Over the past several decades abdominal obesity and physical inactivity have increased at an alarming pace. Since both are related to adverse health risk it is important to determine their independent influence. It is well established that cardiorespiratory fitness (CRF, the ability to perform physical activity) and physical activity (PA) are negatively associated with cardiometabolic risk factors (commonly obtained risk factors for disease, e.g: TG, HDL, etc.). In other words, the higher a person’s levels of PA and fitness, the lower that person’s likelihood of developing cardiometabolic risk factors. Abdominal obesity is positively associated with cardiometabolic risk factors which means the more abdominally obese a person is, the more prone that person is to develop cardiometabolic risk factors. However, it is unknown whether PA influences cardiometabolic risk factors independent of fitness level and/or abdominal obesity. My study objective was to examine whether PA is associated with cardiometabolic risk factors independent of cardiorespiratory fitness and/or abdominal obesity in inactive abdominally obese women. The study enrolled 141 inactive abdominally obese women. PA, cardiorespiratory fitness, and cardiometabolic risk profile were measured in all participants. A novel feature of this study was the use of the accelerometer to objectively measure PA and to divide exercise into different levels of intensity, such as: low PA, moderate to vigorous PA (MVPA), etc. My findings revealed that abdominal obesity was positively associated with cardiometabolic risk independent of PA or CRF. I also observed that CRF was inversely related to cardiometabolic risk independent of PA or abdominal obesity. MVPA explained cardiometabolic risk factors by itself, but with insulin resistance measurements (2-hour glucose, and homeostasis model of assessment) this relationship was abolished when abdominal obesity and CRF were also taken into consideration. The findings of this study provide further support for the recommendation that waist circumference and CRF be included as routine measures screening for cardiometabolic risk factors in inactive obese women. Our findings also support the suggestion that even modest amounts of daily MVPA that are below the recommended threshold of 30 minutes/day convey health benefit. / Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2013-07-23 13:46:57.088

Menopause transition is a natural process in a woman’s life associated with altered body fat distribution, increased cardiometabolic risk, and the presentation of vasomotor symptoms including hot flashes and night sweats. A 5-year observational, longitudinal study (MONET: Montreal Ottawa New Emerging Team), was performed to document the effect of menopause transition on body composition and cardiometabolic risk factors. Initially, the study included 102 healthy non-obese premenopausal women between the age of 47 and 55 years. By the end of year 5, 91 women completed the study, 4% were still premenopausal, 29% were perimenopausal and 67% became postmenopausal. The major finding of the first study was that the increases in body fat mass and visceral fat in our cohort of non-obese women followed through the menopause transition were independent of the increase in body weight. Furthermore, these changes in body composition and body fat distribution were not associated with cardiometabolic deteriorations. We further examined whether specific factors such as reporting vasomotor symptoms (hot flashes and/or night sweats), exaggerated exercise systolic blood pressure, physical activity levels and cardiorespiratory fitness, may be associated with adiposity, body fat distribution and cardiometabolic profile. Overall, women that experienced vasomotor symptoms (paper 2) or presented an exaggerated exercise systolic blood pressure (paper 3), did not present any alterations in their body composition, body fat distribution and cardiometabolic profile compared to asymptomatic women and participants with normal blood pressure response to exercise, respectively. Furthermore, exaggerated exercise systolic blood pressure was not predictive of future hypertension after a 5-year follow-up throughout menopause transition. On the other hand, total volume of physical activity was not linked with measures of a cardiometabolic profile, cardiorespiratory fitness appeared to have the greatest cardioprotective effect (paper 4). Therefore, in generally healthy physically active non-obese premenopausal women, the menopause transition does not generally alter cardiometabolic risk factors, and suggests that cardiorespiratory fitness may have greater cardiometabolic protective effects in this cohort.

