Francesca Pasqui

Stress-related Development of Obesity and Cortisol in Women

Chronic exposure to environmental stress may play a role in the development of obesity, through hyperactivation of the hypothalamic–pituitary–adrenocortical (HPA) axis. This study investigated the dynamics of weight gain and the activity of the HPA axis in women who developed weight gain after a stressful event. This is a case–control retrospective study. Two groups of age‐matched premenopausal women were selected. One (n = 14) included women characterized by a rapid weight gain following a stressful event, defined as the “stress‐related obesity” (SRO) group, and the other (n = 21) women with nonstress‐related development of obesity, defined as the “nonstress‐related obesity” (NSRO) group. Twenty‐one healthy premenopausal women served as normal‐weight controls. Baseline hormonal and metabolic parameters, and 24‐h urinary free cortisol (UFC/24 h) excretion rate (as a measure of HPA‐axis activity) were measured in all women. Anthropometry, diet, and physical activity were similar in both obese groups. Both obese groups showed similar metabolic and hormonal profiles, but the SRO group had UFC/24 h values (41.1 ± 14.3 µg) significantly higher (P < 0.001) with respect to the NSRO (26.6 ± 17.6 µg) or the normal‐weight control groups (21.1 ± 9.8 µg). Moreover, time (years) to achieve maximum Δweight gain (kg) and the Δweight gain/time ratio were significantly shorter (P < 0.001) and higher (P < 0.001) in the SRO group with respect to the NSRO group, respectively. In the SRO group, there was a tendency to a significant correlation between UFC/24 h and the Δweight gain/time ratio. These findings support the concept that SRO has distinct pathophysiological mechanisms, including hyperactivity of the HPA axis.

Is the Mediterranean lifestyle still a reality? Evaluation of food consumption and energy expenditure in Italian and Spanish university students

OBJECTIVE To evaluate the correspondence of diet and lifestyle to the Mediterranean model in two groups of Italian and Spanish university students. DESIGN A cross-sectional nutritional survey to determine BMI, dietary habits (FFQ), energy daily expenditure and lifestyle (SenseWear Armband; BodyMedia Inc.), and to define the Mediterranean diet quality index (MDQI) in the different student groups. SETTING Bologna (Italy) and León (Spain). SUBJECTS The survey was carried out on 210 (105 Italian; 105 Spanish) university students (mean age 27.0 (sd 3.8) years) of two different Mediterranean areas, Bologna (Italy) and León (Spain). RESULTS The frequency of consumption of some food groups showed differences related to nationality and gender. Some classic Mediterranean foods such as cereals and vegetables were generally consumed more frequently by Italian students; others such as fish and pulses by Spanish students. Percentage of overweight was higher among Spanish students in spite of their higher physical activity level. CONCLUSION Young generations seem to give up the traditional Mediterranean dietary pattern, adopting new dietary trends. Overweight appears to be related not only to physical activity level, but also to the poor MDQI.

Circulating obestatin levels and the ghrelin/obestatin ratio in obese women

OBJECTIVE We measured blood levels of obestatin, total ghrelin, and the ghrelin/obestatin ratio and their relationship with anthropometric and metabolic parameters, adiponectin and insulin resistance, in overweight/obese and normal-weight women. DESIGN Outpatients Unit of Endocrinology of the S Orsola-Malpighi Hospital of Bologna, Italy. METHODS Fasting obestatin, ghrelin, adiponectin and lipid levels, fasting and glucose-stimulated oral glucose tolerance test insulin, and glucose levels were measured in 20 overweight/obese and 12 controls. The fasting ghrelin/obestatin ratio was calculated; the homeostasis model assessment-IR (HOMA-IR) and insulin sensitivity index (ISI(composite)) were calculated as indices of insulin resistance. RESULTS Obese women had higher obestatin and lower ghrelin blood levels, and a lower ghrelin/obestatin ratio compared with controls. In all subjects, obestatin was significantly and positively correlated with total cholesterol and triglycerides, but not with ghrelin, anthropometric, and metabolic parameters. In the obese women, however, obestatin and ghrelin concentrations were positively correlated. By contrast, the ghrelin/obestatin ratio was significantly and negatively correlated with body mass index, waist, waist-to-hip ratio, fasting insulin, and HOMA-IR, and positively with ISI(composite) but not with adiponectin. None of these parameters were correlated with the ghrelin/obestatin ratio in the obese. CONCLUSIONS Increased obestatin, decreased ghrelin levels, and a decreased ghrelin/obestatin ratio characterize obesity in women. This supports the hypothesis that the imbalance of ghrelin and obestatin may have a role in the pathophysiology of obesity. On the other hand, some relevant differences between our data on circulating levels of obestatin and the ghrelin/obestatin ratio in obese subjects and those reported in the few studies published so far imply that further research is needed.

