Effects of high-intensity interval training on cardiometabolic risk in overweight and obese African-American women: a pilot study

Objective: Little is known about high-intensity interval training (HIIT) in African-American (AA) women. The purpose of this pilot study was to evaluate the effects of HIIT and steady-state (SS) exercise on cardiometabolic risk factors in young AA women.

Design: A 16-week exercise intervention was conducted 3x/week. Twenty-seven AA women were randomized to SS (n?=?11; 32 continuous minutes of treadmill walking at 60–70% of maximum heart rate (HR_max)), or HIIT (n?=?16; 32?min of treadmill HIIT alternating 3?min at 60–70% of HR_max with 1?min at 80–90% of HR_max). Two-way repeated measures ANOVA with intention-to-treat analysis was used to identify changes between groups. Significance was accepted at P?≤?0.05.

Results: Of the 27 women who entered the study (age: 30.5?±?6.8 years; BMI: 35.1?±?5.1 kg/m²; 5274?±?1646 baseline steps/day), 14 completed the intervention. HIIT significantly decreased waist circumference (107.0?±?11.3 to 105.1?±?11.9 cm) compared to SS, which showed no change. There was a significant time effect for steps where HIIT increased steps/day (5334?±?1586 to 7604?±?1817 steps/day), and SS had no change. There were no significant changes in either group for any other measurements.

Conclusion: HIIT was more effective at reducing waist circumference and increasing daily steps/day than SS treadmill exercise over 16 weeks. Further research in a larger sample is indicated to evaluate the effects of each protocol on cardiometabolic risk factors.     

High prevalence of overweight in a stable Spanish hemodialysis population: a cross sectional study.

OBJECTIVE: In the general population, the prevalence of overweight is high and is considered a mortality risk factor. In maintenance hemodialysis (MHD) patients reports regarding overweight and its predictors are scarce. Our aim was to evaluate the prevalence and predictors of overweight in MHD patients, supplemented with additional follow-up data on mortality. METHODS: Retrospective, observational, cross-sectional study of 190 white, noncomplicated patients on MHD recruited from 5 Spanish dialysis centers. Three anthropometric indexes were scored (relative body weight, skinfold thickness, and midarm muscle circumference), and body mass index (BMI) and dietary intake during a 5-day period were recorded. Patient survival was evaluated during a mean follow-up period of 25 +/- 20 months. RESULTS: Undernutrition (score < 7) was detected in only 15% of patients, and no patient had severe malnutrition (score < 4). The percentage of patients scored below 7, was similar in nondiabetics and type 2 diabetic patients, whereas it was significantly higher in type 1 diabetics (P =.002). Notably, 38% of patients (38% of nondiabetics, 50% of type 2 diabetics, and none of the type 1 diabetics) were overweight (BMI > or = 25 kg/m(2)). To evaluate the predictors of overweight, a stepwise logistic regression analysis was performed entering age, sex, time on dialysis, caloric intake normalized for ideal energy requirements, and protein intake. Overweight was independently influenced only by ageing (odds ratio [OR], 1.04; confidence interval [CI], 1.02-1.07; P =.0007) and female gender (OR, 2.05; CI, 1.09-3.86; P <.0001). By Cox proportional multivariate analysis, survival was positively influenced by BMI (RR, 0.88, CI, 0.79-0.97; P <.01). As expected, albumin also had a positive influence whereas age and diabetes had a negative influence on survival. This preliminary result suggests that a higher BMI may exert a protective role on survival. CONCLUSION: Overweight represents the predominant nutritional abnormality in our MHD population, especially in the elderly, women, and type 2 diabetics.     

上海肥胖超重中小学生糖脂代谢异常干预效果评价

目的研究肥胖和超重学生糖、脂代谢有关的生化指标特点及肥胖项目干预后的变化,为探索有效的肥胖干预效果评价指标提供依据。方法在上海市健康示范学院抽取1所小学和1所初级中学,筛查出55名肥胖学生,在超重、正常学生中按肥胖学生的年龄、性别进行配对;然后在未开展健康示范的学校中按干预学校学生的年龄、性别分别确定肥胖、超重学生各55名。各组对象均用相同年龄、性别的1∶1配对t检验分析。检测生化指标包括谷丙转氨酶(ALT)、胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FG)、空腹胰岛素(F ins)、HOMA胰岛素抵抗指数(HOMA-IR)。结果干预前,肥胖、超重学生的ALT、TG、空腹胰岛素、HOMA-IR均明显高于正常学生。ALT在肥胖、超重、正常学生分别为32,24,15 U/L,TG分别为1.03,0.92,0.80mmol/L,空腹胰岛素分别为14.70,12.34,5.97 IU,HOMA-IR分别为2.97,2.49,1.20。干预后,干预学校肥胖、超重学生的ALT、TG、空腹胰岛素、HOMA-IR均明显下降,肥胖组分别为20 U/L,0.90 mmol/L,11.93 IU,2.42,超重组分别为13 U/L,0.85 mmol/L,10.30 IU,2.05。同期对照学校干预后与干预前,肥胖学生ALT、空腹胰岛素、HOMA-IR明显上升,分别为32 U/L和26 U/L,20.76 IU和12.77 IU,4.57和2.56。结论肥胖、超重学生中存在明显的糖、脂代谢紊乱。健康示范学校创建项目能有效改善糖、脂代谢紊乱。在减肥评估中,除体重指标外,可增加一些生化指标,如ALT、HOMA-IR。     

