Healthy Normal-weight Subjects Research Articles

Serum levels of adiponectin differentiate generalized lipodystrophies from anorexia nervosa.

The differential diagnosis of lipodystrophy involves other disorders characterized by severe fat loss and may be sometimes challenging. Owing to the rarity of lipodystrophy, it is relevant to search for tools and assays that differentiate it from other diseases that may mimic it. We conducted a study on leptin and high molecular weight (HMW) adiponectin serum concentrations in a series of patients diagnosed with lipodystrophy and compared them with those found in anorexia nervosa, one of the illnesses that may be cause of a missed diagnosis of lipodystrophy. Leptin and HMW adiponectin serum concentrations were measured in six patients diagnosed with generalized lipodystrophy (GL), six with progeroid syndromes (PS), 13 with familial partial lipodystrophy type 1 (FPLD1, Kobberling syndrome), 10 with familial partial lipodystrophy type 2 (FPLD2, Dunnigan syndrome), 18 with acquired partial lipodystrophy (APL) and 12 affected by anorexia nervosa (AN). Measurements were compared to those obtained in 12 normal weight healthy subjects. Serum leptin concentrations were reduced to a similar degree in GL, PS and AN, proportionally to the extent of fat loss. Serum concentrations of HMW adiponectin were found extremely low in patients with GL and PS, while comparable to normal weight subjects in patients with AN. Serum HMW adiponectin can be regarded as a useful tool to discriminate between generalized lipodystrophy syndromes (including PS) and AN.

Comparison of selected lipid parameters in young subjectswith normal weight and overweight

<br><b>Introduction:</b> Dyslipidemia is currently the most common risk factor for cardiovascular disease.Population-based studies have confirmed a relationship between dyslipidemia and overweightand obesity, resulting from the pro-inflammatory activity of excessive adipose tissue.</br><br><b>Aim:</b> The aim of study was to compare selected lipid parameters and the prevalence of dyslipidemiain young, healthy normal-weight and overweight subjects.</br><br><b>Material and methods:</b> Study included 60 individuals aged 25-40 years, non-smokers, withnormal fasting blood glucose. The group was divided by BMI value. In all subjects fasting plasmaglucose, TC, TG, HDL-C, apolipoprotein AI and B were measured and the values of LDL-C,non-HDL-C concentrations.</br><br><b>Results:</b> In overweight subjects, higher concentrations of TC, TG, LDL-C, apoB, non-HDL-C andTG:HDL-C were found than in normal weight individuals. In the overweight group, positive correlationswere observed between WHR and TC, waist circumference and non-HDL-C. In normalweight subjects, positive correlations were found between BMI and TC, waist circumferenceand TG. Over 46% of the subjects had hypercholesterolemia, and over 50% had elevated LDL-Clevels. Increased incidence of hypertriglyceridemia, elevated apoB were observed in overweightsubjects, compared to the normal weight.</br><br><b>Conclusions:</b> The prevalence of dyslipidemia is higher in overweight and abdominally obesesubjects, which indicates a higher risk of cardiovascular disease in this group. However, due tothe limitations of the study, primarily the small study group, the results require confirmation ina large population-based study.</br>

Relationship between meteorin-like peptide (Metrnl) serum levels and inflammatory cytokines, oxidative stress biomarkers and body composition parameters in type 2 diabetes patients

PurposeMeteorin like-peptide (Metrnl) modulates energy hemostasis and relieves inflammation and oxidative stress. This study aims to investigate the relationship between Metrnl levels and inflammatory cytokines, oxidative stress biomarkers and body composition parameters in obese type 2 diabetic patients.Design/methodology/approachThis analytical cross-sectional study was carried out between August 2020 and March 2021on 93 people (n = 32 obese type 2 diabetic patients, n = 31 healthy obese, n = 30 healthy normal weight). Serum Metrnl levels were measured by enzyme-linked immunosorbent assay. Serum levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), high-sensitivity C-reactive protein (hs-CRP), malondialdehyde and total antioxidant capacity were measured using standard methods. Body composition was assessed by bioelectrical impedance analysis. p-Value less than 0.05 was considered significant.FindingsSerum Metrnl levels were lower in obese diabetic patients than in healthy normal-weight subjects (82.5 [72.4–94.5] ng/mL compared to 154 [129–189] ng/mL). The difference in Metrnl levels between the two groups was significant (p < 0.001). The difference in Metrnl levels between the two groups was significant. Moreover, a significant correlation between Metrnl level and both TNF-a and hs-CRP was detected (p = 0.006 and p < 0.001, respectively) and the correlation between Metrnl and IL-6 was borderline (p = 0.051). A negative correlation was revealed between Metrnl level and anthropometric measurements and body composition (p < 0.05) with the exception of fat-free mass and skeletal muscle mass.Originality/valueTo discover sufficient evidence for the therapeutic function of Metrnl and its use as a prognostic biomarker in the management of type 2 diabetes mellitus, future clinical studies are needed to highlight other factors influencing Metrnl serum levels.

