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Background: Impedance cardiography (ICG) is a noninvasive hemodynamic monitoring tool which can define hypertensive patients’ hemodynamic profiles and help to tailor antihypertensive therapy. This study assesses the concordance between ICG-derived indexes used to evaluate left ventricular performance and transthoracic echocardiography (TTE) in hypertensive patients. Methods: In this IMPEDDANS post-hoc analysis, the ICG-derived indexes are compared with TTE by Bland-Altman method. Statistical significance of the relationship between the values obtained was assessed by generalized linear mixed-effects models. Results: In supine position, Bland-Altman analysis showed good concordance for cardiac output (CO) (mean difference of 0.006 mL/min [−0.120; 0.133]), cardiac index (CI) (mean difference of 0.016 mL/min/m2 [−0.471; 0.504]), pre-ejection period (PEP) (mean difference of −0.216 ms [−4.510; 4.077]), left ventricular ejection time (LVET) (mean difference of −0.140 ms [−6.573; 6.293]), and systolic time ratio (STR) (mean difference of −0.00004 [−0.008; 0.008]). In orthostatic position, good concordance was found for CO (mean difference 0.028 mL/min [−2.036; 1.980]), CI (mean difference −0.012 mL/min/m2 [−1.063; 1.039]), and STR (mean difference −0.101 [0.296; 0.094]). No significant difference between methods was identified by the linear mixed-effects models. Conclusion: The ICG-derived indexes CO, CI, PEP, LVET, and STR in supine position have good agreement with TTE. Therefore, ICG can be used to accurately evaluate left ventricular performance. [ABSTRACT FROM AUTHOR]

Polymorphisms in genes of leptin-melanocortin and insulin pathways have been associated with obesity and type 2 diabetes. We hypothesized that polymorphisms in IRS1, IRS2, MC3R , and MC4R influence metabolic and inflammatory markers and food intake composition in Brazilian subjects. This exploratory pilot study included 358 adult subjects. Clinical, anthropometric, and laboratory data were obtained through interview and access to medical records. The variants IRS1 rs2943634 A˃C, IRS2 rs1865434 C>T, MC3R rs3746619 C>A, and MC4R rs17782313 T>C were analyzed by real-time polymerase chain reaction. Food intake composition was assessed in a group of subjects with obesity (n = 84) before and after a short-term nutritional counseling program (9 weeks). MC4R rs17782313 was associated with increased risk of obesity (P =.034). Multivariate linear regression analysis adjusted by covariates indicated associations of IRS2 rs1865434 with reduced low-density lipoprotein cholesterol and resistin, MC3R rs3746619 with high glycated hemoglobin, and IRS1 rs2943634 and MC4R rs17782313 with increased high-sensitivity C-reactive protein (P <.05). Energy intake and carbohydrate and total fat intakes were reduced after the diet-oriented program (P <.05). Multivariate linear regression analysis showed associations of IRS2 rs1865434 with high basal fiber intake, IRS1 rs2943634 with low postprogram carbohydrate intake, and MC4R rs17782313 with low postprogram total fat and saturated fatty acid intakes (P <.05). Although significant associations did not survive correction for multiple comparisons using the Benjamini-Hochberg method in this exploratory study, polymorphisms in IRS1, IRS2, MC3R , and MC4R influence metabolic and inflammatory status in Brazilian adults. IRS1 and MC4R variants may influence carbohydrate, total fat, and saturated fatty acid intakes in response to a diet-oriented program in subjects with obesity. Clinical, anthropometric, and laboratory data were obtained from 358 Brazilian adult subjects. IRS1 rs2943634, IRS2 rs1865434, MC3R rs3746619, and MC4R rs17782313 polymorphisms were evaluated. Food intake composition was assessed in 84 subjects with obesity before and after a short-term nutritional counseling program. Variants in IRS1, IRS2, MC3R , and MC4R influence metabolic and inflammatory status. IRS1 and MC4R variants may influence carbohydrate, total fat, and saturated fatty acids intakes in response to a diet-oriented program. Abbreviations: HbA1c, glycated hemoglobin; hsCRP, high-sensitivity C-reactive protein; InsR, insulin receptor; IRS1, insulin receptor substrate 1; IRS2, insulin receptor substrate 2; LDL-c, low-density lipoprotein cholesterol; LepR, leptin receptor; MC3R, melanocortin receptor 3; MC4R, melanocortin receptor 4; SFA, saturated fatty acids; 9w, 9 weeks. [Display omitted] [ABSTRACT FROM AUTHOR]

