Day 1 :
Orlando Regional Medical Center, USA
Time : 09:35-10:15
Muhammad A Jawad is a board certifi ed through the American Board of Surgery and serves as the Medical Director of Orlando Regional Medical Center’s Bariatric Program. He has been an expert in Laparoscopic Surgery since 1989, where he has been performing complicated biliary, colon and endocrine surgery. He has performed more than 4,000 laparoscopic bariatric surgical cases since 2000, safely and with great success. He specializes in the laparoscopic gastric bypass, the adjustable Lap- Band, and sleeve gastrectomy procedures. He has presented more than 45 presentations both nationally and internationally on laparoscopic and bariatric surgery.
More than two-thirds of adults are considered to be overweight or obese. More than one-third of adults are considered to be obese. More than one in 20 (6.3%) have extreme obesity. Almost three in four men (74%) are considered to be overweight or obese. Th is has aff ected increase in the number of diabetes in United States. Diabetes is becoming more common in the United States. From 1980 through 2014, the number of Americans with diagnosed diabetes has increased four-fold (from 5.5 million to 22.0 million). Treatment of diabetes in morbidly obese person with bariatric surgery has shown excellent results, with resolution of diabetes between 70%-90%, depending on the procedure that was done, and the duration of the disease. Since the start of bariatric surgery in 1953 with J-I bypass, gastric bypass, gastro-plasty, BPD-DS, lap-band and the
sleeve gastrectomy, resolution of diabetes has been observed aft er these procedures. Th e mechanism of diabetes resolution and improvement is complex, part of it being results of low caloric intake, weight loss, and hormonal manipulations.
Keynote: Rethinking the cardio risk paradigm
Time : 10:15-10:55
Robert Buist completed his PhD in Medicinal Chemistry and Pharmacology. He spent eight years in Asthma and Cardiovascular Drug Research at Macquarie University, followed by a Postdoctoral Research Fellowship at New York State Health Department. He is presently acknowledged as one of the founders of Nutritional Medicine in Australia. He is currently a Nutritional Educator for pharmacists, doctors, and other health professionals, and is a formulator of nutrition products and functional foods.
For the last 50 years, we have been advised to lower fat intake and reduce blood cholesterol. We have used commercial strategies to make these changes have little impact on the incidence of heart disease. Th ey have, however, resulted in a massive increase in low fat-high sugar products on supermarket shelves with an accompanying world–wide increase in obesity, metabolic syndrome, NAFLD and diabetes. Glycation, oxidation and infl ammation are the new risk factors. Could we change these risk factors through dietary and supplemental control? New dietary advice should emphasize whole, seasonal, high fi ber, unprocessed food. We need to place particular emphasis on understanding the eff ects of sugar in the diet and totally rethink our approach to dietary fat/oil consumption. Evidence indicates that cholesterol per se is not the problem. We are learning that the normal lipoprotein pathology tests are insuffi cient and that we need data on the lipoprotein subclasses. For example: large buoyant LDLs are associated with lower CAD risk and small dense LDLs are associated with increased CAD risk. Such new markers of cardiovascular risk are now being looked with great interest. Th ey include LDL fractionation, number of LDL particles, functional HDL, Apo B:Apo A ratio and triglyceride/HDL ratio. A high triglyceride/HDL ratio can predict a large number of small dense LDL particles whereas lower ratios are associated with large fl uff y (buoyant) LDLs. Th ese new markers and ratios should give valuable insight into the standard lipid panel of LDL-C, HDL-C and triglycerides.
Tokyo Metropolitan Institute of Gerontology, Japan
Keynote: Exercise and nutritional supplementation on community-dwelling elderly Japanese women with sarcopenic obesity
Time : 11:15-11:55
Hunkyung Kim is the Head of Prevention of Musculoskeletal Aging Research team at Tokyo Metropolitan Institute of Gerontology. After graduating from Kyungpook National University (South Korea) in 1986, he pursued Doctorate degree in exercise prescription and gerontology at University of Tsukuba (Tsukuba, Japan). His research focus has been on sarcopenia, frailty, urinary incontinence, falls, geriatric syndromes, locomotive syndrome, exercise, nutrition etc., with a particular interest in sarcopenic obesity in recent years.
