Felipe Caamaño Navarrete

Efectos de un programa de tratamiento multidisciplinar en obesos mórbidos y obesos con comorbilidades candidatos a cirugía bariátrica

INTRODUCTION Morbid obesity is a disease that must be treated comprehensively (i.e. multi/interdisciplinary). Bariatric surgery is an effective and secure procedure for treating this health condition; however, the higher the weight is, the greater the risk of morbimortality might be. OBJECTIVE The aim of this study is to determine the effects of a multidisciplinary treatment program on metabolic and anthropometric parameters and the physical condition of bariatric surgery candidates. MATERIALS AND METHODS 1 man and 9 women of ~42.5 years old, with morbid obesity ( n = 3) or obesity and comorbilities (diabetes mellitus type II, hypertension, dyslipidemia and insulin resistance) (n = 7), all of them candidates for bariatric surgery, were submitted to physical exercise, psychological support and nutritional education, 3 times a week during 3 months. 72 hours before and after the last intervention session: body mass; fat mass index; BMI; waist circumference; physical condition; glycemia; HDL, LDL and total cholesterol; and triglycerides, were assessed (with a ≥12-hour fast). RESULTS After intervention, body mass (p=0.004), BMI (p=0.002), fat mass index (p=0.047) and physical condition (p=0.000) showed significant changes. Despite their tendency to decrease, remaining variables did not show significant changes. CONCLUSIONS A comprehensive reasonable-frequent, short intervention (i.e. 3 sessions per week, during 3 months) may lead to significant weight and body fat loss, apart from enhancing considerably the physical condition of candidates for bariatric surgery. Longer time and/ or higher frequency in interventions might be necessary in order to modify significantly plasmatic variables.

NIVELES DE OBESIDAD, GLICEMIA EN AYUNO Y CONDICIÓN FÍSICA EN ESCOLARES CHILENOS

BACKGROUND Chile has drastically altered eating patterns and physical activity. The main nutritional problem faced by Chilean society is overweight, which arises progressively from an early age. The aim of this study is to determine the nutritional status and compare fitness levels and fasting glucose in students. PATIENTS AND METHODS A descriptive cross-sectional comparative study was conducted, making a comparison by gender and nutritional status, with 100 students (56 men and 44 women) aged 12-15 years old. Body composition, fasting glucose and fitness were evaluated. RESULTS Women had a higher prevalence of overweight and obesity than men (22.73% and 19.65%). In the comparison of gender differences statistics were reported in one repetition maximum (1RM) (p = 0.001), abdominal strength (p = 0.004) and velocity (p = 0.001), there were no significant differences in body mass index (BMI) (p = 0.24) and fasting glucose (p = 0.99). In the comparison of nutritional status, the students classified as obese had a higher waist perimeter (p = 0.001), more time to walk 400 m (p = 0.008). There were no significant differences in other variables. CONCLUSIONS Women have a higher prevalence of overweight and obesity than men. Obese students have a waist circumference more elevated, more time to walk 400 meters (p = <0.05) and they have increased levels of basal glucose.

Doce semanas de ejercicio físico intervalado con sobrecarga mejora las variables antropométricas de obesos mórbidos y obesos con comorbilidades postulantes a cirugía bariátrica

INTRODUCTION for the morbid obesity the bariatric surgery is effective, but to major preoperative weight it might increase morbidity and mortality, for such a motive it is necessary to implement programs that improve this condition. OBJECTIVE to determine the effects of a program of physical exercise interval on the anthropometric profile of the morbidly obese and obese with comorbidities candidates to bariatric surgery. MATERIAL AND METHODS three men and twenty-five women between 18 and 60 years old candidates to bariatric surgery, with morbid obesity (n = 16) or obese and comorbidities (type-II diabetes mellitus, hypertension, dyslipidemia, insulin resistance) (n = 12), they were subjected to a program of physical exercise with interval overload of three months duration (36 sessions). Before and 72 hours after the last intervention session was evaluated on fasting (≥ 12 hours): body weight, body mass index (BMI), waist contour (WC) and contour hip. RESULTS the average age corresponds to 36.96 years, prior to intervention the weight had an average of 102.66 ± 15.96 kg, BMI of 40.84 ± 4.94, the WC 114.22 ± 10.35 cm and the contour hip 126.84 ± 10.65 cm. After twelve weeks of intervention showed significant decreases in weight variables (p = 0.000), BMI (p = 0.001), WC (p = 0.000) and hip contour (0.000). CONCLUSIONS twelve weeks of interval exercise improved preoperative anthropometric conditions, without presenting risks in health and with high adherence to the program, which is why it may be recommended for this type of treatment.