Dead benthic foraminiferal assemblages from the central western Portuguese continental shelf have been studied to identify the prevalent oceanographic processes in the study area. Sediment samples collected at 46 stations along transepts perpendicular to the coastal line, between the latitudes of 38–40 °N and 17–190 m water depth, in April/May 2008, were analysed for selected physicochemical parameters (temperature, redox potential), grain size, organic matter content, and benthic foraminifera. Statistical analysis identified two main groups of stations, the Inshore/Offshore groups, which are not only defined by their geographical positions, but easily distinguishable by different hydrodynamic conditions. The Offshore Group is mainly represented by deeper stations characterized by a higher percentage of fines and TOM, negative values of redox potential and by the higher foraminiferal density and species diversity than the Inshore one. Foraminiferal assemblages of the Offshore Group are dominated/represented by species (such as Cassidulina laevigata / Cassidulina carinata , Bolivina spathulata , Bolivina ordinaria , Globocassidulina minuta , Bulimina elongata / Bulimina gibba and Bulimina marginata ) common in areas with significant concentrations of organic matter. The benthic foraminiferal assemblages of the Inshore Group are instead characterized by epifaunal species such as Lobatula lobatula , Cibicides ungerianus , Planorbulina mediterranensis , Gavelinopsis praegeri and Quinqueloculina seminula . Both the sedimentary and foraminiferal results suggest that this group of stations is subjected to stronger bottom hydrodynamic conditions, caused by waves and swell activity and coastal currents, than the Offshore Group. Bray–Curtis similarity comparison between the stations of both groups reveals that the Offshore Group has a higher internal similarity than the Inshore Group. These differences seem to stem from topographic forcing, from the presence of rocky outcrops, from canyons and capes, from the distribution of rivers and from the magnitude of their discharges, which determine specific hydrodynamic features and differences in the sedimentary deposits and biological productivity. The influence of the Tagus river (supply of fresh water, detritus and organic matter from continental sources), the presence of canyons and capes, which leave the most important imprint on the study area, are marked by changes in the foraminiferal assemblages both in the Inshore and Offshore groups. [ABSTRACT FROM AUTHOR]

The objective of this article is to discuss the meanings that health professionals and patients in treatment attribute to obesity. The research consisted of a qualitative survey in health, based on in-depth interviews with patients and professionals at an out-patient clinic at the University Hospital in Barcelona, Spain. Here, we discuss the concept of obesity, the meanings of diagnoses, the singularities involved in managing treatment, and the process of becoming ill, all in the light of the anthropology of health that has a sociocultural orientation. Obesity is usually seen by the professionals as a risk-factor disease. For patients, the incorporation of this rationality is procedural and is mixed in with other meanings attributed to being overweight/obese that have been gradually developed throughout life. A patient’s autonomy in choosing to be fat, or obese, and to adhere to treatment, is defined as a process that requires support in order to come to joint proposals in caring for these problems. [ABSTRACT FROM PUBLISHER]