Analisar a associação recíproca entre fatores de risco cardiometabólico, níveis de adipocitocinas (leptina e adiponectina de alto peso molecular), endocanabinoides (anandamida [AEA] e 2-araquidonoilglicerol [2-AG]), compostos canabimiméticos (N-oleoiletanolamina [OEA] e N-palmitoiletanolamina [PEA]) e polimorfismos em genes codificadores de componentes do sistema endocanabinoide (enzima de degradação de endocanabinoides FAAH [gene FAAH] e receptor endocanabinoide CB1 [gene CNR1]) e do receptor PPAR-&#945; [gene PPARA], em indivíduos com diferentes graus de adiposidade. Duzentos indivíduos, entre 18 e 60 anos, com diferentes graus de índice de massa corporal (IMC) compuseram a amostra, dividida em dois grupos: cem eutróficos (IMC < 25 kg/m2) e 100 obesos (IMC &#8805; 30 kg/m2), com 50 homens e 50 mulheres em cada grupo. Os obesos ficaram assim distribuídos: grau 1, com IMC < 35 kg/m2 (n=54), 27 homens e 27 mulheres; grau 2, com IMC < 40 kg/m2 (n=32), 16 homens e 16 mulheres e grau 3, com IMC &#8805; 40 kg/m2 (n=14), 7 homens e 7 mulheres. Todos os indivíduos foram recrutados entre funcionários, estudantes e residentes do Hospital Universitário Pedro Ernesto, bem como voluntários do quadro da Polícia Militar do Estado do Rio de Janeiro e selecionados com base em amostra de conveniência. Todos foram avaliados por parâmetros antropométricos, determinação da pressão arterial, análises laboratoriais e genotipagem, para determinar seu perfil metabólico, níveis de endocanabinoides e adipocitocinas e rastreamento dos polimorfismos FAAH 385C>A, CNR1 3813A>G e PPARA 484C>G. Foram excluídos do estudo aqueles com história de comorbidades crônicas, doenças inflamatórias agudas, dependência de drogas de qualquer natureza e em uso de medicação nos dez dias anteriores à entrada no estudo. A atividade inflamatória, avaliada pela proteína C reativa ultrassensível (PCRUS), acompanhou o grau de resistência insulínica. Os níveis de PEA se associaram negativamente com a adiposidade visceral e resistência insulínica, sugerindo um melhor perfil metabólico, enquanto que os níveis de 2-AG se associaram positivamente com a PCRUS, apontando para piora nesse perfil. Os polimorfismos estudados não se associaram com o fenótipo obeso ou insulinorresistente. A presença do alelo 3813G no gene CNR1 mostrou associação independente com níveis reduzidos de adiponectina em obesos, sugerindo pior perfil metabólico nesse grupo. A presença do alelo 484G no gene PPARA, associando-se com níveis mais elevados de IMC e LDL-colesterol nos eutróficos pode indicar maior predisposição desses indivíduos para o desenvolvimento de obesidade e dislipidemia aterosclerótica. O genótipo homozigoto AA na posição 385 do gene FAAH e os níveis de PCRUS foram as principais associações, diretas e independentes, com os níveis de AEA, indicando claramente disfunção da enzima de degradação da AEA e, possivelmente, contribuindo para um perfil cardiometabólico mais vulnerável em portadores dessa variante genética. / To analyze the reciprocal association of cardiometabolic risk factors, levels of adipocytokines (leptin and high molecular weight adiponectin), endocannabinoids (anandamide [AEA] and 2-arachidonoylglycerol [2-AG]), cannabimimetic compounds (N-oleoylethanolamine [OEA] and N-palmitoylethanolamine [PEA]) and polymorphisms in genes encoding components of the endocannabinoid system (endocannabinoid degradation enzyme FAAH [FAAH gene] and endocannabinoid receptor CB1 [CNR1 gene]) and the PPAR-&#945; receptor (PPARA gene) in subjects with varying degrees of adiposity. Two hundred individuals between 18 and 60 years with varying degrees of body mass index (BMI) comprised the sample, divided in two groups: one hundred eutrophic (BMI < 25 kg/m2) and 100 obese (BMI &#8805; 30 kg/m2), 50 men and 50 women per group. The obese were distributed as follows: grade 1, with BMI < 35 kg/m2 (n = 54), 27 men and 27 women; grade 2, with BMI between &#8805; 35 and < 40 kg/m2 (n = 32), 16 men and 16 women and grade 3, with BMI &#8805; 40 kg/m2 (n = 14), 7 men and 7 women. All subjects were recruited from staff, students and residents of Pedro Ernesto University Hospital, as well as volunteers from Military Police of Rio de Janeiro State and selected based on a convenience sample. All were evaluated by anthropometric parameters, blood pressure determination, laboratory analysis and genotyping, to determine their metabolic profile, endocannabinoid and adipocytokine levels and investigate the polymorphisms FAAH 385C>A, CNR1 3813G>A and PPARA 484C>G. Those with a history of chronic comorbidities, acute inflammatory diseases, drug addiction of any kind and on medication in the ten days prior to study entry were withdrawn from the study. The inflammatory activity as assessed by high sensitive C reactive protein (hsCRP), accompanied the degree of insulin resistance. The levels of PEA negatively associated with visceral adiposity and insulin resistance, suggesting a better metabolic profile, whereas 2-AG levels were positively associated with hsCRP, pointing to a worse metabolic profile. The polymorphisms studied were not associated with the obese or insulin resistant phenotype. The presence of the allele 3813G in the CNR1 gene was independently associated with reduced levels of adiponectin in obese patients, suggesting a worse metabolic profile in this group. The presence of the allele 484G in the PPARA gene associating with higher levels of BMI and LDL-cholesterol in eutrophics may indicate a predisposition for the development of obesity and atherosclerotic dyslipidemia in these individuals. The homozygous genotype AA in position 385 of the FAAH gene, along with levels of hsCRP, were the main direct and independent associations with AEA levels, clearly indicating dysfunction of the degradation enzyme of AEA and possibly contributing to a more vulnerable cardiometabolic profile in individuals with this variant genotype.

