Espedita Muscariello

Effects of Intentional Weight Loss on Physical and Cognitive Function in Middle-Aged and Older Obese Participants: A Pilot Study

Objectives: Obesity is a risk factor for cognitive decline and dementia. Whether weight loss improves cognition in older obese adults is not known. The objective was to investigate the effects of intentional weight loss on physical and cognitive function in middle-aged and older obese adults attending a weight loss clinic. Method: Eleven male and 39 female nonsmoking, adult obese (body mass index 30–50 kg/m2) participants were recruited. Participants were stratified by age: middle aged (30–59 years) and older aged (≥60 years). The weight loss target for each subject was 8% to 12% of initial body weight. Information on anthropometry, bioelectrical impedance, hand-grip strength, Mini-Mental State Examination (MMSE), Short Portable Mental Status Questionnaire (SPMSQ), and Trail-Making Test (TMT) A and B were collected at baseline and after weight loss. Results: At baseline, older participants showed a nonsignificant trend for lower global cognitive function (MMSE, SPMSQ) and significantly slower processing speed (TMT-A). Twenty-one participants completed the weight loss study. The average weight loss relative to baseline was 9.7% ± 2.1%. Weight loss was associated with significant improvements in hand-grip strength and cognitive function (MMSE, TMT-A, and TMT-B). MMSE scores improved significantly only in older obese participants (p < 0.05). Conclusions: Weight loss in middle-aged and in older obese participants has a beneficial effect on cognitive and physical function. If confirmed in future trials, weight loss can significantly affect public health strategies for the prevention of dementia as well as on the clinical management of obesity.

Weight loss expectations and body dissatisfaction in young women attempting to lose weight

BACKGROUND Unrealistic weight loss expectations (WLEs) and greater body dissatisfaction may be associated with the poor long-term outcomes of dietary and lifestyle weight loss treatments. We evaluated the association between body size, WLEs and body dissatisfaction in young women attempting to lose weight. METHODS Forty-four young healthy women [age range 18-35 years, body mass index (BMI) range 23-40 kg/m2] were recruited. Women were classified as obese (BMI ≥ 30.0 kg/m2) and non-obese (BMI <30.0 kg/m2). The Body Dissatisfaction scale of the Eating Disorder Inventory-2 and the Body Image Assessment for Obesity silhouette charts were used to assess body dissatisfaction. WLEs were categorised according to personal (ideal, happiness, satisfaction, weight history), lifestyle (fitness) and social (career, family acceptance, peer acceptance, mass media, social pressure) factors. Individual WLEs were compared with recommended clinical targets (5%, 10% and 20%) for weight loss. RESULTS Body dissatisfaction was lower in non-obese subjects and was directly associated with BMI (P < 0.05). WLEs were directly associated with BMI and the obese group reported greater expectations. Five non-obese subjects (23%) desired to lose more than 20% of their body weight, whereas the proportion was significantly higher in the obese group (17 subjects; 74%). Subjects derived the greatest WLEs from mass media, whereas they perceived that family and friends were supportive of a lesser degree of weight loss. CONCLUSIONS We observed a mismatch between clinical and personal expectations, and social pressure and interpersonal relationships appear to have a prominent role with respect to influencing the association.

Effects of Oleuropein and Pinoresinol on Microvascular Damage Induced by Hypoperfusion and Reperfusion in Rat Pial Circulation

The present study was aimed to assess the in vivo acute effects of oleuropein or/and pinoresinol, polyphenols widely diffused in natural sources, on rat pial microvascular responses during transient BCCAO and reperfusion.

Dietary protein intake in sarcopenic obese older women

Objective To determine the prevalence of sarcopenia in a population of obese older women and to assess the effect of a diet moderately rich in proteins on lean mass in sarcopenic obese older women. Materials and methods A total of 1,030 females, >65 years old, body mass index >30 kg/m2, were investigated about their nutritional status. Muscle mass (MM) was estimated according to the Janssen equation (MM =0.401× height2/resistance measured at 50 kHz +3.825× sex −0.071× age +5.102). Sarcopenia was defined according to the MM index, MM/height2 (kg/m2), as two standard deviations lower than the obesity-derived cutoff score (7.3 kg/m2). A food-frequency questionnaire was used to measure participants’ usual food intake during the previous 3 months. Moreover, a group of sarcopenic obese older women (n=104) was divided in two subgroups: the first (normal protein intake [NPI], n=50) administered with a hypocaloric diet (0.8 g/kg desirable body weight/day of proteins), and the second treated with a hypocaloric diet containing 1.2 g/kg desirable body weight/day of proteins (high protein intake [HPI], n=54), for 3 months. Dietary ingestion was estimated according to a daily food diary, self-administered, and three reports of nonconsecutive 24-hour recall every month during the follow-up. Results The 104 women were classified as sarcopenic. After dieting, significant reductions in body mass index were detected (NPI 30.7±1.3 vs 32.0±2.3 kg/m2, HPI 30.26±0.90 vs 31.05±2.90 kg/m2; P<0.01 vs baseline). The MM index presented significant variations in the NPI as well as in the HPI sarcopenic group (NPI 6.98±0.1 vs 7.10±0.2 kg/m2, HPI 7.13±0.4 vs 6.96±0.1 kg/m2; P<0.01 vs baseline). Conclusion A diet moderately rich in proteins was able to preserve MM in sarcopenic women. Therefore, adequate protein intake could contribute to the prevention of lean-mass loss associated with weight reduction in obese older people.