SenseHunger: Machine Learning Approach to Hunger Detection Using Wearable Sensors.

The perception of hunger and satiety is of great importance to maintaining a healthy body weight and avoiding chronic diseases such as obesity, underweight, or deficiency syndromes due to malnutrition. There are a number of disease patterns, characterized by a chronic loss of this perception. To our best knowledge, hunger and satiety cannot be classified using non-invasive measurements. Aiming to develop an objective classification system, this paper presents a multimodal sensory system using associated signal processing and pattern recognition methods for hunger and satiety detection based on non-invasive monitoring. We used an Empatica E4 smartwatch, a RespiBan wearable device, and JINS MEME smart glasses to capture physiological signals from five healthy normal weight subjects inactively sitting on a chair in a state of hunger and satiety. After pre-processing the signals, we compared different feature extraction approaches, either based on manual feature engineering or deep feature learning. Comparative experiments were carried out to determine the most appropriate sensor channel, device, and classifier to reliably discriminate between hunger and satiety states. Our experiments showed that the most discriminative features come from three specific sensor modalities: Electrodermal Activity (EDA), infrared Thermopile (Tmp), and Blood Volume Pulse (BVP).

Reduced leukocyte mitochondrial copy number in metabolic syndrome and metabolically healthy obesity.

ObjectiveThis study aimed to investigate the associations between peripheral blood leukocyte mitochondrial copy number, metabolic syndrome, and adiposity-related body composition phenotypes in a high prevalence population.MethodsA single center cross-sectional study was conducted, consisting of 521 middle-aged subjects of Maltese-Caucasian ethnicity. Participants were stratified according to the presence of metabolic syndrome and different metabolic health definitions based on NCEP-ATP III criteria. Relative leukocyte mitochondrial DNA copy number was determined by quantitative polymerase chain reaction and corrected for leukocyte and platelet count. The associations between mitochondrial copy number and metabolic syndrome components was evaluated and adjusted for age and gender.ResultsSignificant negative correlations between mtDNA copy number and BMI, waist circumference, triglyceride levels, fasting plasma glucose, HbA1c, HOMA-IR and hsCRP were observed, along with a positive correlation with HDL-C levels. Mitochondrial copy number was lower in individuals with metabolic syndrome. When compared to metabolically healthy normal weight subjects, a reduction in mtDNA copy number was observed in both the metabolically healthy and unhealthy obese categories.ConclusionOur data supports the association between reduced leukocyte mtDNA copy number, obesity, and metabolic syndrome. This investigation expands on the spectrum of associations between mtDNA copy number and metabolic phenotypes in different populations and underpins the role of mitochondrial dysfunction in the development and progression of metabolic syndrome and its components.

The Cardiovascular Disease (CVD) Risk Continuum from Prenatal Life to Adulthood: A Literature Review.

The risk of developing cardiovascular diseases (CVDs) arises from the interaction of prenatal factors; epigenetic regulation; neonatal factors; and factors that affect childhood and adolescence, such as early adiposity rebound (AR) and social and environmental influences. Thus, CVD risk varies between the group of low-risk metabolically healthy normal-weight subjects (MHNW); the intermediate-risk group, which includes metabolically healthy obese (MHO) and metabolically unhealthy normal-weight subjects (MUHNW); and the high-risk group of metabolically unhealthy obese (MUHO) subjects. In this continuum, several risk factors come into play and contribute to endothelial damage, vascular and myocardial remodeling, and atherosclerotic processes. These pathologies can occur both in prenatal life and in early childhood and contribute to significantly increasing CVD risk in young adults over time. Early intervention in the pediatric MUHO population to reduce the CVD risk during adulthood remains a challenge. In this review, we focus on CVD risk factors arising at different stages of life by performing a search of the recent literature. It is urgent to focus on preventive or early therapeutic strategies to stop this disturbing negative metabolic trend, which manifests as a continuum from prenatal life to adulthood.