O objetivo deste estudo foi analisar o comportamento dos níveis plasmáticos de grelina, em relação aos fatores de risco cardiometabólico, em uma população multiétnica de eutróficos e de obesos..A grelina é um peptídeo produzido predominantemente pelas células oxínticas gástricas, que desempenha importante papel na homeostase energética, promovendo estímulo do apetite e aumento do peso corporal, além de participar do controle do metabolismo lipídico e glicídico, interagindo diretamente com os fatores de risco cardiometabólico. Este é um estudo transversal. Duzentos indivíduos entre 18 e 60 anos com diferentes graus de índice de massa corporal (IMC) compuseram a amostra, assim dividida: cem eutróficos (IMC < 25 kg/m2) e 100 obesos (IMC &#8805; 30 kg/m2). Todos foram avaliados para parâmetros antropométricos, determinação da pressão arterial (aferida por método oscilométrico através de monitor automático) e variáveis metabólicas (métodos usuais certificados). A grelina acilada foi mensurada pela técnica de sanduíche ELISA; a leptina, pelo método Milliplex MAP. O marcador inflamatório proteína C reativa ultrassensível(PCRUS)foi estimado por nefelometria ultrassensível. A insulina foi determinada por quimioluminescência e o HOMA-IR calculado pelo produto insulinemia (U/ml) X níveis de glicemia de jejum (mmol/L) / 22.5. Foram excluídos do estudo aqueles com história de comorbidades crônicas, doenças inflamatórias agudas, dependência de drogas e em uso de medicação nos dez dias anteriores à entrada no estudo. As concentrações de grelina acilada mostraram tendência de redução ao longo dos graus de adiposidade (P<0,001); a leptina se comportou de maneira oposta (P<0,001). Os níveis de grelina se correlacionaram negativamente com IMC (r = -.36; P<0,001), circunferência da cintura (CC) (r=-.34; P<0,001), relação cintura/quadril (RCQ) (r=-.22; P=0,001), diâmetro abdominal sagital (DAS) (r=-.28; P<0,001), pressão arterial sistólica (PAS) (r=-.21; P=0,001), insulina (r=-.27; P<0,001), HOMA-IR (r=-.24; P=0,001) e PCRUS (r=-.29; P<0,001); e positivamente com o HDL-colesterol (r=.30; P<0,001).A PCRUS acompanhou o grau de resistência insulínica e os níveis de grelina também mostraram tendência de redução ao longo dos tercis de resistência insulínica (P=0,001). Em modelo de regressão linear múltipla as principais associações independentes da grelina acilada foram sexo feminino (P=0,005) e HDL-colesterol (P=0,008), ambos com associação positiva e IMC (P<0,001) (associação negativa). Esses achados apontam para uma associação da grelina acilada com melhor perfil metabólico, já que seus níveis se correlacionaram positivamente com HDL-colesterol e negativamente com indicadores de resistência insulínica e atividade inflamatória. / The aim of this study was to analyze the behaviour of ghrelin levels in relation to cardiometabolic risk factors, in a multiethnic population of lean and obese subjects. Ghrelin is a peptide produced mainly by oxyntic gastric cells. It has an important role in energetic balance, stimulating appetite and weight gain, with a role in lipid and carbohydrate metabolism. It interacts directly with the cardiometabolic risk factors. This is a cross-sectional study. Two hundred individuals between 18 and 60 years with varying degrees of body mass index (BMI) comprised the sample, divided as follows: one hundred eutrophic (BMI < 25 kg/m2), 50 men and 50 women and 100 obese (BMI &#8805; 30 kg/m2), 50 men and 50 women. All were evaluated by anthropometric parameters, blood pressure determination (measured by the oscilometric method using an automatic monitor) and metabolic variables (usual methods certificates). The acylated ghrelin was measured by sandwich ELISA technique; leptin by Milliplex MAP method. The inflammatory marker