Background: Although effective, the impact of bariatric surgery on weight loss is variable, and little is known about the influence of single‐nucleotide polymorphisms (SNPs). The present study investigated the association of eleven SNPs related to obesity with weight loss 1 year after Roux‐Y gastric bypass (RYGB) surgery in female patients. Methods: This prospective study included 351 women with obesity. The genotypes for eleven SNPs (GHRL–rs26802; GHSR–rs572169; LEP–rs7799039; LEPR–rs1137101; 5HT2C–rs3813929; UCP2–rs659366; UCP3–rs1800849; SH2B1–rs7498665; TAS1R2–rs35874116; TAS1R2–rs9701796; FTO–rs9939609) were determined using a real‐time polymerase chain reaction and TaqMan assays. Anthropometric measurements were performed before and 1 year after RYGB surgery. To evaluate the factors that influenced the proportion of weight loss 1 year after surgery, beta regression analysis was used. The models were estimated using the GLIMMIX procedure in SAS statistical software. p < 0.05 was considered statistically significant. Results: The mean ± SD percentage of total body weight loss in 1 year was 64.4 ± 5.8% and the median was 65.0%. When assessing the proportion of weight loss in 1 year after surgery, using univariate analysis (beta regression), no SNPs influenced weight loss. Furthermore, in the multiple analysis, with stepwise process of variable selection, no variable was significant to compose the multiple model. Conclusions: The 11 SNPs investigated did not influence weight loss 1 year after RYGB surgery in female patients. This result indicates that individual behaviours and other factors might better contribute to the magnitude of loss weight loss in a short period after bariatric surgery. Key points: None of the 11 single‐nucleotide polymorphisms (SNPs) investigated from the univariate beta regression showed a significant influence on the proportion of weight loss 1 year after Roux‐Y gastric bypass (RYGB) surgery.Our main finding indicate that the SNPs investigated are not related to weight loss during the first year of RYGB surgery.This enhances the importance of behavioural and environmental variables in the outcome of the surgery because the main obesity‐related genes were considered here.This research indicates that individual behaviours and other factors might better contribute to the magnitude of loss weight loss in a short period after bariatric surgery. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to investigate the influence of food intake on body weight loss (WL) and the association of gene polymorphisms, 1 year after Roux‐en‐Y gastric bypass (RYGB) surgery. Methods: In total, 95 obese women (age ranged 20–50 years) in a Brazilian cohort underwent RYGB surgery and completed the study. Anthropometric measurements and food intake were assessed before and 1 year after surgery. Twelve gene polymorphisms (GHRL rs26802; GHSR rs572169; LEP rs7799039; LEPR rs1137101; 5‐HT2C rs3813929; UCP2 rs659366; UCP2 rs660339; UCP3 rs1800849; SH2B1 rs7498665; TAS1R2 rs35874116; TAS1R2 rs9701796; and FTO rs9939609) were determined using a real‐time polymerase chain reaction and a TaqMan assay. The subjects were divided into quartiles regarding percentage of excess weight loss (%EWL). The effect of genetic variants on energy and macronutrient intake was evaluated by simple logistic regression, followed by multiple logistic regression. Results: Subjects in the first and second quartiles showed a higher initial body mass index. Energy and macronutrient intake before and 1 year after RYGB surgery did not differ between the %EWL quartiles. None of gene polymorphisms investigated showed an association with the estimated energy intake 1 year after surgery. Conclusions: In conclusion, the estimate energy and food intake did not predict a greater body WL 1 year after RYGB surgery. In addition, the 12 gene polymorphism investigated did not affect the energy intake among female patients. Key points: In the simple regression analysis, none of the 12 gene polymorphisms investigated (rs26802; rs572169; rs7799039; rs1137101; rs3813929; rs659366; rs660339; rs1800849; rs7498665; rs35874116; rs9701796; and rs9939609) showed a significant association with estimated energy and macronutrient intake 1 year after surgery. In the multiple regression analysis, TAS1R2 rs9701796 and LEP rs7799039 gene polymorphisms did not demonstrate combined effects on estimated energy and macronutrient intake 1 year after surgery.The main findings of the present study were: (a) estimated energy and macronutrient intake did not differ among subjects that had a higher and lower percentage of excess weight loss and (b) there was a lack of association between 12 gene polymorphisms investigated and the energy intake 1 year after Roux‐en‐Y gastric bypass (RYGB) among female patients.Our data showed no association of dietary intake with body weight loss for the 12 gene polymorphisms investigated 1 year after RYGB surgery. [ABSTRACT FROM AUTHOR]

