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Nobili V.,Liver Research Unit | Corte C.D.,Liver Research Unit | Liccardo D.,Liver Research Unit | Mosca A.,University of Rome La Sapienza | And 4 more authors.
Pediatric Obesity | Year: 2015

Background Lifestyle interventions are often ineffective in the treatment of pediatric obesity. Weight loss devices have been introduced for the temporary nonsurgical treatment of morbid obesity. Objective The aim of the study is to evaluate the efficacy of Obalon Intragastric Balloon on weight loss and on metabolic and cardiovascular parameters in a pediatric population with severe obesity. Methods We enrolled 10 children with severe obesity. In all patients anthropometric parameters, biochemical tests, ultrasound liver examination and blood pressure monitoring were evaluated at the time of insertion and after removal of device. Results The Obalon had a positive effect on decrease of weight, body mass index and percentage of excess body weight within 3 months from placement. Moreover, this safe minimally invasive device improves the cardio-metabolic profiles of obese children. Conclusions The Obalon could be a useful tool in the difficult management of pediatric patients with morbid obesity, inducing in short-term a meaningful weight loss. © 2014 World Obesity.

Bo S.,University of Turin | Fadda M.,Unit of Clinical Nutrition | Castiglione A.,Unit of Clinical Epidemiology | Ciccone G.,Unit of Clinical Epidemiology | And 10 more authors.
International Journal of Obesity | Year: 2015

Background/Objectives:Food-induced thermogenesis is generally reported to be higher in the morning, although contrasting results exist because of differences in experimental settings related to the preceding fasting, exercise, sleeping and dieting. To definitively answer to this issue, we compared the calorimetric and metabolic responses to identical meals consumed at 0800 hours and at 2000 hours by healthy volunteers, after standardized diet, physical activity, duration of fast and resting.Subjects/Methods:Twenty subjects (age range 20-35 years, body mass index=19-26 kg m - 2) were enrolled to a randomized cross-over trial. They randomly received the same standard meal in the morning and, 7 days after, in the evening, or vice versa. A 30-min basal calorimetry was performed; a further 60-min calorimetry was done 120-min after the beginning of the meal. Blood samples were drawn every 30-min for 180-min. General linear models, adjusted for period and carry-over, were used to evaluate the 'morning effect', that is, the difference of morning delta (after-meal minus fasting values) minus evening delta (after-meal minus fasting values) of the variables.Results:Fasting resting metabolic rate (RMR) did not change from morning to evening; after-meal RMR values were significantly higher after the morning meal (1916; 95% confidence interval (CI)=1792, 2041 vs 1756; 1648, 1863 kcal; P<0.001). RMR was significantly increased after the morning meal (90.5; 95% CI=40.4, 140.6 kcal; P<0.001), whereas differences in areas-under-the-curve for glucose (-1800; -2564,-1036 mg dl -1 × h, P<0.001), log-insulin (-0.19; -0.30,-0.07 μU ml -1 × h; P=0.001) and fatty free acid concentrations (-16.1;-30.0,-2.09 mmol l -1 × h; P=0.024) were significantly lower. Delayed and larger increases in glucose and insulin concentrations were found after the evening meals.Conclusions:The same meal consumed in the evening determined a lower RMR, and increased glycemic/insulinemic responses, suggesting circadian variations in the energy expenditure and metabolic pattern of healthy individuals. The timing of meals should probably be considered when nutritional recommendations are given. © 2015 Macmillan Publishers Limited.

Nolfe G.,National Research Council Italy | Spreghini M.R.,Unit of Clinical Nutrition | Sforza R.W.,Unit of Clinical Nutrition | Morino G.,Unit of Clinical Nutrition | Manco M.,Scientific Directorate
European Journal of Endocrinology | Year: 2012

Background: To describe the morphology of glucose curve during the oral glucose tolerance test (OGTT) and any association with glucose tolerance, insulin action and secretion in obese youth. Study design: Cross-sectional. Methods: OGTT data of 553 patients were analysed. Subjects were divided in groups based on the morphology (i.e. monophasic, biphasic, triphasic and upward monotonous) of glucose curve. Insulin action was estimated by the homeostasis model assessment of insulin resistance, the insulin sensitivity, the muscle insulin sensitivity and the hepatic insulin resistance indexes (HIRI), and the oral glucose insulin sensitivity (OGIS). Insulin secretion was estimated by the insulinogenic index (IGI). Disposition index, including the insulin secretion-sensitivity index-2, and areas under glucose (AUC G) and insulin (AUC I) curves were computed. Results: In patients with normal glucose tolerance (n = 522), prevalent morphology of the glucose curve was monophasic (n = 285, 54%). Monophasic morphology was associated with the highest concentration of 1 h plasma glucose (P < 0.0001) and AUC G (P < 0.0001); biphasic morphology with better insulin sensitivity as estimated by OGIS (P < 0.03) and lower AUC I (P < 0.0001); triphasic morphology with the highest values of HIRI (P < 0.02) and IGI (P < 0.007). By combining morphologies of glucose and insulin curves or time of the glucose peak, a deeper characterisation of different phenotypes of glucose metabolism emerged. Conclusions: Morphologies of the glucose curve seem reflecting different metabolic phenotypes of insulin action and secretion, particularly when combined with morphologies of insulin curve or time of glucose peak. Such findings may deserve validation in cohort study, in which glucose metabolism would be estimated by using gold standard techniques. © 2012 European Society of Endocrinology.

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