sensitive C reactive protein (hsCRP) was estimated by ultrasensitive nephelometry. Insulin was determined by quimioluminescency and HOMA-IR calculated as the product of insulin (U/ml) X fasting glucose levels (mmol/L) / 22.5. Those subjects with a history of chronic comorbidities, acute inflammatory diseases, drug addiction and on medication in the ten days prior to study entry were withdrawn from the study. There was a trend of decreasing acylated ghrelin (P<0,001) and increasing leptin levels (P<0,001), respectively, along increasing degrees of adiposity. Acylated ghrelin levels were negatively correlated with BMI (r = -.36; P<0,001), waist circumference (r=-.34; P<0,001), waist-to-hip ratio (r=-.22; P=0,001), sagittal abdominal diameter (r=-.28; P<0,001) , systolic blood pressure (r=-.21; P=0,001) , insulin (r=-.27; P<0,001), HOMA-IR (-.24; P=0,001) and high sensitive C reactive protein (hsCRP) (r=-.29; P<0,001); the correlation of acylated ghrelin with HDL-cholesterol was positive (r=.30; P<0,001).The hsCRP followed insulin resistance degree and acyated ghrelin levels also showed decreasing linear trend along increasing HOMA-IR tertiles (P=0,001). In a linear multiple regression model the independent positive correlates of ghrelin were female sex (P=0,005) and HDL-cholesterol (P=0,008), while BMI associated negatively and independently with ghrelin levels (P<0,001). These findings suggest an association of ghrelin with a better metabolic profile, since its levels were positively correlated with HDL-cholesterol and negatively associated with insulin resistance and inflammatory activity indicators.

Analisar a associação recíproca entre fatores de risco cardiometabólico, níveis de adipocitocinas (leptina e adiponectina de alto peso molecular), endocanabinoides (anandamida [AEA] e 2-araquidonoilglicerol [2-AG]), compostos canabimiméticos (N-oleoiletanolamina [OEA] e N-palmitoiletanolamina [PEA]) e polimorfismos em genes codificadores de componentes do sistema endocanabinoide (enzima de degradação de endocanabinoides FAAH [gene FAAH] e receptor endocanabinoide CB1 [gene CNR1]) e do receptor PPAR-&#945; [gene PPARA], em indivíduos com diferentes graus de adiposidade. Duzentos indivíduos, entre 18 e 60 anos, com diferentes graus de índice de massa corporal (IMC) compuseram a amostra, dividida em dois grupos: cem eutróficos (IMC < 25 kg/m2) e 100 obesos (IMC &#8805; 30 kg/m2), com 50 homens e 50 mulheres em cada grupo. Os obesos ficaram assim distribuídos: grau 1, com IMC < 35 kg/m2 (n=54), 27 homens e 27 mulheres; grau 2, com IMC < 40 kg/m2 (n=32), 16 homens e 16 mulheres e grau 3, com IMC &#8805; 40 kg/m2 (n=14), 7 homens e 7 mulheres. Todos os indivíduos foram recrutados entre funcionários, estudantes e residentes do Hospital Universitário Pedro Ernesto, bem como voluntários do quadro da Polícia Militar do Estado do Rio de Janeiro e selecionados com base em amostra de conveniência. Todos foram avaliados por parâmetros antropométricos, determinação da pressão arterial, análises laboratoriais e genotipagem, para determinar seu perfil metabólico, níveis de endocanabinoides e adipocitocinas e rastreamento dos polimorfismos FAAH 385C>A, CNR1 3813A>G e PPARA 484C>G. Foram excluídos do estudo aqueles com história de comorbidades crônicas, doenças inflamatórias agudas, dependência de drogas de qualquer natureza e em uso de medicação nos dez dias anteriores à entrada no estudo. A atividade inflamatória, avaliada pela proteína C reativa ultrassensível (PCRUS), acompanhou o grau de resistência insulínica. Os níveis de PEA se associaram negativamente com a adiposidade visceral e resistência insulínica, sugerindo um melhor perfil metabólico, enquanto que os níveis de 2-AG se associaram positivamente com a PCRUS, apontando para