(1) Introduction: Coenzyme Q10 (CoQ10) is a component present in the transport chain of mitochondrial electrons with antioxidant property. Currently, there are limited studies which indicate the effects of its supplementation on Metabolic Syndrome (MetS) and Non-Alcoholic Fatty Liver Disease (NAFLD). (2) Objective: This work was conducted to determine the effects of CoQ10 supplementation in women with MetS and NAFLD. (3) Methodology: This double-blind randomized clinical-controlled trial was performed among 22 women with MetS and NAFLD. Patients were randomized into two groups: group A (n = 11), which received 200 mg/day of CoQ10; and group B (n = 11), which received a placebo medication for 12 weeks. The hepatic steatosis present in NAFLD, the volume of abdominal fat, and visceral fat volume were evaluated by Magnetic Resonance Imaging (MRI). Anthropometric, blood pressure, and marker serums that compound the MetS were also analyzed. (4) Results: A decrease in visceral fat volume (p = 0.02), abdominal circumference (p = 0.03/CI = 0.19–3.80), and increase in HDL-cholesterol (p = 0.01/CI = −9.80: −1.44) was observed in the CoQ10-supplemented group. We did not find significant changes in any of the other variables evaluated. (5) Conclusions: Supplementation with CoQ10 for 12 weeks, even if discreetly, brought some benefits for the supplemented group whereas no changes were observed in the control group.

Objective: There is evidence demonstrating that cardiovascular diseases (CVD) manifesting during adulthood result from an intense interaction among risk factors that may have originated during childhood and adolescence.To compare the prevalence and clustering of cardiovascular risk factors in Brazilian schoolchildren with a 15-year interval between samples. Subjects and methods: A cross-sectional analysis based on the scores for cardiovascular risk factors was used to investigate 1,232 Brazilian schoolchildren of both sexes aged 12 to 18 years.The data of 596 schoolchildren of the 2000 sample were compared to those of 636 schoolchildren of the 2015 sample. Results: The prevalence of physical inactivity and abdominal obesity increased exponentially in both sexes from 2000 to 2015. The score for the clustering of cardiovascular risk factors showed that in 2000 the adolescents were exposed to 1 cardiovascular risk factor (31.7%), while in 2015 the greatest percentage was assigned to the category of 3 or more cardiovascular risk factors (34.9%), p < 0.001. Conclusion: The present results demonstrate a high prevalence of exposure to health risk behaviors of the adolescents studied over time. Considering the presence of modifiable risk factors, preventive measures regarding life style are essential.

O aumento da prevalência de sobrepeso e obesidade em crianças e adolescentesé uma preocupação crescente de saúde pública nos países desenvolvidos e emdesenvolvimento. No entanto, há poucos estudos com amostras representativas noBrasil.

Coenzyme Q10 (CoQ10) is an essential component of the mitochondrial electron transport chain responsible for different functions, among them its action as an antioxidant compound. Low CoQ10 levels are related to inflammatory processes and oxidative stress, factors implicated in atherosclerosis, obesity, nonalcoholic fatty liver (NAFLD), as well as metabolic syndrome (MS). MS is a disease characterized by cardiovascular risk factors linked to obesity, dyslipidemia and hyperglycemia. NAFLD is recognized as a hepatic manifestation of MS and, together with the latter, has a high incidence in the world population. Recent investigations have underscored the positive effects of CoQ10 supplementation on the treatment of obesity, oxidative stress, MS, and NAFLD. The objective of the present study was to analyze the evidence of the effects of CoQ10 supplementation on MS and NAFLD and to provide a general view of the mechanisms of action of CoQ10 in both diseases.

Restrictive diet implementation in bariatric surgery (BS) preoperative period is common, although its benefits are not well established. This study aimed to assess the effects of very low calorie diets (VLCD) on liver size and weight loss during BS preoperative period. Surgery-related complications were also assessed. A systematic review of the literature was performed. Terms such as "bariatric surgery" and "very low energy diet" were included in the search strategy. Inclusion criteria were adult patients (aged>18 yr); VLCD treatment in BS preoperative period (10 d to 12 wk); and assessment of 1 the following outcomes: weight loss, liver volume reduction, and surgical complications. There were 9 studies included (849 patients including 250 controls, 196 controls without VLCD). Of the studies, 3 were randomized clinical trials and 6 were observational studies. VLCD treatment led to weight loss (-2.8 to -14.8 kg) and to liver size reduction by 5% to 20% of the initial volume. VLCD treatment did not significantly reduce perioperative complications. However, 1 study (n = 273) reported a protective effect 30 days after surgery. This systematic review found VLCD treatment led to significant weight loss and liver volume reduction when applied to patients with obesity in BS preoperative period. The effect of VLCD on surgical risks is not clear. Standardization of dietary characteristics is needed, because weight loss and decrease in liver size were not connected to higher caloric restriction. This is an important matter in clinical practice as to avoid unnecessary prolonged and/or excessive dietary restriction.

