Scientific Program

Sessions:

Obesity oral presentations

Abstract

Obesity hypoventilation syndrome (OHS) consists of a combination of obesity and chronic hypercapnia accompanied by sleep-disordered breathing. During the last 3 decades, the prevalence of extreme obesity has markedly increased in the United States and other countries. With a global epidemic of obesity, the prevalence of OHS is bound to increase. Patients with OHS have a lower quality of life with increased health-care expenses and are at a higher risk for the development of pulmonary hypertension and early mortality compared to eucapneic patients with sleep-disordered breathing. Despite the significant morbidity and mortality associated with this syndrome, it is often unrecognized and treatment is frequently delayed. Clinicians must maintain a high index of suspicion since early recognition and treatment reduces the high burden of morbidity and mortality associated with this syndrome. In this review, we will discuss the definition and clinical presentation of OHS, provide a summary of its prevalence, review the current understanding of the pathophysiology, and discuss the recent advances in the therapeutic options. KEYWORDS: -- Obesity - obesity hypoventilation syndrome - hypercapnia - sleep disordered breathing

Biography

To be updated...

Speaker
Anil Batta / Govt. Medical College,Amritsar, India

Abstract

ABSTRACT Background: Insulin resistance syndrome has been shown to be associated with many coagulation and fibrinolytic proteins and these associations suggest that some coagulation and fibrinolytic proteins have a role in atherothrombotic disorders. Aim: This study was conducted to determine the levels of some of the haemostatic parameters in subjects having metabolic syndrome and to correlate these values with the anthropometric and metabolic variables associated with this syndrome. Subjects and methods:The study included 46 obese non diabetic subjects of whom 28 subjects(group1) fulfilled the ATP III criteria of the metabolic syndrome and 18 subjects (group2) did not have metabolic syndrome as well as 14 lean subjects (group 3) of matched age and sex as a control group. Clinical and laboratory evaluation of the study groups stressed on anthropometric measurements (weight, height, body mass index, waist circumference, and sagittal abdominal diameter), blood pressure, and laboratory measurements of fasting plasma glucose, fasting insulin, serum lipids, tissue plasminogen activator (t-PA), antithrombin III activity (ATIII), protein C and von Willebrand factor (vWf) antigen. Results: There was significant increase in the concentrations of t-PA and vWf antigens in subjects having metabolic syndrome (group 1) in comparison to the other groups while there were non-significant changes in the levels of protein C antigen and AT III activity. Both t-PA and vWf showed significant correlation with HOMA-IR as a measure of insulin sensitivity. The t-PA showed also significant correlation with most of the variables of metabolic syndrome including waist circumference, BMI, systolic blood pressure, fasting plasma glucose, fasting insulin, and HDL cholesterol. On the other hand, vWf showed significant correlations with fasting plasma glucose, fasting insulin and sagital abdominal diameter, with non-significant correlations with the other variables. Conclusion: Haemostatic and fibrinolytic parameters should be included in the features and characterization of the insulin resistance syndrome. t-PA and vWf antigens concentrations were increased in subjects with metabolic syndrome and correlated with the HOMA-IR measure of insulin sensitivity. Taking into consideration that both t-PA and vWf are mainly released from vascular endothelium, these findings could be an indicator of endothelial dysfunction in that group of subjects.

Biography

To be updated.

Speaker
Nashwa K Abousamra / Faculty of Medicine, Mansoura university,Egypt.

Abstract

The present longitudinal study is being carried out from January, 2012 to December, 2016 with the following objectives: 1. To find out the prevalence and changing pattern of overweight and obesity in medical students 2. To determine the correlates of overweight and obesity Participants were medical students posted in the Department of Community Medicine during 3rd to 5th semesters under Rural Health Posting and medical intern. Total number of participants was 220 comprising of 150 male and 90 female students. They were followed again during Internship, after completion of medical graduation. A pretested questionnaire was given to them and complete personal details, dietary habits were noted down followed by examination. Body Mass Index (BMI) was used to categorize the students into underweight, normal, overweight and obese groups. A BMI of <18.5 Kg/ m2 was taken as cut off point for under weight. Overweight and Obese were taken at the level of >25.0 Kg/ m2 and 30 Kg/m2 and above respectively. During 3rd to 5th semesters, among 150 male students, 15 (10.0%) were overweight while 9 (6.0%) were found to be obese and 6 (4.0%) were underweight. Among 90 girls, 21 (23.3%) were overweight, 10 (11.1%) obese and (7.7%) were found to be underweight. During internship prevalence of obesity was decreased to 5.2% and overweight was declined to 3.4%High calorie intake was noticed in 45 (30.0%) male students and lack of physical activity was observed in 25 (16.7%) male students. Among female students, high calorie intake and lack of physical activity was found in 31 (34.4%) and 20 (22.2%) students respectively. There is urgent need for prevention of obesity and its risk factors among college students. These findings have enormous significance for developing societies emerging from poverty and continuing to bear the double burden of both form of malnutrition in their populations. Preferred form of presentation: Oral Dr. M. Athar Ansari, Head of the Department of Community Medicine, J.N.Medical College, Aligarh Muslim University, Aligarh, INDIA-202002

Biography

Need to be updated.

Speaker
Mohammad Athar Ansari / J.N.Medical College,India.

Abstract

Causal aspects incardiovascular diseases (CVD) and mortality are still debated although many factors are now well established and included in risk scores for CVD prevention. Identification of persons at particular risk and why is of importance. Epidemiologic follow-up of the Oslo study is compared with other scientific studies. The first health survey of men in Oslo was performed in 1972/73 and 30 016 men were invited. The second survey was in 2000 and 12 764 men were eligible and 6 530 men attended. Health information was assembled by questionnaire information, blood samples with analyses, anthropometric measurements, and blood pressure recordings. The first period of follow-up from 1972 to 2000 showed a change in many risk factors for CVD such as an increase in BMI. Associated factors were looked into. At the survey in 2000 oral health information was also included. A possible association between tooth extraction and frequent alcohol consumption was suggested, as was antibodies of four specific oral bacteria and self-reported myocardial infarction. In a 12 ½ year follow-up on mortality persons with diabetes were compared to those without. Oral health data were included in these analyses. The results showed C-reactive protein as an important predictor for mortality in persons with diabetes.

Biography

Lise Lund Håheim DDS PhD is a researcher in cardiovascular disease epidemiology. She has performed follow-up analyses of the cohort the Oslo-study of 1972/73. This cohort was examined in a screening study in 2000. She organized an international seminar on oral infections and cardiovascular disease, the Oslo Workshop, in 2007. From 2001, she also worked with Health Technology Assessment (HTA) alternating with work on quality indicators in the health service. In 2011, she worked as a senior adviser at the Norwegian Ministry for health and social care. She was Chair of the Scientific Committee for the Nordic Conference on epidemiology in 2015. She is past president of the Norwegian Association for Epidemiology.

Speaker
Lise Lund HÃ¥heim / University of Oslo, Norway Institute for Public Health, Norway.

Abstract

Bariatric surgery has emerged as an effective intervention to treat obesity and its related co morbidities. For multitude of factors, access, insurance, patient fears, referrals and the procedures risks, only 1% of the eligible undergoes bariatric surgery. Considerable needs for effective nonsurgical treatment modalities are mandated. The minimally invasive novel endoscopic therapies with less morbidity could be the answer for many morbidly obese patients. Researches advocate the important role of the foregut in the regulation of glucose homeostasis & diabetes. A novel purely endoscopic catheter-based procedure that targets the duodenal mucosa had been developed by Fractyl Laboratories targeting the abnormal hypertrophy and hyperplasia and the alterations in the enteroendocrine cells of the foregut usually seen in patients with diabetes. This minimally invasive Duodenal Mucosal Resurfacing System DMR is known as Revita. Revita involves 2 main steps: First, creation of a protective barrier by lifting the sub mucosal space of the duodenum with endoscopic injection of saline and second, hydrothermal ablation (recirculation of hot water within a balloon tipped catheter) of the circumferential duodenal mucosa. This rejuvenation of the lining of the duodenum will change gut signaling in patients with metabolic diseases caused by insulin resistance. The early results with Revita DMR are quite encouraging, with well tolerated procedure, concerning safety, three instances of duodenal stenosis was reported, and treated using endoscopic balloon dilation. The 1st study involving 39 T2 DM who were failing oral medications, at 6 months, the treatment had improved glycemic control, with significant decrease in FBG, PPG, and HbA1c. The patients receiving DMR on a long segment (average ¼ 9.3 cm, n ¼ 28) compared to short (average 3.4 cm, n ¼ 11) of the duodenum experienced a greater reduction in HbA1c levels at 3 months and achieved a reduction in HbA1c levels from 8.5% to 7.1% at 6 months & about 5 pounds of weight loss. Further studies are necessary to understand the core mechanism, long-term safety, efficacy, durability and how the procedure performs in a randomized clinical trial setting, while also embracing the potential for wider metabolic benefits.

Biography

Dr. Jallo is a Clinical Professor of Medicine and Consultant Endocrinologist in Gulf Medical University GMU in UAE & Faculty in the Canadian Academy of Natural Health. Granted his MBChB from Mosul Medical College in IRAQ, postgraduate Board Certification in Internal Medicine CABM (PhD Equivalent) from the Arab Board, Fellowship of the American College of Endocrinology FACE & certified with Diploma in Dyslipidemia from Boston University School of Medicine from USA . He was an Affiliated Faculty in the Department of Medicine, Mosul Medical College & Department of Clinical Pharmacy, Mosul College of Pharmacy in IRAQ till 2004. He is actively involved as an inviting speaker in many National & International conferences & CME programs. He is the organizer of the annual GMU Diabetes & Endocrinology Conference, and organizing committee member of many international conferences. Editor In Chief: Diabetes Digest from Iraq, Editorial Board Member & reviewer for many international Diabetes & Endocrinology journals, with many publications in medical periodicals and medical conferences abstract & Active Principle Investigator in many National & International Clinical studies. He is a member of many national & international medical societies & associations.