piora nesse perfil. Os polimorfismos estudados não se associaram com o fenótipo obeso ou insulinorresistente. A presença do alelo 3813G no gene CNR1 mostrou associação independente com níveis reduzidos de adiponectina em obesos, sugerindo pior perfil metabólico nesse grupo. A presença do alelo 484G no gene PPARA, associando-se com níveis mais elevados de IMC e LDL-colesterol nos eutróficos pode indicar maior predisposição desses indivíduos para o desenvolvimento de obesidade e dislipidemia aterosclerótica. O genótipo homozigoto AA na posição 385 do gene FAAH e os níveis de PCRUS foram as principais associações, diretas e independentes, com os níveis de AEA, indicando claramente disfunção da enzima de degradação da AEA e, possivelmente, contribuindo para um perfil cardiometabólico mais vulnerável em portadores dessa variante genética. / To analyze the reciprocal association of cardiometabolic risk factors, levels of adipocytokines (leptin and high molecular weight adiponectin), endocannabinoids (anandamide [AEA] and 2-arachidonoylglycerol [2-AG]), cannabimimetic compounds (N-oleoylethanolamine [OEA] and N-palmitoylethanolamine [PEA]) and polymorphisms in genes encoding components of the endocannabinoid system (endocannabinoid degradation enzyme FAAH [FAAH gene] and endocannabinoid receptor CB1 [CNR1 gene]) and the PPAR-&#945; receptor (PPARA gene) in subjects with varying degrees of adiposity. Two hundred individuals between 18 and 60 years with varying degrees of body mass index (BMI) comprised the sample, divided in two groups: one hundred eutrophic (BMI < 25 kg/m2) and 100 obese (BMI &#8805; 30 kg/m2), 50 men and 50 women per group. The obese were distributed as follows: grade 1, with BMI < 35 kg/m2 (n = 54), 27 men and 27 women; grade 2, with BMI between &#8805; 35 and < 40 kg/m2 (n = 32), 16 men and 16 women and grade 3, with BMI &#8805; 40 kg/m2 (n = 14), 7 men and 7 women. All subjects were recruited from staff, students and residents of Pedro Ernesto University Hospital, as well as volunteers from Military Police of Rio de Janeiro State and selected based on a convenience sample. All were evaluated by anthropometric parameters, blood pressure determination, laboratory analysis and genotyping, to determine their metabolic profile, endocannabinoid and adipocytokine levels and investigate the polymorphisms FAAH 385C>A, CNR1 3813G>A and PPARA 484C>G. Those with a history of chronic comorbidities, acute inflammatory diseases, drug addiction of any kind and on medication in the ten days prior to study entry were withdrawn from the study. The inflammatory activity as assessed by high sensitive C reactive protein (hsCRP), accompanied the degree of insulin resistance. The levels of PEA negatively associated with visceral adiposity and insulin resistance, suggesting a better metabolic profile, whereas 2-AG levels were positively associated with hsCRP, pointing to a worse metabolic profile. The polymorphisms studied were not associated with the obese or insulin resistant phenotype. The presence of the allele 3813G in the CNR1 gene was independently associated with reduced levels of adiponectin in obese patients, suggesting a worse metabolic profile in this group. The presence of the allele 484G in the PPARA gene associating with higher levels of BMI and LDL-cholesterol in eutrophics may indicate a predisposition for the development of obesity and atherosclerotic dyslipidemia in these individuals. The homozygous genotype AA in position 385 of the FAAH gene, along with levels of hsCRP, were the main direct and independent associations with AEA levels, clearly indicating dysfunction of the degradation enzyme of AEA and possibly contributing to a more vulnerable cardiometabolic profile in individuals with this variant genotype.

