The follow-up of dietary treatment of obesity

Glycemic variability using 48-hour continuous glucose monitorin, endothelial function, and carotid intima-media thickness in the metabolic syndrome

Circadian rhythms and nutrition

The system of Circadian Rhythms is a mechanism that, in the forms of animal life, has evolved in order to synchronize the behavior and physiological responses to environmental periodical stimuli, so as to allow faster response and better adaptation to environmental changes. These stimuli (light, food availability, presence of predators, availability of a partner for reproduction) in turn depend on the rotation of the earth on its axis and around the sun. In mammals, there is a central hypothalamic clock , said Master Clock, directly regulated by light in its periodicity, which therefore plays the role of primary synchronizer, and several peripheral clocks, Slave Clock, synchronized with eac…

Glycaemic variability (measured by 48h contiinous glucose monitoring) in subjects with metabolic syndrome, with ot without diabetes, is indipendently associated wiith IL-6 blood concentrations

Approccio dietetico alla grande obesità

VALUTAZIONE METABOLICA E NUTRIZIONALE IN GRANDI OBESI SOTTOPOSTI A DIVERSIONE BILIOPANCREATICA: FOLLOW-UP MEDIO 14 +- 0,6

Effects of hypocaloric diets with different glycemic indexes on endothelial function and glycemic variability in overweight and in obese adult patients at increased cardiovascular risk

Background & aims: The role of glycemic index of the diet in glucose control and cardiovascular prevention is still not clear. The aim of this study was to determine the effects of hypocaloric diets with different glycemic indexes and glycemic loads on endothelial function and glycemic variability in nondiabetic participants at increased cardiovascular risk. Methods: Forty nondiabetic obese participants were randomly assigned to a three-month treatment with either a low glycemic index (LGI; n ¼ 19) or high glycemic index (HGI; n ¼ 21) hypocaloric diet with similar macronutrient and fiber content. Endothelial function was measured as flow-mediated dilatation (FMD) of the brachial artery befo…

Valutazione metabolica e nutrizionale in grandi obesi sottoposti a diversione bilio-pancreatica: follow-up medio 14,8 anni

Glycemic variability Using 48-Hour continuous Gglucose monitoring and endothelial function in the Metabolic Syndrome

Glycemic variability using continuous glucose monitoring and endothelial function in the metabolic syndrome and in type 2 diabetes

Aims Subjects who are at increased risk of developing diabetes may have increased glycaemic variability associated with endothelial dysfunction and possibly subclinical atherosclerosis, which may lead to increased cardiovascular risk observed at the time of diabetes diagnosis. To investigate this hypothesis, we measured endothelial function, carotid intima-media thickness and glycaemic variability using 48-h continuous subcutaneous glucose monitoring in 3 groups of overweight or obese subjects – those without the metabolic syndrome, and those with the metabolic syndrome with or without newly diagnosed Type 2 diabetes. Methods Consecutive subjects, aged 30–65 years with a body mass index ‡ 2…

Associazione tra variabilità glicemica (ottenuta attraverso il monitoraggio glicemico continuo delle 48h) ed interleukina-6 in soggetti con sindrome metabolica

Effects of hypocaloric very-low-carbohydrate diet vs. Mediterranean diet on endothelial function in obese women

Obesity is a cardiovascular risk factor associated with endothelial dysfunction, but the effect of different weight loss strategies on endothelial function is not known. The effect of diet on endothelial function in two hypocaloric diets, a very-low-carbohydrate diet (A) and a Mediterranean diet (M), was measured by brachial artery flow-mediated dilation (FMD). Design Using a longitudinal, randomized, open study design, subjects were engaged in a 2-month weight loss diet. FMD, inflammatory cytokines [interleukin-6 (IL-6) and tumour necrosis factor-alpha] and a marker of oxidative stress [8-iso-prostaglandin F2alpha (8-iso-PGF2alpha)] were measured in subjects on three occasions: before init…

