ABSTRACT BACKGROUND: Fat, muscle, and bone are endocrine organs capable of affecting the metabolic profile and cardiovascular risk. Relating these components is important to the establishment of early intervention strategies for overweight patients. AIMS: This study aimed to evaluate the influence of body mass components on the metabolic profile and cardiovascular risk in the preoperative period of bariatric surgery. METHODS: A cross-sectional study was conducted with patients admitted for bariatric surgery at a university hospital in the city of Recife, Brazil, between 2018 and 2019. Body composition was determined using dual-energy x-ray absorptiometry. Cardiovascular risk was assessed using the Framingham risk score. Data were collected on anthropometric, clinical, and lifestyle characteristics. The lipid profile (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides), blood glucose, and vitamin D were determined using the standard methods of the hospital laboratory. RESULTS: A total of 60 patients were analyzed, 86.7% of whom had comorbidities, 33.3% had moderate/high cardiovascular risk, and 71.4% had vitamin D insufficiency/deficiency. Lower lean body mass (adjusted PR 3.24; 95%CI 1.19–5.77) was independently associated with the severity of obesity. The body mass index and waist circumference were negatively correlated with lean body mass (r=-0.52; p<0.01)/r=-0.36; p<0.01). Lean body mass was negatively correlated with fat mass (r=-0.26; p<0.05), trunk fat (r=-0.29; p<0.05), fasting glucose (r=-0.26; p<0.05), and bone mineral density (r=-0.26; p<0.05). A total of 84.2% of individuals with less trunk fat tended to have low cardiovascular risk (p=0.05). However, physical inactivity (adjusted PR 2.14; 95%CI 1.19–5.54) and the risk of alcohol dependence (adjusted PR 2.41; 95%CI 1.76–4.15) were the only variables independently associated with cardiovascular risk. CONCLUSION: Obese patients in the preoperative period of bariatric surgery with less trunk fat tended to have low cardiovascular risk. However, the other components of body mass were also not associated with cardiovascular risk. BACKGROUND Fat muscle AIMS METHODS crosssectional cross sectional Recife Brazil 201 2019 dualenergy dual energy xray x ray absorptiometry score anthropometric clinical characteristics cholesterol highdensity high lowdensity triglycerides, triglycerides , triglycerides) laboratory RESULTS 6 analyzed 867 86 7 86.7 comorbidities 333 33 3 33.3 moderatehigh moderate 714 71 4 71.4 insufficiencydeficiency insufficiency deficiency insufficiency/deficiency adjusted 3.24 324 24 95CI CI 95 1.19–5.77 119577 1 19 5 77 obesity r=0.52 r052 r r= 0.52 0 52 (r=-0.52 p<0.01/r=0.36 p001r036 pr p<0.01 /r= 0.36 p 01 36 p<0.01)/r=-0.36 p<0.01. p001 . p<0.01) r=0.26 r026 0.26 26 (r=-0.26 p<0.05, p005 p<0.05 05 p<0.05) r=0.29 r029 0.29 29 (r=-0.29 p<0.05. 842 84 2 84.2 p=0.05. p=0.05 (p=0.05) However 2.14 214 14 1.19–5.54 119554 54 2.41 241 41 1.76–4.15 176415 76 15 CONCLUSION 20 8 86. 33. 71. 3.2 32 9 1.19–5.7 11957 r=0.5 r05 052 0.5 (r=-0.5 p<0.01/r=0.3 p001r03 p<0.0 /r 036 0.3 p<0.01)/r=-0.3 p00 r=0.2 r02 026 0.2 (r=-0.2 029 84. p=0.0 (p=0.05 2.1 21 1.19–5.5 11955 2.4 1.76–4.1 17641 3. 1.19–5. 1195 r=0. r0 0. (r=-0. p<0.01/r=0. p001r0 p<0. 03 p<0.01)/r=-0. p0 02 p=0. (p=0.0 2. 1.76–4. 1764 1.19–5 119 r=0 (r=-0 p<0.01/r=0 p001r p<0 p<0.01)/r=-0 p=0 (p=0. 1.76–4 176 1.19– 11 (r=- p<0.01/r= p< p<0.01)/r=- p= (p=0 1.76– 17 1.19 (r= p<0.01/r p<0.01)/r= (p= 1.76 1.1 (r p<0.01)/r (p 1.7 1.