Effects of Citrus Flavonoids Against Microvascular Damage Induced by Hypoperfusion and Reperfusion in Rat Pial Circulation.

The aim of the present study was to investigate the in vivo protective effects of hesperidin or diosmin or apigenin on damage induced by transient BCCAO and reperfusion.

Lower weight loss expectations and healthier eating attitudes in older overweight and obese women attempting weight loss

Weight loss outcomes in overweight and obese individuals may be influenced by individual weight loss expectations (WLEs). Research on these phenomena in older women is lacking. This cross‐sectional study compared groups of younger and older women on their WLEs and related attitudes (body dissatisfaction and disordered eating). Twenty‐six younger (18–38 years) and 33 older (60–78 years) overweight and obese women were recruited from a weight loss clinic, prior to treatment. Disordered eating attitudes and body dissatisfaction were assessed using validated questionnaires and a pictorial figure‐choice scale. Participants reported 10 WLEs categorized according to personal, lifestyle and social factors. Overall, women with a higher body mass index had greater WLEs. Older women reported lower WLEs than younger women (−14.5 kg vs. −22.4 kg) in all categories except past weight. Older women perceived that career success would necessitate the greatest level of weight loss (−18.5 kg), whereas younger women derived their greatest WLEs from mass media (−28.5 kg). Both older and younger groups perceived that their families would be supportive of the smallest amount of weight loss (−8.4 and −17.6 kg, respectively). The groups did not differ on body dissatisfaction, but younger womens disordered eating attitudes were significantly higher (p < .001). Older overweight and obese women have lower WLEs than younger women but experience similar levels of body dissatisfaction and healthier eating attitudes. The attitudinal constructs underlying these differences may be useful in clinical practice to tailor age‐specific weight loss interventions.

The Effects of Vaccinium myrtillus Extract on Hamster Pial Microcirculation during Hypoperfusion-Reperfusion Injury

Introduction The present study was aimed to assess the in vivo hamster pial microvessel alterations due to 30 min transient bilateral common carotid artery occlusion (BCCAO) and reperfusion (60 min); moreover, the neuroprotective effects of Vaccinium myrtillus extract, containing 34.7% of anthocyanins, were investigated. Materials and Methods Two groups of male hamsters were used: the first fed with control diet and the other with Vaccinium myrtillus supplemented diet. Hamster pial microcirculation was visualized by fluorescence microscopy through an open cranial window. Pial arterioles were classified according to Strahler’s method. Results In age-matched control diet-fed hamsters, BCCAO caused a decrease in diameter of all arterioles. At the end of reperfusion, the reduction of diameter in order 3 arterioles was by 8.4 ± 3.1%, 10.8 ± 2.3% and 12.1 ± 1.1% of baseline in the 2, 4 and 6 month control diet-fed hamsters, respectively. Microvascular permeability and leukocyte adhesion were markedly enhanced, while perfused capillary length (PCL) decreased. The response to acetylcholine and papaverine topical application was impaired; 2’-7’-dichlorofluoresceine-diacetate assay demonstrated a significant ROS production. At the end of BCCAO, in age-matched Vaccinium myrtillussupplemented diet-fed hamsters, the arteriolar diameter did not significantly change compared to baseline. After 60 min reperfusion, order 3 arterioles dilated by 9.3 ± 2.4%, 10.6 ± 3.1% and 11.8 ± 2.7% of baseline in the 2, 4 and 6 month Vaccinium myrtillus supplemented diet-fed hamsters, respectively. Microvascular leakage and leukocyte adhesion were significantly reduced in all groups according to the time-dependent treatment, when compared with the age-matched control diet-fed hamsters. Similarly, the reduction in PCL was progressively prevented. Finally, the response to acetylcholine and papaverine topical application was preserved and there was no significant increase in ROS production in all groups. Conclusions In conclusion, Vaccinium myrtillusextract protected pial microcirculation during hypoperfusion-reperfusion, preventing vasoconstriction, microvascular permeability, leukocyte adhesion, reduction in PCL and preserving the endothelium function.