A low resting metabolic rate is associated with metabolic syndrome

Background & aims: The metabolic syndrome is associated with central accumulation of fat. Previous studies showed that some obese subjects are characterized by a sparing energy metabolism. The aim of this study was to investigate whether obese subjects with metabolic syndrome have a lower resting metabolic rate than obese subjects without metabolic syndrome. Methods: Forty obese subjects were divided into three groups according to the presence of metabolic syndrome and type 2 diabetes; 15 non-obese healthy control subjects were also enrolled. Body composition (bio-impedance analysis) and resting metabolic rate (indirect calorimetry) were performed. Results: The group with metabolic syndrome…

Variabilità glicemica da monitoraggio continuo delle 48h ed interleukina-6 in soggetti con sindrome metabolica

Low relative resting metabolic rate and body weight gain in adult Caucasian Italians

OBJECTIVE: To investigate the relationship between resting metabolic rate (RMR) and subsequent changes in body size and degree of fatness in a group of adult Caucasian Italians. DESIGN: Prospective, longitudinal, observational study. SUBJECTS: In total, 155 subjects (72 males and 83 females, age range: 18–55 y; BMI: 17.5–63.4 kg/m2) were evaluated. In total, 43 (26 m and 17 f; BMI: 28.971.1 kg/m2, mean7s.e.m.) of them were reassessed 10–12 y later. MEASUREMENTS: Anthropometric and body composition (bioimpedance analysis) parameters and RMR (indirect calorimetry) were taken at baseline and after 10–12 y. RESULTS: Subjects (15 m, 8 f) who gained body weight (arbitrarily defined as a change in…

Evoluzione della terapia dietetica dell'obesità:Diete a confronto

Intra-renal hemodynamics and carotid intima-media thickness in the metabolic syndrome.

Aims: Metabolic syndrome (MetS) is associated with increased cardiovascular risk. We hypothesize that early vascular changes are already present at the time of diagnosis of MetS. The relationship of different measures of early vascular impairment with body fat distribution and the natural progression of MetS was examined in newly diagnosed subjects non-pharmacologically treated. Methods: 246 consecutively enrolled subjects were categorized according to the presence of MetS and type 2 diabetes (T2D). Intra-renal Doppler flow was used to ascertain resistive (RI) and pulsatility (PI) indices as markers of vascular resistance. Carotid intima-media thick- ness (IMT), cutis-rectis (CR) and rectis…

Effects of red orange juice intake on endothelial function and inflammatory markers in adult subjects with increased cardiovascular risk

BACKGROUND Oxidative and inflammatory stresses are involved in the pathogenesis of atherosclerosis. The consumption of fruit and vegetables is associated with improved health and reduced cardiovascular risk. Red oranges have a high content of antioxidant and antiinflammatory substances, but there is a paucity of data concerning their effects on cardiovascular biomarkers in subjects with increased cardiovascular risk. OBJECTIVE We investigated the effect of red orange juice intake on endothelial function, oxidative stress, and markers of inflammation in subjects with increased cardiovascular risk. DESIGN Nineteen nondiabetic subjects with increased cardiovascular risk (aged 27-56 y) were inc…

Glycaemic variability (measured by 48h continous glucose monitoring) in subjects with metabolic syndrome, with ot withoout diabetes,is indipendently associated with IL-6 bood concentrations

Postprandial hyperglycaemia induces endothelial dysfunction thus contributing to the appearance of atherosclerotic lesions and to the high cardiovascular risk of diabetic subjects. Subjects who develop diabetes have an increased cardiovascular risk even before the appearance of diabetes. Insulin resistant subjects with metabolic syndrome (MS) are at both high cardiovascular and diabetes risk and it cannot be excluded that higher postprandial glycaemic excursions might induce endothelial dysfunction in this condition. Furthermore, adipose tissue is known to release factors (adipokines) that are able to influence both insulin sensitivity and endothelial function. The glycaemic variability is …

La spesa energetica a riposo è aumentata nei pazienti diabetici in scadente compenso ed è normalizzata dopo bolo di insulina

Endothelial function and other biomarkers of cardiovascular risk in frequent consumers of street food.

