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Background: Obesity, dyslipidemia, hypertension, and diabetes mellitus are common features after heart transplantation and they lead to coronary artery disease and graft loss. Aim: To determine the effects of a dietary intervention on nutritional status and metabolic outcome of two groups enrolled during or after the first year from the transplant. Methods: Forty two subjects (mean age 51.36±12.4 yr) were studied; 20 were enrolled during the first year by the transplant, 22 were enrolled after the first year from the transplant (7.9±3.86 and 56.86±38.6 months after surgery, respectively). According to diet compliance both groups were divided into two subgroups and they were prospectively followed for 4 years. Anthropometric measurements, biochemical nutritional markers, and dietary records were collected at baseline (T0) and after a 12-month follow-up period (T12) and a 48-month follow-up period (T48). Body composition was performed at T0 and T12. Results: Diet compliance was associated with a decrease in total cholesterol, triglycerides and glucose plasma level and with a weight loss mainly due to a decrease in fat mass. Conclusion: Our study shows the efficacy of dietary intervention to obtain an early and late weight and metabolic control after heart transplant.

BACKGROUND AND AIM: Significant changes in body composition that have important health related effects may occur in the elderly. In this study, we evaluated the bioelectrical characteristics in a large group of apparently healthy Caucasian men in the age range 50-80 years, as a function of age and body mass index. METHODS: We studied 315 men with ages ranging from 50 to 80 years. They were divided into three groups according to body mass index (kg/m(2)): 18.5-24.9 normoweight (NW); 25.0-29.9 overweight (OW); > or =30 obese (OB), and they were classified in nine age subgroups: 50-59 (young-old, YO); 60-69 (old, O); 70-80 (oldest, OS). Fat-free mass, fat mass and body cell mass were investigated using conventional bioelectrical impedance analysis. Body composition was also assessed by bioelectrical impedance vector analysis and the RXc graph method. RESULTS: Body cell mass decreased significantly with age particularly in subgroups of the OW and OB groups (p

Obese adult patients have many dermatoses, such as skin tags, candida infection, cellulite, and intertrigo, but only limited data have been published on obese children and the barrier function of their skin. Sixty-five overweight and obese children (n = 40, BMI 85th-95th percentile; n = 25, BMI95th percentile) (aged 8-15; mean age 11.6) and 30 normal-weight controls (aged 7-15; mean age 11.1) underwent a clinical evaluation and calculation of transepidermal water loss (TEWL). Higher weight percentile was associated with a higher incidence of some dermatoses. Skin tags were found in 40% of subjects in the 95th percentile and 2.5% of those in the 85th percentile. Striae distensae were observed in 32% of patients in the 95th percentile and 22.5% of those in the 85th percentile. Plantar hyperkeratosis was observed only in 20% of the 95th percentile subjects and was not observed in the other groups. TEWL values at the forearm site were significantly higher (p0.05) in obese children than in the control group, but no significant differences in TEWL values according to BMI level were found between the two groups of obese children. Degree of obesity influences the incidence of some associated dermatoses; skin tags, striae distensae, and plantar hyperkeratosis were more frequent in children in the 95th percentile of BMI. Obesity increases the TEWL rate, suggesting that obese children might become more easily overheated as weight increases, with more profuse sweating because of the thick layers of subcutaneous fat.

Background Obese subjects frequently show skin diseases. However, less attention has been paid to the impactof obesity on skin disorders until now.Objective The purposes of this study are: to highlight the incidence of some dermatoses in obese subjects and tostudy the water barrier function of the obese skin using transepidermal water loss (TEWL).Methods Sixty obese subjects and 20 normal weight volunteers were recruited. Obese group was further dividedinto three body mass index (BMI) classes: class I (BMI 30–34.9 kg⁄m 2 ), class II (BMI 35–39.9 kg⁄m ) and class III(BMI 40 g⁄m 2 ). All subjects attended dermatological examination for skin diseases. To assess barrier function, TEWLmeasurements were performed on the volar surface of the forearm using a tewameter.Results The results of this study showed that: (i) obese subjects show a higher incidence of some dermatosescompared with normal-weight controls; in addition the dermatoses are more, frequent as BMI increases; (ii) the rateof TEWL is lower in obese subjects, than in the normal-weight subjects, particularly in patients with intra-abdominalobesity.Conclusion Specific dermatoses as skin tags, striae distensae and plantar hyperkeratosis, could be considered asa cutaneous stigma of severe obesity. The low permeability of the skin to evaporative water loss is observed inobese subjects compared with normal weight control. Although the physiological mechanisms are still unknown, thisfinding has not been previously described and we believe that this may constitute a new field in the research onobesity.Received: 26 November 2008; Accepted: 13 February 2009

Background. In these last years, several traditional risk factors for cardiovascular disease, like obesity, dyslipidaemia, hypertension and post-transplant diabetes mellitus have been also identified as important nonimmunological risk factors leading to the development of chronic allograft nephropathy, the first cause of graft loss in transplanted patients. The aim of the present study was to determine the effects of a 12-month dietary regimen on the nutritional status and metabolic outcome of renal transplant recipients in the first post-transplant year. Methods. Forty-six cadaver-donor renal transplant recipients (mean age 40.8 � 10.1-years), enrolled during the first post-transplant year (4.8 � 3.3 months) and followed prospectively for a 12 month period. Biochemical and nutritional markers, anthropometric measurements, body composition (by conventional bioelectrical impedance analysis) and dietary records (using a detailed food-frequency questionnaire) at baseline and after 12 months. Results. Compliance to the diet was related to sex (male better than female) and was associated with weight loss primarily due to a decrease in fat mass, with decrease in total cholesterol and glucose plasma levels and with a concomitant rise in serum albumin. Conclusion. After renal transplantation, health benefits of proper metabolic balance that include reduced body fat, weight loss, lower cholesterol and triglycerides levels and an improvement, fasting glucose levels can be obtained when dietary intervention occurred.

OBJECTIVE: To describe bioelectrical impedance vector distribution in relation to BMI (body mass index; body weight/stature(2)) in a population of healthy children in order to detect possible changes in body composition status. DESIGN: Observational study involving 464 healthy 8-year-old children. The subjects were divided into three groups based on their BMI: 218 normal weight (NW) children with BMI/=21.6. Skinfold thickness was measured at the triceps using a Holtain caliper. Bioelectrical impedance analysis (BIA) measurements were performed. Total body water (TBW), fat-mass (FM), fat-free mass (FFM), body cell mass (BCM) and extra-cellular water (ECW) were estimated using conventional BIA regression equations. The resistance-reactance graph (RXc graph) method was used for vector BIA using as reference population the set of 353 children with BMI 14.0-21.5kg/m(2). RESULTS: Mean vector displacement followed a definite pattern, with progressive vector shortening in groups with increasing BMI class, and along a fixed phase angle. This pattern indicates an increase in TBW due to an increase in soft tissue mass with an average, normal hydration. In NW children, vectors out of the right and upper half of the 75% tolerance ellipse indicating leanness, and vectors falling out of the right and lower half of the tolerance ellipse indicating undernutrition, show a significantly reduced value of BCM but no significant differences in FM or triceps skinfold thickness (TST), respectively, compared to vectors falling within the 75% tolerance ellipse. CONCLUSIONS: Although BMI is a reliable measure to grade overweight, it cannot differentiate whether weight change is due to variation of FM, FFM or water. In our study a different impedance vector pattern has been associated with normal weight to obesity, and we have established the trajectory followed by the impedance vector of standardized age, healthy children grouped by BMI. This BIVA may be useful for clinical purposes due to ability to detect changes in hydration or body composition in children.