Effects of a nutritional intervention in overweight/obese breast cancer patients

Introduction  Today breast cancer (BC) patients can expect more prolonged survival than in the past, but obesity at diagnosis and/or weight gain during adjuvant therapies increase the risk of recurrences as well as of weight-related disorders (diabetes, cardiovascular disease…). Therefore lifestyle intervention might offer a valuable approach to positively influence the prognosis of survivors. Design and objectives  The charts of 189 overweight/obese outpatients with “early-stage BC” were reviewed to evaluate the effects of nutritional intervention on weight, body mass index (BMI), waist circumference and metabolic parameters. After the first clinical evaluation, in 97 subjects (education group), dieting therapy and periodical medical examinations were connected with brief individual sessions of nutritional education. Instead, 92 patients (no-education group) were treated only with diet and routine visits. At baseline and after nearly 1 year of treatment, data (weight, waist circumference, BMI, systolic and diastolic pressure, metabolic parameters and results of a battery of self-administered questionnaires to assess Nutritional Knowledge (NK), Physical Functioning (PF) and Quality Of Life (QOL) of patients) were collected and compared. Results  Ninety-two (48.7%) patients completed a oneyear follow-up. The dropout rate was higher (73.2%) in traditionally treated women (no-education group) than in education group patients (22.8%); these data highlight that more educated patients completed the programme than non-educated patients (ODs 9.2, p < 0.000). The low follow-up rate makes any comparison between the 2 types of treatment impossible since the weight and metabolic changes of the vast majority of the non-educated subjects remain unknown. Anyway, the education group patients, in active follow-up at 1 year, showed significant weight loss (−6.6 kg, SD 3.7) and improvements of metabolic parameters and questionnaire scores. Conclusions  Data from the study show the usefulness of this simple nutritional education intervention, which appears to increase the adherence to a weight loss programme. In educated patients who completed a 1-year follow-up, the weight reduction and metabolic changes were significant, but the analysis was carried out on less than half of the subjects and this very high global dropout rate (51.3%) makes it impossible to draw generalised conclusions.     

A pilot study to investigate the effect of plate size on meal energy intake in normal weight and overweight/obese women

Background: Smaller plates are often recommended as a strategy for controlling energy intake; however, the effect of plate size on meal energy intake in normal weight compared to overweight or obese individuals is not known. The present study aimed to investigate this further. Methods: Ten normal weight [mean (SD) body mass index, 21.7 (2.0) kg m^?2] and 10 overweight or obese [31.7 (3.6) kg m^?2] women attended a metabolic laboratory on two separate days for lunch. In this cross‐over study, subjects were randomly assigned to eat lunch using either a small (21.6 cm) or a large (27.4 cm) plate. Each subject self‐served spaghetti mixed with tomato sauce from an individual serving bowl onto the assigned plate, and ate until satisfied. The meal was consumed alone at a private table. During the second study day, each subject underwent the same procedure but used the alternate size plate. The amount eaten and energy consumed were calculated and a mixed effects analysis of variance model was used to compare energy intakes. Results: Energy intakes using the small and large plate were 1356 (515) and 1365 (393) kJ, respectively, in normal weight subjects and 1314 (632) and 1226 (431) kJ, respectively, in overweight/obese subjects. Neither plate size, nor plate size by weight status significantly affected meal energy intake. There was no plate size by weight status effect on ratings of palatability, hunger, satiety, fullness or prospective consumption. Conclusions: Plate size did not affect energy intake from a single meal in either the normal weight or overweight/obese subjects.     

高强度间歇训练在健康超重肥胖人群体重管理中的应用探讨

高强度间歇训练作为间歇训练法的分支,普遍用于高水平竞技运动员的体能训练,其安全性已被基本证实,现在逐渐受到运动医学及大众健身方向的关注.文章简要介绍高强度间歇训练的特点及意义,并探讨其在体重管理方面的研究现状及应用优势,最后就其在国内的未来发展应用展开讨论.     

