Day 1 :
Keynote Forum
Maria Fernanda Cury-Boaventura
Professor
Keynote: Obesity and immune cells
Time : 10:30 to 11:20
Biography:
Maria Fernanda Cury-Boaventura has completed her PhD on Human Physiology from University of São Paulo and Post-doctoral studies from University of São Paulo. She is a Professor and Researcher at Institute of Physical Activity and Sport Sciences since 2007. She has published more than 40 papers in reputed journals and has been serving as an Editorial Board Member of repute
Abstract:
Obesity is a major medical problem and causes the development of chronic low-grade metabolic inflammation. The high incidence of metabolic disorders is associated with white adipose tissue (WAT) surrounding intra-abdominal organs. It is believed that the initial cause of metabolic inflammation is adipocyte hypertrophy in visceral adipose tissue (VAT). In the hypertrophic adiposity, non-esterified fatty acids (NEFA) induces local macrophages to produce high levels of TNFa which in turn promote a positive feedback inducing more NEFA, pro-inflammatory cytokines, acute phase proteins and chemokines, which attract more monocytes/macrophages resulting in dysregulation of pro-inflammatory mediators and low-grade inflammation. Hypertrophic adipose expansion also induces hypoxia that promotes angiogenic factors, hypoxia- inducible factor (HIF) 1 and inflammatory response-associated genes upregulation resulting in fibrosis. Lean adipose tissues have various anti-inflammatory immune cells, such as eosinophils, M2 macrophages, Th2 cells, iNKT cells, and Treg cells. In obese adipose tissue, the numbers of pro-inflammatory immune cells, including neutrophils, M1 macrophages, mast cells, Th1 cells, and CD8 T cells, are elevated. Simultaneously, reduced number of anti-inflammatory immune cells accelerates pro-inflammatory response and adipose tissue dysfunction. During the last decade, it was also identiï¬ed that the vast majority of obese are characterized with a gut microbiota dysbiosis. Metabolic diseases are associated with cellular changes in the innate immune compartment of the intestine. The ï¬rst line of intestinal defense is based on the secretion of defensins and IgA by intestinal epithelial cells, which are reduced in obese patients. The high fat diet induces the translocation of bacterial components such as LPS. The translocation of LPS or bacteria to tissues is a physiological mechanism, however, when unregulated, leads to a state of chronic inflammation that depends from the immune and epithelial cells response. A subpopulation of dendritic cells expressing CX3CR1 and innate lymphoid cells 3 are involved in the impairment of appropriate response. This mechanism is linked to the production of large numbers of cytokines such as IL-6, IL-17, IL-22, GM-CSF and TNF.
Keynote Forum
Thais Cesar
Sao Paulo State University, Brazil
Keynote: Orange juice, as a natural source of bioactive compounds, protects against cardiometabolic risks in overweight and obese subjects
Time : 11:40-12:30
Biography:
Thais Cesar is an Associate Professor of Nutrition, Faculty of Pharmaceutical Sciences, Sao Paulo State University (UNESP), Brazil. She has a BS in Biology and PhD in Food Science and Nutrition, University of Sao Paulo, Brazil. She did her Post-doctoral at the Boston University and at the Citrus and Subtropical Products Research Laboratory, ARS-USDA. Her scientific focus is investigating the nutritional and metabolic properties of citrus fruits in clinical studies and animal models, regarding to the effect of its bioactive compounds as a protection factor against the development of chronic diseases.
