Search

Purpose: The gut microbiome is associated with obesity, mainly mediated by bacteria-produced short-chain fatty acids (SCFAs). It is unknown how SCFA concentrations are associated among the phenotypes metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy obese/overweight (MHO), and metabolically unhealthy obese/overweight (MUO). We compared plasma and fecal SCFA concentrations among adult women categorized according to the metabolic phenotypes mentioned above and examined associations between SCFA and adiposity and components of energy and glucose homeostasis. Methods: This was a cross-sectional study involving 111 participants. Body composition was assessed by DEXA. Energy and glycemic homeostasis were assessed by the standard mixed-meal tolerance test coupled with indirect calorimetry. SCFAs were quantified by gas chromatography and mass spectrometry. Results: Only plasma propionate was increased in the MHNW phenotype compared to the MHO and MUO phenotypes [p

Objective: Intrauterine environment can induce fetal metabolic programming that predisposes to adiposity-related chronic diseases in its lifespan. We examined the associations of parental nutritional status and gestational weight gain with offspring body composition in early adulthood. Materials and methods: This is cross-sectional analysis of female participants of the NutriHS who were submitted to questionnaires, clinical examinations and body composition assessed by DXA. Association of pre-conception parental BMI and maternal gestational weight gain (exposures) with body composition measurements (outcomes) were analyzed using multiple linear models adjusted for Directed Acyclic Graphs-based covariables (maternal and paternal educational level, maternal age, and tobacco, alcohol and/or drugs use). The sample included 124 women (median 28 (24-31) years) with a mean BMI of 25.4 ± 4.7 kg/m2. Results: No association between previous paternal BMI and offspring’s body composition was detected. In the fully adjusted linear regression model, maternal BMI was associated with offspring’s total lean mass (β = 0.66, p = 0.001), appendicular skeletal muscle mass index (ASMI) (β = 0.11, p = 0.003) and fat mass index (FMI) (β = 0.03, p = 0.039). Gestational weight gain was associated with increased offspring’s BMI (OR 1.12 [95% CI 1.02-1.20], p = 0.01). The linear regression model adjusted for maternal age and maternal and paternal education levels showed associations of gestational weight gain with offspring’s ASMI (β = 0.42, p = 0.046), FMI (β = 0.22, p = 0.005) and android-to-gynoid fat ratio (β = 0.09, p = 0.035). Conclusion: Our findings suggest that preconception maternal BMI could influence lean mass and general adiposity of young adult female offspring and that gestational weight gain could be useful for predicting centrally distributed adiposity.

Objective: To analyze component-resolved diagnosis of sensitization to Dermatophagoides pteronyssinus (Der p) in patients with respiratory allergy and the association between diagnostic findings and clinical severity in different geographical areas. Methods: The study population comprised 217 patients (mean age, 25.85 [12.7] years; 51.16% female) selected from 13 centers in Portugal (5 from the North, n=65). All had allergic rhinitis with or without asthma and positive skin prick test results to at least 1 dust mite. Specific IgE (sIgE) to Der p, Dermatophagoides farinae, Lepidoglyphus destructor, Der p 1, Der p 2, Der p 10, and Der p 23 was determined using ImmunoCAP. The Mann-Whitney test was applied for the following comparisons: rhinitis vs rhinitis and asthma; mild vs moderate-to-severe rhinitis; North vs South. Results: The prevalence of sensitization was 98.2% for Der p, and 72.4%, 89.4%, 9.7%, and 77% for Der p 1, Der p 2, Der p 10, and Der p 23, respectively. The corresponding median sIgE levels were 8.56, 17.7, 0.01, and 3.95 kUA/L. sIgE to all allergens was higher in patients with moderate-to-severe rhinitis and rhinitis with asthma (nonsignficant). Concentrations of sIgE to Der p 2 were significantly higher in the South than in the North (P=.0496). Conclusions: The most common sensitization in Portugal was to Der p. The highest prevalence and median sIgE level were observed for Der p 2. All sIgE values for molecular components were higher in more symptomatic patients (nonsignificant). Concentrations of sIgE to Der p 2 were higher in the South, probably because of the warmer temperature and/or the larger sample size.