Relationship between Olfactory Function and BMI in Normal Weight Healthy Subjects and Patients with Overweight or Obesity.

Smell plays a critical role in food choice and intake by influencing energy balance and body weight. Malnutrition problems or modified eating behaviors have been associated with olfactory impairment or loss. The obesity epidemic is a serious health problem associated with an increased risk of mortality and major physical comorbidities. The etiopathogenesis of obesity is complex and multifactorial, and one of the main factors contributing to the rapid increase in its incidence is the environment in which we live, which encourages the overconsumption of foods rich in energy, such as saturated fats and sugars. By means of the “Sniffin’ Sticks” test, we measured the olfactory threshold, discrimination and identification score (TDI score) in patients of the Obesity Center of the University Hospital (OC; n = 70) and we compared them with that of healthy normal weight controls (HC; n = 65). OC patients demonstrated a significantly lower olfactory function than HC subjects both general and specific for the ability to discriminate and identify odors, even when they were considered separately as females and males. For OC patients, a negative correlation was found between body mass index (BMI) and olfactory scores obtained by each subject, both when they were divided according to gender and when they were considered all together. Besides, normosmic OC patients showed a significantly lower BMI than hyposmic ones. A reduced sense of smell may contribute to obesity involving the responses of the cephalic phase, with a delay in the achievement of satiety and an excessive intake of high-energy foods and drinks.

Association between rs738409 and rs2896019 single-nucleotide polymorphisms of phospholipase domain-containing protein 3 and susceptibility to nonalcoholic fatty liver disease in Greek children and adolescents.

BackgroundSeveral studies have detected a strong association linking rs738409 and rs2896019 polymorphisms in the patatin-like phospholipase domain-containing protein 3 (PNPLA3) gene with hepatic steatosis and steatohepatitis. In the present study we aimed to determine the association of those PNPLA3 variants with nonalcoholic fatty liver disease (NAFLD) susceptibility in obese and nonobese Greek children and adolescents.MethodsThe study recruited 91 children and adolescents of Greek descent with NAFLD or biopsy-proven nonalcoholic steatohepatitis, and 91 healthy subjects of normal weight (control group) with sex distribution similar to the patient group. DNA samples were amplified using polymerase chain reaction with specifically designed primers. Data were analyzed using the statistical software SPSS version 24.0.ResultsA significant correlation was shown between the rs738409 polymorphism (CG and GG genotypes) and the rs2896019 polymorphism (TG genotype) with the development of hepatic steatosis (P<0.001). The incidences of rs738409 GG, rs738409 CG and rs2896019 TG genotypes were found to be increased in patients with hepatic steatosis (obese and nonobese), but not in obese patients without liver disease. The combined expression of the 2 polymorphisms was associated with a lower age of diagnosis of hepatic steatosis in nonobese patients.ConclusionsWe confirmed a strong association between the 2 polymorphisms and hepatic steatosis. The association of the rs2896019 single-nucleotide polymorphism with hepatic steatosis in obese and nonobese pediatric patients, and the combined study of both polymorphisms in a pediatric population of Greek origin are described for the first time.

Comparison of the Incidence of Cardiovascular Diseases in Weight Groups with Healthy and Unhealthy Metabolism.