Changes in frequency components of blood flow oscillations in hyperglycemic obese people

Microvascular dysfunctions are responsible for the vascular complications of diabetes, frequently observed in obese subjects. The present study was aimed to assess microvascular skin blood flow and related oscillations in hyperglycemic obese subjects. Twenty-eight normoglycemic controls and twenty-nine hyperglycemic subjects were recruited from our Outpatient Clinics. Anthropometric measurements were evaluated and bioimpedance analysis was performed. Moreover, glycemia, glycated hemoglobin (HbA1c) and basal insulin were measured. Finally, skin microvascular blood flow was determined by a laser Doppler flowmeter and oscillations in flow were analyzed by power spectrum methods. The mean skin blood flow and total power spectral density were lower in the hyperglycemic patients than in normoglycemic controls. Moreover, hyperglycemic subjects showed lower power spectral density of oscillations, related to myogenic activity, compared to the those observed in normoglycemic people. Therefore, hyperglycemia appears to be associated to impaired vascular smooth muscle cell function and alterations in microvascular blood flow regulation.

RAT PIAL MICROVASCULAR CHANGES DURING CEREBRAL BLOOD FLOW DECREASE AND RECOVERY: EFFECTS OF CYANIDIN ADMINISTRATION

The reactive oxygen species (ROS) are known to play a major role in many pathophysiological conditions, such as ischemia and reperfusion injury. The present study was aimed to evaluate the in vivo cyanidin (anthocyanin) effects on damages induced by rat pial microvascular hypoperfusion-reperfusion injury by cerebral blood flow decrease (CBFD) and subsequent cerebral blood flow recovery (CBFR). In particular, the main purpose was to detect changes in ROS production after cyanidin administration. Rat pial microvasculature was investigated using fluorescence microscopy through a cranial window (closed); Strahlers method was utilized to define the geometric features of pial vessels. ROS production was investigated in vivo by 2′-7′-dichlorofluorescein-diacetate assay and neuronal damage was measured on isolated brain sections by 2,3,5-triphenyltetrazolium chloride staining. After 30 min of CBFD, induced by bilateral common carotid artery occlusion, and 60 min of CBFR, rats showed decrease of arteriolar diameter and capillary perfusion; furthermore, increase in microvascular leakage and leukocyte adhesion was observed. Conversely, cyanidin administration induced dose-related arteriolar dilation, reduction in microvascular permeability as well as leukocyte adhesion when compared to animals subjected to restriction of cerebral blood flow; moreover, capillary perfusion was protected. ROS generation increase and marked neuronal damage were detected in animals subjected to CBFD and CBFR. On the other hand, cyanidin was able to reduce ROS generation and neuronal damage. In conclusion, cyanidin treatment showed dose-related protective effects on rat pial microcirculation during CBFD and subsequent CBFR, inducing arteriolar dilation by nitric oxide release and inhibiting ROS formation, consequently preserving the blood brain barrier integrity.

Laser Speckle Imaging of Rat Pial Microvasculature during Hypoperfusion-Reperfusion Damage

The present study was aimed to in vivo assess the blood flow oscillatory patterns in rat pial microvessels during 30 min bilateral common carotid artery occlusion (BCCAO) and 60 min reperfusion by laser speckle imaging (LSI). Pial microcirculation was visualized by fluorescence microscopy. The blood flow oscillations of single microvessels were recorded by LSI; spectral analysis was performed by Wavelet transform. Under baseline conditions, arterioles and venules were characterized by blood flow oscillations in the frequency ranges 0.005–0.0095 Hz, 0.0095–0.021 Hz, 0.021–0.052 Hz, 0.052–0.150 Hz and 0.150–0.500 Hz. Arterioles showed oscillations with the highest spectral density when compared with venules. Moreover, the frequency components in the ranges 0.052–0.150 Hz and 0.150–0.500 were predominant in the arteriolar total power spectrum; while, the frequency component in the range 0.150–0.500 Hz showed the highest spectral density in venules. After 30 min BCCAO, the arteriolar spectral density decreased compared to baseline; moreover, the arteriolar frequency component in the range 0.052–0.150 Hz significantly decreased in percent spectral density, while the frequency component in the range 0.150–0.500 Hz significantly increased in percent spectral density. However, an increase in arteriolar spectral density was detected at 60 min reperfusion compared to BCCAO values; consequently, an increase in percent spectral density of the frequency component in the range 0.052–0.150 Hz was observed, while the percent spectral density of the frequency component in the range 0.150–0.500 Hz significantly decreased. The remaining frequency components did not significantly change during hypoperfusion and reperfusion. The changes in blood flow during hypoperfusion/reperfusion caused tissue damage in the cortex and striatum of all animals. In conclusion, our data demonstrate that the frequency component in the range 0.052–0.150 Hz, related to myogenic activity, was significantly impaired by hypoperfusion and reperfusion, affecting cerebral blood flow distribution and causing tissue damage.