O objetivo deste estudo foi analisar o comportamento dos níveis plasmáticos de grelina, em relação aos fatores de risco cardiometabólico, em uma população multiétnica de eutróficos e de obesos..A grelina é um peptídeo produzido predominantemente pelas células oxínticas gástricas, que desempenha importante papel na homeostase energética, promovendo estímulo do apetite e aumento do peso corporal, além de participar do controle do metabolismo lipídico e glicídico, interagindo diretamente com os fatores de risco cardiometabólico. Este é um estudo transversal. Duzentos indivíduos entre 18 e 60 anos com diferentes graus de índice de massa corporal (IMC) compuseram a amostra, assim dividida: cem eutróficos (IMC < 25 kg/m2) e 100 obesos (IMC &#8805; 30 kg/m2). Todos foram avaliados para parâmetros antropométricos, determinação da pressão arterial (aferida por método oscilométrico através de monitor automático) e variáveis metabólicas (métodos usuais certificados). A grelina acilada foi mensurada pela técnica de sanduíche ELISA; a leptina, pelo método Milliplex MAP. O marcador inflamatório proteína C reativa ultrassensível(PCRUS)foi estimado por nefelometria ultrassensível. A insulina foi determinada por quimioluminescência e o HOMA-IR calculado pelo produto insulinemia (U/ml) X níveis de glicemia de jejum (mmol/L) / 22.5. Foram excluídos do estudo aqueles com história de comorbidades crônicas, doenças inflamatórias agudas, dependência de drogas e em uso de medicação nos dez dias anteriores à entrada no estudo. As concentrações de grelina acilada mostraram tendência de redução ao longo dos graus de adiposidade (P<0,001); a leptina se comportou de maneira oposta (P<0,001). Os níveis de grelina se correlacionaram negativamente com IMC (r = -.36; P<0,001), circunferência da cintura (CC) (r=-.34; P<0,001), relação cintura/quadril (RCQ) (r=-.22; P=0,001), diâmetro abdominal sagital (DAS) (r=-.28; P<0,001), pressão arterial sistólica (PAS) (r=-.21; P=0,001), insulina (r=-.27; P<0,001), HOMA-IR (r=-.24; P=0,001) e PCRUS (r=-.29; P<0,001); e positivamente com o HDL-colesterol (r=.30; P<0,001).A PCRUS acompanhou o grau de resistência insulínica e os níveis de grelina também mostraram tendência de redução ao longo dos tercis de resistência insulínica (P=0,001). Em modelo de regressão linear múltipla as principais associações independentes da grelina acilada foram sexo feminino (P=0,005) e HDL-colesterol (P=0,008), ambos com associação positiva e IMC (P<0,001) (associação negativa). Esses achados apontam para uma associação da grelina acilada com melhor perfil metabólico, já que seus níveis se correlacionaram positivamente com HDL-colesterol e negativamente com indicadores de resistência insulínica e atividade inflamatória. / The aim of this study was to analyze the behaviour of ghrelin levels in relation to cardiometabolic risk factors, in a multiethnic population of lean and obese subjects. Ghrelin is a peptide produced mainly by oxyntic gastric cells. It has an important role in energetic balance, stimulating appetite and weight gain, with a role in lipid and carbohydrate metabolism. It interacts directly with the cardiometabolic risk factors. This is a cross-sectional study. Two hundred individuals between 18 and 60 years with varying degrees of body mass index (BMI) comprised the sample, divided as follows: one hundred eutrophic (BMI < 25 kg/m2), 50 men and 50 women and 100 obese (BMI &#8805; 30 kg/m2), 50 men and 50 women. All were evaluated by anthropometric parameters, blood pressure determination (measured by the oscilometric method using an automatic monitor) and metabolic variables (usual methods certificates). The acylated ghrelin was measured by sandwich ELISA technique; leptin by Milliplex MAP method. The inflammatory marker sensitive C reactive protein (hsCRP) was estimated by ultrasensitive nephelometry. Insulin was determined by quimioluminescency and HOMA-IR calculated as the product of insulin (U/ml) X fasting glucose levels (mmol/L) / 22.5. Those subjects with a history of chronic comorbidities, acute inflammatory diseases, drug addiction and on medication in the ten days prior to study entry were withdrawn from the study. There was a trend of decreasing acylated ghrelin (P<0,001) and increasing leptin levels (P<0,001), respectively, along increasing degrees of adiposity. Acylated ghrelin levels were negatively correlated with BMI (r = -.36; P<0,001), waist circumference (r=-.34; P<0,001), waist-to-hip ratio (r=-.22; P=0,001), sagittal abdominal diameter (r=-.28; P<0,001) , systolic blood pressure (r=-.21; P=0,001) , insulin (r=-.27; P<0,001), HOMA-IR (-.24; P=0,001) and high sensitive C reactive protein (hsCRP) (r=-.29; P<0,001); the correlation of acylated ghrelin with HDL-cholesterol was positive (r=.30; P<0,001).The hsCRP followed insulin resistance degree and acyated ghrelin levels also showed decreasing linear trend along increasing HOMA-IR tertiles (P=0,001). In a linear multiple regression model the independent positive correlates of ghrelin were female sex (P=0,005) and HDL-cholesterol (P=0,008), while BMI associated negatively and independently with ghrelin levels (P<0,001). These findings suggest an association of ghrelin with a better metabolic profile, since its levels were positively correlated with HDL-cholesterol and negatively associated with insulin resistance and inflammatory activity indicators.