Summary Background & aims Street food (SF) is defined as out-of-home food consumption, and generally consists of energy dense meals rich in saturated fats, and poor in fibers, vitamins and anti-oxidants. Though SF consumption may have unfavorable metabolic and cardiovascular effects, its possible association with endothelial function has not been considered. Methods Participants were recruited among those who took part in a previous study of ours, done in Palermo, Italy, which investigated the association between consumption of SF and health in 1002 people. In that study, a score of SF consumption was obtained by categorizing each of ten foods consumed less than or more than once a month (0…

Mettersi a dieta. Perchè, quando, come

A low reported energy intake is associated with metabolic syndrome.

Background and aims: Metabolic syndrome (MS) may be associated with the presence of an energy sparing metabolism that predisposes to the excess accumulation of body fat. This study examined the relationship between reported energy intake and obesity in individuals with and without MS. Methods and results: Ninety consecutive non-diabetic obese subjects were divided into two groups based on the presence (MS+: n= 50) or absence (MS-: n= 40) of metabolic syndrome. The study design was cross-sectional. The three-day food record method was used to assess the subjects' usual energy intake and the Diet Readiness Test (DRT) was also administered. Compared to the MS- group, the MS+ group had a signif…

Rischio di pancreatite e variazioni degli enzimi pancreatici in un campione ambulatoriale di diabetici tipo 2 in trattamento con liraglutide

Glycaemic variability from subcutaneous continuous glucose monitoring and interleukin-6 concentrations in subjects with metabolic syndrome.

Inquadramento nosografico dell'obesità

Si definisce obesità una condizione clinica determinata da eccesso del grasso corporeo tale da.....

Effetti acuti del caffè espresso sulla funzione endoteliale e sulla glicemia basale in soggetti sani (ISRCTN85096812)

Acute effects of coffee on endothelial function in healthy subjects

Background/Objectives: Coffee is the most widely consumed beverage in the world, but its effect on the cardiovascular system has not been fully understood. Coffee contains caffeine and antioxidants, which may influence endothelial function, both of which have not yet been investigated. The objective of this study was to investigate the acute effects of coffee on endothelial function measured by brachial artery flow-mediated dilation (FMD). Subjects/Methods: A total of 20 (10 males and 10 females) healthy non-obese subjects underwent a double-blind, crossover study. Subjects ingested one cup of caffeinated (CC) and one cup of decaffeinated (DC) Italian espresso coffee in random order at 5- t…

Bioelectrical characteristics of type 1 and type 2 diabetic subjects with reference to body water compartments.

Since bioelectrical characteristics correspond well to body water compartments, this study investigated bioelectrical differences between type 1 and type 2 diabetic subjects that could reflect differences in body water compartments. We investigated cross-sectionally 612 adult subjects, classified into 10 groups according to sex and disease (control, obese normal glucose tolerant, non-obese type 2 diabetes, obese type 2 diabetes, type 1 diabetes). Resistance (R), reactance (Xc) and phase angle (PA) were measured (800 microA - 50 kHz alternating current). The bioelectrical vector was obtained by plotting R and Xc normalized for height (ht), it is easily identified on the basis of the length (…

Resting energy expenditure and body composition in morbidly obese, obese and control subjects

Resting energy expenditure (REE) was investigated by indirect calorimetry in relation to body composition and to different degrees of obesity in order to assess if a defective energy expenditure contributes to extra body fat accumulation. Differences were found between control subjects (group C; BMI 23 +/- 0.5 kg/m2, REE 5890 +/- 218 kJ/day; mean +/- SEM) and obese subjects (group O; BMI 34.2 +/- 0.9 kg/m2, REE 7447 +/- 360 kJ/day; P0.0001) and between group C and morbidly obese subjects (group MO; BMI 49.9 +/- 1.6 kg/m2, REE 8330 +/- 360 kJ/day; P0.0001); REE was not significantly different between groups O and MO. Body composition data were obtained by means of body impedance analysis. Ev…

Reply from Buscemi Set al.Glycaemic variability using continuous glucose monitoring and endothelial function in the metabolic syndrome and in Type 2 diabetes. Authors’ reply

Ruolo dell'insulina nella escrezione frazionale di sodio nei soggetti con alterata tolleranza agli idrati di carbonio

Confronto a breve e medio termine tra diete ipocaloriche ipoglucidica e mediterranea sulla funzione endoteliale. Risultati preliminari (ISRCTN 53451414).

