CoordenaÃÃo de AperfeiÃoamento de NÃvel Superior / Esta pesquisa teve como objetivo investigar os discursos que circulam no grupo terapÃutico realizado com pacientes diagnosticados obesos de um hospital pÃblico de referÃncia em cirurgia bariÃtrica no municÃpio de Fortaleza-CE e como esses pacientes sÃo subjetivados por esses discursos. Assim, esse estudo possui como tema central a obesidade, porÃm sem tomar como verdade os discursos biomÃdicos hegemÃnicos que a tratam enquanto fenÃmeno de doenÃa, e sim questionar e problematizar discussÃes, com base em Michel Foucault, sobre os efeitos de verdade que esses discursos produzem. A metodologia utilizada foi a observaÃÃo participante do referido grupo composto por pacientes de ambos os sexos que estÃo na fase prÃ-operatÃria da cirurgia bariÃtrica e tambÃm com aqueles que jà se submeteram a essa operaÃÃo. A cirurgia bariÃtrica funciona como uma estratÃgia biopolÃtica que incide sobre o corpo de uma populaÃÃo obesa. Dentre as tÃticas da biopolÃtica percebidas no grupo terapÃutico, pode-se citar: o conjunto de prÃticas discursivas que funcionam como regimes de verdades (prescriÃÃes de dietas, hÃbitos, comportamentos e modos de viver em nome da saÃde), especialistas (mÃdicos, psicÃlogos, nutricionistas, etc) que proferem essa âverdadeâ, intervenÃÃes (clÃnicas, cirÃrgicas) sobre a populaÃÃo obesa e subjetivaÃÃo dos pacientes que sÃo enredados na teia do poder, nas estratÃgias de conduÃÃo de condutas de si e dos outros. Assim, esse trabalho nÃo buscou construir um juÃzo de valor de se posicionar a favor ou contra a cirurgia bariÃtrica, nem assumir uma visÃo moralista diante da obesidade e sim problematizar como o corpo obeso à demarcado por prÃticas (discursivas e nÃo-discursivas) de saber-poder que o constituem. Consistiu, ainda, em pensar diferentemente do que se pensa, criar formas que escapam, que se constituem como resistÃncias, linhas de fuga e formas libertÃrias ao discurso mÃdico-cientÃfico sobre saÃde, beleza e boa forma dos corpos.

Övervikt och fetma som uppkommer i barnaåren kan påverka livskvalitén negativt även i vuxen ålder. Det är därför av största vikt att arbeta för att barn skall uppnå en hälsosam vikt redan under förskoleåldern. Små barn är i beroendeställning till sina föräldrar och därför är det viktigt att föräldrarna får god information gällande hälsofrämjande åtgärder. Barnhälsovårdens uppgift är att främja hälsa och förebygga ohälsa och skall i sitt arbete verka för föräldrarnas delaktighet och empowerment. Med kunskaper om vad, hos föräldrar, som kan påverka barns övervikt och fetma kan sjuksköterskor få bättre verktyg för att stödja föräldrarna. Syftet med litteraturstudien var att undersöka föräldrars påverkan vid utveckling av övervikt och fetma hos barn i förskoleåldern. Artikelsökningar genomfördes i tre olika databaser som innehåller artiklar inom omvårdnad.  I resultatet framkom följande kategorier: Föräldraroll, Kulturell bakgrund och socioekonomi, Matvanor, Fysisk aktivitet. Det är viktigt att redan i tidiga åldrar uppmärksamma barn med risk för övervikt för att kunna sätta in hälsofrämjande åtgärder som samtal och förstärkt föräldrastöd, speciellt i utsatta områden. Mer forskning och kunskap avseende övervikt och fetma hos barn i förskoleåldern är väsentlig då kunskapsläget idag är otillräckligt gällande denna åldersgrupp. / Overweight and obesity gained through childhood may have a negative influence in the quality of life in adulthood. Therefore, it is of utmost importance to aim for a healthy weight in children. Small children are dependent on their parents, therefore it is important that the parents receive good information on health promotion measures that lead to healthy weight development. The task for children's healthcare is to promote health and prevent illness and aim for involvement and empowerment of the parents. Through knowledge about how parents may influence the weight and obesity of their children, the nurses can get better tools to support the parents. The purpose of the literature study was to examine how the parents may influence the development of overweight and obesity amongst preschool children. Research was conducted in three different databases focusing on nursing. In the result the following categories were found: Parents' role, Cultural background and socioeconomic, Eating habits, Physical activity. It is important to pay attention to the risk of obesity in early childhood to promote health measures such as dialogues and promote effective parenting especially in vulnerable areas. More research and knowledge is needed concerning preschoolers as today's knowledge situation is insufficient regarding this age group.