BackgroundWe aimed to identify the relationship between metabolically healthy obesity (MHO), a special subtype of obesity, and the incidence of cardiovascular disease (CVD) in rural Xinjiang.MethodsBody mass index (BMI) and the Joint Interim Statement criteria were utilized to define obesity and metabolic status, respectively. A baseline survey was conducted between 2010 and 2012. The cohort was followed-up until 2017, including 5059 participants (2953 Uyghurs and 2106 Kazakhs) in the analysis.ResultsDuring 6.78 years of follow-up, 471 individuals developed CVD, 10.8% (n=545) of whom were obese, and the prevalence of MHO and MHNW was 5.2% and 54.5%, respectively. Compared with metabolically healthy normal weight subjects, the subjects with MHO had an increased risk of CVD (hazard ratio [HR]=1.76, 95% confidence interval [CI]: 1.23−2.51), while the metabolically unhealthy obesity (MUO) group had an even higher risk (HR=3.80, 95% CI: 2.87−5.03). Additionally, there were sex differences in the relationship between BMI-metabolic status and incident CVD (Pinteraction =0.027). Compared with the subjects with MHO, those with MUO had an increased risk of CVD (HR=1.84, 95% CI: 1.26−2.71).ConclusionMHO was associated with a high risk of CVD among adults in rural Xinjiang. In each BMI category, metabolically unhealthy subjects had a higher risk of developing CVD than did metabolically healthy subjects.

Acanthosis Nigricans in Children and Adolescents with Type 1 Diabetes or Obesity: The Potential Interplay Role between Insulin Resistance and Excess Weight.

Acanthosis nigricans (AN) is associated with obesity and type 2 diabetes, where insulin resistance (IR) is considered a predisposing factor. IR can also affect patients with type 1 diabetes (T1D). We evaluated the prevalence of AN in patients with T1D compared to subjects with obesity in order to define the interplay between IR and excess weight. We considered 138 pediatric patients who presented with T1D and 162 with obesity. As controls, 100 healthy normal-weight subjects were included. A physical examination with the detection of AN and biochemical assessments was performed. IR was calculated by using the homeostasis model assessment for IR in patients with obesity and the estimated glucose disposal rate in T1D. The AN prevalence was higher in T1D and obese subjects compared with controls in whom AN was not detected (p = 0.02 and p < 0.001, respectively). A greater number of AN cases were observed in subjects with obesity compared with T1D (p < 0.001). Patients with AN were older than subjects without AN (p = 0.005), and they had higher body mass index (BMI) values, waist circumference (WC), fasting triglycerides and blood pressure (all p < 0.001). Thirty-five patients with AN exhibited IR with an association between AN presence and IR in patients with obesity (p < 0.001). In T1D, there was an association between AN and being overweight/obese (p = 0.02), independently of IR. AN is a dermatological condition associated with obesity. In T1D, the presence of AN was significantly associated with overweight status or obesity but not IR. The presence of AN in the absence of IR supports the interplay role between impaired insulin signaling, IR and excess weight in the pathogenic mechanism.

Serum Metabolites Responding in a Dose-Dependent Manner to the Intake of a High-Fat Meal in Normal Weight Healthy Men Are Associated with Obesity.

Although the composition of the human blood metabolome is influenced both by the health status of the organism and its dietary behavior, the interaction between these two factors has been poorly characterized. This study makes use of a previously published randomized controlled crossover acute intervention to investigate whether the blood metabolome of 15 healthy normal weight (NW) and 17 obese (OB) men having ingested three doses (500, 1000, 1500 kcal) of a high-fat (HF) meal can be used to identify metabolites differentiating these two groups. Among the 1024 features showing a postprandial response, measured between 0 h and 6 h, in the NW group, 135 were dose-dependent. Among these 135 features, 52 had fasting values that were significantly different between NW and OB men, and, strikingly, they were all significantly higher in OB men. A subset of the 52 features was identified as amino acids (e.g., branched-chain amino acids) and amino acid derivatives. As the fasting concentration of most of these metabolites has already been associated with metabolic dysfunction, we propose that challenging normal weight healthy subjects with increasing caloric doses of test meals might allow for the identification of new fasting markers associated with obesity.

Regional homogeneity and degree of centrality in social jetlag and sleep deprivation and their correlations with appetite: a resting-state fMRI study

ABSTRACT This research aimed to explore in free-living condition, in healthy normal weight subjects, the effect of social jetlag (SJL) and sleep deprivation on resting-state brain connectivity and synchronization, as assessed by resting-state fMRI, and their association with appetite. We found abnormal local functional synchronization in resting-state, as depicted by altered regional homogeneity (ReHo), in posterior cerebellar regions in subjects with SJL and/or sleep deprivation. We also found altered intrinsic global connectivity patterns, as depicted by altered degree of centrality (DC), in cerebellar regions in these subjects. In our sample, ReHo was correlated with appetite in fasting state in subjects with SJL and in those with sleep deprivation, while DC was correlated with appetite only in subjects with SJL. The effect size evaluation showed that 21.1% to 35.7% of the variance in appetite of subjects with SJL was explained by altered ReHo and DC; in subjects with sleep deprivation 21.2% to 61.3% of the variance in appetite was explained by altered ReHo. This analysis provides the first evidence of abnormal resting-state local functional synchronization and intrinsic global connectivity patterns in healthy subjects with SJL in real-life settings. These changes were independent of sleep deprivation and correlated with appetite.