Objectives The aim of this study was to examine whether paternal and maternal body mass indexes (BMIs) were independently associated with obestatin and visfatin levels in adult offspring. Methods This cross-sectional analysis included 124 women who participated in the Nutritionists’ Health Study (NutriHS) at baseline. Early life events, anthropometry, dual-energy x-ray absorptiometry–determined body composition and blood sample were obtained. Associations of parental BMI with outcomes (obestatin and visfatin) were tested by multiple linear regression, using minimal sufficient adjustments recommended by Directed Acyclic Graph. Participants’ mean BMI was 25 ± 5 kg/m2 and 74% were metabolically healthy. Median obestatin and visfatin levels were 56.4 pg/mL (42–72) and 17.7 ng/mL (14–21.8), respectively. Eleven percent of mothers and 39% of fathers were overweight/obese. Results Daughters born from overweight/obese mothers had higher BMI than those born from normal weight women (P = 0.003). In adjusted regression model, offspring obestatin levels were associated with maternal BMI (β = –0.03; P = 0.045) and paternal BMI (β = –0.02; P = 0.048) independently of maternal and paternal education, maternal age, and maternal use of tobacco, alcohol, and/or drugs. No association was detected with visfatin levels. Conclusion Inverse associations of maternal and paternal BMIs with offspring obestatin concentrations in women could suggest a utility of this biomarker of energy regulation determined in early adulthood. Whether obestatin could be an indicator of protection against obesity-related disorders in the life course requires investigation in studies designed to test such hypothesis.

Objective: To compare components of glycemic and energy homeostasis in women with metabolically healthy normal weight (MHNW) and metabolically unhealthy (MUNW), metabolically unhealthy overweight/obese (MUO) and metabolically healthy (MHO) phenotypes. Methodology: Cross-sectional study with 104 women (18-45 years): 30 MHNW, 17 MUNW, 27 MHO, 30 MUO. Overweight was considered BMI ≥ 25 kg/m² and metabolic health without of changes in blood pressure, glycemic, lipemic levels and cardiovascular disease. The standard mixed meal tolerance test and indirect calorimetry were performed (assessments at -15, 0, 30, 60, 120 and 180 min). The quantifications were: areas under the curve (AUC) for glucose, insulin, C peptide, glucagon and GLP-1; insulin sensitivity (IS) by oral glucose insulin sensitivity index; energy expenditure, respiratory quotient, and carbohydrate and lipid oxidation rate were measured at rest and after oral stimulation. Results: The groups did not differ regarding age and HbA1c levels. IS was decreased in MUO compared to MHNW and MHO (p Conclusion: In young and normoglycemic women, there was lower IS and insulin secretion for the MUO phenotype. The greater rate of lipid oxidation in this group compared to the lean ones may be a reflection of the lower IS, and the inability to switch the use of energy substrate to the higher carbohydrate availability after oral stimulation. BMI is not an ideal indicator of the presence or absence of metabolic health. However, even in MHO individuals’, physiological adaptations may happen to maintain the metabolic parameters within normal range. Disclosure F.B. Ribeiro: None. I. Solar: None. R.G. Freitas: None. A.S. Hanada: None. M.G. Barbosa: None. C.M. Xavier: None. N.S.K. Crouchan: None. V.F.D. Santos: None. B.G. Neto: None. I.T. Silva: None. L.G.D. Folchetti: None. B. Almeida Pititto: None. S.G. Ferreira-Vivolo: None. A.J. Vasques: None. Funding Fundação de Apoio a Pesquisa do Estado de São Paulo (2017/10185-9)

