rome and Obesity

The discovery of functional brown adipose tissue (BAT) in adult humans and the possibility to recruit beige cells with high thermogenic potential within white adipose tissue (WAT) depots opened the field for new strategies to combat obesity and its associated comorbidities. Exercise training as well as cold exposure and dietary components are associated with the enhanced accumulation of metabolically-active beige adipocytes and BAT activation. Both activated beige and brown adipocytes increase their metabolic rate by utilizing lipids to generate heat via non-shivering thermogenesis, which is dependent on uncoupling protein 1 (UCP1) in the inner mitochondrial membrane. Non-shivering thermogenesis elevates energy expenditure and promotes a negative energy balance, which may ameliorate metabolic complications of obesity and Type 2 Diabetes Mellitus (T2DM) such as insulin resistance (IR) in skeletal muscle and adipose tissue. Despite the recent advances in pharmacological approaches to reduce obesity and IR by inducing non-shivering thermogenesis in BAT and WAT, the administered pharmacological compounds are often associated with unwanted side effects. Therefore, lifestyle interventions such as exercise, cold exposure, and/or specified dietary regimens present promising anchor points for future disease prevention and treatment of obesity and T2DM. The exact mechanisms where exercise, cold exposure, dietary interventions, and pharmacological treatments converge or rather diverge in their specific impact on BAT activation or WAT browning are difficult to determine. In the past, many reviews have demonstrated the mechanistic principles of exercise- and/or cold-induced BAT activation and WAT browning. In this review, we aim to summarize not only the current state of knowledge on the various mechanistic principles of diverse external stimuli on BAT activation and WAT browning, but also present their translational potential in future clinical applications.

Topics: Adipose Tissue, Brown; Adipose Tissue, White; Diabetes Mellitus, Type 2; Diet; Energy Metabolism; Exercise; Humans; Insulin Resistance; Obesity; Rome; Thermogenesis

The world is rapidly urbanizing, causing alarming health problems to their citizens. The Cities Changing Diabetes program aims to address the social factors and cultural determinants that can increase type 2 diabetes (T2D) vulnerability among people living in cities.. Public data of Italian Institute for Statistics (ISTAT) and available scientific reports were reviewed and findings integrated. The prevalence of T2D in the 8 health districts of Rome was mapped and the correlation between prevalence and social and cultural determinants was assessed.. The metropolitan area of Rome has 4.3 million inhabitants. People over 65 has increased by 136,000 units in the last decade, reaching 631,000 citizens in 2015. Elderly people living alone are 28.4%. The obesity prevalence is 9.3%, as compared to 8.2% in the year 2000. The prevalence of T2D is 6.6%, varying in the different 8 health districts between 5.9% and 7.3%. A linear correlation exists between the prevalence of diabetes in the districts, unemployment rate and use of private transportation rate (Pearson R 0.52 and 0.60, respectively), while an inverse correlation is present with aging index, school education level, and slow mobility rate (Person R -0.57, -0.52, and -0.52, respectively).. Important socio-demographic changes have occurred in Rome during the last decades with a raise in the prevalence of obesity and diabetes. A wide variation exists in the prevalence of T2D among the districts of Rome, associated with social and cultural determinants. This study model can help rethinking diabetes in an urban setting.

Topics: Aged; Data Interpretation, Statistical; Databases, Factual; Diabetes Mellitus, Type 2; Female; Health Services Needs and Demand; Humans; Italy; Male; Middle Aged; Obesity; Prevalence; Risk Assessment; Rome; Socioeconomic Factors; Urban Health; Urban Population

Clinical application of an antibiotic's pharmacokinetic/pharmacodynamic (PK/PD) properties may improve the outcome of severe infections. No data are available on the use of linezolid (LNZ) continuous infusion in critically ill obese patients affected by ventilator-associated pneumonia (VAP).. We conducted a prospective randomized controlled trial to compare LNZ concentrations in plasma and epithelial lining fluid (ELF), when administered by intermittent and continuous infusion (II, CI), in obese critically ill patients affected by VAP.. Twenty-two critically ill obese patients were enrolled. At the steady state, in the II group, mean ± SD total and unbound maximum-minimum concentrations (C max/C max,u - C min/Cmin,u) were 10 ± 3.7/6.8 ± 2.6 mg/L and 1.7 ± 1.1/1.2 ± 0.8 mg/L, respectively. In the CI group, the mean ± SD total and unbound plasma concentrations (C ss and C ss,u) were 6.2 ± 2.3 and 4.3 ± 1.6 mg/L, respectively. Within a minimum inhibitory concentration (MIC) range of 1-4 mg/L, the median (IQR) time LNZ plasma concentration persisted above MIC (% T > MIC) was significantly higher in the CI than the II group [100 (100-100) vs 100 (89-100), p = 0.05; 100 (100-100) vs 82 (54.8-98.8), p = 0.009; 100 (74.2-100) vs 33 (30.2-78.5), p = 0.005; respectively]. Pulmonary penetration (%) was higher in the CI group, as confirmed by a Monte Carlo simulation [98.8 (IQR 93.8-104.3) vs 87.1 (IQR 78.7-95.4); p < 0.001].. In critically ill obese patients affected by VAP, LNZ CI may overcome the limits of standard administration but these advantages are less evident with difficult to treat pathogens (MIC = 4 mg/L). These data support the usefulness of LNZ continuous infusion, combined with therapeutic drug monitoring (TDM), in selected critically ill populations.