Abstract:
Previous studies have associated orange juice consumption with prevention of oxidative stress and systemic inflammation, which may improve insulin sensitivity and reduce the risk of diabetes and cardiovascular disease. These effects are attributed to the bioactive compounds in orange juice, such as flavonoids, carotenoids and vitamin C, which protect the body against oxidative stress and reduce serum lipid levels. Other studies have consistently shown that regular orange juice consumption reduces the serum levels of total cholesterol and LDL-cholesterol and improves the endothelial function, reducing the risk of atherosclerosis. We have conducted several studies to evaluate the effect of regular orange juice consumption on the risk factors for metabolic syndrome and cardiovascular disease. In all these studies the participants have consumed orange juice daily, for two to three-months of period. Anthropometric, hemodynamic, biochemical, inflammatory and oxidative statuses were assessed at baseline and at the end of the intervention period. No changes in the patient’s body weight, percentage of fat mass, and waist circumference was shown after the regular consumption of orange juice, suggesting that orange juice did not contribute to weight or fat mass gain. In fact, the consumption of orange juice improved the diet quality by adding important nutrients as folate, vitamin C, and calcium. Also, it has showed that orange juice significantly reduced blood cholesterol levels, LDL-C, insulin, HOMA-IR, C-reactive protein, blood pressure and, increased serum antioxidant activity by more than a 100 percent. On another transversal study, we also verified that long term orange juice consumption (one year) was associated with low LDL-C and apolipoprotein B in normal and moderately hyper-cholesterolemic subjects. In conclusion, our studies showed that orange juice consumption promoted lipid-lowering, anti-inflammatory and antioxidant activities, which contribute to the prevention of the oxidative stress and the risk factors for diabetes and cardiovascular diseases.
- Obesity: Causes|Genetics of Obesity|Obesity: Associated Health Problems|Obesity and Weight Management|Advances in BMI Test
Chair
Don S Schalch
University of Wisconsin School of Medicine and Public Health, USA
Co-Chair
Maria Fernanda Cury-Boaventura
University of Cruzeiro do Sul, Brazil
Session Introduction
Susan Hazels Mitmesser
Stony Brook University, USA
Title: Determination of plasma and leukocyte vitamin C concentrations in a randomized, double-blind, placebo-controlled trial with Ester-C®
Time : 12:30-12:55
Biography:
Dr. Mitmesser completed a PhD in Nutritional Biochemistry from the University of Nebraska and a Master’s degree from the University of Nebraska Medical Center. She brings numerous years of industry experience and is an adjunct professor in the Department of Family Medicine at Stony Brook University. She has published in many peer-reviewed journals and is a contributing author for numeous book chapters relating to nutrition in adult and pediatric populations.She serves on the Editorial Board of four peer-reviewed journals and is an active member of the American Society of Nutrition, the American Association for the Advancement of Science, and the New York Academy of Sciences. She serves on the Senior Scientific Advisory Council for the Council for Responsible Nutrition.
Abstract:
Rapid uptake of vitamin C into blood and retention in tissues are important indicators of the efficacy of vitamin C supplementation and its immune-supporting role. This double-blind, placebo-controlled, crossover study evaluated the bioavailability of vitamin C in plasma (reflective of recent intake) and leukocytes (reflective of tissue stores on immune function) from a novel vitamin C formulation, Ester-C®. Thirty-six adults were randomized to receive placebo (PL, 0 mg vitamin C), ascorbic acid (AA, 1000 mg vitamin C), and Ester-C® (EC, 1000 mg vitamin C). Plasma and leukocyte vitamin C were measured predose and at 2, 4, 8 and 24 hours postdose. The concentration and percent change from baseline in plasma were significantly higher with EC at all time points when compared to PL. No significant differences between EC and AA were observed in plasma concentration. Plasma area under the curve (AUC0-24h) was higher for EC (P<0.001) compared to PL. The concentration change from baseline in leukocyte vitamin C was increased with EC at 24 h post-dose (P=0.036) while no significant within-group changes were observed in AA or PL at any time point. The percent change in leukocyte vitamin C concentration was higher for EC at 8 and 24 hours compared to AA (P=0.028 and P=0.034, respectively) and PL (P=0.042 and P=0.036, respectively). It is concluded that a single dose of EC resulted in favorable percent change in leukocyte vitamin C concentration compared to AA and PL, indicating EC is retained longer within leukocytes.
Maarten Bak
Maastricht University, Netherlands
Title: Almost all antipsychotics result in weight gain: A meta-analysis
Time : 12:55-13:20
Biography:
Maarten Bak is a Psychiatrist since 1999, trained in Maastricht University Hospital. He has completed his PhD in 2004 in “Coping with Psychosis; Blueler’s Right”. He is Director of the Medication Monitor, assessing effects and side effects of long term antipsychotic use. The side effects monitored are metabolic effects, movement disorders and sexual side effects. His scientific work centers on effect and metabolic side effects of antipsychotics. He has published over 50 papers in reputed journals.