The current study aimed to investigate the validity of three ActiGraph predictive equations that are available to estimate free-living physical activity energy expenditure (PAEE) in women with severe obesity. The study included 20 women with class III obesity (age: 22–38 years). During 14 days of free-living conditions, total energy expenditure was measured using the doubly labelled water method; in addition, participants wore a triaxial accelerometer (model GT3X+) on the hip. The resting metabolic rate was measured by indirect calorimetry. At group level, the Freedson VM3 Combination was found to be more precise (bias = −61 kcal/day) than the Williams Work-Energy (bias = −283 kcal/day) and the Freedson Combination equations (bias = −186 kcal/day) for estimating PAEE. However, the three predictive equations had a wider limit of agreement (Williams Work-Energy [258, −824 kcal/day], Freedson Combination equations [324, −697 kcal/day] and Freedson VM3 Combination [424, −546 kcal/day]), indicating great uncertainty of the estimate. In conclusion, a wide variation was observed in the performance of different ActiGraph equations in estimating free-living PAEE among women with class III obesity. Therefore, our data do not support the use of these equations, and more studies are needed to improve predictive performance in free-living conditions. [ABSTRACT FROM AUTHOR]

The Bolsa Família Program (PBF) has several effects on the population with social risks and vulnerabilities, mainly in relation to food, education, and health. The objective of this study was to identify dietary patterns of beneficiary families or not of PBF in São Paulo municipality, analyzing their association with levels of food insecurity (FI). The study included 150 families. Socioeconomic, demographic, anthropometric, and food consumption aspects were evaluated through validated questionnaires. The FI was evaluated by the Brazilian Food Insecurity Scale (BFIS). Food patterns were calculated using Cluster analysis. The association between FI and PBF with dietary patterns was tested using the Poisson regression model. Three dietary patterns were identified: restricted, healthy and traditional. The restricted pattern was associated with lower educational level, anemia history, moderate FI (MFI) or severe FI (SFI), and higher mean age. In the unadjusted and adjusted for age analysis, the families with MFI or SFI were respectively 55% and 57% more likely to adhere to a restricted pattern and 41% less likely to follow a healthy pattern. Having a healthy or traditional pattern was related to the origin of this population, revealing an important element within the SAN concept: food sovereignty. [ABSTRACT FROM AUTHOR]

Background: Low-grade chronic inflammation in morbid obesity is associated with impaired iron metabolism. Bariatric surgery is effective in weight loss; however, it can induce specific nutritional deficiencies, such as iron, especially in premenopausal women. Alternatively, after surgery, there is an improvement in systemic inflammation, raising questions concerning the dosages of micronutrient supplementation.Objectives: This study aimed to assess the effect of two micronutrient supplementation schemes before and 6 months after a Roux-en-Y gastric bypass (RYGB) surgery on inflammation and iron metabolism in premenopausal women.Methods: This prospective study included 45 premenopausal women (aged 20-45 years; body mass index [BMI] ≥ 35 kg/m2) divided into two supplementation schemes: group 1 (n = 34): daily supplemental dose of 1 RDA 30 days before surgery and 2 RDAs during the six months following surgery; and group 2 (n = 11): daily supplementation of 1 RDA during the 6 months postsurgery. Anthropometry, dietary intake, inflammation, and iron metabolism were monitored.Results: Evident reductions in BMI, high-sensitivity C-reactive protein, and ferritin levels for both groups occurred 6 months after surgery. Additionally, anemia was 9% in both groups after surgery. However, group 1 exhibited an increased transferrin saturation index and reduced transferrin levels. Multivariate regression analysis suggested serum iron, hepcidin, and iron intake determined ferritin values before and after RYGB surgery.Conclusion: Six months after RYGB, systemic inflammation was reduced in both supplementation schemes. However, supplementation of 1 RDA before and 2 RDAs after surgery resulted in better improvements on iron metabolism. [ABSTRACT FROM AUTHOR]