Dietary habits and their relationship with hormones and metabolism in overweight and obese women with polycystic ovary syndrome

This study investigates energy intake, macronutrient composition and habitual food choices in overweight/obese women with polycystic ovary syndrome (PCOS) and controls similar for age and body mass index (BMI), and their relationship with hormonal and metabolic parameters.

Dietary Selenium for the counteraction of oxidative damage: fortified foods or supplements?

Since any significant modification in the Se status, leading to changes in the activity of the seleno-enzymes, may have important consequences on the susceptibility of tissues to oxidative stress, considerable efforts have been made upon increasing Se dietary intake. In this respect, an important debate is still open about the bioavailability and the effectiveness of Se, and more generally nutrients, in supplements compared with foods. Using male Wistar rats, we have compared the effectiveness of two different diets in which an adequate Se content (0.1 mg/kg) was achieved by adding the element as sodium selenite or as component of a lyophilized Se-enriched food, in the counteraction of an oxidative stress induced by intraperitoneal administration of adriamycin. Both Se-enriched diets were able to reduce the consequences of the oxidative stress in liver, mainly by increasing glutathione peroxidase activity. This increase was more evident in rats fed on the diet enriched with the lyophilized food, probably due to the different chemical forms of Se, or to other components of the food itself. Although further studies are needed, data herein presented may contribute to the characterization of the effectiveness of Se from different sources, foods or supplements, in the light of dietary advice to the population concerning improvement of Se intake.

Cortisol, energy intake, and food frequency in overweight/obese women.

OBJECTIVE This retrospective study investigated the relation between daily urinary free cortisol excretion rate, as a marker of cortisol production rate, to daily caloric intake, food choice, body mass index (BMI), and waist circumference. METHODS One hundred twenty-seven overweight/obese women and 21 normal-weight subjects were enrolled in the study. Fasting blood samples for metabolic parameters were taken from each subject, followed by an oral glucose tolerance test. Cortisol excretion rate was assessed on 24-h urine collection (UFC/24 h). In obese patients, the daily caloric intake was calculated, and a weekly food-frequency questionnaire was assessed. Analysis of variance was used to assess the differences between groups. The relations between parameters were investigated by simple and multiple regressions. RESULTS Obese women had significantly higher UFC/24 h than the normal-weight women (P < 0.001). The obese subjects had an unbalanced diet, particularly rich in saturated lipids, and weekly food choice showed a preference for highly caloric foods. UFC/24 h values and waist circumference were significantly correlated (P < 0.001), regardless of BMI. In the obese group, after adjustment for BMI, the UFC/24 h values were also significantly and positively correlated to daily carbohydrate and lipid intake and to weekly starchy food consumption. CONCLUSION We demonstrated a significant association between higher UFC/24 h and energy intake, fats, and consumption of starchy foods, and that these relations were independent of BMI.