Statement of the Problem: Sarcopenic obesity (SO), or the co-existence of both sarcopenia and obesity among elderly people has been an area of interest in current geriatric and gerontological research. Recent research has shown that SO is closely associated with knee osteoarthritis, metabolic syndrome, arterial stiffness, instrumental activities of daily living disability, gait abnormalities, falls, and all-cause mortality, yet there are a very limited number of intervention studies published. The purpose of the study was to determine the effects of exercise and nutritional supplementation on body composition, blood components and physical function in community-dwelling elderly Japanese women with sarcopenic obesity.
Methodology & Theoretical Orientation: A randomized controlled trial was conducted on 139 women defi ned with sarcopenic obesity, who were randomly assigned to one of four intervention groups. The exercise and nutrition (Ex+N), and exercise only (Ex) groups attended a 60-minute class twice a week for three months. The Ex+N and nutrition only (N) groups took essential amino acid and tea catechin supplementation daily for three months. Body composition measured by bioelectric impedance analysis, blood components such as albumin, cholesterol, vitamin D, etc, and physical function including grip strength, knee extension strength, and walking speed were analyzed.
Findings: Signifi cant group×time interactions were observed between the groups in usual walking speed (P=0.012), stride (P=0.004), and vitamin D (P<0.001). Th e Ex+N group showed significant decrease in body fat mass (P=0.036), increase in stride (P=0.038), and vitamin D levels (P<0.001). Further, both Ex+N and Ex groups were over four times as likely to reduce body fat mass as the HE group (OR=4.42, 95%CI=1.21-16.19; OR=4.50, 95%CI=1.13-17.9; respectively).
Conclusion & Significance: Although no additive effects were found, the combination of exercise and nutrition had beneficial effects on body fat, blood components and physical function in sarcopenic obese elderly women.
Capital Medical University, China
Keynote: Obesity leads to iron retention in the duodenum of mice likely due to increased production of adipose-derived hepcidin
Time : 11:55-12:35
Shougang Wei serves as Professor, PhD supervisor and Deputy Director in Department of Children’s and Women’s Health, School of Public Health, Capital Medical University, Peking, China. He has been engaged in the study of child and adolescent health, mainly focused on the field of childhood obesity about its health risks, pathogenic factors, and preventive and treatment measures.
Obese people and animals have higher rates of iron deficiency (ID) than their normal weight peers. It was still uncertain whether obesity-related ID is a true or functional deficiency of iron. This study was to determine the effects and the possible underlying mechanisms of obesity on duodenal iron absorption and liver iron accumulation. C57BL/6J mice were randomly divided into high-fat diet-induced obese (DIO) group and normal control (NC) group to be fed respectively for 16 weeks. Oral iron absorption was tested by measuring serum iron, liver iron and the retained duodenal iron 90 min after intra gastric administration of 57FeSO4 solution. The protein expression levels of iron transporters in duodenum and liver were evaluated by western blotting. Hepcidin mRNA levels in the liver and adipose tissues were quantified by real-time RT-PCR. The results showed that DIO mice had significantly higher iron retention in the duodenum, lower iron concentration in plasma and liver than NC mice. The protein expression levels of ferroportin-1 (Fpn1) in duodenum and transferrin receptor-2 (TfR2) in the liver were markedly decreased in DIO mice. Hepcidin mRNA levels in visceral adipose tissue but not in the liver were higher in DIO mice than NC mice. In conclusion, obesity-related ID may be attributed to impaired intestinal iron absorption of which iron being retained in the duodenal enterocytes, not to that iron being accumulated in the liver. Increased expression of visceral adipose hepcidin probably is the immediate cause for the malabsorption of iron in obesity by inducing reduction of the duodenal Fpn1.