference between groups. However, we highlight the clinical significance of LDL-c reduction in the EVOO group by 5.11 ± 21.79 mg/dL and in the DieTBra group by 4.27 ± 23.84 mg/dL. We also found a mean reduction of around 10% for Castelli II (LDL/HDL) and homocysteine in the EVOO group and TG and the TG/HDL ratio in the DieTBra group. EVOO or DieTBra when administered alone lead to reduction in some cardiometabolic risk parameters in severely obese individuals.
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Affiliation(s)
- Annelisa Silva e Alves de Carvalho Santos
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74.650-050, GO, Brazil; (A.P.d.S.R.); (L.P.d.S.R.); (M.N.)
- Correspondence: (A.S.e.A.d.C.S.); (E.A.S.); Tel./Fax: +55-62-3209-6151 (E.A.S.)
| | - Ana Paula dos Santos Rodrigues
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74.650-050, GO, Brazil; (A.P.d.S.R.); (L.P.d.S.R.); (M.N.)
| | - Lorena Pereira de Souza Rosa
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74.650-050, GO, Brazil; (A.P.d.S.R.); (L.P.d.S.R.); (M.N.)
| | - Matias Noll
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74.650-050, GO, Brazil; (A.P.d.S.R.); (L.P.d.S.R.); (M.N.)
- Instituto Federal Goiano, Rodovia Go-154, Km 03, s/n, Ceres 76300-000, GO, Brazil
| | - Erika Aparecida Silveira
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74.650-050, GO, Brazil; (A.P.d.S.R.); (L.P.d.S.R.); (M.N.)
- Correspondence: (A.S.e.A.d.C.S.); (E.A.S.); Tel./Fax: +55-62-3209-6151 (E.A.S.)
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18
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Santos ASAC, Rodrigues APS, Rosa LPS, Sarrafzadegan N, Silveira EA. Cardiometabolic risk factors and Framingham Risk Score in severely obese patients: Baseline data from DieTBra trial. Nutr Metab Cardiovasc Dis 2020; 30:474-482. [PMID: 31791637 DOI: 10.1016/j.numecd.2019.10.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 09/01/2019] [Accepted: 10/29/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Little is known about differences of cardiometabolic risk factors (CMRF) and the function of Framingham Risk Score (FRS) within severe obesity, thus we aimed to study not only CMRF and FRS, but to determine significant differences between BMI ranges within severe obesity. METHODS AND RESULTS In this baseline analysis of the Traditional Brazilian Diet (DieTBra) Trial, several CMRF were assessed in 150 adult patients in two BMI ranges: 35.0-44.9 kg/m2 (n = 76) and ≥45 kg/m2 (n = 74). Body composition was evaluated by multifrequency bioelectrical impedance analysis to measure the percent of body fat, visceral fat area and waist circumference. Pearson's Chi-squared, Fisher's Exact, Student's t-test, and Mann-Whitney's test were used in the statistical analysis with a 5% significance level. Hypertension, C-reactive protein, systolic and diastolic blood pressure and positive family history for heart diseases were more prevalent in BMI ≥45.0 kg/m2 (p < 0.05). Mean values of waist circumference, body fat %, visceral fat area, and systolic blood pressure were significantly higher in patients with BMI ≥45.0 kg/m2. Regarding the function of FRS, 40.0% of the patients were at high risk. No differences were found for diabetes, lifestyle, lipid parameters, and FRS within different BMI ranges, except for dyslipidemia, significantly higher among participants with BMI 35.0-44.9 kg/m2. CONCLUSION BMI >45 kg/m2 was associated with higher prevalence of hypertension, systolic and diastolic blood pressure, C-reactive protein, waist circumference, body fat % and family history of heart diseases, enhancing the risk for the occurrence of cardiovascular diseases.
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Affiliation(s)
- Annelisa S A C Santos
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Brazil.
| | - Ana Paula S Rodrigues
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Brazil
| | - Lorena P S Rosa
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Brazil
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Erika A Silveira
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Brazil
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Cardoso CKDS, Santos ASEADC, Rosa LPDS, Mendonça CR, Vitorino PVDO, Peixoto MDRG, Silveira ÉA. Effect of Extra Virgin Olive Oil and Traditional Brazilian Diet on the Bone Health Parameters of Severely Obese Adults: A Randomized Controlled Trial. Nutrients 2020; 12:E403. [PMID: 32032997 PMCID: PMC7071276 DOI: 10.3390/nu12020403] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/22/2020] [Accepted: 01/28/2020] [Indexed: 12/11/2022] Open
Abstract
Dietary interventions can stabilize and/or reverse bone mass loss. However, there are no reports on its effects on bone mineral density (BMD) in severely obese people, despite the vulnerability of this group to bone loss. We examine the effect of extra virgin olive oil supplementation and the traditional Brazilian diet (DieTBra) on BMD and levels of calcium, vitamin D, and parathyroid hormone (PTH) in severely obese adults. A randomized controlled trial followed-up with severely obese adults (n = 111, with mean body mass index 43.6 kg/m2 ± 4.5 kg/m2) for 12 weeks. Study participants received either olive oil (52 mL/day), DieTBra, or olive oil + DieTBra (52 mL/day + DieTBra). BMD was assessed by total spine and hip dual-energy X-ray absorptiometry. After interventions, BMD means for total spine (p = 0.016) and total hip (p = 0.029) were higher in the DieTBra group than in the olive oil + DieTBra group. Final mean calcium levels were higher in the olive oil group compared to the olive oil + DieTBra group (p = 0.026). Findings suggest that DieTBra and extra virgin olive oil have positive effects on bone health in severely obese adults. The major study was registered at ClinicalTrials.gov (NCT02463435).
