Day 2 :
Keynote Forum
Don S Schalch
Professor, University of Wisconsin School of Medicine and Public Health, USA
Keynote: Food deserts and swamps impacting on health: Tale of two cities
Time : 9:30-10:10
Biography:
Don S Schalch has completed his MD from the University of Cincinnati, OH, in 1960. He completed his Medicine Residency and Fellowship in Endocrinology and Metabolism from the University of Rochester, NY, in 1964. He was a Visiting Scientist at Erasmus University in Rotterdam and at Kantonspital in Zürich in 1972-73, and joined the University of Colorado Medical School Faculty in Denver, CO in 1974. In 1982, he became the Chief of Endocrinology at the University of Wisconsin School of Medicine and Public Health. He has published 101 papers, has been a reviewer for 3 journals, and became an Emeritus Professor since 1999.
Abstract:
Availability of various foods is an important determinant of what people buy and eat, thus impacting on their health. This is illustrated in our studies of two cities: one large; i.e., Cleveland, Ohio, replete in "food swamps," and one small; i.e., Madison, Wisconsin, site of many "food deserts," food swamp which is readily-accessible convenience stores and fast food restaurants; food desert where it is difficult-to-buy fresh fruits and vegetables. Food swamps and deserts often co-exist. Availability of nutritious food is one determinant of people’s diet; others are cost, cultural, racial, ethnic, habits, and inadequate transportation in low-income areas. Fast foods in restaurants and junk foods in convenience stores, rich in carbohydrates, fats and sugar, are associated with increased risk of being overweight/obese and increased prevalence of type 2 diabetes, hypertension, heart disease, and cancer. Recent WHO European Region report indicated poor diet, overweight and obesity which contribute to a large proportion of cardiovascular diseases and cancer, the two main killers in the Region. Lack of essential nutrients/minerals, lead to growth impairment, organ dysfunction, and failure in maintaining normal nitrogen balance in the body. Using housing- and food-outlet data (Cleveland) and UW APL, UWSMPH, and WI Depts. HS/U&RP data (Madison), employing GIS, food swamps in the former and food deserts in the latter have been mapped, corresponding to areas of poverty, people of color, and increased prevalence and poorly-controlled diabetes. Emphasizing complexity of poor diet choices, a refrigerated 40-foot trailer offering fresh fruits and vegetables in 8 Madison food deserts was unsustainable after 2 years because initial consumer interest declined.
Keynote Forum
Quang Kim Tran
Des Moines University, USA
Keynote: Novel mechanistic insights into the actions of the G-protein coupled estrogen receptor as a moderator of cardiovascular health
Time : 10:10-11:00
Biography:
Quang Kim Tran received an MD from the University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam and a PhD in Vascular Biology and Clinical Cardiology Fellowship from Hamamatsu University School of Medicine, Japan. He pursued Post-doctoral Training in the School of Biological Sciences, University of Missouri–Kansas City, USA, where he later became a Research Instructor. He is now an Associate Professor in the Department of Physiology and Pharmacology, Des Moines University College of Osteopathic Medicine, Iowa, USA. He has served as President of the Iowa Chapter of the American Physiological Society and as Reviewer for various scientific journals in the cardiovascular field.
Abstract:
Plasma estrogen level is closely related to cardiovascular health. Estrogen exerts complex effects that are both dependent and independent on transcriptional activities and are mediated by at least 3 estrogen receptors. The novel G protein-coupled estrogen receptor (GPER) has been shown to participate in many cardiovascular functions such as the control of fat metabolism, insulin resistance and glucose tolerance, and vascular tone and cardiac diastolic functions. However, the regulatory inputs of GPER are not well understood. Both Ca2+ entry and Ca2+ efflux are essential in shaping intracellular Ca2+ signals important for cardiovascular functions. Calmodulin, the ubiquitous transducer of Ca2+ signals, is important for the activities of more than 100 intracellular proteins, yet is insufficiently expressed for all its binding sites, rendering a shortage for calmodulin across cardiovascular tissues. Factors that control Ca2+ influx, Ca2+ efflux and Ca2+-dependent calmodulin signals thus plays important roles in the regulation of cardiovascular activities. Data will be presented on the effects and multiple underlying mechanisms of GPER in the control of Ca2+ efflux, Ca2+ entry and the role of GPER in forming a feed-forward loop that regulates calmodulin expression and functional linkage in the network of calmodulin-dependent proteins in cardiovascular system. A mechanistic model for the role of GPER as a moderator of cardiovascular functions will be presented. The data and summative model encourage therapeutic exploitation of GPER activation and expression in the management of cardiovascular morbidity.