The purpose of the study is to assess whether Roux-en-Y gastric bypass (RYGB) prior to pregnancy is associated with fluid intelligence in offspring. Additionally, perinatal and obstetric outcomes, and children nutritional status were evaluated.

Introduction: The prevalence of overweight and obese children and adolescents is a public health concern. Few studies have critically evaluated this problem in a Brazilian population, despite the growth of community-based programs to combat childhood obesity in this country. Objective: To study the anthropometrics of Brazilian adolescents over a fifteen-year period. Methods: In a cross-sectional analysis, we investigated the anthropometric status of male and female adolescents in Brazil. The anthropometric data and nutritional status of 595 schoolchildren in the year 2000 were compared to 636 schoolchildren in 2015. Results: We found a significant increase in the prevalence of overweight or obese adolescents in 2015 compared to 2000 (23.4% vs. 18.3%, p = .027). A sub-analysis stratified by sex showed that this increase only occurred in females. No statistically significant difference was observed in body mass index between the groups. Waist circumference (73.5 cm vs. 77 cm, p < .001) and the prevalence of abdominal obesity (30% vs. 47.9%, p < .001) were significantly greater in 2015, regardless of sex. Conclusion: Overweight or obese children, as well as abdominal obesity were more prevalent in 2015 than in preceding decades. This is a worrying trend as abdominal obesity increases the risk for cardiometabolic morbidity and mortality in adult life.

Restrictive diets in bariatric surgery (BS) preoperative period have been studied and used for weight loss, liver size reduction and surgical risks decrease. However, the magnitude of the effects of such diets is not yet clearly established.

Background The objective of this study was to analyze the factors associated with change in body mass index (BMI) and with percentage of excess weight loss (%EWL) in patients undergoing Roux-en-Y gastric bypass (RYGB). The following factors were analyzed: sex, age, surgical access (laparotomy vs. laparoscopy), preoperative BMI, waist circumference (WC), type 2 diabetes mellitus (T2DM), high blood pressure, and dyslipidemia.Methods Retrospective cohort study using a convenience sample of 2070 patients of both sexes, aged 18 to 65 years, undergoing RYGB between 2000 and 2013. The outcomes of interest were BMI and %EWL at 0, 6, 12, 18, 24, 30, 36, 42, 48, 54, and 60 months after RYGB.Results After 36, 48, and 60 months, approximately 50 % of patients had BMI > 30 kg/m(2). As for %EWL, 60-month results were poor for 17 % of patients (%EWL < 50 %), good for 40 % of patients (%EWL 50-75 %), very good for 24 % of patients (%EWL from > 75-90 %), and excellent for 19 % of patients (%EWL > 90 %). The four most significant predictors of BMI change 60 months after RYGB (in descending order of magnitude) were preoperative BMI, preoperative WC, surgical access, and age; and of %EWL, surgical access, preoperative BMI, preoperative WC, and age.Conclusions After 60 months of follow-up, the most relevant predictors of weight loss after RYGB were lower preoperative BMI and WC, videolaparoscopy as surgical access, and younger age. Further studies must be carried out to elucidate the impact of these factors on RYGB outcomes.

Introduction The prevalence of smoking habits in severe obesity is higher than in the general population. There is some evidence that smokers have different temperaments compared to non-smokers. The aim of this study is to evaluate the associations between smoking status (smokers, ex-smokers and non-smokers) and temperament characteristics in bariatric surgery candidates. Methods We analyzed data on temperament of 420 bariatric surgery candidates, as assessed by the AFECTS scale, in an exploratory cross-sectional survey of bariatric surgery candidates who have been grouped into smokers, ex-smokers and non-smokers. Results We detected significant statistical differences in temperament related to the smoking status in this population after controlling the current use of psychiatric medication. Smokers had higher anxiety and lower control than non-smokers. Ex-smokers with BMI >50 kg/m2 presented higher coping and control characteristics than smokers. Conclusions Smoking in bariatric surgery candidates was associated with lower control and higher anxious temperament, when controlled by current use of psychiatric medication. Smokers with BMI >50 kg/m2 presented lower coping and control than ex-smokers. Assessment of temperament in bariatric surgery candidates may help in decisions about smoking cessation treatment and prevention of smoking relapse after surgery.

Introduction While the association between cigarette smoking and abdominal fat has been well studied in normal and overweight patients, data regarding the influence of tobacco use in patients with morbid obesity remain scarce. The aim of this study is to evaluate body fat distribution in morbidly obese smokers. Methods We employed a cross-sectional study and grouped severely obese patients (body mass index [BMI] >40 kg/m2 or >35 kg/m2 with comorbidities) according to their smoking habits (smokers or non-smokers). We next compared the anthropometrical measurements and body composition data (measured by electric bioimpedance) of both groups. We analyzed the effect of smoking on body composition variables using univariate and multiple linear regression (MLR); differences are presented as regression coefficients (b) and their respective 95% confidence intervals. Results We included 536 morbidly obese individuals, 453 (84.5%) non-smokers and 83 (15.5%) smokers. Male smokers had a higher BMI (b=3.28 kg/m2, p=0.036), larger waist circumference (b=6.07 cm, p=0.041) and higher percentage of body fat (b=2.33%, p=0.050) than non-smokers. These differences remained significant even after controlling for confounding factors. For females, the only significant finding in MLR was a greater muscle mass among smokers (b=1.34kg, p=0.028). No associations were found between tobacco load measured in pack-years and anthropometric measures or body composition. Discussion Positive associations between smoking and BMI, and waist circumference and percentage of body fat, were found among male morbidly obese patients, but not among females. To the best of our knowledge, this study is the first investigation of these aspects in morbidly obese subjects. We speculate that our findings may indicate that the coexistence of morbid obesity and smoking helps to explain the more serious medical conditions, particularly cardiovascular diseases and neoplasms, seen in these patients.