Topics: Acetamides; Aged; Anti-Bacterial Agents; Critical Illness; Drug Monitoring; Female; Humans; Infusions, Intravenous; Linezolid; Male; Microbial Sensitivity Tests; Middle Aged; Obesity; Organ Dysfunction Scores; Oxazolidinones; Pneumonia, Ventilator-Associated; Prospective Studies; Risk Assessment; Rome

PCOS is the main cause of infertility due to metabolic, hormonal and ovarian dysfunctions. Women affected by PCOS often suffer of insulin resistance and of a compensatory hyperinsulinemia. These conditions put the patients at risk of developing several metabolic disorders. Both myo-inositol (MI) and D-chiro inositol (DCI) glycans administration has been reported to exert beneficial effects at metabolic, hormonal and ovarian level. Beside these common features, MI and DCI are indeed different molecules: they belong to two different signal cascades and regulate different biological processes.. In this study, we aim to verify whether the two molecules have a synergistic action by acting on their specific cellular pathways. The effectiveness in reducing the risk of metabolic syndrome as well as in enhancing the ovarian functions of a combined therapy with MI and DCI was compared to a mono therapy in a randomized controlled trial.. Fifty overweight women with PCOS were enrolled and divided in two groups to receive MI and DCL (MI+DCI group) or MI alone (MI group) for a period of six months. Baseline measurements were repeated at three months (T1) and at the end of the treatment (T2).. At the end of the treatment, both MI and MI+DCI groups showed an improvement of the metabolic parameters and no significant differences were found. As expected, the combined supplementation with MI and DCI resulted to be more effective, compared to the MI group, after three months of treatment.. The combined administration of MI and DCI in physiological plasma ratio (40:1) should be considered as the first line approach in PCOS overweight patients, being able to reduce the metabolic and clinical alteration of PCOS and, therefore, reduce the risk of metabolic syndrome.

Topics: Adolescent; Adult; Analysis of Variance; Biomarkers; Drug Combinations; Female; Humans; Inositol; Metabolic Syndrome; Obesity; Polycystic Ovary Syndrome; Risk Assessment; Risk Factors; Rome; Time Factors; Treatment Outcome; Vitamin B Complex; Young Adult

It is a common understanding that fat-free mass (FFM) increases with body weight. However, limited information is available as to the relationship between weight increase and changes in body composition. We performed the present study to determine quantitatively the relationship between body composition, total body weight, age, and sex. Body composition data were obtained by isotopic dilution on 273 subjects ranging in body mass index (BMI) from about 13 to 70 kg/m(2). Adipose free tissue (AFT) was modeled as a nonlinear, increase-limited function of body weight. Model parameters were evaluated as functions of sex, age, and height. The relationship between AFT and body weight was very well approximated by means of the nonlinear model (R(2) =.95), with maximal AFT being determined by both sex and height and with AFT growth rate determined only by sex. AFT clearly shows a nonlinear behavior, tending to increase less and less with progressively increasing body weight. With the proposed model, an asymptotic maximal AFT may be postulated. The organism seems to have an intrinsic limitation to how much skeletal muscle development may take place to accommodate the necessities of an ever-increasing load. These limits are different between the sexes, with women tending to approach more rapidly than men a lower maximal AFT for the same height.

Topics: Adipose Tissue; Adolescent; Adult; Aged; Aging; Anorexia Nervosa; Body Composition; Body Height; Body Mass Index; Body Weight; Female; Humans; Lipid Metabolism; Lipids; Male; Middle Aged; Models, Biological; Muscle, Skeletal; Obesity; Reference Values; Rome; Sex Factors; White People

The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched the Sarcopenic Obesity Global Leadership Initiative (SOGLI) to reach expert consensus on a definition and diagnostic criteria for Sarcopenic Obesity (SO). The present paper describes the proceeding of the Sarcopenic Obesity Global Leadership Initiative (SOGLI) meeting that was held on November 25th and 26th, 2022 in Rome, Italy. This consortium involved the participation of 50 researchers from different geographic regions and countries. The document outlines an agenda advocated by the SOGLI expert panel regarding the pathophysiology, screening, diagnosis, staging and treatment of SO that needs to be prioritized for future research in the field.

Topics: Humans; Italy; Leadership; Obesity; Rome; Sarcopenia

Topics: Anesthesia; Anesthesiology; Bariatric Surgery; Humans; Obesity; Rome

Obesity has been regarded to be protective against fracture in spite of its association with low levels of vitamin D. Vitamin D is the key regulator of bone metabolism and its deficiency contributes to higher level of parathyroid hormone (PTH), leading to the activation of bone turnover.. We studied 161 subjects of which 65 were young healthy subjects and 96 were elderly subjects. We measured creatinine, 25(OH)D, 1,25(OH)2D, PTH, albumin, and calcium plasma levels, we evaluated physical activity, and we calculated BMI. A sub-cohort of elderly subjects also underwent DXA scans.. Overweight and obese subjects, as well as underweight ones, had lower levels of vitamin D but normal serum concentrations of 1,25(OH)2D and PTH was higher in underweight and obese subjects. Moreover, we found a nonlinear relationship between body mass index (BMI) and PTH with a significant U-shaped exponential regression. Regardless of BMI, 25(OH)D mean levels were higher in subjects who practice physical activity.. These findings suggest that physical activity and BMI had a significant effect on the metabolism of bone and vitamin D, but the effect of BMI was different in underweight, normal weight or obese subjects. In obesity the real vitamin D deficiency could be estimate by serum 1,25(OH)2D concentrations whose lower levels contribute to the higher PTH production and consequently to bone loss and to a greater fracture risk.