Keynote Forum
Deborah A Christel
Washington State University, USA
Keynote: Weight bias in health care: Optimizing care through personal assessment of obesity and weight biases
Time : 11:20-12:20
Biography:
Deborah A Christel has completed her PhD in 2010 from Oregon State University and has studied new approaches of Reducing Weight Bias in many fields including retail, fashion design, marketing, law and medical settings. She is an Assistant Professor at Washington State University in the Department of Apparel Merchandising, Design and Textiles
Abstract:
To increase public awareness about weight bias, I proposed a workshop that provides conference attendees the opportunity to examine their own biases towards obese people. While significant research has been conducted about obesity, little has been done to address and stop bias. Weight bias is highly common in health care setting sand studies have shown that health care professionals are among the most common source of bias. This includes physicians, nurses, psychologists, dietitians, medical students and other professionals who specialize in obesity. Weight bias in health care can cause serious harm. Studies demonstrate that patents with higher weights are more likely to avoid, cancel or delay important preventative appointments. Patients with obesity, state the avoidance results from disrespectful treatment and negative attitudes from providers, unsolicited advice to lose weight, embarrassment about being weighed and negative experiences with medical equipment that is too small for them. The workshop will include an introduction, self- assessment survey, personal reflection, a 17-minute video discussing weight bias, a second opportunity for reflection and concrete strategies to help combat the significant societal problem of weight bias.
- Childhood Obesity and Effects|Diabetes and Obesity|Obesity treatment|Medical Weight loss|Endocrinology
Location: Day-2
Chair
Don S Schalch
University of Wisconsin School of Medicine and Public Health, USA
Co-Chair
Quang Kim Tran
Des Moines University, USA
Session Introduction
Thais Cesar
Sao Paulo State University (UNESP), Brazil
Title: Effect of orange juice on body composition and biochemical profile of obese individuals submitted to weight loss diet
Time : 12:20-12:45
Biography:
Thais Cesar is an Associate Professor of Nutrition, Faculty of Pharmaceutical Sciences, Sao Paulo State University (UNESP), Araraquara, Brazil. She has a BS in Biology and PhD in Food Science and Nutrition from University of Sao Paulo, Brazil. She did 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 the effect of its bioactive compounds as a protection factor against the development of chronic diseases
Abstract:
We have evaluated the effect of regular consumption of orange juice in body composition and biochemical variables. The subjects of this study were obese men and women (36.3±0.8 y) who were submitted to an energy-restricted diet for 12 weeks. They had normal blood serum levels of cholesterol, triglycerides and glucose, and were randomly divided into 2 parallel groups. Group 1 (n=39) had an energy-restricted diet (-500 kcal/d) and Group 2 (n=39) had the same energy-restricted diet supplemented with orange juice (500 mL/d). The assessment of body composition (weight, BMI, fat mass, waist and hip circumference and ratio) were performed at week 0 and every 2 weeks until the end of the 12-week trial period. Evaluations of biochemical parameters (total cholesterol, LDL-C, HDL-C, triglycerides, glucose, insulin, HOMA-IR and CRPu) were performed 0, 4, 8 and 12 weeks. After the treatment, individuals undergoing only energy-restricted diet had a reduction in body composition parameters as well as biochemical parameters. In addition, individuals who also regularly consumed orange juice showed lower levels of blood serum cholesterol (-20%), LDL-C (-19%), CRPu (-49 %), insulin (-27%) and HOMA-IR (-33%). In conclusion, orange juice enhanced the effects of energy-restricted diet improving both lipid and glucose metabolism, showing that it is suitable for weight loss purposes as well as for the improvement of the biochemical profile of obese individuals.
Deborah A Christel
Washington State University, USA
Title: Coping by cross-dressing: An exploration of exercise clothing and consequences for obese heterosexual women
Time : 12:45-13:10
Biography:
Deborah A Christel completed her PhD in 2010 from Oregon State University and focuses her research on plus-size apparel and weight bias. She is an Assistant Professor at Washington State University in the Department of Apparel Merchandising, Design and Textiles.