RESUMO RACIONAL: O tecido adiposo, músculos e ossos representam órgãos endócrinos, capazes de interferir no perfil metabólico e risco cardiovascular. Relacionar esses componentes será importante para estratégias de intervenção precoce, em obesos. OBJETIVOS: Avaliar a influência dos compartimentos da massa corporal, sobre o perfil metabólico e risco cardiovascular, no pré-operatório de cirurgia bariátrica. MÉTODOS: Estudo transversal, com pacientes admitidos para cirurgia bariátrica, em hospital universitário. A composição corporal foi avaliada pela absortometria radiológica de dupla energia e o risco cardiovascular pelo escore de risco de Framingham. Foram analisadas variáveis antropométricas, clínicas e de estilo de vida. Foi avaliado perfil lipídico (colesterol total, HDL-c, LDL-c, triglicerídeos), glicemia e vitamina D, utilizando a metodologia padrão. RESULTADOS: Foram analisados 60 pacientes, 86,7% apresentavam comorbidades, 33,3% risco cardiovascular moderado/elevado e 71,4% insuficiência/deficiência de vitamina D. Menor massa corporal magra associou-se à gravidade da obesidade. O índice de massa corpórea e a circunferência da cintura correlacionaram-se negativamente com a massa corporal magra (r=-0,52; p<0,01)/r=-0,36; p<0,01). A massa corporal magra correlacionou-se negativamente com a massa gorda (r=-0,26; p<0,05), gordura troncular (r=-0,29; p<0,05), glicemia de jejum (r=-0,26; p<0,05) e densidade mineral óssea (r=-0,26; p<0,05). Ao todo, 84,2% dos indivíduos com menos gordura troncular apresentaram tendência a baixo risco cardiovascular (p=0,05). Contudo, inatividade física (razão de prevalência ajustada 2,14; IC95% 1,19–5,54) e risco de dependência alcoólica foram as únicas variáveis independentemente associadas ao risco cardiovascular. CONCLUSÕES: Os pacientes obesos em pré-operatório de cirurgia bariátrica com menos gordura troncular, apresentaram tendência a baixo risco cadiovascular. Contudo, o risco cardiovascular também não foi associado aos demais componentes da massa corporal. RACIONAL adiposo endócrinos precoce OBJETIVOS préoperatório pré operatório MÉTODOS transversal universitário Framingham antropométricas vida colesterol total HDLc, HDLc HDL c, c HDL-c LDLc, LDLc LDL LDL-c triglicerídeos, triglicerídeos , triglicerídeos) D padrão RESULTADOS 6 867 86 7 86,7 comorbidades 333 33 3 33,3 moderadoelevado moderado elevado 714 71 4 71,4 insuficiênciadeficiência insuficiência deficiência associouse associou se obesidade correlacionaramse correlacionaram r=0,52 r052 r r= 0,52 0 52 (r=-0,52 p<0,01/r=0,36 p001r036 pr p<0,01 /r= 0,36 p 01 36 p<0,01)/r=-0,36 p<0,01. p001 . p<0,01) correlacionouse correlacionou r=0,26 r026 0,26 26 (r=-0,26 p<0,05, p005 p<0,05 05 r=0,29 r029 0,29 29 (r=-0,29 p<0,05. todo 842 84 2 84,2 p=0,05. p=0,05 (p=0,05) Contudo razão 2,14 214 14 IC95 IC 1,19–5,54 119554 1 19 5 54 CONCLUSÕES cadiovascular 8 86, 33, 71, r=0,5 r05 052 0,5 (r=-0,5 p<0,01/r=0,3 p001r03 p<0,0 /r 036 0,3 p<0,01)/r=-0,3 p00 r=0,2 r02 026 0,2 (r=-0,2 029 84, p=0,0 (p=0,05 2,1 21 IC9 1,19–5,5 11955 r=0, r0 0, (r=-0, p<0,01/r=0, p001r0 p<0, 03 p<0,01)/r=-0, p0 02 p=0, (p=0,0 2, 1,19–5, 1195 r=0 (r=-0 p<0,01/r=0 p001r p<0 p<0,01)/r=-0 p=0 (p=0, 1,19–5 119 (r=- p<0,01/r= p< p<0,01)/r=- p= (p=0 1,19– 11 (r= p<0,01/r p<0,01)/r= (p= 1,19 (r p<0,01)/r (p 1,1 1,