Unlabelled: In addition to its important role as marker of iron stores, serum ferritin is a marker of systemic inflammation, and obesity has been associated with chronic inflammation.Objective: To verify, six months after surgery, the effect of bariatric surgery on the serum ferritin of women who were hypertensive, diabetic, or comorbidity free before surgery.Sample and Methods: This retrospective study included 200 women aged 20 to 45 years, with a body mass index (BMI) equal to or greater than 35 kg/m2, submitted to Roux-en-Y gastric bypass (RYGB). Seventy of these women were hypertensive, forty had type 2 diabetes (T2D), and ninety were comorbidity free (CF). They were assessed before and six months after surgery. Anthropometric, laboratory (serum ferritin and hemoglobin), and comorbidity- related data were collected from their medical records.Results: Before surgery, women with comorbidities were older, the hypertensives had higher BMI, and the diabetics had higher serum ferritin levels than the CF women. The study comorbidities had resolved in 68% of the hypertensive women and 86% of the diabetic women six months after RYGB. Also at this time, the serum ferritin of hypertensive women decreased from 110.1±86.3 to 88.7±80.5 ng/dL and of diabetic women, from 164.8±133.4 to 101.2±97.7 ng/dL (p0.05).Conclusion: High ferritin in premenopausal obese women was associated with the main obesity-related comorbidities, and these comorbidities determined the reduction of serum ferritin after bariatric surgery. [ABSTRACT FROM AUTHOR]

Abstract: Restricted food intake after bariatric surgery can be an important factor both in the long-term control of body weight and in the onset of nutritional deficiencies. The objective of this study was to assess the adequacy of food intake in women two or more years after bariatric surgery according to the excess weight lost. A group of 141 women who underwent banded Roux-en-Y gastric bypass (RYGB) was divided according to the percentage of excess weight they lost (%EWL)<50; 50┤75; = 75. The habitual energy and nutrient intakes were determined by a 24-hour recall over two days and the probability of adequate intake was based on the Dietary Reference Intake. The mean total estimated energy requirement (EER) as well as energy, macronutrient and cholesterol intakes did not differ among the groups. Only the %EWL<50 group had an intake equal to their EER, but they presented a higher number of inadequacies, such as low levels of magnesium, folic acid and vitamins C and E. Calcium and dietary fiber intakes were extremely low in all three groups. In conclusion, weight loss after surgery is associated with food habits that favor energy intake over micronutrient intake. [Copyright &y& Elsevier]

• DietSys database facilitate and expedite diet data processing and analysis. • Database containing Brazilian serving sizes will be leverage to diet assessment in Brazil. • Dietsys standard NOVA and food groups allows for comparisons over three countries. • DietSys database is the unique reference on NOVA with Brazilian servings for food items. • DietSys database contains nutrient composition of three countries. Databases composed by nutrient composition tables, food groups, food processing categories, and servings and portion sizes adjusted for local population food habits or specific study aims are paramount to diet data assessment quality. We assembled a database, comprising the food composition tables of Brazil, Argentina and the USA, in which foods are classified into food groups, food processing categories, and assigned portion sizes to food items consumed locally, expanding the usability of the DietSys, a diet data processing system for the Brazilian population. Three food composition tables were incorporated, converted to an Excel® spreadsheet, coded, classified into food groups and classified into four food processing categories based on the NOVA classification system. Serving sizes from food photo albums and from tables were coded and assigned to food items. The DietSys database comprises 9851 foods, from which 5901 were assigned of one to 27 servings or portion size options. Forty one percent of all items were classified as ultra-processed food products (UPP). The DietSys food and nutrient database will allow researchers to calculate food intake, food groups, food processing categories, and nutrient content of local foods representative of the Brazilian, Argentine, and North-American populations' diet, particularly making it feasible the calculation of food intake from servings for the Brazilian population. The current iteration of DietSys is fully operational in Brazil, but to equally applicable to the USA and Argentinean populations, it requires including serving/portion sizes options representative of these countries. [ABSTRACT FROM AUTHOR]