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El Síndrome Metabólico (SMet) se diagnostica por el cumplimiento de al menos tres criterios: hipertrigliceridemia, HDL-C disminuido, hipertensión arterial, glucemia alterada en ayunas y obesidad. Dicha obesidad constituiría el punto inicial para el desarrollo del SMet. Según la evidencia científica, las dietas hipocalóricas, incluyendo la mediterránea y la reducida en grasa con alto contenido en carbohidratos, reducen la masa grasa (MG) de estos pacientes y su efecto se potencia al combinarse con ejercicio físico (EF), pero se desconoce aún su influencia sobre la tasa metabólica basal (TMB). Objetivo: Conocer el efecto de dos dietas hipocalóricas: mediterránea y baja en grasas, combinadas o no con EF, sobre la TMB y la composición corporal (CC) de adultos con SMet. Métodos: 36 voluntarios, > 50 años, ambos sexos, con diagnóstico de SMet. Se asignaron aleatoriamente a uno de los cuatro grupos de intervención: Dieta hipocalórica mediterránea (MED), Dieta hipocalórica baja en grasa (CHO) ó ambas asociadas a EF (MEDE y CHOE respectivamente). Se evaluó CC (antropometría) y TMB (calorimetría indirecta) antes y después de la intervención. Resultados: La adición de EF a los dos tratamientos hipocalóricos produjo mayor pérdida de peso y MG que las dietas por sí solas, siendo esta pérdida en CHOE > MEDE (p < 0,05). Dichos grupos descendieron la TMB siendo MEDE > CHOE (p < 0,05). La Dieta Mediterránea, combinada o no con EF, disminuyó la MM siendo MEDE > MED (p < 0,05). Conclusiones: CHOE fue el tratamiento que mayor pérdida de peso y MG produjo, induciendo menor reducción de TMB y manteniendo un mejor perfil de CC que MEDE. Background: Metabolic syndrome (MetS) is diagnosed by the detection of at least three criteria (hypertriglyceridemia, low HDL-C, hypertension, obesity and altered fasting glucose). Visceral fat excess would be the starting point for its development. Scientific evidence supports hypocaloric diets -mediterranean or low fat diet and rich in complex carbohydrates diet included- as the best treatment to reduce fat mass (FM), maximizing its impact by combining them with physical exercise (PE). However, the effects of these treatments on basal metabolic rate (BMR) of patients with MetS, are unknown. Objective: To study the effect of the hypocaloric diet -mediterranean or low fat diet- with or without PE on the BMR and body composition (BC) of adults with MetS. Methods: 36 volunteers, MetS, both sexes, > 50 years, meeting the inclusion criteria. They were randomly assigned to a group of intervention (3 months) of hypocaloric diet: mediterranean diet (MED), low fat and rich in complex carbohydrates diet (CHO) and both combined with PE (MEDE and CHOE respectively). Anthropometric data was taken (weight, muscle mass (MM) and FM) and BMR was determined by indirect calorimetry, before and after intervention. Results: The addition of PE to both hypocaloric treatments produced greater FM loss and weight loss than dieting alone, being this loss in CHOE > MEDE (p < 0.05). These groups decreased the BMR after treatment being MEDE > CHOE (p < 0.05). Mediterranean diet with or without PE lost MM (p < 0.05) being MEDE > MED Conclusions: CHOE induces less reduction of BMR while supporting a better profile of BC than MEDE.

A 90 mujeres con sobrepeso y obesidad del área de atracción del Programa de Atención Integral en Salud (PAIS) se les midió la tasa metabólica basal por calorimetría indirecta y se les evaluó tanto el nivel de actividad física como la ingesta de energía y macronutrientes. Se observó una correlación positiva entre el Índice de Masas Corporal y la tasa metabólica basal de estas mujeres. Aunque se encontró diferencia significativa entre el gasto metabólico basal estimado por la ecuación de Harris-Benedict y el gasto metabólico basal medido por calorimetría indirecta, no se encontró diferencia significativa en el total de energía expedida obtenida por ambos métodos. En estas pacientes con sobrepeso no se encontró diferencia significativa entre el gasto energético total y la ingesta energética diaria obtenida, lo que sugiere un estado de equilibrio energético adaptado a la nueva condición de fisiológica. Según la distribución de macronutrientes fue la grasa la que excedió la recomendación dietética diaria. A group of 90 women with overweight and obesity, residing in the area covered by the Program for Integral Attention in Health (PAIS) participated in this study. The following measurements were made: basal metabolic rate by indirect calorimetry, level of physical activity and intake of energy and macronutrients. There was a positive correlation between Body Mass Index and the basal metabolic rate for these women. Although a significant difference was found between the average basal metabolic expenditure of the group, as estimated by the Harris-Benedict equation and average basal metabolic expenditure as measured by indirect calorimetry, there was no significant difference between total energy expenditure as estimated by both methods. No significant difference was found between average energy expenditure and average energy intake for these women, suggesting a state of energy balance which is an adaption to the new physiological condition. According to the distribution of macronutrients, fat intake exceeded nutritional recommendations.

Obesity is the most prevalent nutritional disease in people of less than 20 years old. Aim: To report biological, familial and metabolic characteristics in obese children. Patients and methods: A retrospective review of 187 children seen at obesity clinics and that had a complete metabolic study. Results: Ninety five prepuberal and 92 puberal children, aged 8.7±2.2 and 12.6±2.2 years old respectively, were studied. Body mass index was over 4 standard deviations in 48.4% of prepuberal children and in 39.1% of puberal children. Paternal obesity was twice more prevalent (30.2%) than in the general population. The daily caloric intake and basal metabolic rate (BMR) were within the normal range; nevertheless there was a positive caloric balance due to minimal physical activity. The mean daily fat intake was normal (26.4±8.5 and 25.3±9.1% of total calories in prepuberal and puberal children respectively). The daily fiber intake was under 70% of recommendation. The total cholesterol was over 200 mg/dl in 26.6 and 23.9% of prepuberal and puberal children. LDL cholesterol was over 130 mg/dl in 27.3 and 26.6% and triacylglycerol was over 150 mg/dl in 16.9 and 25% of prepuberal and puberal children respectively. Basal serum insulin was over 20 uIU/ml in 27.7 and 42.2% of prepuberal and puberal children, respectively. Post glucose serum insulin was over 60 uIU/ml in 40 and 63% of prepuberal and puberal children, respectively. Conclusions: Infantile and juvenile obesity is a chronic disease with a high incidence of metabolic alterations (Rev Méd Chile 2001; 129: 1155-62)

The total energy metabolism, expressed in terms of calorm can for the amount of oxygen needed to support it is measured. This measurement is possible because oxygen has a caloric value known as the kind of food that is burned in the body, and because you can know what kind of food (carbohydrates, fats or proteins) or mixture thereof, is burned by the relationship between CO2 and O2 evolved consumed, ie, by the Respiratory Quotient, this fact Indirect Calorimetry methods for assessing the Basal Metabolism are based., El metabolismo energético total, expresado en términos de calorm puede se medido por la cantidad de oxígeno necesaria para mantenerlo. Es posible esta medición porque el oxígeno tiene un valor calórico conocido según la clase de alimento que se quema en el organismo, y porque se puede saber que clase de alimento (hidratos de carbono, grasas o proteínas) o mezcla de ellos, se quema por la relación entre el CO2 desprendido y el O2 consumido, vale decir, por el Cuociente Respiratorio, En este hecho se basan los métodos de Calorimetría Indirecta para la apreciación del Metabolismo Basal.