Immunological and behavioral responses to in vivo lipopolysaccharide administration in young and healthy obese and normal-weight humans

Obesity is associated with an increase prevalence of neuropsychiatric symptoms and diseases, such as depression. Based on the facts that pro-inflammatory cytokines are able to modulate behavior, and that obesity is characterized by a chronic low-grade inflammatory state, inflammation has been hypothesized to contribute to the neuropsychiatric comorbidity in obese individuals. However, a causal link between inflammation and the development of neuropsychiatric symptoms is hard to establish in humans. Here, we used an inflammatory stimulus, i.e. the intravenous injection of lipopolysaccharide (LPS), in a double-blind placebo-controlled design, to determine the vulnerability of obese individuals to inflammation-induced behavioral changes. The hypothesis was that obese individuals would show heightened behavioral response compared to normal-weight subjects for the same inflammatory stimulus, reflecting an increased sensitivity to the behavioral effects of pro-inflammatory cytokines. LPS (dose 0.8 ng/kg body weight, adjusted for estimated blood volume in obese subjects) and placebo (saline) were intravenously injected in 14 obese healthy subjects and 23 normal-weight healthy subjects in a within-subject, randomized, crossover design. LPS administration induced, in both groups, an acute increase in blood concentrations of cytokines (interleukin-6, tumor necrosis factor-α, and IL-10), as well as in body temperature, cortisol, norepinephrine, sickness symptoms, fatigue, negative mood, and state anxiety. There were little differences in the immune and behavioral responses to LPS between obese and normal-weight subjects, but the cortisol response to LPS was strongly attenuated in obese individuals. Higher percentage of body fat was related to a lower cortisol response to LPS. Taken together, the population of young and healthy obese individuals in this study did not exhibit an increased behavioral sensitivity to cytokines, but an attenuated cortisol response to the immune challenge. Future studies will need to determine whether additional physiological and psychological factors interact with the state of obesity to increase the risk for inflammation-induced neuropsychiatric symptoms.

Clinical, laboratory and radiological assessment of skeletal maturation in children and adolescents with obesity

BackgroundChildhood obesity is related to multiple serious health problems and an enhanced risk of premature onset of diseases. The relation of skeletal maturation to obesity is undetermined. The study aims to evaluate skeletal maturation in children and adolescents with obesity, to correlate it with their anthropometric data, body fat content, BMI, fat mass and pubertal stage.ResultsOur study shows that obese children and adolescents have accelerated skeletal maturation compared to control normal-weight healthy subjects (mean skeletal age difference of 0.123 ± 0.67 years versus − 0.175 ± 0.32 years). Also, there were significant positive correlations between bone age and BMI (r = 0.435, P value 0.00).ConclusionThe mean skeletal age difference was more in the obese group as compared to the control group and suggesting accelerated skeletal development in the obese group. It is important to assess skeletal maturity in growing patients to determine the best timing for orthopedic and orthodontic treatment around the growth spurt.

Social jetlag and sleep deprivation are associated with altered activity in the reward-related brain areas: an exploratory resting-state fMRI study

ObjectiveThe aim of this research was to assess the effect of social jetlag (SJL) and its interaction with partial sleep deprivation on resting-state brain activity using the fractional amplitude of low-frequency fluctuation (fALFF) during free-living conditions. MethodsA total of 28 normal weight healthy subjects were enrolled in four study groups (with SJL [with sleep deprivation and without sleep deprivation] and without SJL [with sleep deprivation and without sleep deprivation]), matched 1:1:1:1 for age, gender, and body mass index (BMI). Resting-state functional magnetic resonance imaging (fMRI) scans were collected with SIEMENS 3T scanner while subjects were in a fasting state. ResultsParticipants with SJL had significantly higher fALFF values in right lingual gyrus and right putamen and significantly lower fALFF values in left and right inferior parietal lobe in comparison with participants without SJL and without sleep deprivation. Subjects with sleep deprivation had significantly higher fALFF in the thalamus and left superior frontal gyrus. In those with both SJL and sleep deprivation, we observed higher fALFF values in right Brodmann Area (BA)18 and lower values in left and right parietal inferior lobe. Subjects with SJL alone had significantly lower fALFF values in left frontal mid gyrus (BA6) than those with sleep deprivation alone. ConclusionsSJL was associated with altered resting-state brain activity in regions that have been shown to be involved in hedonic feeding. The effect of SJL was independent of effects induced by short sleep duration. These alterations might represent the substrate for the increased risk of obesity observed in those with SJL.