Speaker
Mahir Khalil Ibrahim Jallo / Gulf Medical University & Thumbay Hospital - UAE

Abstract

Abstract With more than 2 billion people (30% of the world’s population) overweight/obese and an annual cost of $2.1 trillion, obesity poses severe global health and economic problems. At double the global average, 63% of the UAE population is currently overweight/obese, instigating huge health challenges and an economic burden of $6 billion/yr. A multifactorial condition, obesity is the product of an intricate interplay between genetic and metabolic/inflammation factors with functional implications on the musculoskeletal system. This is the first study to investigate the multidimensional measures of obesity in the UAE and one of the first international studies to address the multifaceted aspects of obesity in terms of associated disease. This project combines multidisciplinary engineering, science, and clinical expertise with new OMICS technologies to investigate the multifactorial nature of obesity by integrating its main risk factors (genetic and environmental) with functional factors (musculoskeletal). Specifically, quantitative genetic, metabolic/inflammatory and biomechanical profiles of Emirati youth were studied towards devising an integrative predictive model for the early prediction of obesity- associated chronic disease. 600 UAE obese and non-obese nationals (ages 18-30) from Khalifa, Zayed Universities were recruited for the study. Blood samples were obtained upon consent to investigate the genetic and metabolic/inflammation attributes. An instrumented Walkway was used for the collection of biomechanical data.

Biography

Dr. Kinda Khalaf received her B.S. (Summa Cum Laude, Distinction) and M.S. (Honors) degrees in Mechanical Engineering from the Ohio State University, USA. Her Ph.D., also from OSU, is in Biomechanics/Computational Biomechanics, specializing in Biomaterials, and Dynamic modeling and control. Dr. Khalaf has held faculty appointments in Engineering and Medicine at several prestigious universities including the University of Miami and the American University of Beirut, and currently serves as associate chair of Biomedical Engineering at Khalifa University in Abu Dhabi. She has numerous publications in the areas of Orthopedic/Spinal and Computational Biomechanics, as well neuromusculoskeletal modeling/control. Dr. Khalaf is on the list of International Who Is Who of Professionals. She has been awarded various awards and honors including the prestigious National Merit Scholar. She is a member of many professional organizations and sits on local hospital research boards, as well as editorial board of several respected journals in her field.

Speaker
Kinda Khalaf / Khalifa University of science and Technology, Abu Dhabi, UAE

Abstract

OBESITY AND PHYSICAL FACTORS Obesity is a major global health problem and predisposes individuals to several comorbidities that can affect life expectancy. Interventions based on lifestyle modification (for example, improved diet and exercise) are integral components in the management of obesity. However, although weight loss can be achieved through dietary restriction and/or increased physical activity, over the long term many individuals regain weight. The aim of this article is to review the research into the processes and mechanisms that underpin weight regain after weight loss and comment on future strategies to address them. Maintenance of body weight is regulated by the interaction of a number of processes, encompassing homoeostatic, environmental and behavioural factors. In homoeostatic regulation, the hypothalamus has a central role in integrating signals regarding food intake, energy balance and body weight, while an ‘obesogenic' environment and behavioral patterns exert effects on the amount and type of food intake and physical activity. The roles of other environmental factors are also now being considered, including sleep debt and iatrogenic effects of medications, many of which warrant further investigation. Unfortunately, physiological adaptations to weight loss favour weight regain. These changes include perturbations in the levels of circulating appetite-related hormones and energy homoeostasis, in addition to alterations in nutrient metabolism and subjective appetite. To maintain weight loss, individuals must adhere to behaviours that counteract physiological adaptations and other factors favouring weight regain. It is difficult to overcome physiology with behaviour. Weight loss medications and surgery change the physiology of body weight regulation and are the best chance for long-term success. An increased understanding of the physiology of weight loss and regain will underpin the development of future strategies to support overweight and obese individuals in their efforts to achieve and maintain weight loss Abstract CONTEXT: Weight loss elicits physiological adaptations relating to energy intake and expenditure that antagonize ongoing weight loss. OBJECTIVE: To test whether dietary composition affects the physiological adaptations to weight loss, as assessed by resting energy expenditure. DESIGN, STUDY, AND PARTICIPANTS: A randomized parallel-design study of 39 overweight or obese young adults aged 18 to 40 years who received an energy-restricted diet, either low-glycemic load or low-fat. Participants were studied in the General Clinical Research Centers of the Brigham and Women's Hospital and the Children's Hospital, Boston, Mass, before and after 10% weight loss. MAIN OUTCOME MEASURES: Resting energy expenditure measured in the fasting state by indirect calorimetry, body composition by dual-energy x-ray absorptiometry, cardiovascular disease risk factors, and self-reported hunger. RESULTS: Resting energy expenditure decreased less with the low-glycemic load diet than with the low-fat diet, expressed in absolute terms (mean [SE], 96 [24] vs 176 [27] kcal/d; P = .04) or as a proportion (5.9% [1.5%] vs 10.6% [1.7%]; P = .05). Participants receiving the low-glycemic load diet reported less hunger than those receiving the low-fat diet (P = .04). Insulin resistance (P = .01), serum triglycerides (P = .01), C-reactive protein (P = .03), and blood pressure (P = .07 for both systolic and diastolic) improved more with the low-glycemic load diet. Changes in body composition (fat and lean mass) in both groups were very similar (P = .85 and P = .45, respectively). CONCLUSIONS: Changes in dietary composition within prevailing norms can affect physiological adaptations that defend body weight. Reduction in glycemic load may aid in the prevention or treatment of obesity, cardiovascular disease, and diabetes mellitus.

Biography

Need to be updateed.

Speaker
Anil Batta / Govt.Medical college,Amritsar Session,India.

Abstract

Non-alcoholic fatty liver disease (NAFLD) represents an increasing cause of chronic liver disease worldwide, with an estimated global prevalence of ~25%. Its prevalence has grown proportionally with obesity, sedentary lifestyle, unhealthy diet and metabolic syndrome. First line treatment is a combination of dietary modifications and increased physical activity. To address the challenge of empowering patients and clinicians to better manage lifestyle, we have designed a novel mobile application entitled F for Fitness. We have developed an intelligent and integrated solution for patients with Non-Alcoholic Fatty Liver Disease, consisting of: A smart mobile application for coaching and monitoring patients during their daily activities and a cloud-based web application for the management of patients and the storage / analysis of data. The central web application features intelligent issue tracking and a Powerful web analytics providing real-time track of users and their behavior. It is based on Apache Cordova, HTML5, JavaScript and supporting Android, iOS, Windows Phone. We specified, prototyped and developed a system consisting of an Android app accessible to the patients and a central platform accessible to the clinicians.The app consists of five main screens: Exercise, Food and Water Intake, Alcohol Consumption and Weight/BMI. Exercise is expressed in steps, meters and calories per day. Each meals recorded choosing between different visual options, ranging from raw ingredients to processed food. Similarly, the patients are asked to enter the quantity and the type of alcohol consumed daily. In order to give an educational feedback, nutritional facts are displayed after each choice and a pie chart shows the amount of calories consumed vs burned at the end of the day. Water intake is also required for the correct interpretation of variations in weight and BMI. Finally, each section tracks the history from the beginning of the use of the app. Built-in sensors and third party devices could fit in easily to manage health and environmental records such as heart rate, blood pressure, glucose levels. Through the central platform, clinicians can access to the records and analyze patients’ diet, food intake/exercise balance and alcohol habits. Moreover, each record is pre-filled with clinical data, such as latest Liver Function tests, Liver Stiffness Measurement and Histology report. Push notifications could be send to the patient by the operator, when necessary. F for Fitness is a novel application prototype in Non-Alcoholic Fatty Liver Disease. This application acts as an educational tool for the patients and as a real-time follow up of lifestyle for the clinicians, allowing for a personalized management in this group. F for Fitness might be used in clinical practice and in future studies to monitor the effectiveness of behavioural programs.

Biography

Dr Roberta Forlano is a Phd Student holding an EASL Fellowhisp in the Department of Hepatology, Imperial College London in the group led by Prof. Mark Thursz and Dr Pinelopi Manousou, lead hepatologist of the NAFLD Service. She graduated from the University of the Study of Foggia (Italy) with a Master degree in Medicine and completed her Specialty Training in Internal Medicine, focusing on Hepatology, under the supervision of Prof. Gaetano Serviddio. During her specialty training in Italy, she was in charge of projects involving animal models of NASH and the analysis of oxidative stress in hepatocytes. Roberta is a clinical scientist with a research interest in Non-Alcoholic Fatty Liver Disease (NAFLD), focusing on diagnosis (quantitation of fat, ballooning and collagen in liver biopsies using machine learning), lifestyle management (development of a unique smart mobile application to coach and monitor patients), cardiovascular risk and non-invasive markers in NAFLD. She is first author in more than 20 scientific papers, including abstracts and conference papers and she is an active member of several scientific associations (EASL, AISF).

Speaker
Roberta Forlano / Imperial College London, England, United Kingdom

Abstract

Co-Authors: Janitza L. Montalvo-Ortiz, Hannah Holbrook,Kerry O’Loughlin,Catherine Orr,Catherine Kearney,Bao-Zhu Yang,Tao Wang,Hongyu Zhao,Robert Althoff,Hugh Garavan,Joel Gelernter,James Hudziak Objective: The association between adverse childhood experiences(ACE) and deleterious health outcomes was first reported nearly two decades ago. The mechanisms responsible for these highly replicated findings have remained largely elusive. This presentation will discuss results of a study that was designed to determine if measures of ACE and DNA methylation relate to indices of obesity in youth. Study Design: Participants were derived from a cohort of 321 8-15 year-old children recruited for an investigation examining risk and resilience and psychiatric outcomes in maltreated children. Assessments of obesity were collected as an add-on for a subset of 234 participants (56% female; 52% maltreated). Illumina arrays were used to examine whole genome epigenetic predictors of obesity in saliva DNA. For analytic purposes, the cohort analyzed in the first batch comprised the discovery sample (N=160), and the cohort analyzed in the second batch the replication sample (N=74). Results: After controlling for race, sex, age, cell heterogeneity, three principal components, and whole genome testing, 10 methylation sites were found to interact with ACEs to predict cross-sectional measures of body mass index (BMI), and an additional six sites were found to exert a main effect in predicting BMI (p < 5.0 x 10-7, all comparisons). Eight of the methylation sites were in genes previously associated with obesity risk (e.g., PCK2, CxCl10, BCAT1, HID1, PRDM16, MADD, PXDN, GALE), with several of the findings from the discovery data set replicated in the second cohort. Conclusions: To the best of our knowledge, no prior studies have reported ACE and methylation main, interaction, and mediation effects in predicting obesity. This study lays the groundwork for future longitudinal studies to elucidate these mechanisms further and identify novel interventions to alleviate the health burdens associated with early adversity. Methods associated with a current ongoing prospective study will be discussed, together with prevention and intervention implications of the research.