RESUMO Objetivo: avaliar a associação do consumo alimentar com estado nutricional, atividade física e fatores sociodemográficos no pré-operatório de cirurgia bariátrica. Métodos: estudo transversal, realizado no período de 2018 a 2019, com pacientes internados para a cirurgia bariátrica no Hospital Universitário Oswaldo Cruz da Universidade Federal de Pernambuco. Foram obtidos dados sociodemográficos, estado nutricional pelo índice de massa corporal (IMC), circunferência da cintura, maior peso e peso pré-cirúrgico, consumo alimentar obtido pelo questionário de frequência alimentar baseado na pirâmide alimentar adaptada para o paciente bariátrico e atividade física. Resultados: participaram do estudo 60 pacientes, sendo 78,3% do sexo feminino, com idades de 38,8±9,6 anos, 53,3% casados e 70% dos indivíduos com mais de 12 anos de estudo. Na prática de atividade física, 31,7% eram sedentários. Sobre o estado nutricional, a média de IMC observada foi de 47,3±6,96kg/m2. O peso pré-operatório, maior peso atingido antes da cirurgia e circunferência da cintura foi maior no sexo masculino (p<0,05). Houve associação entre atividade física e consumo alimentar, sendo que indivíduos sedentários consumiam mais carboidratos (p=0,041). Por outro lado, dados sociodemográficos e estado nutricional não apresentaram associações com o consumo. Conclusão: o nível de atividade física evidenciou associação significativa apenas com o consumo de carboidratos.

ABSTRACT Objective: to evaluate the association of food consumption with nutritional status, physical activity and sociodemographic factors in the bariatric surgery period preoperative. Methods: we conducted a cross-sectional study from 2018 to 2019, with patients admitted for bariatric surgery at the Oswaldo Cruz University Hospital, Federal University of Pernambuco. We collected data sociodemographic and nutritional data such as body mass index (BMI), waist circumference, highest weight and pre-surgical weight. We evaluated food consumption with the food frequency questionnaire based on the food pyramid adapted for bariatric patients and physical activity. Results: the study involved 60 patients, 78.3% were female, mean age was 38.8±9.6 years, 53.3% were married, and 70% had more than 12 years of education. As for physical activity, 31.7% were sedentary. Regarding nutritional status, the mean BMI was 47.3±6.96kg/m2. Preoperative weight, highest weight reached before surgery and waist circumference were higher in males (p<0.05). There was an association between physical activity and food intake, and sedentary individuals consumed more carbohydrates (p=0.041). On the other hand, sociodemographic data and nutritional status were not associated with food consumption. Conclusion: the level of physical activity showed significant association only with carbohydrate consumption.

Introduction: obesity, characterized by adiposity excess, is associated with endothelial dysfunction and possible inflammatory state with release of cytokines that determine endothelial function and can trigger chronic diseases. The dietary pattern are associated with the synthesis these cytokines. Fruits as the acai, which is rich in flavonoids, have a direct and beneficial effect on the control of this inflammatory process through the exercised antioxidant capacity. Objective: to evaluate the effect of acai pulp consumption on the inflammatory markers, anthropometric measurements, body composition, biochemical and dietary parameters in healthy women. Methods: forty women, were divided in 25 eutrophic and 15 with overweight. They intaked 200 g of acai pulp during 4 weeks. Anthropometric measurements, body composition, inflammatory markers, biochemical data, dietary intake and dietary antioxidants capacity were evaluated before and after the intervention. Results and discussion: after the intervention, there was significant increase of EGF (p = 0.021) and PAI- 1(p = 0.011) in overweight women. Moreover, there was increase in body weight (p = 0.031), body mass index (p = 0.028), percentage of truncal fat (p = 0.003) and triceps skinfold thickness (p = 0.046) in eutrophic women. However, the skinfold thickness (p = 0.018) and total body fat (p = 0.016) decreased in overweight women. There was reduction of total protein (p = 0.049) due to the globulin reduction (p = 0.005), but the nutritional status was maintained in eutrophic group. Conclusion: the intake of 200g acai pulp, modulated the EGF and PAI-1 expression, possibly by modulation of acai on the parameters of body composition, dietary, clinical, biochemical and inflammatory, led to a redistribution and resizing of body fat of the trunk area, and presumably increased visceral fat.