hjlahgih / Thesis (DPhil (Human Movement Science))--University of Pretoria, 2005. / Biokinetics, Sport and Leisure Sciences / unrestricted

abstract: Sedentary behavior and excessive weight gain have been proven to deteriorate many characteristics of muscle. Low muscular power and mass with excess fat mass are risk factors for a multitude of chronic conditions and functional disabilities. Resistance training (RT) has long been accepted as a rehabilitative method of maintaining or enhancing muscular performance and composition. There are various methods of determining lower extremity muscular power; however, isokinetic dynamometry has emerged as one of the most accurate and reliable methods in clinical and research settings. Likewise, various methods exist for determining muscle thickness; however, many of those methods are expensive and can expose individuals to radiation. Ultrasonography has emerged as an accurate and reliable alternative to measuring lower extremity muscle thickness. The objective of this study was to assess the effects of high-load/low-volume (HLLV) and low-load/high-volume (LLHV) RT on isokinetic knee extensor and flexor peak power in sedentary, RT naïve, overweight or obese men and women (Body Mass Index ≥ 25 kg/m2). Twenty-one subjects (n = 21) completed this study and were randomized into one of the following groups: control, a HLLV group that performed three sets of 5 repetitions for all exercises until volitional fatigue, and LLHV which performed three sets of 15 repetitions for all exercises until volitional fatigue. Subjects randomized to the RT groups performed full-body exercises routines on three non-consecutive days per week. Changes in isokinetic knee extensor and flexor peak power, quadriceps ultrasound muscle thickness, and right leg segment of dual-energy X-ray absorptiometry (DEXA) scans were measured before and after the 12-week RT intervention. There were no significant differences found in group, time or, group by time interactions for knee extensor and flexor peak power using isokinetic dynamometry. Other than a group interaction for vastus intermedius muscle thickness (P=0.008), no significant interactions or differences were observed for any of the other variables tested. Based on the results of this study, neither high- nor low-load RT resulted in significant differences between intervention groups in peak power of the knee extensors and flexor, muscle thickness changes of the vastus intermedius, and vastus lateralis and, in the right lower extremity segmented body composition measures using DEXA. / Dissertation/Thesis / Masters Thesis Exercise and Wellness 2020