Topics: Adiposity; Adult; Aged; Aged, 80 and over; Biomarkers; Body Mass Index; Bone Density; Exercise; Female; Humans; Male; Middle Aged; Obesity; Osteoporotic Fractures; Prevalence; Retrospective Studies; Risk Assessment; Risk Factors; Rome; Vitamin D; Vitamin D Deficiency

Obesity was recently identified as a major risk factor for worse COVID-19 severity, especially among the young. The reason why its impact seems to be less pronounced in the elderly may be due to the concomitant presence of other comorbidities. However, all reports only focus on BMI, an indirect marker of body fat.. To explore the impact on COVID-19 severity of abdominal fat as a marker of body composition easily collected in patients undergoing a chest CT scan.. Patients included in this retrospective study were consecutively enrolled among those admitted to an Emergency Department in Rome, Italy, who tested positive for SARS-Cov-2 and underwent a chest CT scan in March 2020. Data were extracted from electronic medical records.. 150 patients were included (64.7% male, mean age 64 ± 16 years). Visceral fat (VAT) was significantly higher in patients requiring intensive care (p = 0.032), together with age (p = 0.009), inflammation markers CRP and LDH (p < 0.0001, p = 0.003, respectively), and interstitial pneumonia severity as assessed by a Lung Severity Score (LSS) (p < 0.0001). Increasing age, lymphocytes, CRP, LDH, D-Dimer, LSS, total abdominal fat as well as VAT were found to have a significant univariate association with the need of intensive care. A multivariate analysis showed that LSS and VAT were independently associated with the need of intensive care (OR: 1.262; 95%CI: 1.0171-1.488; p = 0.005 and OR: 2.474; 95%CI: 1.017-6.019; p = 0.046, respectively).. VAT is a marker of worse clinical outcomes in patients with COVID-19. Given the exploratory nature of our study, further investigation is needed to confirm our findings and elucidate the mechanisms underlying such association.

Topics: Aged; Aged, 80 and over; Betacoronavirus; Body Composition; Body Mass Index; C-Reactive Protein; Comorbidity; Coronavirus Infections; COVID-19; Critical Care; Female; Humans; Inflammation; Intra-Abdominal Fat; L-Lactate Dehydrogenase; Lung; Male; Middle Aged; Obesity; Pandemics; Pneumonia, Viral; Retrospective Studies; Risk Factors; Rome; SARS-CoV-2; Tomography, X-Ray Computed; Treatment Outcome

Effective and sustained blood pressure (BP) control in hypertensive patients with moderate-to-severe obesity is often difficult to achieve. We evaluated clinic, 24h, day-time and night-time systolic/diastolic BP levels and control in a large cohort of adult outpatients with different classes of obesity. A single center, prospective, cohort study was conducted at Hypertension Unit, Division of Cardiology, Sant'Andrea Hospital, Rome Italy. All BP measurements were performed and BP thresholds were set according to guidelines. Study population was stratified according to BMI. We included 4,766 individuals (women 48.6%, age 60.3 ± 11.6 years, clinic BP 143.8 ± 18.2/90.9 ± 12.3 mmHg, 24h BP 130.2 ± 13.3/79.1 ± 9.5 mmHg), among whom 36.0% had normal weight, 43.5% were overweight, 15.7% had class I, and 4.8% class II/III obesity. Obese outpatients had higher prevalence of risk factors, and were treated more frequently and with more antihypertensive drugs than those with normal body weight. Obese outpatients showed higher systolic BP levels at all BP measurements, mostly 24h and night-time periods, than those observed in normal weight outpatients. BMI resulted significantly related with clinic (r = 0.053; P < 0.001), 24h (r = 0.098; P < 0.001) and night-time systolic BP (r = 0.126; P < 0.001), and left ventricular mass indexed by height^2.7 (r = 0.311; P < 0.001). BMI was also negatively and independently associated with predefined BP goals at all types of BP measurements. Obesity was associated with higher systolic BP levels during the entire 24h period and increased left ventricular mass. These effects were independently observed, even after correction for major cardiovascular risk factors and comorbidities, as well as the number and type of antihypertensive drug classes.

Topics: Aged; Antihypertensive Agents; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Comorbidity; Female; Humans; Hypertension; Male; Middle Aged; Obesity; Outpatients; Predictive Value of Tests; Prevalence; Retrospective Studies; Risk Assessment; Risk Factors; Rome; Severity of Illness Index; Time Factors; Treatment Outcome

In the last decade, several studies have reported an unexpected and seemingly paradoxical inverse correlation between BMI and incidence of cardiovascular diseases. This so called "obesity paradox effect" has been mainly investigated through imaging methods instead of histologic evaluation, which is still the best method to study the instability of carotid plaque. Therefore, the purpose of our study was to evaluate by histology the role of obesity in destabilization of carotid plaques and the interaction with age, gender and other major cerebrovascular risk factors.. A total of 390 carotid plaques from symptomatic and asymptomatic patients submitted to endarterectomy, for whom complete clinical and laboratory assessment of major cardiovascular risk factors was available, were studied by histology. Patients with a BMI ≥ 30.0 kg/m. Unstable carotid plaque OR for obese patients with age < 70 years was 5.91 (95% CI 1.17-29.80), thus being the highest OR compared to that of other risk factors. Unstable carotid plaque OR decreased to 4.61 (95% CI 0.54-39.19) in males ≥ 70 years, being only 0.93 (95% CI 0.25-3.52) among women. When obesity featured among metabolic syndrome risk factors, the OR for plaque destabilization was 3.97 (95% CI 1.81-6.22), a significantly higher value compared to OR in non-obese individuals with metabolic syndrome (OR = 1.48; 95% CI 0.86-2.31). Similar results were obtained when assessing the occurrence of acute cerebrovascular symptoms.. Results from our study appear to do not confirm any paradoxical effect of obesity on the carotid artery district. Conversely, obesity is confirmed to be an independent risk factor for carotid plaque destabilization, particularly in males aged < 70 years, significantly increasing such risk among patients with metabolic syndrome.