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Affiliation(s)
- Camila Kellen de Souza Cardoso
- The Postgraduate Program in Health Sciences, School of Social Sciences and Health, Nutrition Course, Pontifical Catholic University of Goiás, Goiânia, 74605-020 Goiás, Brazil;
| | - Annelisa Silva e Alves de Carvalho Santos
- The Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, 74605-220 Goiás, Brazil; (A.S.e.A.d.C.S.); (L.P.d.S.R.); (C.R.M.)
| | - Lorena Pereira de Souza Rosa
- The Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, 74605-220 Goiás, Brazil; (A.S.e.A.d.C.S.); (L.P.d.S.R.); (C.R.M.)
| | - Carolina Rodrigues Mendonça
- The Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, 74605-220 Goiás, Brazil; (A.S.e.A.d.C.S.); (L.P.d.S.R.); (C.R.M.)
| | - Priscila Valverde de Oliveira Vitorino
- The Postgraduate Program in Health Sciences, Professor of the School of Social Sciences and Health, Pontifical Catholic University of Goiás, Goiânia, 74605-020 Goiás, Brazil;
| | - Maria do Rosário Gondim Peixoto
- The Postgraduate Program Nutrition and Health, Faculty of Nutrition, Federal University of Goiás, Goiânia, 74605-220 Goiás, Brazil;
| | - Érika Aparecida Silveira
- The Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, 74605-220 Goiás, Brazil; (A.S.e.A.d.C.S.); (L.P.d.S.R.); (C.R.M.)
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20
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de Siqueira RA, Rodrigues APDS, Miamae LM, Tomimori EK, Silveira EA. Thyroid Nodules in Severely Obese Patients: Frequency and Risk of Malignancy on Ultrasonography. Endocr Res 2020; 45:9-16. [PMID: 31256691 DOI: 10.1080/07435800.2019.1625056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: We aimed to compare the thyroid ultrasonographic findings of severely obese versus nonobese individuals, and the frequency, characteristics, and risk of malignancy in detected nodules.Design: Case-control study including 67 adults with severe obesity (body mass index [BMI] ≥ 35 kg/m2) and 67 nonobese controls (BMI < 30 kg/m2). The participants underwent ultrasound evaluation of the thyroid and cervical subcutaneous tissue. The risk of malignancy in detected nodules was determined using the American Thyroid Association (ATA) 2015 and the Thyroid Imaging Reporting and Data System (TI-RADS) classifications. Fine-needle aspiration biopsy (FNAB) was performed in nodules for which the procedure was recommended according to the ATA-2015 or TI-RADS criteria, and the cytological evaluation followed the Bethesda classification.Results: The mean BMI values in the case and control groups were 47.0 ± 6.1 kg/m2 and 22.8 ± 2.7 kg/m2, respectively. There were no differences between groups regarding sex, age, total T3, and antiperoxidase (antiTPO) antibody positivity. When compared with controls, severely obese individuals showed a greater frequency of parenchymal hypoechogenicity (p = 0.042), cervical subcutaneous tissue thickness (p < 0.001), overall frequency of thyroid nodules (p = 0.038), and frequency of multiple nodules (p = 0.013). No significant differences were observed in terms of risk of nodular malignancy according to both the ATA-2015 and TI-RADS classifications in severely obese compared with nonobese individuals.Conclusions: Severely obese individuals (versus nonobese controls) presented increased parenchymal hypoechogenicity and frequency of thyroid nodules on ultrasonographic evaluation. However, no significant differences were observed in terms of risk of nodular malignancy between both groups according to the ATA-2015 and TI-RADS criteria. Thus, ultrasonographic thyroid screening of severely obese individuals is not justified.