Objetivo: Evaluar la asociación entre síndrome metabólico (SM) y carga glicémica (CG) de la ingesta alimentaria en niños y adolescentes obesos atendidos en consulta endocrinológica de un hospital de referencia pediátrica en Lima, Perú. Pacientes y método: Estudio transversal en niños y adolescentes obesos (IMC ≥ percentil 95) de 10 a 15 años. Se utilizó los criterios de la International Diabetes Federation (IDF) para la clasificación de SM. Se aplicó recordatorio de 24 horas y se calculó la CG total y por tiempos de comida. Se evaluó la asociación entre los terciles de CG (comparación contra el inferior) y SM usando razones de prevalencia ajustadas (RPa) por variables demográficas, familiares, actividad física y consumo total de carbohidratos en modelos de regresión de Poisson con varianza robusta. Resultados: De 273 niños y adolescentes obesos, 52,4% fueron varones, 94,9% fueron físicamente inactivos y el IMC promedio fue 27,2 kg/m2. La mediana de carga glicémica fue de 213,3 (p25-p75:164,8 – 287,35) y de 2275 kcal (p25-p75: 1851,05 – 3024) de ingesta calórica diaria, dado principalmente por carbohidratos (62%).La prevalencia de SM fue de 22,3%, los componentes más prevalentes fueron la obesidad abdominal (81,7%) y el HDL bajo (63,7%). Se encontró asociación entre el consumo elevado de CG y el riesgo a presentar SM (RPa: 4,5; IC95%:1,3-15,31). Conclusiones: Existe asociación entre el alto consumo de CG y la presencia de SM en niños y adolescentes con obesidad. / Objective: Evaluate the association between metabolic syndrome (MS) and glycemic load (GL) of the food intake in obese children and adolescents attended in endocrinology consultation of a pediatric referral hospital in Lima, Peru. Patients and methods: Cross-sectional study in obese (BMI ≥ 95 percentile) children and adolescents between 10 to 15 years old. MS was classified according to the International Diabetes Federation (IDF). 24- hours recall was applied and calculated the GL total and by meal. The association between the tertiles of GL (comparison against the lower) and MS was found using adjusted prevalence ratios (RPa) for demographic variables, family, physical activity and total carbohydrates intake by Poisson regression models with robust variance. Results: 273 obese children and adolescents were recruited, 52.4% were male and 94.9% were physically inactive and IMC average was 27, 2 kg/m2. The median of GL was 213, 3 (164, 8 – 287, 35: 122, 6) and 2275 kcal (1851, 05 – 3024: 1172, 9) for daily caloric intake, mainly due of carbohydrates (62%). The prevalence of MS was 22, 3%, the components more relevant were abdominal obesity (81,7%) and low HDL (63,7%). The association between a high consumption of CG and the risk having MS (Rpa: 4,5; IC95%: 1,3-15,31) Conclusions: There is an association between the high intake of GL and the presence of MS. / Tesis

In this qualitative study excessive weight gain in men is placed in the context of a life course trajectory with its characteristic stages. A combination of symbolic interactionism and life course perspectives was deemed appropriate for studying obesity as their basic assumptions complement each other to create a holistic view of the phenomenon. Both the life course and symbolic interactionism perspectives stress the interaction between individuals and their social environment, an observation particularly evident when viewed as a micro-level experience. The chosen approach emphasises the social creation of meanings about life transitions and individual development. The obese man cannot be seen as an isolated unit as, like all people, he is a social being forming part of a network of relationships. Theoretically those with whom he is socialising can be classified as significant others, general others and reference group others. It is their influence that is important in his personal development and experience of the self. While the symbolic interactionism perspective accentuates the development of the self in interaction with others, the life course perspective gives clarity on the way the individual handles transition experiences in order to regain balance after a time of disequilibrium resulting from different trajectories. The theory of cognitive appraisal used in this study enhanced understanding of the obese man‟s passion for food, and the emotion of joy experienced when busy with food-related activities. Cognitive appraisal takes place in each situation when the obese man needs to make a decision or take action in terms of food and life style behaviour. The strategy of enquiry for this research followed a phenomenological and qualitative approach. The unit of analysis was a white man who was obese. The inclusion criteria for the sample were: being older than 21; and complying with the acknowledged criterion for obesity of having a BMI greater than 30kg/m². A purposive sampling technique was employed with each of the 14 participants being interviewed on more than one occasion. Participants were expected to, and were able to describe their experiences of being obese retrospectively. The researcher made almost exclusive use of lengthy, individual, in-depth, unstructured interviews. Three themes emerged from the data namely the meaning of food, the sadness of obesity and coping with obesity. The findings from this study show that, as a social object, the obese man‟s eating habits and the meaning that food has for him are influenced by, and learnt from others such as his family during childhood and adolescence, and his married partner and work colleagues in young adulthood. Essentially, indulgence in eating is for the anticipated pleasure it brings. Thus several factors like marriage, friends and career influence the food trajectory of the obese man. The obese man‟s food trajectories affect his weight trajectory and have a negative impact on his experience of self. His overweight body gives rise to distressing physical constraints and causes emotional experiences of sadness. He is unable to make peace with his obese state and needs to consciously address the situation. Coping strategies used by the obese participants were critical in their handling of their obesity. In the process of self-appraisal they needed confirmation that they could handle the problem so that it did not influence the way they experienced their physical and inner selves. Regardless of all the coping strategies adopted, the participants were not totally able to handle their plight. It actually got worse and impacted extremely negatively on their well-being. / Thesis (PhD)--University of Pretoria, 2012. / gm2014 / Consumer Science / unrestricted