Abstract:
Over the past decade participation in physical activity for adult women has decreased while body size has increased. Overweight and obese individuals are considered the majority demographic in the United States; however, plus-sized clothing sales are minimal in comparison to other segments. Furthermore, there is little known about the clothing practices of obese women who engage in physical activity. The current study addresses this research gap by exploring obese heterosexual women’s clothing practices for exercise, with an emphasis on what women wear, their perceived choices, alternatives and satisfaction. Lowe and Anspach’s notion of freedom of dress was the guiding conceptual framework for in-depth interviews with (n=56) obese women. A majority of the women perceived having limited freedom in dress, and reported cross-dressing in men’s clothing to engage in physical activity, which resulted in a perceived lack of gender expression. Cross-dressing is wearing clothing of the opposite sex and gender expression; it is a way in which a person acts to communicate gender within a given culture. Women in this study indicated and the authors discuss that as clothing size increases, perceived freedom in dress decreases. In order to increase freedom in dress, our participants tended to believe that it is their personal responsibility to lose weight
Codjo H Leopold
University of Parakou, Benin
Title: Childhood overweight and obesity at school: Case of the city of Parakou (Benin) in 2016
Time : 13:55-14:20
Biography:
Codjo H Leopold has completed his PhD and Post-doctoral studies from Faculté des Sciences de la Santé de Cotonou. He is the Head of the Cardiology Unit of Departmental Teaching Hospital of Borgou (North Bénin). He has published more than 15 papers in reputed journals and has been serving as an Editorial Board Member of repute (cardiovascular Journal of Africa, annales de l’université de Parakou, British Journal of Medicine and Medical Research).
Abstract:
Introduction: The objective of this study was to determine the prevalence of overweight among adolescents in public schools in the city of Parakou.
Methods: It was a descriptive and analytical cross sectional study with prospective data collection from 7 December 2015 to 31 March 2016. Were included, students regularly enrolled in public secondary public schools of Parakou, aged 10 to 18 who received the written consent of their parents. The selection of students was done in a three degree random sampling technique. Overweight was defined by body mass index, according to BMI curves of the World Health Organization. The threshold values ​​provided by the NHANES III were used to define abdominal obesity. The blood glucose and lipids were performed by enzymatic colorimetric methods on specimens from patients fasted for at least 6 hours. Other variables were blood pressure, eating habits, smoking, alcohol consumption and physical activity.
Results: A total of 422 students including 259 girls were identified. The mean age was 15.22±2.27 years. The prevalence of overweight was 27.96% (95% CI [23.78%-32.55%]), while that of obesity was 18.48% (95% CI [14.96%-22.55%]). Abdominal obesity was at 10.19% (95% CI [7.55%-13.58%]). The majority (95.35%) of students with abdominal obesity was overweight. Metabolic syndrome was observed in 5.45% (95% CI [3.24%-7.56%]). The factors significantly associated with overweight were the female sex, age ≥15 years, high blood pressure, total cholesterol and LDL, hypertriglyceridemia and hyperglycemia.
Conclusion: These data from a poor country like Benin revealed a high prevalence of obesity and metabolic syndrome in children and adolescents in schools. Preventive measures need to be taken.
Salime Das
University of Mons, Belgium
Title: Childhood obesity- Psychic life in 8-12 year-old-children, according to 3 axes: Individual, familial and academic
Time : 14:20-14:45
Biography:
Salimé Das has been doing a PhD research at the University of Mons since September 2015. She is a Psychologist and works with children and adult people. She has carried out oral communication in France and presented some posters in Belgium and France.
Abstract:
Some studies have shown that obese children can suffer from psychic life in a medical and psychic perspective, but so far no study has analyzed the individual, familial and academic axes simultaneously. The objective of this research is then to take these 3 axes together into account. Variables will be collected in 8-12 year-old-children data and mothers data in 90 dyads mothers/children groups: Participants were assigned to 3 conditions: Obese, overweight and control. Research hypotheses supposed that there will be differences between the 3 groups and psychic suffering from obesity and overweight dyads in the studied variables, which are: Self-esteem, body-esteem, anxiety, depression, alexithymia and social support. Results will be obtained by questionnaires and interviews and will be analyzed with a statistical method and qualitative analysis. First results and case-studies will be presented as preliminary results.
Ononamadu C.J
Nigeria Police Academy, Nigeria
Title: Performance of anthropometric indices of obesity in predicting risk of hypertension and prehypertension in a Nigeria
Time : 14:45-15:10
Biography:
Ononamadu C.J is obtained hos B.Sc and M.Sc in Applied Biochemistry in 2008 and 2012, respectively, he also obtained a certificate in quantitative methods in clinical and public health researches. He is currently doing his PhD research work on Diabetes, Hypercholesterolemia and Oxidative stress.