BACKGROUND: Although Brazilian National Public Health System (BNPHS) has presented advances regarding the treatment for obesity in the last years, there is a repressed demand for bariatric surgeries in the country. Despite favorable evidences to laparoscopy, the BNPHS only performs this procedure via laparotomy. AIM: 1) Estimate whether bariatric surgeons would support the idea of incorporating laparoscopic surgery in the BNPHS; 2) If there would be an increase in the total number of surgeries performed; 3) As well as how BNPHS would redistribute both procedures. METHODS: A panel of bariatric surgeons was built. Two rounds to answer the structured Delphi questionnaire were performed. RESULTS: From the 45 bariatric surgeons recruited, 30 (66.7%) participated in the first round. For the second (the last) round, from the 30 surgeons who answered the first round, 22 (48.9%) answered the questionnaire. Considering the possibility that BNPHS incorporated laparoscopic surgery, 95% of surgeons were interested in performing it. Therefore, in case laparoscopic surgery was incorporated by the BNPHS there would be an average increase of 25% in the number of surgeries and they would be distributed as follows: 62.5% via laparoscopy and 37.5% via laparotomy. CONCLUSION: 1) There was a preference by laparoscopy; 2) would increase the number of operations compared to the current model in which only the laparotomy is available to users of the public system; and 3) the distribution in relation to the type of procedure would be 62.5% and 37.5% for laparoscopy laparotomy.

Obesity is linked to the development of cancer. Previous studies have suggested that there is a relationship between bariatric surgery and reduced cancer risk. Data sources were from Medline, Embase, and Cochrane Library. From 951 references, 13 studies met the inclusion criteria (54,257 participants). In controlled studies, bariatric surgery was associated with a reduction in the risk of cancer. The cancer incidence density rate was 1.06 cases per 1000 person-years within the surgery groups. In the meta-regression, we found an inverse relationship between the presurgical body mass index and cancer incidence after surgery (beta coefficient −0.2, P < 0.05). Bariatric surgery is associated with reduced cancer risk in morbidly obese people. However, considering the heterogeneity among the studies, conclusions should be drawn with care.

Obesity is a public health problem of epidemic proportions that affects a significant portion of the world population. The increase of morbidity associated with obesity is particularly important because it is related to increased risk of chronic diseases. Diets and stimulation to physical activity, in association to behavioral therapy, are the initial approach to the problem, which may include the use of pharmacological agents. Exhausted the chances of success of clinical treatment, surgical treatment is indicated. Besides the benefit of significant weight reduction, bariatric surgery is associated with reduction in the incidence of diabetes, dyslipidemia and mortality. However, adverse effects of bariatric surgery should be considered, which can occur both in the short term, as in the long term. Changes in calcium and vitamin D metabolism and bone loss in post-operative care are significant adverse effects that have been reported in recent years. Deficiency of vitamin D leads to decreased intestinal calcium absorption, reduced calcium levels and parathyroid hormone rise, determining increased bone calcium mobilization and decreased renal elimination, along with increased phosphate clearance. Obese subjects who undergo procedures that promote restriction and/or malabsorption of nutrients are at greatest risk of changes in the metabolism of calcium, phosphorus and vitamin D deficiency. Bone loss begins in the first months after surgery. Surgical techniques that cause malabsorption are at the higher risk levels for developing bone diseases. However, there are studies demonstrating changes in bone metabolism in purely restrictive techniques. Regarding fractures risk, it is known that low body weight is a risk factor for fractures, especially in the elderly. However, few studies have demonstrated the occurrence of fractures after bariatric surgery, which is controversial. Based on this review, bariatric surgery is associated with reduced calcium absorption, vitamin D deficiency, bone loss and possibly increased risk of fractures.

Roux-en-Y gastric bypass (RYGB) surgery is the gold standard surgical treatment for obesity. However, unintended nutritional deficiencies following this surgery are common, including changes in bone metabolism. We assessed changes in bone mineral density (BMD), nutritional compounds, and bone resorption markers before and 1 year following RYGB surgery.

Evidence indicates that eating habits established during childhood related to food intake persist when the child becomes an adult. Parental obesity is positively associated with the development of obesity in the offspring, who tend to become sick and obese young adults during the reproductive phase and end up looking for bariatric surgery in order to reverse the non-communicable diseases (NCDs) already established.