Biography

Need to be updated.

Speaker
Joan Kaufman / Kennedy Krieger Institute, Johns Hopkins School of Medicin,united states..

Abstract

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Biography

Speaker
Nuru Alam Siddique / Metal Agro Ltd, Bangladesh

Abstract

A lesson from history often shows short-cuts and frequently some wrong ways .These have also shown up in the field of diabetes and its dietetic treatment (1). But I do not only want to describe these ways and also the wrong ways, but also to explain how they originated. In fact: they are the consequences of the state of the art at the time which lacked many of the methods and perceptions which for us in modern times seem to be obvious. But in those days these recommendations were logical and pretty much plausible. One example: Most of us know today that our earth turns around the sun, but only 400 years ago for every reasonable man and first of all for theologians it was clear and could be spelled out without danger of being burned at the stake that the sun rotates around the earth as is written in the holy Bible (Josua 10, 12-13). In fact the astronomical observations, measurements and explanations of Ptolemaeus using epicycles as an expedient fitted this theory astoundingly well (2). The illness: “Diabetes” is known since antiquity. Diabetes in Greek signifies “through-flow” and describes the observation of the physician Aretaios in Kappadocia (80-131 p. C.) that in these patients the beverages “ran through” in spite of their heavy thirst and that they even lost weight. (1) The word “mellitus” was added only much later in Europe after the 30 years war when the British physician Thomas Willis stuck his finger in the urine of a diabetic patient and licked it. (3) Hindus, on the other hand had noticed already around the year 1.000 that this urine attracted ants and other insects and had drawn the correct conclusion - maybe testing also with their fingers – that it contained sugar. But this observation never got out of India. But based on these observations, the Indian physicians of these times developed rather more modern dietetic recommendations for their patients: oat or wheat-meal with honey and physical exercise, either extended walking or – maybe for rich patients – riding on elephants. Much earlier, the Roman physician Celsus recommended: restraint when eating or drinking sour wine, this is advice which could be also given today. The old Egyptians (1.500 a. C.) published a recipe in Papyrus Ebers, but which concerns all form of polyuria. (4) Diabetes was considered - which is understandable – a renal disease, and physicians tried to concentrate the watery urine by recommending milk as a drink. Much later, in the 19. century, Kussmaul noticed the exhalation of acetone and described the diabetic coma and the pronounced respiration of comatose patients named after him. (5) People had learned to demonstrate the presence of sugar and acetone in the urine, but could not measure them exactly, and no method was known to gauge the levels of sugar, fats or cholesterol in blood. Therefore physicians concentrated on the sugar in urine whose presence they could demonstrate. They used the expression “sugar-disease” and tried to ban sugar from nutrition. They also knew that sugar is a carbohydrate and limited the uptake of carbohydrate-containing nutrients. They also followed the suggestion of A. Bouchardat: “Mangez le moins possible” i. e. :” eat as little as you can” (6), an advice which also nowadays could eliminate and also prevent about every second case of diabetes (7). “Diabetic patients with type 2 frequently don’t have a diabetes, but a belly.” Bouchardat had found out during the famine caused by the Prussian siege of Paris in 1870, that his diabetic patients benefitted from this enforced fasting and that the sugar in their urines diminished considerably. His experiences were also confirmed in both world wars with the ensuing periods of starvation (8). Before insulin was discovered, especially American physicians among them F. M. Allen (9) propagated days of total fasting and extreme cures of hunger. They succeeded in diminishing death by coma, but quite a few patients died from malnutrition. Therefore, in Sweden and in the USA nutrition schemes were developed which contained lots of fat, but little carbohydrates and proteins – to prevent gluconeogenesis – with the aim of lowering sugar excretion. Erich Grafe, the medical teacher of my father in Würzburg, reported after a visit to Stockholm (10): “Swedes are used to much greater amounts of fat than Germans, and the sight of 12 diabetic patients taking slices of cucumber smeared with lots of butter for a second breakfast as I observed in a hospital-room of Professor Petrén would be unthinkable in a German hospital.” On the other hand, von Noorden in Frankfurt had noticed that ketoacidosis improved after administering oats and recommended “oat days” with 150 to 180 grams of oats to prevent an impending diabetic coma. (11) And this also was a correct observation and logical since we know today: “fats burn in the fire of carbohydrates.” Only the burning of fat after administration of carbohydrates can limit the formation of ketone bodies and thereby possibly prevent a diabetic coma. Carbohydrate uptake also prevents the formation of so-called “nutritional acid slush”, i. e. the formation and excretion of acetone which diet-apostles try to fight by cures of total fasting and others. They don’t know or don’t acknowledge that this slush formation is only the consequence of the lack of carbohydrates due to their dietetic teachings. It is logical that oat-days with the administration of carbohydrates and calories were successful in preventing diabetic comas, but they were not appropriate for long-term nutrition. This “oat cure” advised soups from 100 to 200 grams of oats for one to two weeks combined with 200 to 300 grams of butter, red wine and tea. Also known were slowly decomposable carbohydrate-carriers and diabetics were encouraged – as in our days – to prefer whole-meal products instead of white meal bread. v. Noorden shaped the expression “Broteinheit” i. e. bread-unit. It is defined as containing 10 up to 12 grams of digestible carbohydrates, e. g.: one (thin) slice of bread or a middle-sized apple or a potato. (12) Content of bulk material and retarded digestion are much more significant in diabetes diet than the sometimes absurd discussion of relative amounts of fat or carbohydrates in daily nutrition. Taken together: before the discovery of insulin, especially patients with diabetes of type 1 died either in coma or by starvation. Their diet was supposed to be sparse and devoid of glucose. Proteins should be included sparingly and people had to change to oat-meal following v. Noorden or to the “Mehlfrüchte-Kur” i. e. “cereals” plus vegetables, recommended by W. Falta (13) or to fat in the “Petrén-diet”. Without insulin, you had to drive a car without brakes, as often as possible without accelerating or going downhill. The fear of glucose was certainly justified before the discovery of insulin, but this acceptable attitude during the time of the German emperors was for a long time the scientific basis of official recommendations for the nutrition of patients with diabetes. It was also the legal base for the production of useless special “Diabetiker-Lebensmittel” as dietetic products. The EU has banned them many years ago, and Germany was the last nation to stop their production. This fixation on sugar - strengthend by the unlucky German expression of “Zuckerkrankheit” - has lead to much misery. But even today elder, obese diabetic patients are frequently warned by outmoded dieteticians to avoid sugar and carbohydrates. They are asked – even those without insulin treatment – to calculate their intake of carbohydrates in “Broteinheiten”. Thereby carbohydrates are branded as dangerous and their uptake is diminished by a too small prescription of these “bread-units”. Consequences were obvious: voracious appetite and these hungry patients started to eat more fats and proteins; they put lots of butter and sausage not on cucumber as in Sweden of old days, but on very thin slices of bread. During the 19th century, the determination of blood sugar required around 250 ml. of blood. Only after the medical student CH Best had learned to measure blood sugar with a newly developed method, FG Banting was able to discover insulin in 1922. (14) This dependence of a discovery on a correct measurement-procedure showed up again in the field of diabetes during world war II, when A. Loubatières in Montpellier worked with the first sulfonylurea product and found out that it was a poor antibiotic, but could lower blood sugar down to deadly hypoglycemias (15). After the discovery of insulin, the situation changed dramatically: Many diabetic patients nearing death by starvation could be maintained in life – some of them for many years - in a tolerable state of health. The two Canadian researchers offered their discovery to humanity without applying for a patent, and the pharmaceutical industry was soon able to start the mass-production of this life-saving hormone. The victory over diabetes was then proclaimed triumphantly, but erroneously. Some complications appeared, which had not been noticed before. It had been known previously that diabetic patients could develop blindness, but before insulin was discovered few of them had survived long enough to reach this state. Now the frequency of diabetic coma diminished dramatically, but patients had to confront diabetic microangiopathy and its effects on the eyes, kidneys, nerves and feet to its full extent. Soon it was correctly assumed that an efficient correction of the diabetic metabolism could lessen and retard these complications remarkably. The “Alt-Insulin” of these days contained many impurities. This resulted in a strong formation of antibodies and these antibodies bound insulin in blood and set it free only slowly. Thereby the effect of insulin was retarded. This had a good and a bad consequence: Patients did not have to inject their insulin as often as they would be obliged to do today after being transferred to highly purified normal insulin which induces only a small antibody-production, but even with only two injections per day their insulin levels stayed highly elevated for a long time after their meals and they had to fear hypoglycemias. In addition, pharmaceutical firms had soon developed longer acting insulin-preparations which further increased these good and bad consequences. In-between and late meals had to be introduced to compensate for these persisting insulin levels, and doctors and patients were obliged to adapt nutritional intake more to the timetable of insulin injections, the quantities injected and to the action profile of the insulin preparation used. (16) Now the diet proposal for a diabetic patient – and unfortunately not only for patients requiring insulin – could include e. g.: 20 bread-units, distributed over 6 meals: • 2 BE for the first breakfast meal • 3 BE for the second • 6 BE for lunch • 2 BE for afternoon tea • 5 BE for supper • And 2 BE for a late night-meal These meals had to be served exactly on time and sugar remained forbidden. Patients learned to estimate roughly their sugar - and if needed their acetone-levels - in the urine, not to measure them. But determination of blood-sugar remained difficult and could only be performed maybe once per month in the doctor’s office. It is understandable that such a strict regime of insulin injections and meals, if it had proved to be of value, had to be maintained as strictly and for such a long time as possible. This stiff corset had to be accepted in those days: the physicians, e. g. my grandfather and my father had been medical officers in wartime and patients came to a garde à vous when the hospital physician appeared, and they accepted these strict prescriptions more or less and without question. Today, we have learned to simplify prescriptions for insulin injections and nutrition. We use kitchen-measurements (handful, tip of a knife) instead of diet-balances and know better how to motivate our patients by these methods. But there is still too much talk about percentage of fat and there are too little practical suggestions such as “five a day”= 5 small (in children) or big (in adults) handfuls of vegetables or fruits per day. But progress gave us better and more precise methods for blood-sugar determination, even on appropriate “strips” for “dry-chemistry”. Now our patients are able to measure themselves and get an impression of the quality of their diabetes handling. But it took quite a while until this “democratization” of diabetes treatment established itself. Nowadays patients themselves can decide how much and when to inject insulin and fix their meals accordingly. Michael Berger and EA Chantelau from Düsseldorf could point to original the ideas of JP Joslin and succeeded in implanting this more liberal attitude towards diabetes diet in Germany. (17) Doctors learnd that insulin offered the possibility to control a moderate intake of glucose. Today it can reach about 10 % of daily nutritional-uptake. The car now has a brake. The differences in nutrition of diabetic patients and metabolically healthy persons are getting smaller and smaller. There is a convergence of our nutrition proposals. A relief for those cooking. One meal now can be served to the whole family. This change was supported by observations that diabetic patients did not so much die any longer in coma, but suffered from the deadly consequences of arteriosclerosis i. e. myocardial infarctus and strokes as did persons without diabetes, only more frequently and earlier. People got older and more obese. Wealth had its price, more and more people suffered from diabetes type 2. They did not die any longer from starvation but from the effects of obesity. Research discovered and described the metabolic syndrome, the deadly quartet consisting of: Obesity, Hypertension, Diabetes and Hyperlipoproteinaemia. (18). In the meantime the methods for determination of cholesterol and its components e. g. LDL and HDL as determinants of arteriosclerosis had been established. Furthermore epidemiologists had proven in the UKPDS-study (19) that for diabetes-patients it was more important to normalize their hypertension, their lipid levels and their bodyweight than to fine-tune their bloodsugar-levels. After this abandonment of the “glucocentric” view of diabetes – again due to the advent of new laboratory methods – which is somewhat comparable to the Kopernikanian revolution - diabetic patients not needing insuline now can nourish themselves pretty much the same way as persons without diabetes, they don’t need to follow a special diet, but they try to realize a reasonable nutrition, e. g. “mediterranean diet” following the advice of diabetologists worldwide (20). In changing long-term habits of nutrition, we have to avoid a number of mistakes which are typical for eating and drinking in our industrial society: • Too fat • Too much sugar • Too much salt • Too much alcohol • Not enough cellulose as bulk material • And not enough secondary plant constituents Diabetic persons without insulin-treatment don’t need a kitchen balance any longer, but a well functioning bath-room balance. They should not insist on counting pieces of sugar and bread units, but they should know unhealthy fat preparations and avoid them. Inquiries have partially confirmed the affirmations of obese people, that they didn’t eat so much more as their neighbours with normal weight. They may consume less sugar, but much more saturated animal fat which may lead to arteriosclerosis. They should seek to lose about 5 to 10 kgs in a year by diminishing their caloric intake and take up more physical exercise. Such an obtainable and persistent moderate weight loss consists mostly of fats from “unhealthy” depots in liver and abdomen. It lowers blood-sugar levels, helps to spare medication and lowers high blood pressure and blood-lipid-levels (21). Many benefits from one singular treatment. And a lowered nutritional intake combined with more physical activity is a really natural treatment without chemistry on one and less hocus-pocus on the other hand. But today still, recommending an uptake of 55 and more relative percent carbohydrates is mistaken, since this advice can be followed only by professional cycling-sportsmen maybe taking part in the tour de France. Facit: With our proposals for nutrition – no longer with the focus on a special diet – in diabetes mellitus, we should keep the wrong ways of the past to the back of our minds, but should not err around with them. 1. Hans Schadewaldt: Geschichte des Diabetes mellitus. Springer Berlin-Heidelberg-New York, 1975: 118-124. 2. Gerhard Fasching: Sternbilder und ihre Mythen. Springer Wien-New York. 1993: 218, 223. 3. Thomas Willis: Pharmaceutice Rationalis sive Diatriba de Medicamentorum Operationibus, London, 1674, Sect. 4, Cap. 3: 113 ff. 4. Deines H. V., Grapow H., Westendorf W.: Grundriß der Medizin der alten Ägypter. Berlin Akademie-Verlag 1958, Bd. 4, 1: 134 ff. 5. Kussmaul, A.: Zur Lehre vom Diabetes mellitus. Über eine eigenthümliche Todesart bei Diabetischen, über Acetonämie, Glycerin-Behandlung des Diabetes mellitus und Einspritzungen von Diastase im Blut bei dieser Krankheit. Dtsch. Archiv klin. Med. 14: 1-46 (1874). 6. Bouchardat A.: De la glycosurie ou diabète sucré. Paris (1875) 7. WHO : Obesity : Preventing and Managing the Global Epidemic. Geneva, 3. - 5. June 1997. 8. Liebermeister, Hermann: Adipositas. Deutscher Ärzte-Verlag 2002: 40. 9. Allen F. M.: Protein Diets and Undernutrition in Treatment of Diabetes mellitus. J. Amer. Med. Ass. 74; 571-577 (1920). 10. Grafe, Erich: Ernährungs- und Stoffwechselkrankheiten und ihre Behandlung. Springer, Berlin-Göttingen-Heidelberg, 1958: 749. 11. von Noorden, C.: Über Haferkuren bei schwerem Diabetes mellitus. Berl. klin. Wschr. 40, 817-821 (1903). 12. Liebermeister H.: Die Broteinheit – erneut und breiter definiert. Akt. Ern. Med. (1994); 19: 188-190. 13. Falta W.: Die Mehlfrüchtekur bei Diabetes mellitus. Berlin-Wien (1920). 14. Best CH: The Discovery of Insulin. Proc. Amer. Diab. Ass. 6, 87-93 (1947) 15. Loubatières A: Analyse du mécanisme de l’action hypoglycémiante du p-aminobenzènesulfamidothiobenzol (2254 RP). C. R Soc. Biol. Paris 96, 766-767 (1944). 16. Joslin EP et al. : Treatment of diabetes mellitus. Philadelphia Lea&Febiger, 8 ed. (1946). 17. Oyen D, Chantelau EA, Berger M: Zur Geschichte der Diabetes Diät. https://books.googlebooks?isbn=3642704980. 18. Jahnke K, Daweke H, Liebermeister H et al.: Hormonal and metabolic aspects of obesity in humans. Proc. VI th Congress IDF, Excerpta Medica, Amsterdam (1969): 533-539. 19. United Kingdom Prospective Diabetes Study (UKPDS): Lancet 352 (1998): 837-853 and 854-865. 20. Greaves CJ, Sheppard KE, Abraham C et al. from the IMAGE Study Group: Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions. BMC Public Health (Feb. 2011); 11: 119. 21. Singh RB, Rastogi SS, Verma R et al.: Randomized controlled trial of cardioprotective diet in patients with recent acute myocardial infarction: Results of 1 year follow-up. British Medical Journal; 304: 1015-1019 (1992) 22. DIABDIÄ32_Lit Prof. Dr. Hermann Liebermeister PVS Mosel-Saar Boxbergweg 3a D-66538 Neunkirchen-Saar DIABDIÄ31_wrong ways