<p>Diet is the number one leading modifiable cause of poor health globally, with poor diets accounting for 10.9 million (22%) of all deaths among adults in 2017. In addition, one of our generation’s forthcoming challenges is the rapid expansion of the population aged 60 years and older. Although people are living longer, there is an associated increase in the prevalence of aged-related chronic diseases and functional impairment, such as cardiometabolic diseases and sarcopenia. As such, dietary components can play a role in positively or negatively influencing the prevention and treatment of chronic cardiometabolic diseases and sarcopenia. One such dietary component is dietary protein, which is essential throughout the life course, from gestation through old age. Evidence supports dietary protein playing an important role in reducing the risk of developing age-related chronic diseases such as sarcopenia and cardiometabolic diseases. </p> <p><em><strong>     Study 1, Chapter 2:</strong></em> The Dietary Guidelines for Americans (DGA) recommends consuming a variety of “Protein Foods” based on “ounce equivalent” (oz-eq) portions. In addition, the 2020-2030 Strategic Plan for NIH Nutrition Research includes to “define the role of nutrition across the lifespan” with an objective to “assess the role of nutrition in older adults to promote healthy aging.” However, there is a paucity of primary research that directly compares EAAs bioavailability between young and older adults consuming the same oz-eq portions of varied Protein Foods. No study has assessed the same oz-eq portions of animal- versus plant-based Protein Foods on essential amino acids (EAAs) bioavailability for protein anabolism in young and older adults. Therefore, we conducted two sequential randomized, investigator-blinded, crossover, acute feeding trials with the same study design; first in a cohort of young adults and second in a cohort of older adults. The primary objective of this project was to assess the effect of consuming two oz-eq portions of animal-based (unprocessed lean pork or whole eggs) vs. plant-based (black beans or sliced almonds) Protein Foods as part of a mixed whole foods meal on plasma EAAs bioavailability for protein anabolism. Consistent with our hypotheses, participant age did not affect postprandial EAAs bioavailability, and consuming a meal with two oz-eq of unprocessed lean pork or whole eggs resulted in greater postprandial EAAs bioavailability compared to a meal with two oz-eq of black beans or raw sliced almonds in 1) young adults; 2) older adults; and 3) young and older adults combined. These findings show on the same oz-eq basis, consuming these animal- vs. plant-based Protein Foods more effectively provide bioavailable EAAs for protein anabolism. </p> <p><em><strong>     Study 2, Chapter 3:</strong></em> Poultry meat is the most consumed type of meat worldwide and in the US. Poultry is generally considered to be a “healthy” meat as it is a high-quality protein source and provides other essential nutrients. However, research assessing poultry and its effects on and relations with chronic diseases in humans is sparse, and the forms of poultry typically consumed in the US, are not necessarily in line with recommendations provided by the DGA. Therefore, we conducted a scoping review to systematically search and chronicle scientific literature pertinent to poultry intake and human health. Main findings from this project were 1) historically, little research, especially randomized diet-controlled feeding trials, has been conducted to understand associations between and effects of consuming poultry products on human health; 2) the majority of research is from observational studies assessing relationships between poultry intake and risks of morbidity and mortality from various types of cancer; 3) a paucity of research exists to support chicken as a health-promoting food in children; and 4) research taking into account poultry product processing and cooking methods is needed. Science and health professionals, the poultry industry, and the public will benefit from new observational and experimental research to address cutting-edge scientific, public policy, and consumer topics pertinent to poultry intake and human health. </p> <p><em><strong>     Study 3, Chapter 4:</strong></em> Emerging research on whey protein supplementation suggests it may be a potential modifier of type 2 diabetes mellitus (T2DM) risk factors, including glucose control. As systematic reviews and/or meta-analyses of randomized controlled trials are gaining importance in nutrition literature, we conducted an umbrella systematic review to search for and chronicle published systematic reviews and/or meta-analyses of randomized controlled trials pertinent to whey protein supplementation and T2DM modifiable risk factors (study 3, Chapter 4). Among the 13 systematic reviews, including 12 meta-analyses critically assessed for this umbrella review, no reviews reported any adverse effects of whey protein on any reported T2DM-related risk factor. Collectively, a preponderance of evidence indicates whey protein supplementation improves multiple clinical indicators of glucose control in apparently healthy adults and those at increased risk for type 2 diabetes mellitus. </p>