Impairments in insulin sensitivity can occur in patients with chronic kidney disease (CKD). Correction of metabolic acidosis has been associated with improved insulin sensitivity in CKD, suggesting that metabolic acidosis may directly promote insulin resistance. Despite this, the effect of acid or alkali loading on insulin sensitivity in a rodent model of CKD (remnant kidney) has not been directly investigated. Such studies could better define the relationship between blood pH and insulin sensitivity. We hypothesized that in remnant kidney rats, acid or alkali loading would promote loss of pH homeostasis and consequently decrease insulin sensitivity. To test this hypothesis, we determined the impact of alkali (2 wk) or acid (5-7 days) loading on plasma electrolytes, acid-base balance, and insulin sensitivity in either sham control rats, 2/3 nephrectomized rats, or 5/6 nephrectomized rats. Rats with 5/6 nephrectomy had the greatest response to insulin followed by rats with 2/3 nephrectomy and sham control rats. We found that treatment with 0.1 M sodium bicarbonate solution in drinking water had no effect on insulin sensitivity. Acid loading with 0.1 M ammonium chloride resulted in significant reductions in pH and plasma bicarbonate. However, acidosis did not significantly impair insulin sensitivity. Similar effects were observed in Zucker obese rats with 5/6 nephrectomy. The effect of renal mass reduction on insulin sensitivity could not be explained by reduced insulin clearance or increased plasma insulin levels. We found that renal mass reduction alone increases sensitivity to exogenous insulin in rats and that this is not acutely reversed by the development of acidosis.

SAMMANFATTNING I Sverige är cirka 40 procent av alla kvinnor i fertil ålder överviktiga eller har fetma. Detta medför ökade risker för kvinnan och fostret under graviditet såsom graviditetsdiabetes, preeklampsi, kejsarsnitt, intrauterin fosterdöd och barn som föds stora för tiden. I Sverige idag finns inga riktlinjer för vad som är lämplig viktuppgång utifrån Body mass index innan graviditet. Att banta under graviditet är inget som rekommenderas, men samtidigt visar studier att en överdriven viktuppgång under graviditet ökar riskerna för viktretention efter graviditeten. Det finns otillräcklig kunskap både hos gravida kvinnor och hos vårdpersonal om vad som är lämplig viktuppgång under graviditet. En kvinna som redan innan graviditet är överviktig eller har fetma utsätter sig själv och sitt ofödda barn för ytterligare risker genom överdriven viktuppgång under graviditet. Syftet med detta arbete var att undersöka interventioners effekt på att begränsa viktuppgång hos gravida kvinnor, med övervikt eller fetma, samt om dessa interventioner påverkar kvinnan eller barnet i övrigt under graviditet och förlossning. En litteraturöversikt utfördes där 15 vetenskapliga artiklar inkluderades. Artikelsökningen genomfördes i databaserna Cinahl och Pubmed. Genom att läsa artiklarna ett flertal gånger och göra understrykningar i texten hittades mönster som svarade på arbetets syfte och frågeställningar. Utifrån detta kategoriserades fakta i artiklarna. Resultatet visade att fysisk aktivitet, kostråd och beteendestrategier kan ha effekt på att begränsa viktuppgången hos gravida kvinnor med övervikt eller fetma. Många av kvinnorna som deltog i studierna förbättrade sina matvanor. I övrigt hade dessa interventioner även till viss del positiv effekt på blodtrycket och förekomsten av graviditetsdiabetes, men resultatet är på många områden inte entydigt. Ingen tydlig effekt på att begränsa födelsevikten kunde påvisas hos barnen, men det fanns en viss begränsning av barn som föddes med en födelsevikt över 4000 gram. Livsstilinterventioner kan vara effektiva för att begränsa viktuppgången under graviditet för kvinnor med övervikt eller fetma. Vidare forskning behövs för att säkerställa att detta sker på ett säkert sätt utifrån BMI klassificering.

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