Glycaemic variability and inflammation in subjects with metabolic syndrome.

Subjects who develop diabetes have an increased cardiovascular risk even before the appearance of diabetes. The aim of this study was to investigate the glycaemic variability measured by continuous glucose monitoring (CGM CV%) in nondiabetic subjects with metabolic syndrome (MS) and to explore if glycaemic variability was associated with circulating levels of interleukin-6 (IL-6), a proinflammatory cytokine, or with an anti-inflammatory factor like adiponectin. Three groups of obese subjects with (MS+: 6m, 8f; BMI 33.1 ± 1.4 mean ± SEM) or without metabolic syndrome (MS−: 2m, 4f; BMI 29.2 ± 2.2) and with MS associated with type 2 diabetes (MS/T2D: 3m, 5f; BMI 32.9 ± 1.4) were investigated. …

Associazione tra variabilità glicemica (ottenuta attraverso il monitoraggio glicemico continuo delle 48 ore) ed interleukina 6 in soggetti con sindrome metabolica

Relationships between maximal oxygen uptake and endothelial function in healthy male adults: a preliminary study

Aerobic capacity, as indicated by maximal oxygen uptake (VO(2) max) has an important role in contrasting the traditional cardiovascular risk factors and preventing cardiovascular morbidity and mortality. It is known that endothelial function, measured as flow-mediated dilation (FMD) of the brachial artery, is strictly linked to atherogenesis and cardiovascular risk. However, the relationship between VO(2) max and FMD has not been fully investigated especially in healthy non-obese subjects. This preliminary study cross-sectionally investigated the relationship between VO(2) max and FMD in 22 non-obese, healthy sedentary male subjects. Dividing the cohort in two subgroups of 11 subjects each …

Long-term effects of a multidisciplinary treatment of uncomplicated obesity on carotid intima-media thickness

Obesity is associated with well-known cardiovascular risk factors and a lower life expectancy. This study investigated whether nonoperative nutritional treatment of obesity without comorbidities influenced the carotid intima-media thickness (c-IMT) in the long run. Fifty-four subjects of an original cohort of 251 subjects were re-evaluated 10 years after a medical nutritional treatment (MNT) with cognitive-behavioral approach for uncomplicated obesity. Forty subjects were classified as failure (10-year body weight change >0.5 kg) and 14 (body weight change ≤0.5 kg) as a success of the MNT. Ten years after MNT, c-IMT significantly increased (0.06 ± 0.02 mm; P = 0.004) in the failure group an…

Short and middle term effects of hypocaloric low carbohydrate diet vs hypocaloric Mediterranean diet on endothelial function in obese subjects

Adequate nutritional treatment is required to address the problem of increasing prevalence of obesity in Western countries. The Mediterranean diet style is now acknowledged to have large scientific evidences in terms of cardiovascular prevention. However, many popular diets are diffusing also as self-prescribed treatments. Among those, the efficacy of low-carbohydrate diets (also known as Atkins’ diet in its most popular variety) has been addressed by some investigations. It is generally concluded that the low-carbohydrate diet is able to induce a greater weight loss, at least in the middle term, and a better serum lipid profile than the conventional diet. In this longitudinal, randomised, …

The effects of muscular exercise on glucose, free fatty acids, alanine and lactate in type I diabetic subjects in relation to metabolic control.

Metabolic effects of muscular exercise were studied in eleven subjects with type I diabetes mellitus during poor metabolic control, and again during good metabolic control, and in ten healthy control subjects. All the subjects were submitted to a submaximal gradual triangular test on an electrically braked bicycle ergometer; glucose, FFA, alanine and lactate were measured at rest, and after exercise. In poorly controlled patients, glucose and FFA were unchanged after exercise, whereas blood alanine and lactate increased by a percentage similar to that of the controls, and well-controlled diabetic patients. Baseline alanine concentrations were lower and lactate concentrations higher than in …

Resistenze intra-renali, spessore mio-intimale carotideo ed interleukina-6 in soggetti con sindrome metabolica