Discovery of adipose-produced cytokines and gut hormones has improved the understanding obesity-related mechanisms. The developmental origins of diseases theory also helped to explain the obesity risk in adults exposed to adverse intrauterine environment. In contrast to maternal conditions, the role of paternal characteristics for outcomes has been less investigated. Whether paternal adiposity is associated with obesity biomarkers in adults prior to the development of metabolic disturbances is unknown. This cross-sectional analysis included 124 women (28±5yrs) who participated in the NutriHS baseline. Early life events questionnaire, anthropometry, DXA-determined body composition and blood sample were obtained. Associations of paternal BMI with outcomes were tested by multiple linear regression, using the minimal sufficient adjustments (pre-gestational maternal, paternal education levels and current family income) suggested by Directed Acyclic Graphs. Participants had mean BMI of 25±5 kg/m2 (49% were overweight but metabolically healthy). Blood pressure and biochemical values were within the normal range. Mean obestatin and visfatin levels were 58.9±22.2 mg/dl and 18.8±8.1 mg/dl, respectively; these values did not differ between subsets with BMI Disclosure R.G. Freitas: None. A.J. Vasques: None. F.B. Ribeiro: None. I. Solar: None. M.G. Barbosa: None. A.S. Hanada: None. A.M. Valente: None. B. Almeida-Pititto: None. B.G. Neto: None. S.G. Ferreira-Vivolo: None. Funding Fundação de Amparo à Pesquisa do Estado de São Paulo (2018/11433-9); Fundação de Amparo à Pesquisa do Estado de São Paulo (2018/11401-0)

Introduction: Many studies report that environmental factors occurring in childhood may modulate the composition of the gut microbiota in adulthood, which in turn, produces short chain fatty acids (SCFA) with metabolic effects on inflammatory cascades associated with glycemic homeostasis. Objective: This study aims to analyze associations between type of delivery (vaginal/cesarean section), type of breast-feeding (maternal/artificial) and solid food introduction (start and quality) with fecal SCFA concentrations in women. Method: A cross-sectional study including 106 women, 28±5 years old and BMI 25±5 kg/m2, a questionnaire regarding from birth until the first year of life. For quantification of acetate, butyrate and propionate it was used gas chromatography-mass spectrometry in fecal samples. Results: Of the women surveyed 63% were cesarean delivered and 93% received maternal breast milk at some point. There was no correlation between SCFA concentration and type of delivery (p>0.05). Positive correlation was found between breastfeeding time and butyrate (r=0.24; p=0.02), there was a tendency with propionate (r=0.20; p=0.06). There was no correlation between time received infant formula and SCFA. There was a tendency of correlation between butyrate and beginning of cow’s milk intake (r=0.194; p=0.052). Age at solid food introduction correlates with propionate (r=0.22; p=0.026) and butyrate (r=0.25; p=0.012), and report a tendency with the acetate (r=0.18; p=0.07). In the first year of life, individuals who prefer salty crackers and pasta/potatoes had less concentration of propionate and acetate, respectively (p=0.026). Conclusion: The type of delivery was not associated with SCFA, but there was a favorable association with prolonged breastfeeding, late beginning of cow’s milk intake, introduction of solids starting after 6 months of age and lower intake of refined cereals. Disclosure M.G. Barbosa: None. I. Solar: None. R.G. Freitas: None. F.B. Ribeiro: None. C.O. Ramos: None. M.R. Sant’Ana: None. A.S. Hanada: None. N.S.K. Crouchan: None. C.M. Xavier: None. B.G. Neto: None. L.G.D. Folchetti: None. I.T. Silva: None. B. Almeida-Pititto: None. S.G. Ferreira-Vivolo: None. A.J. Vasques: None. Funding São Paulo Research Foundation (2017/10185-9, 2019/05450-0)

A obesidade e caracterizada por uma doenca cronica nao transmissivel, podendo resultar em diferentes fenotipos metabolicos. Um dado de extrema importância para um bom planejamento na pratica clinica do nutricionista e o gasto energetico de repouso, podendo ser estimado por equacoes preditivas ou mensurado pela calorimetria indireta, metodo padrao-ouro. O presente trabalho e um estudo transversal, parte do Nutritionists Health Study - NutriHS, que teve como objetivo comparar o gasto energetico de repouso estimado por 12 equacoes preditivas versus o mensurado por calorimetria indireta em 78 jovens mulheres agrupadas em quatro diferentes fenotipos metabolicos e de adiposidade corporal. Para os quatro grupos estudados, foi possivel observar que a equacao com melhor acuracia individual e populacional foi a de Owen 2, que leva em consideracao a composicao corporal do individuo. A maioria das equacoes comumente utilizadas superestimaram o gasto energetico de repouso em mais de 50%, sugerindo que sua utilizacao na pratica clinica e em pesquisa deve ser feita com cautela.