Abstract:
Background: Obesity is a well-established risk factor of hypertension and some other cardiometabolic disorders. However, the best anthropometric index of obesity that predicts hypertension and related conditions remains controversial and inconclusive owing to some factors.
Objective: This study compared the performances of eight (8) anthropometric measures of obesity- Body Mass Index (BMI), Ponderal Index (PI), Waist Circumference (WC), Hip Circumference (HC), Waist- Hip Ratio (WHR), Waist–Height Ratio (WHtR), Body Adiposity Index (BAI) and Conicity Index (CI) in predicting risk of hypertension and prehypertension.
Methods: This community based cross sectional study was conducted in Anambra State, South Eastern Nigeria from 2012-2013. A total of nine hundred and twelve persons (436 male and 476 female) drawn from three (3) major cities (Awka, Onitsha and Nnewi) in the state participated in the study. Information on demography and life style were obtained using a well-structured and validated questionnaire. The Systolic/Diastolic Blood pressure and anthropometric measurements were taken by well-trained personnels. The resulting data were analyzed using descriptive statistics, Logistic Regression, Poisson regression and Receiver Operative Curve (ROC) analysis.
Result: The mean values of all the anthropometric indices studied increased from Normotension, through Prehypertension to Hypertension in both sexes. BMI, WC, HC and CI were significantly higher (p<0.05) in males than the females. All the anthropometric indices studied were significantly (p<0.001 except for CI) correlated with systolic and diastolic blood pressure. BMI, WHtR, WC and PI (with higher correlation coefficients for Blood pressure) were the best predictors of hypertension and prehypertension in the study - BMI (Cutoff=24.49, AUC=0.698; Cutoff=23.62; AUC=0.659), WHtR (Cutoff=0.55, AUC=0.682; Cutoff=0.5; AUC=0.636), WC (Cutoff=91.44, AUC=0.692; Cutoff=82.55; AUC=0.645), PI (Cutoff=14.45, AUC=0.670; Cutoff=13.69; AUC=0.639), in male and BMI (Cutoff=24.44, AUC=0.622; Cutoff=28.01, AUC=0.609), WHtR (Cutoff=0.51, AUC=0.624; Cutoff=0.6; AUC=0.572), WC (Cutoff=96.62, AUC=0.616; Cutoff=96.52; AUC=0.584), PI (Cutoff=16.38, AUC=0.619; Cutoff=17.65; AUC=0.599), in female for hypertension and prehypertension respectively. In predicting hypertension risk, WC and WHtR did not perform significantly different from BMI and did not significantly improve the performance of BMI in models when added using our decision rule. While in predicting prehypertensive risk, BMI and WC were better off. CI had a very poor discriminatory power for both conditions in this study.
Conclusion: BMI, WHtR, WC and PI emerged the best predictors of hypertension risk and BMI, WC and PI for prehypertension in this study. The anthropometric indices of Obesity, WHtR and WC did not outperform or add to the performance of the anthropometric index of general Obesity, BMI, which is the most widely used anthropometric index. Thus, we recommend the simultaneous but independent use of BMI and either of WC or WHtR for predicting hypertension and BMI and WC for prehypertension risk bearing in mind that both types of index (abdominal and general obesity) account for different form of obesity.
Caroline Bonner
European Genomic Institute for Diabetes, France
Title: Insulin independent regulation of glucagon secretion
Time : 15:10-15:35
Biography:
Caroline Bonner has completed her PhD in 2009 from the Royal College of Surgeons in Ireland focusing on: Differentiation and regeneration of beta cells using genetic models of HNF1A-MODY and HNF4A-MODY. She has pursued a Post-doctoral fellowship in Translational Studies in the same laboratory (2009-2011), focusing on the discovery and validation of serum biomarkers (microRNAs and secreted proteins) in MODY patients as well as in T1D and T2D subjects. She joined EGID in 2012, where she pursued an Independent Human Translational Research Project on the transcriptional regulation of non-beta cells on pancreatic hormone and gene expression. She has published more than 25 papers in reputed journals including Nature Medicine.