超重肥胖儿童的脂代谢异常与INSIG2基因的关联研究

目的 研究儿童超重肥胖和脂代谢与胰岛素诱导基因2(INSIG2)变异的相关性.方法 选择北京市2030名7～18岁的儿童进行身体测量及血脂、INSIG2基因rs13428113多态性检测.结果 研究对象rs13428113多态性的等位基因突变率(T>C)为49.3%.比较体重正常、超重和肥胖组基因型及等位基因频率,发现三组差异无统计学意义(P>0.05).在超重组中CC基因型携带者的体重指数、腰臀比、肱三头肌和髂前上棘皮褶厚度高于TT/TC基因型携带者;在肥胖组中CC携带者总胆固醇水平高于TT/TC携带者(P<0.05).结论 INSIG2基因rs13428113多态性与超重肥胖儿童的脂代谢异常有关,可能加重肥胖、血脂异常程度.     

Determinants of overweight in a cohort of Dutch children

BACKGROUND: To improve the effective prevention and treatment of obesity, it is important to focus on body weight (BW) development and its determinants during childhood. OBJECTIVE: The aim of the present study was to investigate the effects of early development, parental and genetic variables, and behavioral determinants on overweight at 12 y. DESIGN: In a Dutch cohort of 105 children, anthropometric measurements were conducted from birth until age 7 y. At age 12 y, anthropometric measurements were obtained again, as were measurements of body composition, leptin concentration, 3 polymorphisms, and physical activity, and the Three-Factor Eating Questionnaire was conducted. In addition, parental body mass indexes (BMIs, in kg/m2) and Three-Factor Eating Questionnaire scores were determined. RESULTS: The children's mean (+/-SD) BMI at 12 y was 19.0 +/- 2.6, and 15.2% were classified as overweight. From the first year of life, BMI tracked significantly with BMI at age 12 y (r = 0.24, P < 0.05). Linear regression analyses showed that a rapid increase in BW during the first year of life, a high BMI of the father, and a high dietary restraint score of the mother were significantly associated with overweight at age 12 y (P < 0.05). No significant genetic relation was observed. In addition, overweight was positively associated with dietary restraint of the child, and percentage body fat was negatively associated with the child's activity score (P < 0.05). CONCLUSIONS: In this homogeneous cohort of normal-weight to moderately overweight children, tracking of BMI during childhood took place from the first year of life. Overweight at age 12 y was predicted by an early rapid increase in BW and parental influences. Overweight during childhood may be maintained or even promoted by a high dietary restraint score and low physical activity.     

Determinants and spatial patterns of adult overweight and hypertension in a high HIV prevalence rural South African population

We conducted a large population-based survey among adults measuring weight, height, and blood pressure nested within an HIV survey in rural KwaZulu-Natal, South Africa, to identify and characterize clusters of overweight and hypertension in a typical rural African population and to explore whether geographic clusters can be accounted for by established individual-level risk factors. 58.4% of the participants were overweight and 22.6% were hypertensive. One cluster of high prevalence of overweight (RR=1.50, p<0.001) was identified using Kulldorff spatial scan statistic as the most likely cluster, whereas a low-risk cluster was identified in the nearby high-density settlement area (RR=0.62, p<0.05). No geographic clusters of hypertension were identified. After controlling for age, sex, educational attainment, household wealth, marital status, place of residence, and HIV status, no spatial clustering of overweight remained. The results provided clear evidence for the localized clustering of overweight. Identification of clustering of chronic disease could provide additional insights into the prevention and control for the rural South African population.     

Effectiveness of a community-based intervention for weight loss on cardiometabolic risk factors among overweight and obese women in a low socio-economic urban community: findings of the MyBFF@home

Background

The effectiveness of lifestyle intervention for weight loss on cardiometabolic risk factors among overweight and obese individuals in the community setting remains inconclusive. This study aimed to evaluate the effect of a 6-month weight loss lifestyle intervention on cardiometabolic risk factors among overweight and obese women and the sustainability of the changes in those markers at 12-month follow-up, comparing an intervention group with a control group.

Methods

A total of 243 participants from MyBFF@home were included in this study. Fasting blood samples at baseline, 6- and 12-month were assessed for fasting plasma glucose (FPG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides. The effect of the intervention on cardiometabolic risk markers were investigated within and between study groups using t-test and general linear model (GLM) repeated measure ANOVA.