High-intensity Interval Training Promotes the Shift to a Health-Supporting Dietary Pattern in Young Adults.

A healthy lifestyle is based on a correct diet and regular exercise. Little is known about the effect of different types of exercise on dietary preferences. To address the question of whether high-intensity interval training (HIIT) could modulate spontaneous food choices, an experimental study was carried out on 32 young, healthy normal-weight subjects. The spontaneous diet of each subject has been monitored over nine weeks of indoor-cycling training, divided into three mesocycles with an incremental pattern: total energy intake, macronutrients and micronutrients have been analysed. A two-way mixed model has been used to assess differences in dietary variables; a principal factor analysis has been performed to identify sample subgroups. An increased energy intake (+17.8% at T3; p < 0.01) has been observed, although macronutrients’ proportions did not vary over time, without differences between sexes. An increase of free fat mass was found in the last mesocycle (+3.8%), without an augmentation of body weight, when, despite the increased training load, a stabilization of energy intake occurred. Three different subgroups characterized by different dietary modifications could be identified among participants that showed a common trend towards a healthier diet. Nine weeks of HIIT promoted a spontaneous modulation of food choices and regulation of dietary intake in young normal-weight subjects aged 21–24. Importantly, this life-period is critical to lay the foundation of correct lifestyles to prevent metabolic diseases and secure a healthy future with advancing age.

Metabolically healthy obesity reduces the risk of Alzheimer's disease in elders: a longitudinal study.

A subgroup of overweight/obese individuals, who had favorable metabolic profiles, was termed as metabolically healthy overweight/obese (MHO). Several studies suggested that MHO individuals were not at increased risk of cardiovascular disease and all-course mortality. However, whether MHO is associated with excess risk of Alzheimer’s disease (AD) in elders remains unclear. To explore the risk of AD among MHO phenotype and investigate whether MHO associates with neurodegenerative biomarkers of AD, we assessed body mass index-metabolic status phenotypes of 1199 longitudinal elders from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) cohort using the Adult Treatment Panel-III (ATP- III) criteria. MHO subjects were at a significantly decreased risk for AD (adjusted HR=0.73, 95% CI: 0.54-0.97) compared with metabolically healthy normal weight (MHNW) subjects. In multivariable linear regression models, the cross-sectional associations of MHO with cerebrospinal fluid (CSF) biomarkers, brain Aβ load, and cortical structure were explored. MHO was positively correlated with CSF-Aβ (β=0.746, P=0.015), hippocampal volume (β=0.181, P=0.011), and whole brain volume (β=0.133, P=0.004). The MHO phenotype of the elder conferred a decreased risk of AD and its role may be driven by Aβ.

Effects of gastric bypass surgery on postprandial gut and systemic lipid handling