Biography

Need to be updated.

Speaker
Herman Liebermeister / PVS Mosel-Saar Boxbergweg 3a D-66538 Neunkirchen-Saar

Abstract

The food assistance program was implemented by WFP to assist the poorest Syrian refugees in Lebanon. The aim of this study was to evaluate the impact of the food assistance on food security and diet diversity and compare the frequency of consuming main food groups between assisted and non-assisted households (HHs) in six poles of North Lebanon. From August till December 2017, 383 HHs were interviewed based on a random sampling. Collected data was analyzed and results showed that 7.2% of assisted HHs and only 1 % of not assisted HHs were food secure. Dietary diversity was also influenced by the food assistance where 66.7% of assisted HHs had a high dietary diversity in comparison with 42.4% of not assisted HHs. Consumption patterns are high for starchy staples, oil and sweets (mainly sugar) and condiments for both assisted and not assisted HHs. However, for the remaining food groups which are milk and dairy products, fruits, vegetables, meat, chicken, fish and eggs, the low consumption pattern of assisted households is even lower for not assisted ones.However, although the results clearly state that WFP’s food assistance is increasing the food security level and diet diversity score, the food consumption pattern of assisted Syrian refugees does not comply with the dietary recommendations of MyPlate guidelines. Therefore, the lack of orientation should be tackled by awareness sessions and public health strategies that aim to help beneficiaries of food assistance achieving more balanced diet. Keywords: Food assistance, food security, dietary diversity, consumption patterns, Syrian refugees, North Lebanon.

Biography

Biography Yonna sacre has earned her PhD from Humboldt University in Berlin and her Masters Degree in HumanNutrion and Dietetics from Saint Joseph University Beirut.She is actallyHead of the Human Nutrition and Dietetics department at the Holy Spirit University of Kaslik , teaching different human and community nutrition courses.She is member of the Lebanese National Nutrition Exam Committee and Jury member and president of several master theses’ defense committees at USEK-Kaslik, Lebanon Presenting author details Full name: Yonna Sacre Contact number: 00961 3 568402 Category: (Oral presentation/ Poster presentation)

Speaker
Yonna Sacre / Holy Spirit University of Kaslik, Lebanon

Sessions:

Abstract

- Investigation of the respiratory symptomatics according to the risk of suffering from Tuberculosis, Havana, 2004-2005. (7/2005). Results: The average age was 20.0 ± 61.0 years old. Out of the surveyed patients with respiratory symptoms, retirees accounted for 45.8%. All sputum samples were helpful samples, 12.5% of the cultures were not performed because of contamination or inadequate samples. 12.5% of patients needed more follow-up after diagnosis and 18.8% did not improve. 81% of the patients presented at least one risk factor. Conclusions: the importance of surveys in order to monitor patients with respiratory symptoms according to the risks of tuberculosis becomes paramount with this study. - Educational Intervention for the cardiovascular prevention in teenagers of Junior High School, Havana 2007-2008. (5/2009) Results: There were significant statistical associations with a confidence limit of 95% between initial and final state of knowledge in relation to cardiovascular risk factors in the intervention group (p = 0.0001), in the control group (p = 0.035) and between the study group versus the control group after the intervention (p = 0.0001). Conclusions: An educational-participatory program for health promotion and prevention of major risk factors of cardiovascular disease (inadequate dietary habits, smoking and physical inactivity) among teenagers, contributes to increase their knowledge and encourages the adoption of healthy daily habits and lifestyles. - Clinical-anatomopathological diagnostic discrepancy of diabetes mellitus as the basic cause of death, Havana, 2014. (4/2017) Results: Sex and the most represented age group were: female (106, 63.5%) and 60-79 years (93, 77.7%), respectively. The most frequent direct causes of death were septic shock (38; 22.7%), followed by pulmonary thromboembolism (27; 16.2%). The discrepancy between the MCD and the necropsy result, as for DM as BCD was 34.7%. The doctor who certified the most death, was the guard (138; 82.6%). Of the 58 MCD´s in which there was no diagnostic discrepancy, the most frequent method of recovery from the diagnosis of DM was repair (32; 52.6%), followed by the recoding method (26; 44.8%). Conclusions: The diagnostic discrepancy between the direct cause of death (DCD) in the MCD and the result of the necropsy of the deceased studied presented values higher than the proposed standard. - Evaluation of three methodologies for risk prediction of impaired glucose metabolism in overweighed and obese subjects. (2017) Results: the frequency of impaired glucose metabolism (impaired fasting glycemia and type 2 diabetes) after two and a half years, according to the previous existence or not of impaired fasting glycemia, insulin resistance and moderate/high risk of type 2 diabetes, was higher in subjects with previous impaired fasting glycemia (72,4 % [21/29]), with insulin resistance at the beginning (65.6 % [40/61]) and with moderate/high risk (54,4 % [43/79]) than in those individuals without impaired fasting glycemia, insulin resistance and with low diabetes risk (41.0 % [25/61], p= 0,005; 20.7 % [6/29], p= 0.006 and 27.3 % [3/11], p< 0.0001, respectively). Insulin resistance index and moderate/high risk of type 2 diabetes showed high sensitivity to identify subjects with impaired glucose metabolism (87.0 and 93.5 %, respectively), in contrast to impaired fasting glucose whose sensitivity was low (45.7 %). Of 19 individuals who developed type 2 diabetes two and a half years later, 100 % had moderate/high risk of type 2 diabetes and 94.7 % had insulin resistance at the beginning. Conclusions: Insulin resistance and risk of type 2 diabetes could be very useful in detecting individuals with high risk of developing diabetes. - Glycemic control and level of physical activity in patients with diabetes, Policlinic "Héroes del Moncada", Havana, 2017. (is currently being applied) - Strategy of intervention of modifiable risk factors of diabetes mellitus in individuals at risk of suffering the disease, Havana, 2017. (is currently being applied) - Cut-off value of the conicity index as an independent predictor of dysglycemia. (is currently being applied) - Cutoff value of the waist/hip index as an independent predictor of dysglycemia. (is currently being applied) Peer Reviewed Publications. [ResearchGate Index: 8,71 MSC (76 Citations)] 1. BI Formental, Arnold Y. AIDS: Evaluación educativa en jóvenes con riesgo social, Municipio de La Habana Vieja, enero de 2008. Revista Cubana de Higiene y Epidemiología. 2009; 47 (3): 1-10. 2. BI Formental, Arnold Y. Presentación de un enfoque de control de tuberculosis pulmonar, municipio de La Habana Vieja, octubre de 2004. Revista Cubana de Higiene y Epidemiología. 2010. 48 (2): 25. 3. Arnold Y. Dengue: Evaluación de la lucha antivectorial en el Policlínico Isidro de Armas, julio de 2006 - noviembre de 2006. Revista Cubana de Higiene y Epidemiología. 2011; 49 (1): 105. 4. Arnold Y. Intervención Educativa para la prevención cardiovascular en adolescentes de Secundaria, La Habana 2007-2008. 1. Revista Finlay. 2011; 1 (2): 97. 5. Arnold Y, Chappi Y, Díaz A, Rodríguez S, Trimiño AA. Evaluación del Programa Internacional de Control de la Salud en el Policlínico "Nguyen Van Troi", Centro Habana, La Habana, 2007. Revista Cubana de Higiene y Epidemiología. 2011; 49 (2): 231 6. Arnold Y, Arnold M. Evaluación del uso de plaguicidas en la Campaña antivectorial, Policlínico Antonio Maceo, 2007. Revista Cubana de Salud y Trabajo. 2011; 12(3):14. 7. Arnold Y. Dengue: Valoración de la Lucha Antivectorial en el Policlínico Isidro de Armas, Julio 2006-noviembre 2006. Revista Cubana de Higiene y Epidemiología. 2011; 49(1): 105. 8. Arnold Y. Algunos aspectos relevantes de la Epidemiología de la diabetes mellitus en Cuba. Revista Peruana de Epidemiología. 2011; 15(3) [6pp.] 9. Arnold Y, Trimiño AA. Evaluación de la calidad de la bioseguridad en el Hospital Clínico-Quirúrgico “Joaquín Albarrán”, Ciudad de La Habana, 2007. Revista Cubana de Higiene y Epidemiología. 2012; 50(1):67. 10. Arnold Y. Elaboración de programas de promoción y educación en enfermedades crónicas no transmisibles. Aspectos básicos.” Revista Científica “Finlay” (Sobre ENT) 2012; 2(2): 120. 11. Arnold Y. Evaluación de la Vigilancia y lucha antivectorial en el Pol. Tomas Romay, Habana Vieja, 2009. Revista Cubana de Higiene y Epidemiología. 2012; 50 (2):222. 12. Arnold Y. Comportamiento de indicadores epidemiológicos de morbilidad por diabetes mellitus en Cuba, 1998-2009.” Revista Peruana de Epidemiología. 2012; 16 (1): [6pp.] 13. Arnold Y, Castelo L, Licea ME, Medina I. Diabetes mellitus y tuberculosis. Revista Peruana de Epidemiología.2012 Mes; 16(2): [8 pp.] 14. Arnold Y, Licea ME, Castelo L.VIH/Sida y terapia antirretroviral: efectos endocrino-metabólicos. Revista Peruana de Epidemiología.2012; 16(3): [9 pp.] 15. Arnold Y, Licea ME, Castelo L, Pagán P, Iglesias. Mortalidad por causa básica de diabetes mellitus en Cuba, 2000-2009. Revista Peruana de Epidemiología. 2012; 17(1): [6 pp.] 16. Arnold Y. Bioseguridad y salud ocupacional en laboratorios biomédicos. Revista Cubana de Salud y Trabajo.2012; 13(3): 53-8. 17. Castelo L, Arnold Y, Trimiño AA, de Armas Y. Epidemiología y prevención del síndrome metabólico. Revista Cubana de Higiene y Epidemiología. 2012; 50(2): 250. 18. Arnold M, Arnold Y, Alfonso Y, Villar C, González TM. Pesquisaje y prevención de la diabetes mellitus tipo 2 en población de riesgo. Revista Cubana de Higiene y Epidemiología. 2012; 50(3): 380. 19. Castelo L, Licea ME, Aladro F, Hernández J, Arnold Y. Factores de riesgo y diagnóstico de la enfermedad carotidea. Revista Peruana de Epidemiología.2013; 17(1): [7 pp.] 20. Toirac N, Massip T, Massip J, Arnold Y. Prevalencia de factores de riesgo de cardiopatía isquémica en adultos mayores. Revista de Higiene y Sanidad Ambiental. 2013; 13(1): 925-34. 21. Rodríguez J, Prieto S, Correa C, Arnold Y, Álvarez L, Bernal P, Mora J, Soracipa Y, Rojas N, Pineda D. Dinámica de la epidemia del dengue en Colombia: predicciones de la trayectoria de la epidemia. Revista Científica “Med” Universidad Militar de Nueva Granada, Colombia. 2013; 21(1): 44. 22. López X, Massip J, Massip T, Arnold Y. Factores de riesgo de infecciones respiratorias altas recurrentes en menores de cinco años. Revista Panamericana de Infectología. OPS. 2014 Mes; 16(1): 7-16. 23. Trimiño AA, Arnold Y, Méndez B, Avalos R, Arnold ML. Evaluación de indicadores de calidad del Departamento de Vigilancia y Lucha Antivectorial, Policlínico Docente de Playa, La Habana 2008. Revista Peruana de Epidemiología. 2014; 18(1):1-7. 24. Massip T, Massip J, Arnold Y. Caracterización de variables biosociales en la epidemia de VIH/SIDA en el Municipio Plaza de la Revolución, 1986-2010. Revista Cubana de Higiene y Epidemiología. 2014; 52(1): 44. 25. Arnold Y. Evaluación de conocimientos y prácticas sobre bioseguridad, Hospital IESS Ibarra, Ecuador, agosto 2014. Revista “Desafíos”, de la Facultad de Ciencias de la salud. Universidad del Tolima. Colombia. 2015; 9(2): 15-39. 26. Arnold Y. Intervención educativa en manipuladores de alimentos, Hospital IESS Ibarra, Enero 2015. Revista “Desafíos”, de la Facultad de Ciencias de la salud. Universidad del Tolima. Colombia. 2015; 9(2): 60-71. 27. Álvarez L, Arnold Y. Envejecimiento poblacional y efecto en la diabetes mellitus en Cuba. Revista Científica de la Facultad de Ciencias Químicas y Farmacia. USCG. Guatemala. 2016; 26(1): [71-7] 28. Cabrera-Rode E, Rodríguez V, Lezcano SE, Rodríguez J, Cuba I, Álvarez Á, Arnold Y, Díaz O. Evaluación de tres metodologías para la predicción del riesgo de alteraciones del metabolismo de la glucosa en sujetos con sobrepeso y obesidad. Revista Cubana de Endocrinología. 2017; 28(2): [6pp.] 29. Arnold Y, Cabrera-Rode E. Cuál sería la mejor estrategia para pesquisar alteraciones del metabolismo de la glucosa en la atención primaria de salud. Revista Cubana de Endocrinología. 2017; 28 (2): [2pp.] 30. Arnold Y, Ruiz Y, Iglesias I, Martínez MA, Mazorra V, Díaz O, González O, Padilla L. Discrepancia diagnóstica clínico-anatomopatológica de la diabetes mellitus como causa básica de muerte. Revista Cubana de Endocrinología. 2017; 28(2): [6pp.] 31. Álvarez L, Arnold Y. La transición demográfica y epidemiológica y su repercusión en la diabetes mellitus, Cuba, 1970-2015. Revista Científica de la Escuela Universitaria de las Ciencias de la salud (Campus San Pedro Sula). UNAH Honduras. 2017; 4(1): [5-14] 32. Castelo L, Calero JL, Arnold Y. Incidencia de la disfunción eréctil en pacientes atendidos en la consulta de andrología, Centro de atención al diabético, período 2009-2012. Revista Argentina de Urología. 2017; 82(1): [32-41] 33. Arnold Y, González O, Martínez N, Formental BI, Arnold ML. Incidencia de la diabetes mellitus en Cuba, según tipo, en menores de 18 años de edad. Revista Cubana de Endocrinología 2017; 28(3): [4pp.] Post-Graduated Training: 1. First Grade Expert in Hygiene and Epidemiology. February/2006 to May/2009. Instituto Nacional de Higiene, Epidemiología y Microbiología. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 2. Second Grade Specialty in Hygiene and Epidemiology. December/2012. School of Medical Sciences “Comandante Manuel Fajardo”. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 3. Master’s degree on Infectious and Tropical Diseases. November/2004 to July/2007. School of medical Sciences “General Calixto García”. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 4. Floral Therapy and Bioenergetics. March - June/2005. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 5. Update Course on treatment of Diabetes Mellitus. February/2005. School of Medical Sciences “General Calixto García”. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 6. Update course on Antibioticotherapy. November/2009. School of Medical Sciences “General Calixto García”. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 7. Course on Clinical Epidemiology. November/2009. School of Medical Sciences “General Calixto García”. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 8. Virtual course on Epidemiological control of H1N1. (Sponsored by WHO/OPS). Marzo/2009. Ministry of Public Health, Havana, Cuba. 9. Couse on Insulin resistance. November/2009. School of Medical Sciences “General Calixto García”. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 10. Basic Course on management of SPSS statistics software. December/2009. Instituto Nacional de Higiene, Epidemiología y Microbiología. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 11. Course on research methodology for Endocrinology. May-July/2010. Instituto Nacional de Endocrinología. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 12. Pre-congress course (VII Cuban Endocrinology Congress): ALAD Symposium “Update Symposium on mellitus” and “Update on metabolic syndrome”. April/2010. “Hermanos Ameijeiras” Hospital, Havana, Cuba. 13. Virtual course on: “Comprehensive attention to addictive behaviours”. Jan-Feb/2011. Centro de Estudios sobre la Drogadicción. School of Medical Sciences “Comandante Manuel Fajardo”. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 14. Course on management of SPSS statistics software for Researchers (Basic and Advanced). June/2011. Instituto Nacional de Gastroenterología. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 15. Virtual Diploma Course on Pharmacoepidemiology and Pharmacovigilance. Oct/2010 to July/2011. Escuela Nacional de Salud Pública. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 16. Virtual Diploma course on parasitary and Infectious diseases. August 2010 to July/2011. Instituto de Medicina Tropical “Pedro Kourí”. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 17. Course on Medical Trials (Subjects in the Masters’ course on Epidemiology). 18. Virtual Diploma in health promotion management. Oct/2010 to Sept2011 (Sponsored by WHO/OPS). Escuela Nacional de Salud Pública. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 19. Course on Biosecurity in health institutions. May/2011. MINSAP, Havana, Cuba. 20. Virtual course on "Risk factors in biomedical laboratories". May/2011. Instituto Nacional de Higiene, Epidemiología y Microbiología. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 21. Course on Education on diabetes mellitus. May/2011. Instituto Nacional de Endocrinología. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 22. Course on epidemiological methods (Sponsored by the International Epidemiological Association). May/2012. Universidad “Cayetano Heredia”, Lima, Peru. 23. Virtual course on methodology of qualitative research. Jan-July/2012. School of Medical Sciences “General Calixto García”. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 24. Virtual Diploma course on “Care and education for peersons with diabetes mellitus”. April-Nov/2012. Instituto Nacional de Endocrinología. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 25. Virtual course on handling diabetes mellitus. Mayo/2012. (Sponsored by WHO-OPS). Escuela Nacional de Salud Pública. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 26. Workshop on Diagnosis and new treatments for chronical obstructive pulmonary disease. June/2015. Hospital del Instituto Ecuatoriano de Seguridad social, Ibarra, Imbabura, Ecuador. 27. Workshop on basic Tuberculosis Concepts. September/2015. Hospital del Instituto Ecuatoriano de Seguridad social, Ibarra, Imbabura, Ecuador. 28. Virtual course on Chikungunya fever. Jan-April/2015. Ministerio de Salud Pública del Ecuador, Quito, Ecuador. 29. Course on quality of death certificates. April/2015. Ministerio de Salud Pública and Instituto nacional de Estadísticas y Censos, Ibarra, Imbabura, Ecuador. 30. Basic course on epidemiological notification by the Ministry of Health of Ecuador. Jan/2015. Ibarra, Imbabura, Ecuador. 31. Course on management of health statistics. April/2015. Ministerio de Salud Pública del Ecuador, Ibarra, Imbabura, Ecuador. 32. Course on social determining factor son health, Eco epidemiology and theory of the course of life. (Sponsored by WHO/ OPS) Oct/2016. Facultad de Ciencias médicas “Comandante Manuel Fajardo”. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 33. First Workshop on Scientific Evidence. May/2017. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 34. Basic Course on Clinical trials. June - July/2017. Centro Nacional Coordinador de Ensayos clínicos e Instituto Nacional de Endocrinología. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. 35. Diploma on teaching Medical Sciences. (ongoing) started in January/2018. School of Medical Sciences “Comandante Manuel Fajardo”. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. Participation in International Scientific Events: 1. XVI International Congress on Diabetic Foot. Oct/2010. Palacio de las Convenciones. Havana, Cuba. Presenter. (Electronic poster). 2. Latin American Congress of Nutrition: health Promotion and Disease Prevention. November/2012. Palacio de las Convenciones. Havana, Cuba. Invited. 3. Cuba Salud 2015. International Convention on Public Health. April/2015. Palacio de las Convenciones. Havana, Cuba. Presenter. (Electronic poster).” Population aging and its effects on diabetes mellitus in Cuba.” 4. I International Nurse Congress, on Sterilization. Sept/2015. Ibarra, Imbabura, Ecuador. Presenter. (Master Class) “Control of hospital infections in patients with diabetes mellitus”. 5. IV International Symposium on patient safety, care quality. Sept/2015. Ibarra, Imbabura, Ecuador. Invited. 6. I Mesoamerican congress on nutrition and obesity. Centro de Estudios Urbanos November/2016. Universidad Católica de Honduras (campus San Pedro Sula), San Pedro Sula, Honduras. Presenter. (Conferencia magistral) “Epidemiologia social de la diabetes mellitus”. 7. Taller: Desafíos de la salud laboral ante las enfermedades crónicas no transmisibles. Septiembre/2017. Universidad Católica de Honduras (campus San Pedro Sula), San Pedro Sula, Honduras. Presenter. (video-conference).” Design of a system of epidemiological vigilance of diabetes mellitus at the workplace” Participation in National Scientific Events: 1. VII Congreso Cubano de Endocrinología. April/2010. Palacio de las Convenciones. Havana, Cuba. Participant. 2. Jornada Nacional Científica de graduados “115 aniversario del Instituto Nacional de Higiene, Epidemiología y Microbiología”. April/2017. Instituto Nacional de Higiene, Epidemiología y Microbiología, La Habana, Cuba. Master Class. “La transición demográfica y epidemiológica y su repercusión en la diabetes mellitus.” (co-author), “Discrepancia diagnóstica clinico-anatomopatológica de la diabetes mellitus como causa básica de muerte, La Habana, 2014.” (author) and “Nivel de conocimientos, dominio del uso y utilización del glucómetro en el automonitoreo de glucosa, en pacientes diabéticos, La Habana, 2011” (author) 3. VIII Congreso Cubano de Endocrinología. Noviembre/2017. Palacio de las Convenciones. Havana, Cuba. Co-author. Electronic poster. “Geographical distribution of diabetes mellitus in Cuba 2011-2015.” Teaching activity: - 2004 - 2006, Professor of Family Medicine for 2nd and 5th year medical students. Subject: “Basic Epidemiology”. School of Medical Sciences “General Calixto García”. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. - 2010 - 2011. Tutor of Final paper for a Master’s Degres on Tropical and Infectious deseases by Dr. Ángel Trimiño Fleitas: “Evaluación de la Lucha antivectorial en Playa, La Habana 2010” (An Assessment on Anti-vectorial campaign in Playa Municipality, Havana, 2010). School of Medical Sciences “Dr. Joaquín Albarrán.” Universidad de Ciencias médicas de La Habana, Havana, Cuba. - 2012 - 2013, Postgraduate professor for resident Doctors in Hygiene and Epidemiology. Subject: “Epidemiology of Diabetes mellitus”. Instituto Nacional de Endocrinología. Universidad de Ciencias médicas de La Habana, Havana, Cuba. - 2012 - 2014. Tutor of Final paper of residence on Family Medicine of Dra. Glenda Jones Pérez: “Educational Intervention on STD in students at ESBU Enrique Galarraga, 2013.” School of Medical Sciences “General Calixto García”. Universidad de Ciencias Médicas de La Habana, Havana, Cuba. - February/2015.Professor/Coordinator of course on Pharmacovigilance and Pharmacoepidemiology. Hospital Universitario del Instituto Ecuatoriano del Seguro Social. Universidad Central del Ecuador, Ibarra, Imbabura, Ecuador. - May/2016. Professor/Coordinator of Course on Disaster medicine and Epidemics Control. Hospital Universitario del Instituto Ecuatoriano del Seguro Social. Universidad Central del Ecuador, Ibarra, Imbabura, Ecuador. - 2012- Present day. Postgraduate Professor for Endocrinology residents. Subject: “Design of epidemiological studies in Endocrinology-applied research.”, taught at Research Methodology. Instituto Nacional de Endocrinología. Universidad de Ciencias médicas de La Habana, Havana, Cuba. - 2014 - 2016. Professor of Epidemiology and Public Health. Subject “Basic and Advanced Epidemiology I and II). Hospital Universitario del Instituto Ecuatoriano del Seguro Social. Universidad Central del Ecuador, Ibarra, Imbabura, Ecuador. - 2016 - 2017. Tutor of Final Endocrinology residence paper by Dr. Yurenia Ruiz de León: “Clinical-anatomopathological diagnosis discrepancy on diabetes mellitus as basic cause of death, 2014.” Instituto Nacional de Endocrinología. Universidad de Ciencias médicas de La Habana, Havana, Cuba. - 2016- present day: profesor of Public Health and Epidemiology of 5th-year medicine students. Subject: “Epidemiology of non-communicative diseases and of diabetes mellitus”. School of Medical Sciences “Comandante Manuel Fajardo”. Universidad de Ciencias médicas de La Habana, Havana, Cuba. - 2017- present day. Postgraduate profesor for Endocrinology residents. Subject: “Nutricional epidemiology, Social epidemiology of diabetes mellitus, Population testing and intervention strategies in diabetes mellitus.” Instituto Nacional de Endocrinología. Universidad de Ciencias médicas de La Habana, Havana, Cuba. - 2016- present day. Professor of summer course and International Trainings for Doctors on diabetes mellitus (Coordination Center OPS/WHO). Subject: “Epidemiology of diabetes mellitus” Instituto Nacional de Endocrinología. Universidad de Ciencias médicas de La Habana, Havana, Cuba. Other activities: - Reviewer (Peer review) for medical Science magazines [4 Cuban/1 Peruvian); Revista Cubana de Endocrinología. (4 articles reviewed); Revista Cubana de Salud Pública (1 article reviewed), Revista Correo Científico Medico (1 article reviewed); Revista de Ciencias Médicas de Cienfuegos (Medisur) (1 article reviewed); Revista Peruana de Epidemiología (4 articles reviewed).