Insatisfacción con la imagen corporal y su relación con el estado nutricional, riesgo cardiometabólico y capacidad cardiorrespiratoria en niños pertenecientes a centros educativos públicos

INTRODUCTION The increase in abdominal fat and excess weight are related to dissatisfaction with body image, which nowadays is highly prevalent nationally and internationally. AIM The purpose of the study was to relate dissatisfaction levels to body image, nutritional status, cardiometabolic risk and cardiorespiratory capacity in pre-adolescent students. MATERIAL AND METHODS Three hundred and thirty-nine students participated in the study, 165 girls (11.29 ± 0.69 years) and 174 boys (11.22 ± 0.72 years). Anthropometric data were collected: BMI, percentage of body fat (%BF), waist circumference (WC), height-to-weight ratio (HWR), VO2max and body image. RESULTS In the comparison by sex, we found higher V02max values in boys (p < 0.001). No significant differences were found for the variables BMI, WC, HWR, blood pressure and body image (p > 0.05); 27.7% of the study sample were overweight and 29.2% were obese. The subjects with obesity had the lowest VO2max levels. Dissatisfaction with body image was found to be associated with nutritional status (p < 0.001). In addition, 8.1% of the obese students presented extreme dissatisfaction with their body image and 19.4% of the children with cardiometabolic risk exhibited some type of dissatisfaction; the two variables were related (p = 0.008). CONCLUSIONS The study provides evidence that children with malnutrition by excess present disorders associated with body dissatisfaction and other health indicators that limit integral growth in pre-adolescence.

Variaciones en el estado nutricional, presión arterial y capacidad cardiorrespiratoria de obesos candidatos a cirugía bariátrica: beneficios del ejercicio físico con apoyo multidisciplinar

la obesidad mórbida disminuye considerablemente la esperanza y la calidad de vida. el objetivo del estudio fue determinar los efectos del ejercicio físico con apoyo multidisciplinar sobre el estado nutricional, la capacidad cardiorrespiratoria y la presión arterial de obesos mórbidos candidatos a cirugía a bariátrica. doce mujeres y un hombre entre 18 y 60 años candidatos a cirugía bariátrica, 10 con obesidad mórbida y 3 con obesidad y comorbilidades, fueron sometidos a un programa de ejercicio físico con educación nutricional y apoyo psicológico durante 5 meses. Peso corporal, índice de masa corporal (IMC), contorno de cintura (CC), capacidad cardiorrespiratoria, presión arterial sistólica y diastólica fueron evaluados antes y posterior a la intervención. el promedio de edad de los participantes de la investigación fue de 49,92 años, el de altura fue 1,62 m. Todas las variables de estudio mejoraron significativamente (p < 0,05): peso (p = 0,000), IMC (p = 0,000), CC (p = 0,005), capacidad cardiorrespiratoria (p = 0,009), presión sistólica (p = 0,006) y presión arterial diastólica (p = 0,010). La capacidad cardiorrespiratoria aumentó un 9,17%, la presión arterial diastólica y sistólica disminuyeron 5,16% y 7,68% respectivamente. El IMC disminuyó un 8,39% y el CC un 6,63%. el programa mejoró los niveles de presión arterial sistólica y diastólica y la capacidad cardiorrespiratoria, esto se vio complementado por la pérdida de peso significativa en los participantes de esta investigación. El ejercicio físico con apoyo multidisciplinar demuestra beneficios para el tratamiento preoperatorio produciendo adaptaciones favorables en los factores de riesgo cardiovascular.