5^thAsian Obesity Specialists and Endocrinologists Annual Meeting July 11-12, 2016 Kuala Lumpur, Malaysia

Obesity has become a significant worldwide contributor to morbidity with an alarming increase of incidence of obesity in children and adolescents. There is a lack for studies that evaluate parental feeding practices and its impact on children obesity in the Middle East. Comprehensive feeding practice questionnaire was validated in different age groups and in different countries, however no previous studies validated the questionnaire in the middle east. This study validated the questionnaire in the middle east and evaluated the children and adolescent obesity and parental feeding practice Method: 970 children aged 6-12 completed the Arabic translated version of the comprehensive feeding practice questionnaire(CFPQ). The height and weight of the children were measured. The children BMI, BMI z-scores and obesity status was determined. Confirmatory factor and Exploratory Factor Analysis were used to evaluate different factor models. Univariate analysis was conducted to evaluate the association between maternal feeding habits, maternal BMI and education level and child’s weight status (normal, overweight, and obese) Results Confirmatory Analysis of the CFPQ determined that the original 12 factors structure of the questionnaire was not suitable for this sample. The analysis suggested that the most suitable structure was a 10 Factors model (CMIN/DF=2.26, GFI= 0.92, CFI= 0.933, TLI= 0.925 and RMSEA= 0.03) that included Modelling, Monitoring, Child control, Food as a reward, Emotional regulation, Involvement, Restriction for health, Restriction for weight control, Environment, and Pressure. The results indicated that 12.6% of the children tested were obese and 25.1% were overweight. The regression indicated that child’s obesity was positively associated with Maternal BMI (p<0.01), Emotional regulation (p<0.01), Restriction for health (p=0.02) and Restriction for weight control (p=0.02) and negatively associated with modeling (p=0.03), Monitoring (p=0.02), child control (p<0.01), Environment (p=0.01) and Involvement (p=0.01). Conclusion This study indicated that Jordanian children aged 6-12 had high prevalence of overweight/obesity and this was associated with negative parental feeding practice.

Childhood is an important opportunity to develop healthy patterns for life and prevent weight problems. Children who are overweight or obese can benefit from healthy eating and regular physical activity (exercise). Children may use different methods for weight loss like adults. This study was aimed to determine methods for weight loss in children with overweight and obese. School children aged 6-16 years included in study. Height and weight measurements of 1695 children were evaluated and body mass index values were calculated. After that questionaire forms were given for evaluating weight loss methods. Of all children, 99 (5.8 %) were overweight, 72 (4.2 %) were obese and 198 (11.7 %) were underweight (BMI < 5 percentile). The ratios of any methods used for weight loss were 2.6 %, 4.1 % and 10.0 % in normal, overweight and obese groups, respectively. This result was statistically significant (p < 0.01). While 7.0 % of overweight children, 15.0 % of obese children practiced diet, exercise and alternative methods for weight loss, 2.9 % of children with normal weight interestingly reported diet, exercise and alternative methods. The most common alternative methods was herbal tea (green tea, fennal tea, chamomilla, sage tea ve mix herbal tea). Normal, overweight and obese school children drunk herbal tea as 1.4 %, 4.0 % and 6.9 %, respectively. Others methods were eating parsley, peppermint and drinking vinegar in the morning during a fast. Alternative methods were significantly frequent in obese children (p<0.001) and in older age group (11-16 age) (p<0.01). As a result the most common method was herbal teas among school children. Although effects on weight loss and adverse reactions of these methos is not described well, alternative weight loss methods are very common among overweight and obese school children even among normals. Education related to professional advice from a doctor or dietitian can help reach and maintain a healthy weight.

Background: Fibroblast growth factor(FGF-23) is a hormonal regulator of circulating phosphate and vitamin D levels,and it may also act as a 'hormone-like' factor involved in the glucose and fat metabolism. Some studies have showen that FGF-23 has a potential role in the development of insulin resistance and vascular dysfunction and adverse thickening of the vascular wall, however ,it remains controversial. Aim: It was to investigate the possible correlations between serum FGF-23 levels and body compositions,insulin resistance and carotid intima media thickness(cIMT) in obese adolescents Material and methods. The study included 46 obese adolescents (22 boys and 24 girls) and 46 non-obese healthy adolescents( 18 girls and 28 boys).The exclusion criteria were presence of disorders of calcium phosphor metabolism or any chronic diseases. HOMA-IR values were calculated by using fasting insulin and blood glucose values in all patients and controls. Plasma FGF-23 level was measured using ELISA, cIMT was evaluated ultrasonographically. Results. HOMA-IR , fasting insulin levels were significantly higher in obese group than controls, but FGF-23 and klotho levels were significantly lower in obese group . In this group, FGF-23 and Klotho were negatively correlated fasting insulin and HOMA-IR. cIMT values were incresead in obese group and positively correlated with BMI , fasting insulin and HOMA-IR level, but not FGF-23 levels. Conclusion. These findings suggest that incresed insulin level may cause of lower FGF-23 and klotho levels in obese patients. Increased cMIT is more likely related to insulin resistance , but not FGF-23 in obese patient.