Topics: Age Factors; Aged; Body Mass Index; Carotid Arteries; Carotid Stenosis; Cerebrovascular Disorders; Comorbidity; Female; Humans; Male; Middle Aged; Obesity; Plaque, Atherosclerotic; Prognosis; Risk Assessment; Risk Factors; Rome; Rupture, Spontaneous; Sex Factors

The association between nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease has attracted interest and attention over recent years. However, no data are available in children. We determined whether children with NAFLD show signs of renal functional alterations, as determined by estimated glomerular filtration rate (eGFR) and urinary albumin excretion. We studied 596 children with overweight/obesity, 268 with NAFLD (hepatic fat fraction ≥5% on magnetic resonance imaging) and 328 without NAFLD, and 130 healthy normal-weight controls. Decreased GFR was defined as eGFR < 90 mL/min/1.73 m². Abnormal albuminuria was defined as urinary excretion of ≥30 mg/24 h of albumin. A greater prevalence of eGFR < 90 mL/min/1.73 m² was observed in patients with NAFLD compared to those without liver involvement and healthy subjects (17.5% vs. 6.7% vs. 0.77%; p < 0.0001). The proportion of children with abnormal albuminuria was also higher in the NAFLD group compared to those without NAFLD, and controls (9.3% vs. 4.0% vs. 0; p < 0.0001). Multivariate logistic regression analysis revealed that NAFLD was associated with decreased eGFR and/or microalbuminuria (odds ratio, 2.54 (confidence interval, 1.16-5.57); p < 0.05) independently of anthropometric and clinical variables. Children with NAFLD are at risk for early renal dysfunction. Recognition of this abnormality in the young may help to prevent the ongoing development of the disease.

Topics: Case-Control Studies; Child; Cross-Sectional Studies; Female; Glomerular Filtration Rate; Humans; Male; Non-alcoholic Fatty Liver Disease; Obesity; Overweight; Prevalence; Renal Insufficiency, Chronic; Risk Factors; Rome

Coeliac disease (CD) is a chronic, gluten-dependent enteropathy with a prevalence of approximately 1% in Western countries. Up to now, CD has been described only in sporadic cases of obesity. Our study aimed to evaluate retrospectively CD prevalence in a large series of overweight/obese children and adolescents. Among the 1527 overweight/obese children and adolescents consecutively evaluated, 17 (7 boys, 1.11%) were positive for serology and showed villous atrophy. In all of the patients with CD a well-balanced gluten-free diet was started, and a loss of weight rapidly obtained. Our study demonstrates that CD prevalence in overweight/obese children is similar to the general paediatric population in Italy.

Topics: Adolescent; Adolescent Development; Adult; Body Mass Index; Celiac Disease; Child; Child Development; Child Nutritional Physiological Phenomena; Child, Preschool; Cohort Studies; Diet, Gluten-Free; Female; Follow-Up Studies; Humans; Male; Mass Screening; Obesity; Overweight; Pediatric Obesity; Prevalence; Retrospective Studies; Rome; Weight Loss; Young Adult

To simplify body weight measurement and, particularly, to encourage children and their parents to participate in the Italian nutritional surveillance system OKkio alla SALUTE, children were measured with clothes and then the weight was corrected for the estimated weight of the clothes. In the present study we compared the children's weight measured in underwear, as recommended by the WHO (WWHO), with that obtained using the OKkio alla SALUTE protocol (WOK) and investigated how the latter affects the calculation of BMI and the assessment of overweight and obesity prevalence.. Weight (twice in close sequence, with and without clothing) and height were measured. A checklist was used to describe the type of clothing worn. The estimated weight of clothing was subtracted from the WOK. BMI was calculated considering both values of weight and height; ponderal status was defined using both the International Obesity Task Force and WHO BMI cut-offs.. Thirty-seven third grade classes of thirteen primary schools in Rome and in two towns in the Lazio Region were recruited.. The anthropometric measurements were taken on 524 children aged 8-9 years.. The error in the calculation of BMI from WOK was very low, 0·005 kg/m2 (95 % CI -0·185, 0·195 kg/m2); the agreement between the percentages of overweight (not including obesity) and obese children calculated with the two methods was very close to 1 (κ = 0·98).. The error in BMI and in nutritional classification can be considered minor in a surveillance system for monitoring overweight/obesity, but eases the procedure for measuring children.