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Affiliation(s)
- Raquel Andrade de Siqueira
- Health Science postgraduate program, Medical School, Universidade Federal de Goiás, Goiânia, Brazil
- Endocrinology Unit, Thyroid Department, Goiânia General Hospital, Goiânia, Brazil
| | | | - Lucas Massao Miamae
- Department of Radiology at Clinical Hospital, Universidade Federal de Goiás, Goiânia, Brazil
| | | | - Erika Aparecida Silveira
- Health Science postgraduate program, Medical School, Universidade Federal de Goiás, Goiânia, Brazil
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21
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Siqueira RAD, Noll M, Rodrigues APDS, Silveira EA. Factors Associated with the Occurrence of Thyroid Nodules in Severely Obese Patients: A Case-Control Study. Asian Pac J Cancer Prev 2019; 20:693-697. [PMID: 30909666 PMCID: PMC6825758 DOI: 10.31557/apjcp.2019.20.3.693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: The association of obesity with the occurrence of thyroid nodules and thyroid cancer has been demonstrated. However, there is limited knowledge on the risk factors of thyroid nodules in in severely obese patients. The aim was to evaluate the occurrence of thyroid nodules in severely obese and nonobese patients and determine the factors associated considering sociodemographic, lifestyle, and biochemical variables. Methods: This is a case-control study of 134 adults which 67 nonobese, control group, and 67 severely obese (BMI ≥ 35 kg/m2), case group. All participants underwent thyroid ultrasound. Results: The occurrence of thyroid nodules in a control group was 13.4% (n = 9), while in a case group was 29.9%, n = 20), difference statistically significant (p = 0.017). Factors associated with the occurrence of thyroid nodules in severely obese patients were lower mean age (p = 0.022); higher economic class (p = 0.010); nonconsumption of alcohol (p = 0.017); higher fasting glycemia (p = 0.009), fasting insulin (p = 0.001), homeostatic model assessment of insulin resistance [HOMA-IR] (p = 0.045), and triglyceride (p = 0.009) mean values; and lower vitamin D3 (p = 0.045) and high-density lipoprotein cholesterol (p = 0.041) mean values. Conclusions: Occurrence of thyroid nodules in severely obese patients was higher than nonobese. Lower age at diagnosis, higher economic level, nonconsumption of alcohol, hyperinsulinemia, higher HOMA-IR scores, and lower vitamin D3 levels were factors associated with the occurrence of thyroid nodules in severely obese patients.
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Affiliation(s)
| | - Matias Noll
- Instituto Federal Goiano, Brazil.,Programa de Pós-Graduacão em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás (UFG), Brazil
| | | | - Erika Aparecida Silveira
- Programa de Pós-Graduacão em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás (UFG), Brazil
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22
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Wan R, Ding Z, Xia S, Zheng L, Lu J. Effects Of PPARγ2 Pro12Ala Variant On Adipocyte Phenotype Dependent Of DHA. Diabetes Metab Syndr Obes 2019; 12:2273-2279. [PMID: 31802926 PMCID: PMC6830383 DOI: 10.2147/dmso.s214526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 10/03/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Peroxisome proliferator-activated receptor γ2 (PPARγ2) plays a critical role in the regulation of adipocyte differentiation and adipocytokine production. The Pro12Ala variant is the most common mutation in the PPARγ2 gene. Its effect appears to be sensitive to dietary factors, such as docosahexaenoic acid (DHA) level. The purpose of this study was to investigate the interaction effect between PPARγ2 Pro12Ala variant and DHA on the phenotypes of adipocytes. METHODS We generated stable 3T3-L1 cell lines expressing wild-type PPARγ2 or PPARγ2 Pro12Ala variant. These two cell lines were cultured with different concentrations of DHA (0, 50, 200 umol/L). Then Oil red O staining was used to observe cell differentiation and the degree of lipid accumulation, TUNNEL assay was used to detect cell apoptosis, and ELISA assays were used to detect the changes of TNF-α, resistin and adiponectin levels in cell culture supernatant. RESULTS PPARγ2 Pro12Ala variant reduced lipid droplet accumulation in 3T3-L1 preadipocytes treated with or without 50 μmol/L DHA, but not with 200 μmol/L DHA, compared to that of wild-type PPARγ2. PPARγ2 reduced resistin production and increased adiponectin production in 3T3-L1 adipocytes, whereas PPARγ2 Pro12Ala variant diminished these effects. However, the absence of DHA blocked PPARγ2 Ala12 variant-induced effects on adiponectin production. There was no significant difference in TNF-α secretion between wild-type PPARγ2 and PPARγ2 Pro12Ala cells whether with or without DHA. CONCLUSION These results indicated that the effects of PPARγ2 Pro12Ala variant were dependent on DHA concentration.
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Affiliation(s)
- Renhui Wan
- Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai200433, People’s Republic of China
| | - Zhengping Ding
- Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai200433, People’s Republic of China
| | - Sheng Xia
- Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai200433, People’s Republic of China
| | - Longyi Zheng
- Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai200433, People’s Republic of China
| | - Jin Lu
- Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai200433, People’s Republic of China
- Correspondence: Jin Lu; Longyi Zheng Department of Endocrinology, Changhai Hospital, Second Military Medical University, No.168, Changhai Road, Shanghai200433, People’s Republic of China Email ;
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