Plasma antioxidant enzymes and clastogenic factors as possible biomarkers of colorectal cancer risk

Oxidative damage plays an important role in the pathogenesis of colorectal (CR) cancer. This study investigated the activities of antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), glutathione reductase (GR), and glutathione-S-transferase (GST) in plasma of 82 participants of a screening program for CR cancer prevention (30 females and 52 males; age 50-70 years). All subjects resulted positive to fecal occult blood test and were subsequently classified, according to the colonoscopy and histological findings, in patients with CR cancer, patients with colorectal polyps or controls. Furthermore, the activity of clastogenic factors (CFs) in plasma from study population was measured as the ability of inducing micronuclei (MN) in vitro in peripheral of a healthy donor. CAT and GR activities were significantly lower in CR cancer patients compared to controls (P<0.05) and polyps groups (P<0.05). SOD activity was significantly higher in patients with CR cancer than in polyp (P<0.05) and control (P<0.05) groups. GST activity was not significantly different in plasma of the three groups. An increase of CFs induction was observed in plasma of CR cancer patients (MN: 8.89±3.42) with respect to control (MN: 6.37±0.96 P<0.05). These results can contribute to define plasma biomarkers associated to oxidative stress damage that could predictive of CR cancer risk.

Relationships between iodothyronine peripheral metabolism and ketone bodies during hypocaloric dietary manipulations

Relationships between iodothyronine and metabolic substrate metabolism during undernutrition were evaluated in four normal subjects who fasted for 48h (Group I) and in four groups (II to V) of obese patients who underwent selective dietary manipulations: 360 calories [carbohydrate (CHO) 40 g/day]; 800 calories containing respectively 19 g/day — ketogenic — (K) and 112 g/day — non ketogenic — (NK) of CHO; and a step-diet programme (during which total calories were progressively reduced from 2500 to 500). Serum T3 levels decreased significantly and constantly during fasting, 360 and 800 K studies, and transiently during the 800 NK diet. During the step-diet programme, a significant fall was found only when 1250 K or less were given. Conversely, serum reverse T3 rose significantly and constantly during 360 and 800 K diets, while a transient increase was found during the 800 NK diet. During the step-diet programme reverse T3 rose only when 750 calories were given. Ketogenesis developed in all studies but one (800 NK), and in the step-diet programme significantly below the 1000 calorie step. Other substrate modifications in each study were also evaluated. Serum T3 levels showed a significant correlation with ketone bodies (KB) in all the ketogenic studies, while no correlation was found in non ketogenic study (800 NK). During the step-diet programme ketone bodies and iodothyronine modifications appeared to be related to the amount of calories. Based on these results, we suggest a relationship between the dietary-induced modifications of iodothyronine metabolism and the development of ketogenesis.

Non-invasive diagnostic approach to non-alcoholic fatty liver disease: current evidence and future perspectives

Non-alcoholic fatty liver disease is a new epidemic liver disease, thus, its early diagnosis and the identification of those patients with the worst prognosis is mandatory. Liver biopsy is still the diagnostic gold standard, even if it is associated to a significant rate of complications; moreover, the interpretation of histological samples is not always univocal. Several non-invasive alternative scores have been proposed for the diagnostic approach to non-alcoholic fatty liver disease. This article evaluates the performance of the currently available non-invasive diagnostic strategies. The authors also suggest a potential diagnostic algorithm, with two or more non-invasive techniques, to increase the overall accuracy for identifying patients with worst prognosis, and to minimize the recourse to liver biopsy.

Dietary habits and related psychological and social factors: influence on the body weight of elementary school children.

This article studies the alimentary habits of children in relation to their body mass index (BMI) and food preferences, and to underline the influences of cultural and social aspects. The investigation tested 198 children (90 male and 108 female) from Cento (Ferrara), using food frequency questionnaires that were completed by the children. Subjects were subdivided into three groups based on their BMI—normal weight, overweight and underweight—taking into consideration their food frequency and preferences. The correlations between the BMI of children, mothers geographic origin and cultural level revealed differences between boys and girls. The variability of results does not allow precise correlations to be made between food frequency and childrens weight, psychological and social aspects. Some incorrect dietary habits were revealed in the overweight and underweight groups. These could be controlled for and corrected by an alimentary education programme.