Topics: Body Mass Index; Body Weight; Child; Clothing; Female; Humans; Male; Obesity; Overweight; Population Surveillance; Reference Values; Rome; Schools

Objective of the study was to estimate the prevalence of obesity, overweight and thinness in a children population in Rome, Italy.. The study sample was created, after informed consent, in a school in Rome, available to the study project. A total of 595 children (289 males, 306 females), aged between 6 to 19 years, underwent following measurements: height and weight, evaluation of body mass index.. A normal BMI was recorded in 73.6% of cases. Morbid obesity, obesity, overweight, and thinness grade 1 and 2 prevalence was 1.2%, 4%, 15.3%, 9.2% and 3.8%, respectively, without statistical differences in both genders, except the prevalence of overweight that resulted statistically significant (11.4% females vs. 19.3% males, P<0.05). Differences in the age groups have been found. About 17.2% and 18.7% of children between 7 to 11 years were overweight and obese and about 33.3% and 26.6% between 6 to 8 years thin grade 1 and 2, respectively.. The study suggests a prevalence of overweight and obesity in our sample lower than that reported in a recent epidemiological survey carried out on Italy. Attention must be taken to underweight, particularly with regard to the most severe form, as a public health problem for all possible risks correlated. In addition, our study shows the involvement of specific age groups. This finding, if confirmed in a larger population, should be associated with a major attention on specific age groups at risk, in order to plan an appropriate treatment program.

Topics: Adolescent; Child; Female; Humans; Male; Obesity; Overweight; Prevalence; Rome; Thinness; Young Adult

To date, the relationship among adiposity, insulin resistance, and cardiovascular risk factors at the onset of overweight or obesity has been unexplored.. To assess whether insulin resistance and metabolic abnormalities are detectable at the onset of obesity and to unravel the interplay among adiposity, insulin resistance, and other such abnormalities.. The Origin of Cardiovascular Risk in Overweight Preschool Children cohort study aimed to evaluate at the onset of obesity in preschool children the prevalence of metabolic abnormalities, including hypertension, dyslipidemia, impaired carbohydrate metabolism, and nonalcoholic fatty liver disease. Between July 1, 2011, and July 30, 2012, in the Rome municipality, 13 family pediatricians enrolled healthy children (age range, 2.0-5.8 years) in the study during their routine practice of growth monitoring. Clinical medical records of 5729 children were reviewed; 597 children manifested new-onset overweight or obesity as their body mass index changed from normal weight to overweight or obesity in the previous 12 months according to the International Obesity Task Force classification. Of them, 219 were studied.. Patients with new-onset overweight or obesity underwent clinical laboratory testing, including oral glucose tolerance test, and ultrasonographic investigations of fatty liver and intimal medial thickness of the common carotid arteries, subcutaneous adipose tissue, and visceral adipose tissue. The homeostatic assessment model algorithm-insulin resistance was calculated.. Among the entire population (n = 5729), overweight increased from 7.0% at 2.0 years to 16.9% at 5.8 years, with corresponding figures of 1.1% to 2.9% for obesity. In total, 597 overweight or obese children (10.4%) were identified, and 219 of them (36.7%) were studied. Among the latter, 86 patients (39.3%) had at least 1 metabolic abnormality. Hypertension was diagnosed in 29 patients (13.2%), dyslipidemia in 55 patients (25.1%), impaired fasting glucose level in 7 patients (3.2%), and glucose intolerance in 6 patients (2.7%). Nonalcoholic fatty liver disease was diagnosed in 68 patients (31.1%).. Cardiometabolic risk factors, including fatty liver, are detectable in preschoolers at the onset of overweight or obesity, despite short-term exposure to excess weight and reduced insulin sensitivity. Our findings suggest the need to screen for cardiometabolic abnormalities at an earlier age than is now recommended.

Topics: Adolescent; Age Distribution; Body Mass Index; Child; Child, Preschool; Cohort Studies; Female; Humans; Insulin Resistance; Male; Metabolic Syndrome; Obesity; Risk Factors; Rome

A study was conducted on children from a junior high school in Rome, Monteverde district, to observe data on hypertension and obesity. Data were compared with results from the study carried on two years ago in the same school by the same working group.. The study enrolled 336 students, 52% males and 48% females. Blood pressure was measured with Omron 2 automatic monitor, with child cuffs. Weight and height were measured with Seca scale with stadiometer. We assessed hypertension by means of recent Task Force Tables, overweight and obesity with the tables by Cole et al.. A proportion of 5% of screened children presented hypertension, 13.9% overweight, 2.3% obesity.. Prevalence of hypertension, overweight and obesity was lower than prevalence observed two years ago in the same school, thanks to a change in eating habits which included breakfast promotion, adoption of correct food choices for lunch and dinner, and most of all an increase in extracurricular sports activity, currently performed by 92% of students.

Topics: Adolescent; Body Mass Index; Diet Surveys; Feeding Behavior; Female; Humans; Hypertension; Male; Obesity; Overweight; Prevalence; Risk Factors; Rome; Schools; Socioeconomic Factors; Students; Weight Loss

To assess the prevalence of obesity, overweight, and thinness among children in an Italian school.. Five hundred ninety-five children (289 males and 306 females) were enrolled, aged between 6 and 19 years old, in Italian school in Rome. Body mass index (BMI) was calculated according to International Obesity Task Force (IOFT) cut-off points. By age criterion all participants have been classified in age classes.. A normal BMI was recorded in 73.6% of all cases. Obesity, overweight, and thinness prevalence was 5.9%, 9.6%, and 10.9%, respectively, without statistical differences in both genders, except the prevalence of overweight that resulted statistically significant (13.1% males versus 6.2% females, P < 0.05). Differences in the age groups have been found. About 23.4% of children between 7 to 11 years were defined obese and about 42.3% between 6 to 8 years thin grade 2, respectively.. The study reports the low prevalence of overweight and obesity, in contrast to the unexpected thinness prevalence. The identification of specific age groups with abnormal nutritional status could be the first step to address future epidemiological investigations in order to plan strategic approach in selected age periods.