Results

Results from repeated measures ANOVA showed intervention effect only in TC where significant reduction was found in the intervention group (? 0.26 mmol/L [95% CI: – 0.47 to ? 0.06], p?<?0.01) compared to the control group (? 0.06 mmol/L [95% CI: – 0.28 to 0.17]) at 12 months. At 6 months, TC was reduced significantly in both groups but only intervention group retained the reduction in maintenance phase while, the level increased significantly in the control group (0.22 mmol/L [95% CI: 0.06 to 0.38]). This attributed to significant increase in TC/HDL-C ratio in the control group during maintenance phase (0.32 [95% CI: 0.15 to 0.50], p?<?0.001). The intervention group also showed trend of reduction in FPG at 6 months and further decreased during maintenance phase (??0.19 mmol/L [95% CI: – 0.32 to ? 0.06], p?<?0.01). At 6 months HDL-C was maintained in the intervention group but reduced significantly in the control group (??0.05 mmol/L [95% CI: – 0.10 to ? 0.01], p?<?0.05). No significant difference was detected in both markers when compared between groups.

Conclusions

In the context of low socio-economic communities, this study supports that weight loss related lifestyle modifications over a 6-month period could improve selected cardiometabolic risk factors, particularly fasting glucose, TC and HDL-C in overweight and obese women with favourable sustainability over a 12-month period.

     

肥胖儿童心血管代谢风险相关的预警指标研究进展

儿童期肥胖增加血脂异常、高血压、高血糖等心血管代谢风险(CMR),并可持续至成人,使代谢性疾病低龄化。近年发现,尿酸、视黄醇结合蛋白4、维生素D、颈围等与肥胖儿童CMR密切相关,可作为CMR的预警指标,为心血管代谢疾病的早期防治提供新靶标。认识预警指标与代谢风险的关系、作用机制和临床意义,有助于早期识别有CMR相关因素的高危人群并进行干预。     

Profile of overweight and obese people in a Mediterranean region

OBJECTIVE: To assess the prevalence of excess weight (obesity and overweight) and the related environmental risk factors in a Mediterranean population. Self-perception of body weight, attitudes toward weight-control behaviors, and the associated factors were also examined. RESEARCH METHODS AND PROCEDURES: A cross-sectional nutritional survey was carried out in the Balearic Islands between 1999 and 2000. A random sample (n = 1200) of the adult population (20 to 60 years old) was interviewed. Dietary questionnaires and a global questionnaire incorporating questions related to sociodemographic and lifestyle variables were utilized. Anthropometric measurements were also obtained. RESULTS: Nearly one-half of the population of the Balearic Islands is above the normal weight range (BMI > 25). The predictors of overweight and obesity in the Balearic Islands are to be over 40 years old, to be married, to form part of the lowest educational levels, and to have a sedentary lifestyle. A large percentage of excess-weight individuals tend to underestimate their BMI, are not concerned about their weight status, tend to snack more often, and have never dieted. DISCUSSION: Although the likely causes of the rise in obesity prevalence are difficult to elucidate from this study, we have identified the profile of individuals with excess weight in the Balearic Islands as well as their attitudes toward their body image.     

Estimation of exposure to furan in the Spanish population

The presence of furan in foods has received recent attention because of its association with harmful effects to human health. This compound, which is originated as a consequence of thermal treatment, is mainly found in canned, jarred, toasted and fried foods. The aim of this study was to estimate the exposure to furan in the Spanish population and to study the evolution of furan content in the main categories of foods in recent years, taking into account changes in dietary patterns. With respect to exposure to furan in the Spanish population from 2001 to 2009, no large differences were found. The maximum furan exposure recorded in this study (1.95?μg/kg?bw/day) is lower than the 'no observable adverse effect level' of 0.08?mg/kg?bw/day determined in the studies of experimental animals, and is close to the reported acceptable daily intake of 2?μg/kg?bw/day.     

Estimation of exposure to furan in the Spanish population

The presence of furan in foods has received recent attention because of its association with harmful effects to human health. This compound, which is originated as a consequence of thermal treatment, is mainly found in canned, jarred, toasted and fried foods. The aim of this study was to estimate the exposure to furan in the Spanish population and to study the evolution of furan content in the main categories of foods in recent years, taking into account changes in dietary patterns. With respect to exposure to furan in the Spanish population from 2001 to 2009, no large differences were found. The maximum furan exposure recorded in this study (1.95 μg/kg bw/day) is lower than the ‘no observable adverse effect level’ of 0.08 mg/kg bw/day determined in the studies of experimental animals, and is close to the reported acceptable daily intake of 2 μg/kg bw/day.