Acute effects of coffee on QT interval in healthy subjects

Abstract The coronary endothelial function is recognized to have an important role in the physiology of the diastolic ventricular relaxation, a phase of the heart cycle that influences the electrocardiographic QT interval. Endothelial function is investigated in vivo by flow mediated dilation (FMD) in the brachial artery and has proven to be a strong predictor of both coronary endothelial function and cardiovascular events. It has been reported that coffee acutely induces FMD changes. In particular, the brachial artery FMD seems to decrease after caffeinated coffee (CC) and to increase after decaffeinated coffee (DC) ingestion. Since the cardiovascular effects of coffee are still a debated …

Il follow-up del trattamento dietetico dell'obesità

Trattamento cronico con diuretici ed omeostasi glico-metabolica in un campione di adulti privi di diabete noto

Ruolo dell'insulina nella escrezione frazionale di soggetti con alterata tolleranza agli idrati di carbonio

Stile di vita e sindrome metabolica in un campione di adulti apparentemente sani

Influences of obesity and weight loss on thyroid hormones. A 3-3.5-year follow-up study on obese subjects with surgical bilio-pancreatic by-pass

The effects of changing body size, energy intake and substrate oxidation on serum T4, FT4, T3, FT3 and TSH were investigated in ten morbidly obese subjects (4 men/6 women; age: 37 ± 6 years; BMI: 53.8 ± 6.5 kg/m2; mean ± SD) who had undergone a surgical bilio-pancreatic by-pass in order to reduce their body weight. The starting value of serum FT3 was inversely related to the BMI (r = -0.63; p < 0.05). After 1-3 months, all the subjects were losing weight and their intake of carbohydrates was almost negligible; at this time a significant reduction of T3 (-14.6%, p < 0.0001), T4 (-19.5%, p < 0.0001), and FT3 (-10.5%, p < 0.001) was observed. Nine to 16 months after surgery, all th…

Dose-dependent effects of decaffeinated coffee on endothelial function in healthy subjects

ackground/Objectives: Coffee is known to contain antioxidant substances whose effects may be blunted because of caffeine that may unfavorably affect the cardiovascular system. This study was designed to investigate the acute dose-dependent effects of decaffeinated coffee (DC) on endothelial function measured by the brachial artery flow-mediated dilation (FMD). Subjects/Methods: A total of 15 (8 men and 7 women) healthy nonobese subjects underwent a single-blind, crossover study. Subjects ingested one and two cups of decaffeinated Italian espresso coffee in random order at 5- to 7-day intervals. Results: In the hour following the ingestion of two cups of DC, FMD increased (mean±s.e.m.): 0 mi…

Stile di vita e prevalenza di obesità, ipertensione e diabete in un campione di bambini, adolescenti e adulti. Lo studio ABCD

Il profilo distributivo centrale del grasso corporeo si associa ad aumentato spessore mio-intimale carotideo

Associazione tra pattern dietetici, insulino-resistenza ed arteriosclerosi carotidea silente in un campione di adulti apparentemente sani

Glycaemic variability using continuous glucose monitoring and endothelial function in the metabolic syndrome and in Type 2 diabetes

Diabet. Med. 27, 872–878 (2010) Abstract Aims  Subjects who are at increased risk of developing diabetes may have increased glycaemic variability associated with endothelial dysfunction and possibly subclinical atherosclerosis, which may lead to increased cardiovascular risk observed at the time of diabetes diagnosis. To investigate this hypothesis, we measured endothelial function, carotid intima-media thickness and glycaemic variability using 48-h continuous subcutaneous glucose monitoring in 3 groups of overweight or obese subjects – those without the metabolic syndrome, and those with the metabolic syndrome with or without newly diagnosed Type 2 diabetes. Methods  Consecutive subjects, …

Ruolo dell’insulina nell’escrezione frazionale di sodio nei soggetti con alterata tolleranza agli idrati di carbonio

Approccio dietetico alla grande obesità. In: Manuale di nutrizione clinica e scienze dietetiche applicate

Coffee and endothelial function: a battle between caffeine and antioxidants ?