Topics: Adolescent; Age Factors; Body Mass Index; Child; Cross-Sectional Studies; Female; Humans; Male; Nutritional Status; Obesity; Overweight; Rome; Schools; Sex Factors; Thinness

Transoral gastroplasty (TOGA) is a safe and less invasive procedure than traditional bariatric surgery. We studied the effects of TOGA on the risk of progression from prediabetes to overt type 2 diabetes mellitus (T2DM) or on regression from diabetes or prediabetes to a lower risk category.. Prospective, observational study (October 2008 to October 2010) performed at Catholic University, Rome, Italy. Fifty consecutive subjects 18-60 years old, 35 ≥ body mass index < 55 kg/m², were enrolled. Glucose tolerance, insulin sensitivity, and secretion were studied at baseline and 1 week and 1, 6, and 12 months after TOGA. Plasma glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP), and ghrelin levels were measured.. Forty-three patients (86%) completed the 1-year postoperative follow-up. Patients lost 16.90% of baseline weight (P level × factor time <0.001). Body mass index decreased from 42.24 ± 3.43 to 34.65 ± 4.58 kg/m² (P < .001). Twenty-three patients (53.5%) were diagnosed as normal glucose tolerance (NGT) before treatment, 2 (4.6%) were impaired fasting glucose (IFG), 12 (27.9%) were impaired glucose tolerance (IGT), 1 (2.3%) had both IFG and IGT, and 5 (11.6%) had T2DM. At 1-year posttreatment, the percentages changed to 86.0% NGT, 2.3% IFG, 11.6% IGT, 0% IFG plus IGT, and 0% T2DM, respectively. Peripheral insulin resistance and homeostasis model of assessment-insulin resistance improved significantly. Fasting glucose-dependent insulinotropic peptide and ghrelin decreased from 316.9 ± 143.1 to 156.2 ± 68.2 pg/mL (P < .001) and from 630.6 ± 52.1 to 456.7 ± 73.1 pg/mL (P < .001), respectively, whereas GLP-1 increased from 16.2 ± 4.9 to 23.7 ± 9.5 pg/mL (P < .001).. TOGA induced glucose disposal improvement with regression of diabetes to NGT or IGT and regression of IGT and IFG to NGT in half of the cases. Regressors showed a much larger increase of GLP-1 levels than progressors.

Topics: Adolescent; Adult; Body Mass Index; Coronary Disease; Diabetes Mellitus, Type 2; Disease Progression; Follow-Up Studies; Gastric Inhibitory Polypeptide; Gastroplasty; Ghrelin; Glucagon-Like Peptide 1; Humans; Insulin Resistance; Middle Aged; Obesity; Obesity, Morbid; Prediabetic State; Prospective Studies; Risk; Rome; Weight Loss; Young Adult

This study aims to investigate prevalence of hypertension and cardiovascular risk factor clustering in children and adolescents attending a lipid clinic as well as the relationship of their hypertensive status with indicators of fat distribution and parental fat distribution and blood pressure (BP). In this cross-sectional primary prevention study, data on indicators of fat distribution (waist, hip, and middle-upper arm circumferences), body mass index (BMI), BP, high-sensitivity C-reactive protein (hsCRP), lipid and glucose profile of 370 children and adolescents (180 M, 190 F, mean age 9.5 years, (range 6-14 years)) were collected. Parents (502, 251 M, 251 F, age range 28-36 years), who gave their informed consent, underwent BMI, fat distribution, and BP measurements. There were 131 (35.4 %) hypercholesterolemic subjects and 72 (19.5 %) hypertensives. Using tests on medians, in comparison with 298 normotensives, the 72 hypertensives had higher levels of insulin (p<0.005) and no differences in cholesterol levels, age, and height. BMI and all the indicators of fat distribution were significantly higher (all p<0.01) in hypertensives than normotensives. BMI and waist circumferences were higher (both p<0.05) in the mothers of hypertensives, but not in the fathers. Hypertensive subjects' BMI was related to mothers' hip and waist circumferences (r=0.28 and 0.21, respectively).. In this study, children's hypertension was a component of the metabolic syndrome, but uric acid and hsCRP levels were not contributive. This hemodynamic and metabolic disorder was related to maternal fat distribution and BMI suggesting an epigenetic etiology.

Topics: Adiposity; Adolescent; Blood Pressure; Body Mass Index; C-Reactive Protein; Child; Cross-Sectional Studies; Female; Humans; Hypercholesterolemia; Hypertension; Male; Metabolic Syndrome; Obesity; Parents; Prevalence; Risk Factors; Rome

A study was carried out on students of a middle school with a medium-high social level in a southern zone of Rome, to assess the current situation regarding obesity and arterial hypertension in subjects with a parental environment favouring correct eating habits.. We considered 693 students, mean age 11.2 + 0.6. Hypertension was defined according to blood pressure (BP) tables for children and adolescents of the NIH - Fourth Report (systolic and diastolic BP >95th percentile for age and sex). Overweight and obesity were determined according to the International Obesity Task Force. Dietary habits and life-style were investigated by specific questionnaires.. The prevalence of overweight and obesity was respectively 23.1% and 3.3% of the subjects studied. Moreover, 5.2% of them showed BP values between 90th and 95th percentile and 7.8% was hypertensive. Food habits of the current students were fairly correct, favouring the Mediterranean diet and with the proper number of daily meals.. A justification for the high number of hypertensive could be due to the elevated consumption of salt added to food (60% of young people), the elevated frequency of those who often eat fast food (43%) and a family history of hypertension in the parents (24%). Only 24.5% of males and 22.9% of females used to practice physical activity; whereas 40% of males and 41% of females used to spend more than 3 hours a day in front of the TV and/or computer.