Obesity is often associated with increased postprandial triglyceride (TG) concentrations, mainly from chylomicrons- and VLDL-TG. These alterations are usually reverted to normal after gastric bypass surgery (GB), through mechanisms which remain unknown. The objective of this study was therefore to assess the contribution of exogenous labelled fatty acids ingested with a meal to postprandial blood chylomicrons and VLDL-TG concentrations after GB. 7GB patients 3-5 years after surgery (GB: 2M/5F, mean BMI 30±2kg/m2, mean age 40±3 years), 6 overweight non operated subjects (OW: 1M/5F, mean BMI 31±3kg/m2, mean age 38±2 years) and 8 normal weight healthy subjects (NW: 4M/4F, mean BMI 22±1kg/m2, mean age 26±4 years) were studied over 7h following ingestion of a liquid meal containing 18g fat labelled with 250mg 13C16 palmitate, 22g protein, 36g fructose and 36g glucose. TG, 13C palmitate (13C-palm) and apoB48 concentrations were measured hourly in whole plasma and/or in chylomicrons and VLDL lipoprotein sub-fractions. OW subjects had higher chylomicron-than NW (chylo-TG 96.5 (23.1) vs 28.8 (11.8) mmol/l*420min (p=0.02)), but similar total, chylo-13C-palm and apoB48 iAUCs. In GB, chylo- 13C-palm and apoB48 increased earlier after meal ingestion, but then remained lower than in NW and OW throughout the postprandial period. GB also had lower chylo-TG iAUCs than OW (8.9 (11.5) vs 96.5 (23.2) mmol/l*420min, p=0.003). Their apoB48 iAUCs were not different from NW and OW (509.2 (90.5) vs 710.2 (80.5) and 870.1 (297.6) pg/ml*420min, all p>0.05). An accelerated postprandial apoB48 rise, together with unchanged postprandial apoB48 iUAC, suggests that intestinal fat absorption and chylomicron secretion was quantitatively unaltered, but accelerated after gastric bypass. In contrast, the decreased postprandial chylo-TG and 13C-palm iAUCs suggest that plasma chylomicron clearance was enhanced after gastric bypass.

Effects of Dietary Protein and Fat Content on Intrahepatocellular and Intramyocellular Lipids during a 6-Day Hypercaloric, High Sucrose Diet: A Randomized Controlled Trial in Normal Weight Healthy Subjects.

Sucrose overfeeding increases intrahepatocellular (IHCL) and intramyocellular (IMCL) lipid concentrations in healthy subjects. We hypothesized that these effects would be modulated by diet protein/fat content. Twelve healthy men and women were studied on two occasions in a randomized, cross-over trial. On each occasion, they received a 3-day 12% protein weight maintenance diet (WM) followed by a 6-day hypercaloric high sucrose diet (150% energy requirements). On one occasion the hypercaloric diet contained 5% protein and 25% fat (low protein-high fat, LP-HF), on the other occasion it contained 20% protein and 10% fat (high protein-low fat, HP-LF). IHCL and IMCL concentrations (magnetic resonance spectroscopy) and energy expenditure (indirect calorimetry) were measured after WM, and again after HP-LF/LP-HF. IHCL increased from 25.0 ± 3.6 after WM to 147.1 ± 26.9 mmol/kg wet weight (ww) after LP-HF and from 30.3 ± 7.7 to 57.8 ± 14.8 after HP-LF (two-way ANOVA with interaction: p < 0.001 overfeeding x protein/fat content). IMCL increased from 7.1 ± 0.6 to 8.8 ± 0.7 mmol/kg ww after LP-HF and from 6.2 ± 0.6 to 6.9 ± 0.6 after HP-LF, (p < 0.002). These results indicate that liver and muscle fat deposition is enhanced when sucrose overfeeding is associated with a low protein, high fat diet compared to a high protein, low fat diet.

Body hydration assessment using bioelectrical impedance vector analysis in neurologically impaired children.

Dehydration is common and frequently under-diagnosed in chronic malnourished children, leading to life-threatening conditions. In this pilot study we applied bioimpedance vector analysis (BIVA) to determine hydration status in 52 neurologically impaired (NI) paediatric patients (14.08 ± 5.32). Clinical and biochemical data were used to define malnutrition and dehydration. Body composition analysis and hydration were also assessed by BIVA and we considered 143 normal-weight healthy subjects (15.0 ± 1.7), as controls for hydration status assessment. BIVA revealed a pathological hydration status in NI children, showing higher resistance (p < 0.001) and reactance values (p = 0.001) compared to controls. No differences in reactance and resistance were detected between well-nourished and under-nourished subjects. Four patients out of 52 showed mild signs of dehydration; no severe dehydration was detected. Laboratory data, suggestive for dehydration, were similar in well-nourished and under-nourished NI subjects. In conclusion, in our sample of NI paediatrics, dehydration according to clinical signs and laboratory data was under-diagnosed. BIVA showed specific bioelectrical characteristics that could be compatible with impaired hydration status. Further studies are necessary to confirm that BIVA may an applicable tool for defining dehydration status and guiding rehydration in NI children.