A obesidade e uma doenca multifatorial associada a diversas comorbidades. Com prevalencia crescente, torna-se fundamental a avaliacao nutricional nestes individuos. Novos indices para avaliacao da adiposidade corporal tem sido propostos como ferramentas de baixo custo, eficacia e praticidade¹²³. Objetivou-se avaliar se os indices de adiposidade corporal (IAC), de forma corporal (IFC), e massa gorda relativa (MGR) diferem dos marcadores antropometricos tradicionais (indice de massa corporal- IMC, circunferencia de cintura- CC e relacao cintura quadril- RCQ) na identificacao de um perfil metabolico desfavoravel e na avaliacao da adiposidade corporal em mulheres.

Summary Background & aims Cancer is one the principal causes of death, and is considered a health issue worldwide. Cancer patients are at high risk of malnutrition due to the disease and the treatment itself. Nutritional therapy is part of a multi-modal treatment and it is important to be aware of the patient's energy expenditure to aid in decision-making for dietotherapeutic prescription. Indirect Calorimetry (IC) is the gold standard method for measuring energy expenditure (EE); but due to its often high cost in clinical practise, equations that measure energy expenditure are usually used. Objectives To perform an integrative systematic review, searching in the literature for how predictive equations of EE behave in relation to IC in cancer patients with solid tumors, considering the overall accuracy for cancer patients, the different tumor types, and the type of anti-cancer therapy applied. Methods A review was carried out of systematic integrative type literature. The articles were searched for in three databases (Pubmed, Embase, and Web of Science) using descriptors accompanied by Boolean operators. Inclusion and exclusion criteria were determined, and the articles found went through selection, analysis and extraction of their results. Results A total of 688 articles were identified that underwent a thorough selection, resulting in 15 studies that included in this review. In five studies, the results showed that predictive equations underestimated the EE of cancer patients; in three studies the EE was overestimated by predictive equations, and in seven studies predictive equations underestimated or overestimated the EE. The low accuracy of predictive EE equations was present regardless of tumor type and type of anti-cancer therapy received by patients. Conclusion The predictive energy expenditure equations available to date are generally not in accordance with IC results for cancer patients with solid tumors, since these individuals present clinical situations or are exposed to factors that alter EE and are not considered in these equations.

This study aimed to identify cutoff points for detecting hypertriglyceridemic waist phenotype (HTWP) in adolescents and to investigate the association of the HTWP with insulin resistance (IR) and metabolic syndrome components.A multicentric cross-sectional study of 861 adolescents (10-19 years of age, 504 girls) was conducted. Pubertal stage, anthropometric, and laboratory parameters were assessed. IR was assessed by Homeostasis Model Assessment for Insulin Resistance (HOMA1-IR) index and hyperglycemic clamp (n = 80). HTWP was defined by the presence of increased plasma triglycerides (TGs) and increased waist circumference (WC) according to cutoff points obtained in ROC curve analysis given the HOMA1-IR index as a reference method.Cutoffs for WC and TGs, with a higher sum of sensitivity (S) and specificity (E), were, respectively:84 cm (S:65.1%, E:71.9%) and87 mg/dL (S:65.1%, E:73.4%) in pubertal girls;88.5 cm (S:80.2%, E:60.2%) and78 mg/dL (S:60.5%, E:53.2%) in postpubertal girls;94 cm (S:73.1%, E:83.1%) and79 mg/dL (S:61.5%, E:60.2%) in pubertal boys; and99 cm (S:81.3%, E:78.7%) and86 mg/dL in postpubertal boys (S:68.1%, E:60.7%). HTWP frequency was 27.5%. In the phenotype presence, after adjustment for age and pubertal stage, blood pressure and fasting glucose levels were elevated and high-density lipoprotein cholesterol was lower (p 0.001). Adolescents with the HTWP showed more IR, evaluated both by the HOMA1-IR and by the clamp test (p 0.003).The findings suggest HTWP as an IR status in adolescents. Cutoff point standardization for gender and pubertal stage, combined with the ease of application of the method, may allow their use for screening adolescents who would most benefit from lifestyle changes.