Topics: Adolescent; Child; Feeding Behavior; Female; Humans; Hypertension; Male; Motor Activity; Obesity; Prevalence; Rome

To evaluate overweight and obesity in a sample of children of school age in the city of Rome (Italy).. A sample of 18.299 school children (9.531 males and 8.768 females) aged between 3 and 15 years was studied. Height and weight have been measured in order to calculate the BMI. The percentile distribution of BMI has been determined and then subdivided according to the categories proposed by Cole. The analysis has been done using the program "Statistica" produced by StatSoft, Italia.. The prevalence of overweight exceeded 20% in all age groups with the exception of the two extremes 3 years old and 15 years old in which the prevalence was 11.8% and 15.4% respectively. Children between 5 and 10 years old have the highest rates of obesity. The prevalence of obesity was highest in females between 4 and 8 years, while for the males it was 8 to 15 years. However the difference in the prevalence between males and females was statistically significantly different only in ages 9 and 10.. The prevalence of overweight rises to a peak at age 9, reaching 30%, but declines at older ages. The prevalence of obesity peaks at an earlier age reaching between 12% and 15% at ages 5-8 years. The prevalence of obesity declines as the children get older.

Topics: Adolescent; Age Distribution; Body Mass Index; Child; Child, Preschool; Cross-Sectional Studies; Female; Humans; Male; Obesity; Overweight; Prevalence; Rome; Sex Distribution

Non-alcoholic fatty liver disease, ranging from hepatic steatosis to necro-inflammation with or without fibrosis (non-alcoholic steatohepatitis), is a growing clinical liver disorder in children.. The goals of this study were to characterize liver disorders associated with elevated aminotransferases and establish the non-alcoholic fatty liver disease/non-alcoholic steatohepatitis prevalence in hypertransaminasemic children admitted to the emergency room.. The medical records of 3280 children (2-17 years of age) admitted to the emergency room of Bambino Gesù Children's Hospital of Rome, and presenting with hypertransaminasemia were analysed retrospectively.. Elevation of serum alanine aminotransferases was present in 897 patients. Of these, 520 (58%) spontaneously normalized alanine aminotransferases, and 179/897 (20%) maintained persistently elevated alanine aminotransferases levels. Twenty-one patients were excluded because of medication or alcohol use. In the remaining 157 patients with elevated alanine aminotransferases, obesity was found in 87 (55%), viral infections in 52 (33%) and genetic diseases in 14 (9%). Obesity-related alanine aminotransferases elevation was associated with a histological diagnosis of non-alcoholic fatty liver disease in 85% of patients. In particular, steatosis was histologically confirmed in 74 patients; 43/74 (58%) had steatohepatitis, and 12/74 (16%) had fibrosis.. Twenty percent of children with elevated aminotransferases on routine testing may hide non-alcoholic fatty liver disease/non-alcoholic steatohepatitis. A careful diagnostic workup of persistent hypertransaminasemia in all obese subjects is warranted in the paediatric setting.

Topics: Adolescent; Alanine Transaminase; Child; Child, Preschool; Comorbidity; Emergency Service, Hospital; Fatty Liver; Female; Humans; Liver; Male; Obesity; Prevalence; Retrospective Studies; Rome; Ultrasonography

The aim of this study is to look for correlation between a physiological variable (skin conductance, SCL) and cognitive variables (reaction time, RT and productivity score) obtained in a memory task. Subjects were 17 females, including 7 patients and 10 controls. Patients were recruited among women who went to a clinic for alimentary disorders because of obesity and volunteered for this study; controls were normal women of comparable age without any alimentary problem. Tonic variations of SCL were recorded by a computerized polygraph during the execution of the cognitive task, which consisted of a computerized presentation of frequent, everyday used words evenly divided according to an alimentary/nonalimentary content and to a high/low imagery quality. The acquisition session was followed by an immediate recognition session where subjects were asked to identify the previously presented words among an equal number of similar words not included in the acquisition list. The two session series (acquisition and recognition) were repeated three times to evaluate the learning curve and habituation. This same procedure was separately performed with high imagery alimentary/nonalimentary words and with another list of low imagery alimentary/nonalimentary words. During the recognition tasks, both RT and productivity scores were recorded. A correlation analysis between cognitive and physiological variables was carried out to explore how subjects with different attitudes to food react in cognitive and somatic terms when exposed to verbal stimuli concerning this topic and to neutral verbal stimuli. Results show that obese patients have a different emotional activation in front of these verbal stimuli where both the cognitive activity and the somatic responses are affected by their involvement with the verbal stimuli. On the contrary, the imagery effect does not seem to be influenced by the content and by the idiosyncratic reactions to it of the specific groups of subjects.