Although coffee is largely consumed by adults in Western countries, controversy exists about its impact on the cardiovascular system. We recently demonstrated that caffeinated and decaffeinated espresso coffee have different acute effects on endothelial function in healthy subjects, measured using flow-mediated dilation (FMD) of the brachial artery. In this study, we measured the anti-oxidant capacity of two coffee substances in terms of free stable radical 2,2-diphenyl-1-picryl-hydrazyl 50% inhibition (I(50) DPPH). The caffeinated coffee had a slightly higher anti-oxidant capacity than decaffeinated espresso coffee (I(50) DPPH: 1.13±0.02 vs 1.30±0.03 μl; P0.001). We suggest that the unfavo…

Confronto a breve e medio termine tra dieta ipocalorica ipoglucidica ed ipocalorica mediterranea sulla funzione endoteliale. Risultati preliminari. (ISRCTN 53451414)

Reply to: Letters to the article “Glycaemic variability using continuous glucose monitoring and endothelial function in the metabolic syndrome and in Type 2 diabetes” of Buscemi S. et al. [Diabet. Med. 27, 872–878 (2010)]

Favorable clinical heart and bone effects of anti-thyroid drug therapy in endogenous subclinical hyperthyroidism

Although subclinical hyperthyroidism (SCH) has been associated with increased risk of osteoporosis and cardiac arrhythmias, its treatment is still controversial. This study was designed as a prospective, randomized, intervention, control-study with a 1-year follow-up in order to investigate whether normalization of serum TSH in SCH using methimazole has favorable bone and heart clinical effects. Fourteen patients with endogenous SCH (not Graves' disease) were enrolled, 7 (5 women/2 men; group T) were treated with methimazole (2.5-7.5 mg/day), and 7 (5 women/2 men; group C) were followed without treatment; 10 healthy subjects were also included in the study as controls. Serum free-T3 (FT3), …

Characterization of street food consumption in palermo: possible effects on health

Abstract Background Street Food (SF) consists of out-of-home food consumption and has old, historical roots with complex social-economic and cultural implications. Despite the emergence of modern fast food, traditional SF persists worldwide, but the relationship of SF consumption with overall health, well-being, and obesity is unknown. Methods This is an observational, cross-sectional study. The study was performed in Palermo, the largest town of Sicily, Italy. Two groups were identified: consumers of SF (n = 687) and conventional restaurant food (RES) consumers (n = 315). Study subjects answered a questionnaire concerning their health conditions, nutritional preferences, frequency of consu…

Glycaemic variability (measured by 48h continuous glucose monitoring) in subjects with metabolic syndrome, with or without diabetes, is independently associated with IL-6 blood concentrations.

Effects of muscular exercise on erythrocyte adenosine triphosphate concentration in patients with insulin-dependent diabetes mellitus.

Type I diabetes mellitus represents a metabolic disorder in which intracellular glycolytic pathway is inhibited by insulin deficiency, with the subsequent decreased availability of energetic substrates such as ATP. Some aspects of the energetic metabolism in response to an intensive demand (muscular exercise) were investigated, in a group of 10 ketotic diabetic patients, by measuring erythrocyte adenosine triphosphate (ATP) and blood glucose, free fatty acids (FFA) and lactate levels. In the diabetic subjects, in comparison with normal subjects, the decreased levels of erythrocyte ATP at rest did not increase after exercise, while the increased levels of FFA at rest did not diminish after e…

Relationship between epicardial fat and diastolic dysfunction in obese subjects: an echocardiographic study

Effects of dynamic exercise and metabolic control on left ventricular performance in insulin-dependent diabetes mellitus

In subclinical diabetic cardiomyopathy, previous reports did not positively correlate the altered cardiac performance with metabolic parameters. Fifteen insulin-dependent diabetic subjects, without any clinical or instrumental evidence of heart diseases, were studied. Signs of diabetic microangiopathy were absent. Systolic time intervals, metabolic and hormonal parameters (blood glucose, free fatty acids, blood lactate and plasma norepinephrine) were evaluated at rest and after dynamic exercise during poor (MAGE 6.36 +/- 0.72 mmol/l) and good (MAGE 3.46 +/- 0.66 mmol/l) metabolic control, obtained by means of insulin therapy. Rest values of systolic time intervals were normal during poor an…

La distribuzione corporea del grasso influenza le resistenze intra-renali e lo spessore intima media carotideo nei soggetti con e senza sindrome metabolica