Improved Plasma FFA/Insulin Homeostasis Is Independently Associated With Improved Glucose Tolerance After a One-Year Lifestyle Intervention in Viscerally Obese Men.

Improved Plasma FFA/Insulin Homeostasis Is Independently Associated With Improved Glucose Tolerance After a One-Year Lifestyle Intervention in Viscerally Obese Men.

Diabetes Care. 2013 May 21;
Borel AL, Boulet G, Nazare JA, Smith J, Alméras N, Tremblay A, Bergeron J, Poirier P, Carpentier AC, Després JP

OBJECTIVESElevated plasma free fatty acids (FFAs) are one important link between excess visceral adiposity, insulin resistance, and the development of type 2 diabetes. Effects of lifestyle interventions on FFA metabolism are poorly known. This open-label study was conducted to test the effects of a 1-year healthy eating/physical activity intervention program on plasma FFA homeostasis in 117 viscerally obese men with dyslipidemia associated with insulin resistance (waist circumference ?90 cm; triglycerides ?1.69 mmol/L; and/or HDL-cholesterol <1.03 mmol/L).RESEARCH DESIGN AND METHODSBody weight, body composition, and fat distribution were assessed by dual-energy X-ray absorptiometry/computed tomography. Oral loads of lipid (60 g fat/m(2) body surface area) and glucose (75 g) were measured before and after the intervention.RESULTSAfter 1 year of lifestyle intervention, visceral adiposity was reduced by -26% (95% CI -29 to -23), whereas cardiorespiratory fitness improved by +20% (95% CI +16 to +24). After 1 year, the suppression of FFAs after the glucose load improved, whereas insulin concentrations were drastically reduced. After the oral lipid load, the late increase in FFA was reduced together with reduced circulating insulin. We calculated an insulin sensitivity index to reflect the concentration of insulin needed to manage plasma FFAs after the oral lipid load, which increased after the intervention and was associated with improved glucose tolerance, independent of changes in visceral or total adiposity.CONCLUSIONSA 1-year healthy eating/physical activity intervention improved the suppression of FFAs after oral glucose and lipid load tests in viscerally obese men, possibly due to improved responsiveness to insulin. This insulin-mediated regulation of postprandial plasma FFA levels could be a link between visceral obesity and impaired glucose homeostasis. HubMed – eating

 

Historical Study on Factors Inducing Soil- Transmitted Helminth Infection among People of Old Seoul City during Joseon Dynasty.

Uisahak. 2013 Apr; 22(1): 89-132
Ki HC, Bae JH, Shin DH

In a series of paleo-parasitological investigations, we have been able to obtain invaluable data on parasite infection patterns prevalent among the Joseon (1392-1910) people in Korea. Thus far we have established that the Joseon people were in fact heavily infected by various species of parasites, though precise patterns and exact statuses of infection in specific town and cities have proved elusive. In the present study, relevant historical documentation was obtained and examined, shedding light on some of the operative socio-cultural factors that might have played a role in inducing a high infection prevalence of Ascaris, a soil-transmitted roundworm, in Joseon society. On this evidentiary basis, we could confirm that the recycling of human feces as fertilizer and the habit of eating raw vegetables were both closely related to infection. These factors were sufficient to maintain the life cycle of Ascaris, there by perpetuating a cycle of infection and reinfection among the Joseon inhabitants. Overall, this study demonstrated the value of close medical-scientist / historian interdisciplinary collaboration infacilitating comprehensive and meaningful paleo-parasitological findings and interpretations. HubMed – eating

 

The experience of critically ill children: A phenomenological study of discomfort and comfort.

Dynamics. 2013; 24(1): 19-27
Carnevale FA, Gaudreault J

Emerging evidence indicates that critically ill children are particularly at risk for incurring significant psychological harm. Little is known about these children’s actual experiences.The aim of the study was to examine children’s experience of critical illness. The research question was: What are a critically ill child’s sources of discomfort and comfort?Interpretive phenomenology was selected as the study’s method. Children’s accounts were examined to identify what they considered meaningful, in terms of their experienced discomfort and comfort. Data sources included formal and informal interviews with child-participants, drawings provided by some participants, and field-notes documenting observed non-verbal data.Twelve children were enrolled in the study, ranging from 3 to 17years of age; including four girls and eight boys.Although all participants were able to discuss the discomfort and comfort they experienced, they reported difficulties in remembering part or most of their experience. Some participants characterized their Pediatric Intensive Care Unit stay quite favourably or as “not that bad”, while some described their experience unfavourably. Diverse types of discomforts were reported, including fears and worries, hurt and pain, invasive interventions, missing significant people, noise, food or eating problems, boredom, physical symptoms, as well as four additional discomforts reported by individual participants. Several sources of comfort were described, including parents, visitors and friends, hospital staff (principally nurses), stuffed animal/favourite blanket, entertainment and play, food, selected medical interventions, thinking of going home, being able to walk or run, sleep, waking up, gifts, along with two other comforts reported by individual participants. Embodiment and a tension between aloneness and being with were identified as the principal phenomena underlying these children’s experiences.The findings complement existing knowledge regarding the psychological impact of critical illness by highlighting how children regard specific phenomena as discomforting or comforting. This sheds light on future directions for practice and research development in pediatric critical care. HubMed – eating

 


 

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