Topics: Adult; Arousal; Attention; Emotions; Female; Food; Galvanic Skin Response; Humans; Imagination; Memory, Short-Term; Middle Aged; Obesity; Reaction Time; Reading; Rome; Semantics; Statistics as Topic; Verbal Learning

Topics: Data Collection; Endocrine System Diseases; Environmental Pollutants; Female; Humans; Hydrocarbons, Chlorinated; Insecticides; Male; Obesity; Pesticide Residues; Rome

Obesity is an ever increasing pathological condition in Western countries. Genetic, metabolic, social and cultural factors play different roles in the varying pictures of obesity, together with nutritional behavior. This research proposes to formulate a comparison through the literary sources of the classical world, so as to determine the modalities with which obesity and nutritional habits have been perceived in the past. In Greek and Roman art, obesity often assumed the characteristics of caricature and of satire, confirmed by the elaboration of the stereotype of the sponger. Obesity generated irony and sarcasm; meanwhile the figure of the tyrant too was modelled on the physical type of the obesus, in whom the vice both of alimentary and sexual excess was concentrated. The evaluation of obesity, in the course of the time, has seen alternate phases, that propose different physical models and elaborate different aesthetical canons, but always closely related to a strong social factor as a distinctive sign: opulence. Nowadays obesity is seen, on the contrary, as an ever increasing nutritional disorder, both in prevalence and in incidence, and, to the ideal of the fat subject, very recent years have progressively substituted a different aesthetic typology, also because hyperalimentation has been qualified as a concomitant cause for a number of degenerative disorders.

Topics: Adolescent; Adult; Aged; Body Mass Index; Child; Diagnosis, Differential; Diet; Esthetics; Evidence-Based Medicine; Female; Greece, Ancient; History, Ancient; Humans; Incidence; Male; Obesity; Overnutrition; Prevalence; Research; Rome; Socioeconomic Factors

The relationship between obesity and traumatic dental injuries was evaluated in a study population of 938 6- to 11-year-old schoolchildren from Rome, Italy, and it was suggested by the lifestyle and the physical activity of obese children, which, according to many authors, is different from the lifestyle of other children. The subjects were examined at school: presence and type of dental injury, overjet, incisor protrusion, upper lip incompetence and presence of obesity were recorded. Trauma predisposition was evaluated with a questionnaire investigating the behaviour which may predispose to impacts. Six out of eight questions in this questionnaire concerned the children's lifestyle and the trauma predisposition score was therefore also considered an estimate of lifestyle and physical activity. The dental injury prevalence of the study population was 21.3% and obesity prevalence was 11.4%. Of the obese children 30.8% had dental injuries vs. only 20.0% of non-obese subjects (P = 0.007). Obese children had only enamel and enamel-dentine fractures and the main reported trauma cause was indoor play; conversely, lean children also had other types of injuries and the most frequently reported cause was outdoor play. The main predisposing factors significantly affecting the probability of dental injury, evaluated with multiple logistic regression, were upper lip uncoverage (OR: 1.23; P = 0.02), overjet larger than 3 mm (OR: 1.68; P = 0.001) and obesity (OR: 1.45; P = 0.01). Surprisingly, trauma predisposition was a protective factor (OR: 0.50; P = 0.00001). The results of this study were explained by the significant inverse correlation between obesity and trauma-predisposing behaviour, thus suggesting that subjects frequently playing sports and lively games were not only less obese but also more skillful and, for this reason, less prone to trauma when they fell or sustained impacts.

Topics: Accident Proneness; Age Distribution; Child; Child Behavior; Cross-Sectional Studies; Female; Humans; Life Style; Male; Obesity; Prevalence; Risk Factors; Rome; Sex Distribution; Surveys and Questionnaires; Tooth Injuries

Two-hundred-thirty teenagers of a Roman liceo (specializing in classical studies) have been checked with particular regard to growth, pressure and feeding. The diet of teenagers proved to be particularly unbalanced from the qualitative point of view. There is an excessive intake of fats especially to the detriment of carbohydrates and starches. The incidence of obesity (6.9%) and of hypertension (6%) is not particularly high, probably due to the fact that youngsters at this age "look at themselves in the mirror a lot" for the first case and the second one can be considered as a direct consequence of the first.

Topics: Adolescent; Adolescent Nutritional Physiological Phenomena; Energy Intake; Female; Humans; Hypertension; Incidence; Male; Obesity; Rome; Socioeconomic Factors; Urban Population

The purpose of this study is to assess the body fat content of 871 Roman children, aged 7-14 years, by a simple method based on measurement of body density from skinfold thickness. Weight, height, triceps, biceps, subscapular and suprailiac skinfold were measured for every child and calculated body mass index and percentage of body fat. Girls tended to have more fat than boys and an increase of values with age; boys presented an increase of fat until 11 years, than a decrease more considerable at 14 years. Body fat percentage has a higher correlation with age than BMI and therefore is added to other body mass indices, based on weight and height, for a careful assessment of body composition.

Topics: Adolescent; Body Height; Body Mass Index; Body Weight; Child; Child, Preschool; Female; Humans; Male; Nutritional Status; Obesity; Rome; Skinfold Thickness; Urban Population

Topics: Female; History, Ancient; Humans; Male; Obesity; Rome

Topics: Adult; Age Factors; Coronary Disease; Dietary Fats; Energy Intake; Health Education; Humans; Hypercholesterolemia; Hypertension; Male; Middle Aged; Obesity; Physical Exertion; Risk; Rome; Smoking Prevention

Topics: History, Ancient; Humans; Obesity; Physical Exertion; Rome