Abstract:
Introduction: Antipsychotics (AP) induce weight gain. However, reviews and meta-analyses generally are restricted to second generation antipsychotics (SGA) and do not stratify for duration of AP use. It is hypothesized that patients gain more weight if duration of AP use is longer.
Method: A meta-analysis was conducted of clinical trials of AP that reported weight change. Outcome measures were body weight change, change in BMI and clinically relevant weight change (7% weight gain or loss). Duration of AP-use was stratified as follows: ≤6 weeks, 6-16 weeks, 16-38 weeks and >38 weeks. Forest plots stratified by AP as well as by duration of use were generated and results were summarized in figures.
Results: 307 articles met inclusion criteria. The majority were AP switch studies. Almost all AP showed a degree of weight gain after prolonged use, except for amisulpride, aripiprazole and ziprasidone, for which prolonged exposure resulted in negligible weight change. The level of weight gain per AP varied from discrete to severe. Contrary to expectations, switch of AP did not result in weight loss for amisulpride, aripiprazole or ziprasidone. In AP-naive patients, weight gain was much more pronounced for all AP.
Conclusion: Given prolonged exposure, virtually all AP are associated with weight gain. The rational of switching AP to achieve weight reduction may be overrated. In AP-naive patients, weight gain is more pronounced.
Deborah A Christel
Washington State University, USA
Title: Thermographic profiling of post bariatric female patient’s abdominal pannus region
Time : 14:20-14:45
Biography:
Deborah A Christel completed her PhD in 2010 from Oregon State University and focuses her research on plus-size apparel, functional and comfort design for obese bodies, and weight bias. She is an Assistant Professor at Washington State University in the Department of Apparel Merchandising, Design and Textiles.
Abstract:
This manuscript addresses the added value of thermography in the practice of product development of garments for post-bariatric patients and the obese. The development of new thermal technologies applied in medical settings has allowed better understanding of wound healing post-surgery. Infrared thermography is a technique that allows visualization of heat radiated from a body using infrared emission, a spectrum that is not visible to human. Used in the medical field, it can provide doctors with information about the physiological responses associated with skin temperature (Tsk) to identify possible pain symptoms. Recently, thermography has been used in product development in sport settings and is an increasingly important tool for diagnosing medical issues. The objective of this study was to establish the thermographic profile of the abdominal pannus in post-bariatric female patients. Ten post-bariatric female patients from the Pacific Northwest of the USA (53.8±9.15 years) participated in the study. Four thermal images of each patient allowed us to record minimum, maximum and average skin temperature in 3 regions of interest (Anterior, Anterior while lifting the pannus, Sagittal and Posterior). Small bilateral differences were found. Significant differences occurred under skin folds of the pannus and pubic region compared to other Tsk. Heat and sweat form excess skin and the pannus skin folds should be seriously considered in apparel product development for post-bariatric and obese populations
Maria Fernanda Cury Boaventura
Cruzeiro do Sul University, Brazil
Title: Benefits of regular exercise on inflammatory and cardiovascular risk markers in normal weight, overweight and obese adults
Time : 14:45-15:10
Biography:
Maria Fernanda Cury Boaventura has completed her PhD on Human Physiology and Post-doctoral studies from University of São Paulo. She is Professor and Researcher at Institute of Physical Activity and Sport Sciences since 2007. She has published more than 40 papers in reputed journals and has been serving as an Editorial Board Member of repute.
Abstract:
Obesity is a worldwide epidemic that increases the risk of several well-known co-morbidities. There is a complicated relationship between adipokines and low-grade inflammation in obesity and cardiovascular disease (CVD). Physical activity practices have beneficial health effects on obesity and related disorders such as hypertension and dyslipidemia. We investigated the effects of 6 and 12 months of moderate physical training on the levels of adipokines and CVD markers in normal weight, overweight and obese volunteers. The 143 participants were followed up at baseline and after 6 and 12 months of moderate regular exercise, 2 times a week, for 12 months. The volunteers were distributed into 3 groups: Normal weight group (NWG,), overweight group (OVG) and obese group (OBG). We evaluated blood pressure, resting heart rate, anthropometric parameters, body composition, fitness capacity (VO2max and isometric back strength), cardiovascular markers (CRP, total cholesterol, LDL-c, HDL-c, homocysteine) and adipokine levels (leptin, adiponectin, resistin, IL-6 and TNF-alpha). There were no signiï¬cant changes in anthropometric parameters and body composition in any of the groups following 6 and 12 months of exercise training. Leptin, IL-6 levels and systolic blood pressure were signiï¬cantly elevated in OBG before the training. Regular exercise decreased HDL-c, leptin, adiponectin and resistin levels and diastolic blood pressure in OVG. In OBG, exercise diminished HDL-c, homocysteine, leptin, resistin, IL-6 and adiponectin. Moderate exercise had no effect on the body composition; however, exercise did promote beneficial effects on the low-grade inflammatory state and CVD clinical markers in overweight and obese individuals.