La santé maternelle et la santé pédiatrique font partie des priorités de santé publique mondiale. La présente thèse a pour objectif d’élargir les connaissances portant sur l’influence de la santé maternelle durant la grossesse sur la santé pondérale et cardiométabolique de la population pédiatrique. Une première étude a montré qu’une exposition intra-utérine à une ou plusieurs conditions gestationnelles sous-optimales (diabète gestationnel, désordres hypertensifs de la grossesse, tabagisme maternel durant la grossesse) avait un effet délétère sur la santé pondérale et cardiométabolique de la population pédiatrique et que cet effet était spécifique au sexe. Une seconde étude a montré que l’efficacité mécanique et l’oxydation des substrats énergétiques (lipides et glucides) au repos et durant l’exercice ne sont pas altérées dans cette population en comparaison avec les enfants non exposés. Ainsi, ce résultat suggère que d’autres mécanismes seraient à l’origine des effets délétères des conditions gestationnelles sous-optimales sur la santé pondérale et cardiométabolique de cette population. Enfin, la troisième étude a montré que seule l’activité physique d’intensité légère réduisait l’effet délétère d’une exposition intra-utérine à plus d’une condition gestationnelle sous-optimale sur le taux de cholestérol à lipoprotéine de haute densité chez les garçons. De plus, une durée de sommeil correspondant aux recommandations canadiennes actuelles n’avait pas d’effet protecteur vis-à-vis du risque d’obésité abdominale (enfants) et d’obésité (filles) dans le contexte d’une exposition au tabagisme maternel durant la grossesse. Par ailleurs, les autres saines habitudes de vie telles que l’activité physique d’intensité moyenne à élevée et une alimentation riche en fruits et légumes, en produits laitiers et en produits céréaliers n’ont pas contrecarré les effets délétères d’une exposition intra-utérine à une ou plusieurs conditions gestationnelles sous-optimales sur la santé pondérale et cardiométabolique des enfants. L’ensemble de ces résultats souligne l’importance de la santé maternelle durant la grossesse pour la santé pondérale et cardiométabolique de la population pédiatrique. Par ailleurs, étant donné que ces effets délétères ne sont que peu contrecarrés par les habitudes de vie durant l’enfance, il reste important de continuer les efforts de prévention et de prise en charge des conditions gestationnelles sous-optimales auprès des femmes enceintes qui les présentent. En terminant, il est important de continuer à explorer les mécanismes sous-jacents à ces effets délétères et à déterminer si des interventions en habitudes de vie peuvent prévenir l’obésité et les facteurs de risque cardiométaboliques dans cette population. / Maternal and children’s health are major worldwide public health concerns. The current thesis aimed to explore the impact of maternal health during pregnancy on children’s and adolescents’ health and included three original research projects. The first study found that a prenatal exposure to independent or combined suboptimal gestational factors (SGF : gestational diabetes mellitus, hypertensive disorders during pregnancy, maternal smoking during pregnancy) was positively associated with obesity and cardiometabolic risk factors in children around puberty, and these associations were sex-dependent. The second study found that children exposed to one SGF display a similar physiological response in terms of mechanical efficiency and substrate oxidation at rest and during exercise (submaximal and maximal) in comparison with non-exposed children. The third study of the thesis found that light-intensity physical activity reduced the adverse impact of prenatal exposure to combined SGF on high density lipoprotein-cholestrol levels in boys. A sleep duration within the range of the current Canadian recommendations for sleep did not mitigate the risk of high waist circumference (children) and obesity (girls) in a context of exposure to maternal smoking during pregnancy. Furthermore, other lifestyle factors such as moderate-to-vigorous physical activity and a healthy diet (intakes of: fruits and vegetables, grains, and dairy products), did not mitigate the adverse impact of a prenatal exposure to independent or combined SGF on children’s risk of obesity and cardiomeatbolic outcomes. Taken together, these results suggest that it is important to continue maternal SGF prevention and management programs to provide optimal health for children. Moreover, future studies should also develop and evaluate the impact of lifestyle habits interventions to design future prevention strategies during childhood and adolescence to reduce obesity and cardiometabolic risk factors in this population.