Mariana Laitano Dias de Castro

Obesity coexists with malnutrition? adequacy of food consumption by severely obese patients to dietary reference intake recommendations

To assess the adequacy of food intake in severely obese patients and describe their main nutritional deficiencies on the basis of Dietary Reference Intakes (DRIs). Patients on a waiting list for bariatric surgery were sequentially recruited from March 2010 to November 2011. All subjects underwent nutritional status assessment (anthropometry, dietary recall and semi-structured interview), socioeconomic evaluation (Brazilian Association of Research Companies criteria) and laboratory testing (glucose/hormone/lipid panel). A total of 77 patients were assessed, 50 of whom (76.6%) were female. Mean age was 44.48 ± 12.55 years. The most common comorbidities were hypertension (72.4%), binge eating disorder (47.4%), type 2 diabetes mellitus (32.9%), sleep apnea (30.3%) and dyslipidemia (18.4%). Macronutrient intake was largely adequate, in view of the high calorie intake. However, some micronutrient deficiencies were present. Only 19.5% of patients had an adequate intake of potassium, 26.0% of calcium, and 66.2% of iron. All subjects consumed more than the minimum recommended intake of sodium, with 98.7% reaching the upper limit. Bcomplex vitamin intake was satisfactory (adequate in >80% of subjects), but lipid-soluble vitamin (A, D, E) intake often fell short of the RDI. The diet of severely obese patients is unbalanced, with high calorie intake paralleled by insufficient micronutrient intake. When these patients are assessed and managed, qualitative dietary changes should be considered in addition to routine caloric restriction.

Food consumption in patients referred for bariatric surgery with and without binge eating disorder.

INTRODUCTION The prevalence of Binge Eating Disorder (BED) is high in obese patients referred to bariatric surgery. Although the total energy intake is increased, the risk of nutritional deficiencies in these patients is unknown. This study proposes to evaluate and compare the intakes of candidate patients for bariatric surgery with and without BED, using for this purpose the Dietary Reference Intakes. METHODS 116 patients referred for bariatric surgery were submitted to nutritional, laboratory and psychological assessments. RESULTS Among the patients, 46.6% had BED, of these, 25.9% had the severe form. The patients with current depression (31.9%) were more compulsive than those without depression (p < 0.001). The mean age was significantly higher in patients without BED (46.94 ± 12.05 vs 42.32 ± 10.60, p = 0.030). The only difference in anthropometric parameters individuals with and without BED was the mid-upper arm circumference (P = 0.047). The percentage of energy from carbohydrates was higher in patients with BED (53.78%) than without BED (48.88%) (U = 1222, P = 0.018, r = − 0.22). The percentage from total fat (13.63% versus 12.89%, U = 1201.0, P = 0.019, r = − 0.22) and from saturated fat (9.04% versus 8.15%, U = 1074.0, P = 0.023, r = − 0.21), was higher in patients without BED. When adjusted for the body weight of patients, these differences were not significant. CONCLUSION Patients with BED eat more carbohydrates and have larger mid-upper arm circumference in the face of similar body weight, suggesting a higher percentage of fat mass.

Polimorfismo Ala54Thr do gene fatty acid-binding protein-2 (FABP-2): uma revisão bibliográfica

O polimorfismo p.Ala54Thr (rs1799883) do gene fatty acid-binding protein-2 ( FABP2 ) tem associacao com resistencia insulinica, sindrome metabolica e obesidade. A hipotese e de que o alelo mutante aumente a absorcao de acidos graxos intestinais, a concentracao lipidica plasmatica e a oxidacao de gordura. Assim, o objetivo deste trabalho foi revisar o papel do polimorfismo p.Ala54Thr do gene FABP-2 na obesidade. A busca da literatura foi realizada na base de dados MEDLINE, atraves do PubMed e no Portal de Periodicos de Aperfeicoamento de Pessoal de Nivel Superior (Capes) com termos relacionados com o polimorfismo e obesidade. Parece nao haver uma associacao significativa da presenca do alelo Thr54 com obesidade, apesar de ser uma doenca complexa e que possivelmente nao tenha sido captada por estudos de associacao; diferente do colesterol total e lipoproteina de baixa densidade ( low density level cholesterol , LDL-c), maior nos portadores do alelo Thr54. Alteracoes de adipocitocinas devem estar associadas a estas diferencas de perfil lipidico.

FTO polymorphism (RS9939609) and BED in patients with morbid obesity for evaluation towards bariatric surgery.

Background Obesity is a major health problem in the twenty-first century. Recent research shows that, among people with severe obesity, there is a sub-population that does not respond to behavioral treatment for weight loss. This group presents a type of eating disorder known as Binge Eating Disorder (BED). Recent studies indicate a link between obesity in adults and the rs9939609 polymorphism of the FTO gene. A frequent association of obesity and BED has also been found. Variations in the gene, including the rs9939609 polymorphism, have been associated with obesity and diabetes.

The role of fat mass and obesity associated gene (fto) in satiety and binge eating disorder

Obesity is a major health problem and one of the biggest predictors of the development of chronic diseases. Variations in the Fat mass and obesity associated gene (FTO) have been shown to associate strongly with obesity. Among patients with severe obesity, there is a subpopulation that presents an eating disorder known as Binge Eating Disorder. Because of its expression in the hypothalamus, FTO could be associated with modulation of satiety and, perhaps, play a role in the genesis of BED, contributing to severe obesity. A search in PubMed was carried out with the following terms: Morbid Obesity AND FTO, FTO AND Satiety Response, Binge Eating Disorder AND FTO. No restriction on the date of publication, language or type of design was applied. Sixteen articles were found. Twelve were related to FTO and grade III obesity, and three were related to FTO and satiety. Ten studies were excluded. Thus, six articles were evaluated in this review. The scarce literature limits further conclusions about the potential impact of the associations with FTO in the treatment of obesity, but all articles included in this revision show association with at least one SNP of FTO. Further studies are required to clarify these associations, especially in relation to rs9939609 (A/T), because, up to this moment, it seems to be the one variant with greatest impact on obesity in humans.