Maiadah Alfares
University of Bristol, UK
Title: A novel role for insulin like growth factor II (IGF-II) in adipocyte regulation: Site-specific actions due to differences in insulin receptor distribution
Time : 15:10-15:35
Biography:
Maiadah has obtained her MBBS degree at the age of 24 years from the Univeristy of Dammam where she also achieved her MSc degree in endocrine physiology. She was awarded a scholarship to proceed with her higher education journey and she is currently a Ph.D. student at the university of bristol, school of clinical sciences ,United kingdom
Abstract:
IGF-II levels in the circulation are maintained at high levels throughout life and IGF-II has been strongly linked to obesity in genetic studies but its metabolic role is still far from understood.We aim to investigate the role of IGF-II as a regulator of adipocytes and its specific effects on visceral adipocytes in relation to the differential distribution of insulin receptors between visceral and subcutaneous fat depots and the possible metabolic consequences.Matched pairs of visceral and subcutaneous pre-adipocytes were collected from biopsies of normal children undergoing routine surgery for non-malignant, non-septic conditions. These cells were grown and differentiated into mature adipocytes using a unique adipocyte cell culture system developed in our laboratory.Tritiated thymidine incorporation Assay (TTI) was used to assess cell proliferation after dosing with IGF-II in different glycaemic conditions (5 & 25 mM). Oil red O staining, western blotting and reverse transcription polymerase chain reaction (RT-PCR) techniques were employed to assess levels of adipogenesis markers and levels of the insulin receptor and insulin receptor isoforms.We found that IGF-II could promote proliferation of primary preadipocytes from subcutaneous and visceral fat depots and this proliferative effect was more profound in subcutaneous preadipocytes in euglycemic (5mM) conditions. Furthermore, IGF-II promoted preadipocyte differentiation into adipocytes in subcutaneous preadipocytes but showed an inhibitory effect on visceral preadipocyte differentiation. Visceral adipocytes had a higher level of insulin receptors in comparison to subcutaneous preadipocytes and IGF-II caused a down regulation of insulin receptor mRNA expression that was more profound in visceral fat cells. In conclusion, IGF-II is a regulator of preadipocyte proliferation and this effect is altered by the concentration of glucose. IGF-II may have a protective role against visceral adiposity by reducing preadipocyte differentiation into mature adipocytes and by reducing insulin receptor expression.
Hellas Cena
Pavia University, Italy
Title: Childhood obesity and dieting: risk factors for eating disorders
Time : 15:35-16:00
Biography:
Hellas Cena has graduated from Medical School at the age of 24 years from Pavia University in Italy with full marks and attended the 4-years Postgraduate Residency in Dietetics and Clinical Nutrition at Pavia’s University with fellowship. She is an Assistant Professor at Pavia University, Faculty of Medicine, she is head of the outpatient's laboratory of Dietetics and Clinical Nutrition and Academic Director of the master’s degree (MAS) in Dietetics and Clinical Nutrition. She has wrote 194 papers that have been either published or brought to National and International Congresses and has been serving as an editorial board member and reviwer of repute for national and international journal.
Abstract:
Childhood obesity is a major public health issue worldwide. Its prevalence has reached epidemic proportions, and therefore combatting childhood obesity is a common goal among industrialized and developing countries. Classifying obesity as a chronic disease in children and adolescents is essential in order to increase societal awareness and individual consciousness, as well as implementing targeted actions, as recently written by the European Childhood Obesity Task.Since childhood obesity is a strong predictor not only of premature development of cardiovascular diseases and other comorbid conditions, but also of psychological distress, there is serious need for improving early diagnosis and intervention.