Biography

Speaker
Arnold Domínguez Yuri / National Institute of endocrinology

Abstract

Leptin, a peptide discovered more than 10 years ago, is a 16-kDa-peptide hormone that is primarily synthesized and secreted by adipose tissue. One of the major actions of this hormone is the control of energy balance by binding to receptors in the hypothalamus, leading to reduction in food intake and elevation in temperature and energy expenditure. In addition, Leptin, through both direct and indirect mechanisms, may play an important role in cardiovascular and renal regulation. Leptin was initially believed to be an anti- obesity hormone, due to its metabolic effects. However, obese individuals, for unknown reasons, become resistant to the satiety and weight –reducing effect of the hormone, but preserve leptin-mediated sympathetic activation to nonthermogenic tissue such as kidney, heart, and adrenal glands. Leptin has been shown to influence nitric oxide production, and along with chronic sympathetic activation, especially to kidney, it may lead to sodium retention, sympathetic vasoconstriction and blood pressure elevation. Consequently, leptin is currently considered to play an important role in the development of hypertension in obesity. Because it appears to function as a pressure and volume-regulating factor under conditions of health. However, in abnormal situations characterized by chronic hyperleptinemia such as obesity, it may function pathophysiologically for the development of hypertension and possibly also for direct renal, vascular, and cardiac damage. So Leptin hormone has importantrole in controlling appetite and many metabolic function and mayhavingarole in producing Hypertension in obese males.Leptin is measured in 4 groups : lean normotensives , leanHyprtensives , obese normotensives and obese Hypertensives .The level of leptin was highest in obese Hypertensive males whencompared to other groups .

Biography

Speaker
DHASTAGIR Sultan Sheriff / Faculty of Medicine, University of Benghazi,Libya.

Abstract

Comparative treatment between sitagliptin vs. metformin, alone or in combination, in patients with polycystic ovary syndrome. A clinical entity at high risk for developing diabetes mellitus and gestational diabetes: A pilot study Objective To determine the efficacy of sitagliptin alone or in combination with metformin in women with polycystic ovary in terms of ovarian cyclicity, fertility and cardiometabolic profile compared to metformin alone. Rationale Polycystic ovarian syndrome (PCOS) affects a percentage of 5–10% of women of reproductive age worldwide and has a prevalence of 6.6% (95% CI: 2.3–10.9%) in Mexican women and most common cause of infertility in developed countries. Treatment with insulin sensitizing drugs (metformin and pioglitazone) has been shown to improve menstrual cyclicity and fertility in the metabolic profile with polycystic ovarian patients. Incretins and DPP-4 inhibitors have been shown to enhance pancreatic β cell activity, increasing weight loss by its anorexic effect and resulting in an adequate weight control and improved fertility. Previous evidence has compared the effect of exenatide and alone or in combination with metformin in the treatment of PCOS, in this article we will compare sitagliptin and metformin alone or in combination. Study design Blind, controlled and randomized clinical trial. Patients Women between 18 and 40 years of age, with a BMI >20 and diagnosed with PCOS with the Rotterdam criteria. Results In the normalized index of menstruations it was found that there was a statistically significant intragroup increase in each one of the treatments. With a higher percentage of change, that of metformin with 80%, followed by that of sitagliptin with 65% and then COMBO with 30%. No statistically significant differences were found between treatment groups. Conclusion Therapeutic effect of sitagliptin was observed in patients with PCOS comparable to metformin and the combination of metformin-sitagliptin is more effective in terms of ovulation than the other two treatments alone.

Biography

Dr. Juan Carlos Paredes Palma is a Specialist in internal medicine, Subspecialist in Endocrinology, Biology of human reproduction and endocrine gynecology, has a Master in Medical Sciences and a PHD in Health Sciences. He has held various positions in one of the most important public health institutions in Mexico; Institute of Social Security and Health of workers of the State, (ISSSTE), was National Coordinator of Clinical Research, Head of Teaching of the Hospital Dr. Darío Fernández Fierro of Mexico City and currently is the Head of Teaching and Research of the Delegation South of ISSSTE. He was the winner of The National Research prize of the ISSSTE in 2015. (ju.paredes@issste.gob.mx)

Speaker
Juan Carlos Paredes Palma / Head of Teaching and Research of the South Zone Delegation of ISSSTE,México

Abstract

The world has undoubtedly always had crises of many kinds: floods, droughts, famines, disease pandemics, wars, encroaching glaciers, and now more recently, epidemic nutritional excesses resulting in increasing numbers of overweight and obese people in vast populations, and associated type 2 diabetes with growing prevalence of complications including hypertension, hyperlipidemia, heart disease, kidney dysfunction, neurologic disorders, blindness, amputations and strokes. It has recently been said (personal communication), before the terrible starvation witnessed in the present wars of the Middle East and Africa, that there are more people on earth who suffer from over-nutrition than the opposite. How could this be?! It’s not a problem of less well-developed nations; it’s a problem inalmost every country on earth, no matter what their GNP is or on which continent they are! Availability of various foods is important determinant of what people buy and eat, thusit impacts on their health. It is seen in every continent! Onesuch illustration, in a highly developed country, the U.S.A., is seen in our studies of two cities: one large; (Cleveland, Ohio, replete in "food swamps," and one small; (Madison, Wisconsin), the site of many "food deserts," Terminology: Food swamp = readily-accessible junk foods in convenience stores and fast food restaurants; food desert = difficult-to-buy fresh fruits and vegetables. Food swamps and deserts often co-exist. Availability of nutritious food is only one determinant of people’s diet;others are cost, cultural, racial, ethnic, habits, and inadequate transportation in poverty areas. Millions of Americans live more than a mile from a grocery store and have no automobile. "Fast foods" in restaurants and "junk foods" in convenience stores, rich in carbohydrates, fats and sugar, are associated with increased risk of being overweight/obese and the increased prevalence of type 2 diabetes, hypertension, heart disease, and cancer. Recent WHO European Region report indicated, "poor diet, overweight and obesity contribute to a large proportion of … cardiovascular diseases and cancer, the two main killers in the Region." Using food resource interviews in Cleveland, and Public Health Service plus AppliedPop. Lab. data in Madison, and employing the geographical information system (GIS)method, food swamps in the former and food deserts in the latter have been mapped, found corresponding to areas of poverty, mainly inhabited by people of color. To underlinecomplexity of poor diet choices, a refrigerated 40-foot trailerselling fresh fruits and vegetables in 8 food deserts in Madison was unsustainable after 2 years because of decliningconsumer interest. Thus, in one of the richest countries of the earth, the problem of obesity and diabetes is far from solved, it is evident that it probably will remain a critical challenge for the world as a whole for some time in the future.

Biography

Speaker
Don S. Schalch / Univesrsity of Wisconsin School of Medicine and Publlic Health

Abstract

Introduction: It is known that hypothyroidism is associated with metabolic disorders, primarily dyslipidemia. Correlation between subclinical hypothyroidism (SH) and metabolic syndrome (MS) still remains unclear. Objective: To determine the association of SH and MS in postmenopausal women. Materials and methods: The cross-sectional study included 140 postmenopausal women at the Clinic for Endocrinology, University Clinical Center Sarajevo. Sixty-one postmenopausal women with SH were compared with 79 euthyroid controls. The following data were collected: age, duration of postmenopause, height, weight, waist and hip circumference, body mass index (BMI), waist-to-hip ratio (WHR), type 2 diabetes history, hypertension, fasting glucose, lipid profile. Results: The incidence of MS was significantly higher in women with SH than in euthyroid controls. SH was associated with increased waist circumference, WHR, BMI, cholesterol, triglycerides, LDL-C and decreased HDL-C, but was not associated with hypertension nor type 2 diabetes. Conclusion: SH is independently associated with MS in postmenopausal women.

Biography

Amina Godinjak is an internal medicine specialist at the Clinical Center of the University of Sarajevo, Bosnia and Herzegovina. She completed her graduate, postgraduate studies and PhD at the University of Sarajevo School of Medicine. She worked as an intern at the Clinic for Endocrinology, Diabetes and Metabolic Diseases 2010-2013 and as a resident at the Medical Intensive Care Unit of the Clinical Center of the University of Sarajevo 2013-2017. She is an active member of the Association of Endocrinologists and Diabetologists of the Federation of Bosnia and Herzegovina, and the European Society of Endocrinology. She contributed to many educational workshops and conferences with her lectures, had published 17 studies, and is currently working on her first book. Her primary research interest is endocrinology, but she had also published in the fields of critical illness and intensive care.

Speaker
Amina Godinjak / Clinical Center of the University of Sarajevo, Bosnia and Herzegovina

Abstract

Introduction: Women with Polycystic Ovary Syndrome (PCOS) are at increased risk for cardiovascular morbidity and metabolic disorders including: dyslipidaemia, hypertension, insulin resistance, gestational diabetes, type 2 diabetes and systemic inflammation. The prevalence of obesity and insulin resistance in women with PCOS is significantly higher compared to the general population. Lipid accumulation product is a new, cheap and easily available predictor for metabolic syndrome both in general population and in women with PCOS. Materials and methods: The study included 50 patients at the Clinic of Endocrinology, Diabetes and Metabolic Disorders, Clinical Center University of Sarajevo. All patients were diagnosed with PCOS according to the Rotterdam ESHRE criteria and were divided into two groups according to their body mass index (BMI). A prospective study established the following parameters: waist circumference, height, weight, BMI, serum triglycerides and insulin resistance. LAP was calculated using the formula: LAP (women) = [waist circumference (cm)–58] × [triglycerides (mmol/L)]. Results: Waist circumference in women with BMI ≤ 24.9 kg/m2 was 31 cm lower than waist circumference in women with a BMI > 25 kg/m2. Mean triglyceride value of the patients in group BMI ≤ 24.9 kg/m2 was 1.15 mmol/l lower than the mean value of triglycerides in women with a BMI >25 kg/m2. Insulin resistance was present in 66.7% in group with BMI ≤ 24.9 kg/m2, and in 75.0% in the group with BMI>25.0 kg/m2. LAP was shown to be a marker for the differentiation of insulin–resistant and nonresistant patients with a cut-off value of 17.91. Conclusion: Patients with PCOS and BMI ≤ 24.9 kg/m2 were significantly different from those with BMI>25 kg/m2 in the values of body weight, waist circumference and triglycerides. LAP values were higher in patients in the group with BMI > 25 kg/m2. LAP was a marker for differentiation of insulin – resistant and non-resistant women with PCOS.