Introduction: Obesity is increasing in prevalence in the United States and worldwide, In Taiwan men prevalence was 19.2% nearly South Korea 12 times that of Japan 8 times. in woman prevalence was 16.6% also South Korea and Japan 5 times. Health hazards associated with obesity in adults including type 2 diabetes, heart disease, stroke, certain cancers, osteoarthritis, liver disease, obstructive sleep apnea, and depression. cost of treating obesity and its complications in the United States is approximately 100 billion dollars per year. increased rate of death from all causes and from cardiovascular disease. Method: Case 56year old male patient past history of(1) DM with OADs and insulin control over 10years,102/5/21 C-peptid 3.97ng/dl(2)CAD,DVD s/p cardiac catheter(with drug eluting Stenting)(3)erythromatous gastritis and esophagitis regular PPI(4)old lacunar Infarction.BMI:38 visit GS with Bariatric surgical LSG(mechanisms: restriction:102/6/26)with Dietitian nutrition consultation and follow. Result: BW loss at post op 2 months 11kg. post op three months Bw loss:18kgblood glucose controlwellHbA1C:10.3(5/1)→8.7(7/10) →7.7(8/6) →6.4(103/4). AC sugar control :189mg/dl(5/1). →133 mg/dl(7/10) →113 mg/d (8/6) →103(103/4)Insulin injection:NPH: 20u→15u→10u. lipid profile:HDL:40mg/dl LDL:120mg/dl.UA:6.3mg/dl.Body fat :34.3—30and waistine 105cm hips:105cm. Conclusion For many study Bariatric surgical(Roux-en-Y gastric bypass) treatment DM Ghrelin is a peptide hormone secreted in the foregut (stomach and duodenum) that stimulates the early phase of meal consumption. in laparoscopic sleeve gastrectomy exaggerated response of peptide YY (PYY) may also contribute to the loss of appetite Hormones such as glucagon-like peptide-1 (GLP-1) and cholecystokinin (CCK), which are increased after RYGB, may promote an anorectic state. In this case use LSG and diet control and adequate excise successful weight control and treatment DM and metabolic syndrome. Key word: Moderate obesity、Bariatric surgical、 Laparoscopic sleeve gastrectomy、DM、Metabolic syndrome

Dr Mini Joseph is Assistant Professor in Food & Nutrition at Government College for Women, Trivandrum, Kerala. She is presently pursuing post-doctoral fellowship at the Department of Endocrinology, Diabetes & Metabolism, at Christian Medical College, Vellore, Tamil Nadu, India. She is recipient of Young Scientist Award from the Nutrition Society of India 2012. Her interests are in community nutrition, energy expenditure research, sports nutrition and Diabetes.

Introduction: Weightlifting is a power sport placing intense physical demands on the individual. The body composition of weightlifters is considerably different from that of other athletes. Materials and methods: This cross-sectional study was done on 30 selected elite professional male weightlifters in the age group of 18-28 years who were actively competing at National/International level from Vellore District in Tamil Nadu, India. The study was approved by the Institutional Review Board of Christian Medical College and Hospital, Vellore, Tamil Nadu, India( IRB Min No. 7443, dt:16th March 2011). Their Anthropometric measurements and Body composition ()were assessed and analysed. All data were analysed using SPSS 16.0 for Windows. Results and Discussions: The mean age of the participants was 21.5+2.87 years. The average duration of competitive weightlifting was 5.04+2.68 years. The mean height was 168.83+6.32cm and mean weight was 75.95+14.73 kg. Their mean BMI indicated that they were overweight, (26.09+4.28) inspite of a low fat percentage of 15.2+5.3 9 (obtained by DXA [Hologic Delphi W (S/N 70471 DXA scanner)]. They had a high mean lean body mass of 60.9 +9.2 kg indicating a well-developed musculature. Conclusion: Thus we opine that BMI should be used as a sole tool to assess nutritional status but must be used in in conjunction with the body composition to get the actual picture.