Abstract:
There are 60 million people with type 2 diabetes (T2D) in Europe. Obesity contributes to 65-80% of new cases of T2D. T2D is a complex metabolic disorder, the pathogenesis of which is not understood. Impaired insulin sensitivity, hyperglucagonemia, endogenous glucose production and islet cell dysfunction are major traits of the disease, but the sequence of events leading to hyperglycemia remains unclear. For decades, the mechanisms by which nutrients stimulate insulin secretion have been studied extensively, whilst the neighboring alpha (which secrete glucagon) have been ignored. A renewed interest in the regulation of glucagon secretion has been re-discovered since reports of elevated glucagon levels in T2D patients, by unexplained mechanisms. We have recently discovered SGLT2, which is specifically expressed in pancreatic alpha cells. Notably, inhibition of SGLT2 with dapagliflozin resulted in a marked increase (more than 83%) of glucagon secretion at glucose concentrations of 6 mM. Given the biochemical properties of SGLT2 (Km~6 mM), these data suggested that the SGLT2 glucose transporter is very effective in preventing hypoglycemia. Importantly, human islets co-treated with 15 mM glucose and dapagliflozin had no effect on glucagon secretion, thus suggesting that there are other glucose transporters (most likely the GLUTs) present on alpha cells, which are effective in hyperglycemia. Indeed, the specific expression and function of GLUT transporter proteins in human vs. rodent islets are conflicting and confusing. So given the known increased risk for T2D, understanding the complex pathways underlying glucose transport defects and islet hormone dysfunction in human should now become a priority for European healthcare.
Rui Azevedo Guerreiro
Holy Spirit Hospital EPE, Portugal
Title: Ophthalmic complications of bariatric surgery
Time : 16:30-16:55
Biography:
Rui Azevedo Guerreiro has graduated in Medicine from NOVA Medical School in Lisbon, Portugal and is currently attending the Clinical Scholars Research Training Program from Harvard Medical School. He has worked in the Bariatric and Metabolic Diseases Surgical Unit of the Central Lisbon Hospital Centre where, together with Rui Ribeiro, president of the Portuguese Society of Bariatric Surgery and Metabolic Diseases he has developed his work on Ophthalmic Complications of Bariatric Surgery.
Abstract:
Obesity is increasing vastly in the world, and the number of bariatric surgeries being performed is also increasing. Patients being submitted to bariatric surgeries, especially malabsorptive procedures have an increased risk of developing nutrient deficiencies, which can culminate in symptomatic hypovitaminosis, if supplementation is not done correctly. The eye and the optic system need an adequate level of several vitamins and minerals to perform properly, especially vitamin A, and my presentation wants to cover the main nutrients involved, the possible ophthalmic complications that can arise by their deficiency, and the management of those complications.
Nina Holland
University of California, USA
Title: Obesity in children: New data on epigenetic and other molecular mechanisms related to prenatal exposure to endocrine disruptors from CHAMACOS birth cohort study
Time : 16:55-17:20
Biography:
Nina Holland is a Faculty at the School of Public Health (SPH) and a Director of the SPH Bio-repository and the Children’s Environmental Health Laboratory at the University of California, Berkeley. She has a background in genetics with extensive experience in molecular epidemiology, cytogenetics and epigenetics. Her main scientific interest is in biomarkers of children's environmental health and the relationship of early life exposures with obesity, neurodevelopment and other health outcomes. She has been an invited speaker at many national and international meetings, and organized several symposiums on molecular epidemiology of Children’s Environmental Health and Environmental Epigenetics. She has published more than 150 papers and book chapters.
Abstract:
The prospective nature of birth cohort studies and wealth of epidemiological data and biological samples provide unique opportunities to address effects of early life exposures on health outcomes later in life. The obesity epidemic in the United States and other countries is a growing public health problem. We aimed to study the relationship of prenatal exposure to obesogens with adipokines, epigenetic modifications and life style factors, in children from birth through adolescence. Urinary phthalates and BPA were measured at 2 time points during pregnancy from 400 women participating in the CHAMACOS study, an ongoing longitudinal birth cohort of low-income Mexican-Americans living in agricultural Salinas, California. We characterized adipokines and DNA methylation in bloods collected from children at several time-points. Obesity parameters in children including BMI, waist circumference, metabolic profiles and adipokines were assessed, as were nutrition and physical activity. Over 55% of CHAMACOS children were already overweight or obese at 9 years of age, and the trend continues at 14 years. Maternal phthalates were detected in a wide range of concentrations, similar to those in other US women of child-bearing age, while BPA levels were lower. Phthalates were associated with differences in child BMI Z-score, waist circumference and adipokines while BPA was positively associated with plasma leptin in boys and adiponectin in girls. Prenatal obesogens were associated with DNA hypomethylation and other epigenetic modifications in cord blood and at age 9. Molecular markers provide insights into mechanisms of obesity development and effects of in utero exposure to endocrine disruptors.