Increasing evidence shows that early onset obesity is not only a risk factor for metabolic complications in adulthood, but it increases the risk to develop eating disorders (EDs) during adolescence. Evidences highlight that childhood obesity and self-restrictive diets should be considered as two possible predisposing factors for the development of EDs. The prevalence of EDs and the delayed diagnosis of such pathologies suggest the necessity to increase awareness amongst clinicians who treat children with overweight and obesity.
A late diagnosis of EDs contributes to the chronicity and severity of the disease, leading to growth disorders and clinical complications over both the short and long terms.
An accurate nutritional assessment with an appropriate nutritional counseling may prevent ED onset and should be performed in all families of children with obesity.
Munira Alghafaily
King Saud University, Saudi Arabia
Title: Is BMI≥50 kg/m2 a predictor of higher morbidity during doing laparoscopic sleeve gastrectomy? An observational study at King Khalid University Hospital, Saudi Arabian experience
Biography:
Munira Alghafaily, is a final year medical student at King Saud University, Saudi Arabia. I have no publication until now but I have three researches on cardiology,gastroentology and laparoscopic sleeve gastrectomy and I am waiting for publication
Abstract:
Objectives: This study was to assess operative and post-operative complications, of laparoscopic sleeve gastrectomy (LSG), in super-obese and compare it to morbid obese on in KKUH, Saudi Arabia.
Methods: We reviewed the 708 medical records of consecutive patients who underwent LSG surgery at KKUH from 2009 till 2015. Then, we compared our SMO (BMI≥50 kg/m2) patients’ data results to (our international reports) MO (BMI<50 kg/m2) patients’ category who underwent LSG.
Results: Male sex was predominant in SMO (63.6%). Both groups had homogeneous baseline characteristics and comorbidities except sleep apnea were higher in SMO. There is no significant difference in the duration of operation, length of stay and recovery room time between the 2 groups. Mean number of trocars was 4 for both groups. HDU admission 62 (28.6%) patients of SMO, and 32 patients of MO. No conversion to open or documented intraoperative complications in both groups. For postoperative complications: It has developed in 6% of patients in SMO included 1.4% of patients developed leakage, and 10 patients developed bleeding in the drain. On the other hand, 4.3% of patients in MO had developed complications, includes, (2.2%) patients developed leak, 2% patients developed bleeding and 4 patients only needed blood transfusion. There was no surgical mortality.
Conclusion: There is no significant difference in the duration of operation, number of trocars and intra-operative complication between SMO and MO. The BMI≥50 kg/m2 is not a predictor of higher morbidity during doing LSG if done in a tertiary care center with dedicated bariatric center serves.
Aghanenu Godfrey Chukwudi
University of Venda, South Africa
Title: The determinants of obesity among students of the University of Venda, Limpopo Province of South Africa
Biography:
Aghanenu Godfrey Chukwudi has completed his Master of Public Health (MPH) from the University of Venda, Limpopo Province of South Africa.
Abstract:
Background: Obesity is a serious public health issue; recognized as a global epidemic by the World Health Organization (WHO, 1998).
Purpose: The purpose of the study was to describe the determinants of obesity among students of the University of Venda.
Methodology: The design of the study was a quantitative correlational survey. Instrument for data collection was a questionnaire. Simple random sampling and systematic sampling methods was used to select the participants. The data were analyzed using statistical package for social science (SPSS), version 22. Descriptive analyses were performed to show frequency distributions. Chi square test was used to compare relationship between obesity and socio-demographic; dietary and environmental variables among students.
Results: Overweight and obesity is prevalent among student population with 20% of the participants being overweight and 9.5% obese. Unhealthy eating practices were found among the participants. There was statistical significant difference in BMI between male and female gender with female (66%) being more obese than male (34%). In terms of socio-demographic variable this study found gender and age of participants as important factor of overweight and obesity.
Conclusion & Recommendations: Regular nutrition education campaign needs to be carried out in the University in order to motivate more healthy food choices. Also, moderate to vigorous physical activities (MVPA) is recommended.