Biography

Amina Godinjak is an internal medicine specialist at the Clinical Center of the University of Sarajevo, Bosnia and Herzegovina. She completed her graduate, postgraduate studies and PhD at the University of Sarajevo School of Medicine. She worked as an intern at the Clinic for Endocrinology, Diabetes and Metabolic Diseases 2010-2013 and as a resident at the Medical Intensive Care Unit of the Clinical Center of the University of Sarajevo 2013-2017. She is an active member of the Association of Endocrinologists and Diabetologists of the Federation of Bosnia and Herzegovina, and the European Society of Endocrinology. She contributed to many educational workshops and conferences with her lectures, had published 17 studies, and is currently working on her first book. Her primary research interest is endocrinology, but she had also published in the fields of critical illness and intensive care.

Speaker
Amina Godinjak / Clinical Center of the University of Sarajevo, Bosnia and Herzegovina

Abstract

Background Nowadays, young females are seeking optimal fitness most of the time through unhealthy practices .Most females don’t follow the health recommendations on dietary guidelines. Normal weight female behave differently than overweight and obese female and perceive food and diet practices in other ways. Since those dieting practices are not always adapted to promote a healthy body weight, this study aims to determine the dieting practices used among normal, overweight and obese female and identify dieting practices that could be pursued to help these females more appropriately achieve and maintain a healthy body weight. Methods A total of 120 females aged 18 to 26 years participated in this study. Height, weight, waist and hip circumferences, and skinfold thickness were measured to assess body composition. Surveys included food questionnaire and physical activity recall. Participants were classified according to body mass index (BMI) as normal weight (n = 80), overweight (n = 25), or obese (n = 15). Data were analyzed using JMP IN® software. Descriptive statistics included means, standard deviations, and frequency. Results Majority of participants (79%) used dieting for weight loss and believed they would be almost 4% greater than current weight if they did not diet; normal weight, overweight, and obese groups perceived attractive weight to be 94%, 85%, and 74%, respectively, of current weight; 75% of participants reported using physical activity to control weight, although only 21% exercised at a sufficient level to promote weight loss; only two of 15 dieting behaviors assessed differed in terms of prevalence of use among groups, which were consciously eating less than you want (44% normal weight, 57% overweight, 81% obese) and using artificial sweeteners (31% normal weight and overweight, 5% obese); and the most prevalent explicit maladaptive weight loss behavior was smoking cigarettes (used by 9% of participants) and most unhealthy was skipping breakfast (32%). Conclusion Collectively, results indicate females , regardless of weight status, would benefit from open discussions and education sessions with health educators regarding healthy and effective dieting practices to achieve/maintain a healthy body weight.

Biography

Dr Vera Matta is a registered dietitian , she has a master’s degree in nutritional psychotherapy and a PhD in counseling and nutritional psychotherapy. She is a current researcher in many health topics like diabetes , obesity…She is a therapeutic dietitian , treating all kind of nutrition related diseases and a consultant for many food related companies

Speaker
Vera Matta / Sweet Diet Clinic, Lebanon

Abstract

Background: A new treatment paradigm is needed because ischemic heart disease (IHD) and stroke continue to rank among the top causes of death globally. A review of the literature revealed no evidence that fish and chicken cholesterol translates into human total cholesterol (CHOL), triglycerides (TG), very low-density lipoproteins (VLDL), and/or low-density lipoproteins (LDL) plasma levels at a lower rate than beef, lamb, turkey bacon, cheese, and eggs. Objectives: To introduce four dietary CHOL, TG, VLDL, and LDL detoxification protocols followed by a fish, chicken, beef, lamb, cheese, and egg CHOL challenge, followed by tabulation of the corresponding changes in lipoprotein plasma levels. Methods: The subject consented to be screened regarding protocol inclusion criteria. His abnormal baseline lipid panel results were lowered to within normal ranges. The subject had a lipid panel drawn the next morning, then consumed one of the aforementioned cholesterol containing foods, and had a lipid panel drawn the next morning. Milligrams of food-specific exogenous-CHOL consumed were divided by the endogenous delta LDL, which yielded a lipoprotein index (LI) value for each food. Results: The subject’s LDL plasma levels were increased most by chicken and fish, and to a lesser extent by beef, lamb, cheese and egg, respectively. Conclusion: Dietary recommendations to eat more fish and poultry appear to have correlated with this subject’s inability to achieve normal lipid panel results for over a decade. Could this subject’s results translate to the general population, or are these findings specific only to this subject? It is hoped that the reader is inspired sufficiently to try the condensed protocol in order to help answer this vital question. The complete study will be available on http://psychepubs.com.

Biography

Speaker
James A. Cocores / CarpeVITA Genomics, Inc, & PMR Labs

Abstract

This lipidomicsstudy was designed to find via a high-fat (HF) diet induced insulin resistant (IR) and/or type-2 diabetes (T2DM) C57Bl/6 mouse model potential novel biomarkers. Major aiming is to find following this lipidomics based approach novel safe biomarkers applicable for humans with IR/T2DM that can be used in the assessment of diagnosis, intensive treatment, clinical use and new drug development. In addition, the biomarker has to be found in blood-plasma simultaneously while is not a component of the HF-diet.Reversed phase liquid chromatography coupled to mass spectrometry (LC-MS) were used to quantify and qualify the rearrangement and repartitioning of fat stores in the heart-, hind limb-, carcass-muscle, liver, brain, and blood plasma of this mice model following a systems biology lipidomics based approach.Two potential biomarkers were found for this HF-diet mouse model. The first biomarker was a 20:3 cholesteryl-ester (20:3-ChE) which significantly increased (P ≤ 0.016) in the fatty heart with 1317% while it rose very significantly (P ≤ 0.00001) in blood plasma with 1013% in the HF diet group in comparison to the control-group. (Co). The second biomarker was a 36:1 phosphatidylcholine (36:1-PC), which rose significantly (P ≤ 0.025) mainly in heart muscle with 400% while concentrations increased significantly strongly (P ≤ 0.002) in blood plasma with 1493% in the high-fat diet vs. Co. As an earlier defined prerequisite, both compounds were not found in the food.The 20:3-ChE biomarker (dihomo-γ-linolenic; 20:3 n-6) has been classified as a potential type 2 diabetes biomarker (T2DM) biomarker in a human cohort of the Uppsala longitudinal study of adult men (ULSAM). In addition, we give a biochemical explanation for the 36:1- PC as hypoxic biomarker for cardiovascular diseases (CVD) diagnosis and therapy. Both biomarkers are interesting candidates for further validation in human cohorts.

Biography

:Dr.Dr.Ir. Vincent van Ginneken has completed his first PhD at the age of 33 years from Leiden University (Faculty: Mathematics & Natural Sciences) followed by postdoctoral studies resulting in a second PhD at Wageningen University (Faculty: Agricultural Sciences). The here presented scientific work has been performed in cooperation with Dr. Elwin Verheij, TNO Healthy Living, Zeist, Netherlands and Prof.Dr. Jan van der Greef, Sino-Dutch Centre for Preventive and Personalized Medicine, Leiden University, Netherlands. In addition, Vincent van Ginneken is the scientific director of Bluegreentechnologies, a think-tank organization with several disciplines: biomedical, agricultural, seaweed biotechnology. He has published more than 115 papers in reputed journals among them Nature and has been serving as an editorial board member of some of these reputed journals. Presently he is involved as researcher at lipidomics based cancer/tumor research following a Systems Biology approach at Optical Molecular Imaging Dept. Radiology, Erasmus Medical Centre Rotterdam, Netherlands.

Speaker
Vincent van Ginneken / Erasmus Medical Centre, Rotterdam

Abstract

Cardiometabolic risk is defined as a risk for development of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Metabolic syndrome (MS) is a cluster of factors that increase cardiometabolic risk. Central obesity and insulin resistance are considered as the core defects of the MS. Consequently dietary or pharmacologic approach that promote weight loss and decrease insulin resistance could reduce cardiometabolic risk. We investigated the effect of metformin on central obesity, insulin resistance, hyperinsulinaemia, dyslipidaemia and arterial hypertension in normal glucose tolerant persons with MS according to the IDF definition, who represent a high-risk group for development of type T2DM and CVD. Metformin was applied at a mean dose of 2.55±0.2 g daily on an usual diet and physical activity. Body weight, body mass index and waist circumference decreased significantly at 6 month of metformin treatment and this effect continued to the end of the observation and it was no more pronounced at 1 year compared to the 6 month. The mean body weight reduction was 7.7 kg at 6 month and 12.1 kg at 1 year. Fasting serum insulin and homeostasis model assessment of insulin resistance significantly reduced at 6, 9 month and at 1 year. Triglycerides, LDL cholesterol, systolic and diastolic blood pressure significantly decreased at 9 month and at 1 year. HDL cholesterol significantly increased at 1 year of metformin treatment. In conclusion: metformin reduces cardiometabolic risk factors in normal glucose tolerant persons with central obesity and MS and could be considered as a therapeutic alternative for reduction of cardiometabolic risk.

Biography

Petya Kamenova-MD, PhD is an Assistant Professor at the Department of Diabetology of Clinical Center of Endocrinology and Gerontology, Medical University, Sofia. She is an author of above 90 papers and scientific presentations, specialist on internal diseases, endocrinology and diseases of metabolism and educator of students, trainee doctors, spcializing doctors and general practitioners.

Speaker
Kamenova / Department of Diabetology, Clinical Center of Endocrinology and Gerontology, Medical University, Sofia, Bulgaria

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