Introducción: la obesidad, que se caracteriza por el exceso de adiposidad, se asocia con disfunción endotelial y posible estado inflamatorio con liberación de citoquinas que determinan la función endotelial y pueden desencadenar enfermedades crónicas. El patrón de dieta está asociado con la síntesis de estas citoquinas. Los frutos de el acai, que es rico en flavonoides, tienen un efecto directo y positivo en el control de este proceso inflamatorio a través de los ejercicios de la capacidad antioxidante. Objetivo: evaluar el efecto del consumo de pulpa de acai en los marcadores inflamatorios, las medidas antropométricas, la composición corporal y los parámetros bioquímicos y dietéticos en mujeres sanas. Métodos: cuarenta mujeres fueron divididas en 25 eutróficas y 15 con sobrepeso. Se las adeministró 200 g de pulpa de acai durante 4 semanas. Antes y después de la intervención se evaluaron: medidas antropométricas, composición corporal, marcadores inflamatorios, datos bioquímicos, ingesta dietética y antioxidantes en la dieta. Resultados y discusión: después de la intervención, hubo un aumento significativo de EGF (p = 0,021) y PAI-1 (p = 0,011) en las mujeres con sobrepeso. Por otra parte, en las mujeres eutróficas hubo aumento del peso corporal (p = 0,031), el índice de masa corporal (p = 0,028), el porcentaje de grasa del tronco (p = 0,003) y el espesor del pliegue cutáneo del tríceps (p = 0,046). Sin embargo, el espesor del pliegue cutáneo (p = 0,018) y la grasa corporal total (p = 0,016) se redujeron en las mujeres con sobrepeso. Hubo una reducción de la proteína total (p = 0,049) debida a la disminución de globulina (p = 0,005), pero el estado nutricional se mantuvo en el grupo eutrófico. Conclusión: la ingesta de 200 g de pulpa de acai modula el EGF y PAI-1 de expresión, posiblemente por la modulación del acai en los parámetros de la composición corporal, la dieta, clínicos, bioquímicos e inflamatorios, lo que dio lugar a una redistribución y modificación del tamaño de la grasa corporal de la zona del tronco, y, presumiblemente, un aumento de la grasa visceral.

Introduction: Among the inflammatory mediators involved in the pathogenesis of obesity, the cell adhesion molecules P-selectin, E-selectin, VCAM-1, ICAM-1 and the chemokine MCP-1 stand out. They play a crucial role in adherence of cells to endothelial surfaces, in the integrity of the vascular wall and can be modulated by body composition and dietary pattern. Objectives: To describe and discuss the relation of these cell adhesion molecules and chemokines to anthropometric, body composition, dietary and biochemical markers. Methods: Papers were located using scientific databases by topic searches with no restriction on year of publication. Results: All molecules were associated positively with anthropometric markers, but controversial results were found for ICAM-1 and VCAM-1. Not only obesity, but visceral fat is more strongly correlated with E-selectin and MCP-1 levels. Weight loss influences the reduction in the levels of these molecules, except VCAM-1. The distribution of macronutrients, excessive consumption of saturated and trans fat and a Western dietary pattern are associated with increased levels. The opposite could be observed with supplementation of w-3 fatty acid, healthy dietary pattern, high calcium diet and high dairy intake. Regarding the biochemical parameters, they have inverse relation to HDLC and positive relation to total cholesterol, triglycerides, blood glucose, fasting insulin and insulin resistance. Conclusion: Normal anthropometric indicators, body composition, biochemical parameters and eating pattern positively modulate the subclinical inflammation that results from obesity by reducing the cell adhesion molecules and chemokines.

Introducción: Entre los mediadores inflamatorios involucrados en la fisiopatogenia de la obesidad, se destacan las moléculas de adhesión P-selectina, E-selectina, VCAM-1, ICAM-1 y la quimiocina MCP-1. Estas desempeñan un papel crucial en la adherencia de células en las superficies endoteliales y en la integridad de la pared vascular y pueden ser moduladas por la composición corporal y patrón alimentario. Objetivos: Describir y discutir la relación de esas moléculas de adhesión y quimiocina con marcadores antropométricos, composición corporal, bioquímicas y dietéticas. Métodos: Se utilizaron bases científicas electrónicas para selección de artículos, sin límite de año de publicación. Resultados: Todas las moléculas se asociaron de forma positiva con marcadores antropométricos; sin embargo, se encontraron resultados controvertidos para ICAM-1 y VCAM-1. No solamente la obesidad per si, sino también la grasa visceral está más fuertemente relacionadas con las concentraciones de E-selectina y MCP-1. La pérdida de peso influencia en la reducción de las concentraciones de esas moléculas, con excepción de la VCAM-1. La distribución de macronutrientes, el consumo excesivo de grasa saturada y trans y un patrón alimentario occidental están asociados con aumento de sus concentraciones. El inverso se pudo observar con la suplementación de ácido graso w-3 en la dieta, el patrón alimentario sano y dieta rica en calcio y productos lácteos. Ya en cuanto a los parámetros bioquímicos, las mismas poseen relación inversa con HDL-c y positiva con coles-terol total, triacilgliceroles, glicemia e insulinemia de ayuno y resistencia a insulina. Conclusión: Marcadores antropométricos, composición corporal, parámetros bioquímicos y patrón alimentario adecuados modulan positivamente la inflamación subclínica derivada de la obesidad por medio de la reducción de las moléculas de adhesión y quimiocinas.