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Is Brown Fat Relevant to Obesity Prevention or Treatment?
Abstracts / Can J Diabetes 37 (2013) S217eS289
6 months of 62.918.3%, with fat representing 10kg (95.2%) of the lost weight and lean tissue 0.5kg (4.8%). A repeated-measuresANOVA was used to explore longitudinal changes and found significant differences for measures of FT, AF (7.30kg to 3.62kg), FNBMD (1.1495g/cm2 to 1.1008g/cm2), and THBMD (1.2135g/cm2 to 1.1556g/cm2) (all p’s<0.001); and in lumbar spine BMD (p<0.05). For LT, there was a significant difference after 3 months (p<0.001) but no difference between 3 and 6 months (p¼0.335). This data may help health professionals seek interventions to attenuate loss of lean tissue and BMD during the first three months following metabolic surgery. 554-OR Ergometric Test or Six-Minute Walk Test in Morbidly Obese Patients? SHIRLEY FABRIS DE SOUZA, JOEL FAINTUCH, SONIA MARIA FABRIS Department of Physical Therapy, Hospital Universitário de Londrina, Londrina State University, Londrina, Paraná, Brazil Aim: To compare ergometric test and six-minute walk test in obese patients undergoing bariatric surgery. Methods: 45 morbidly obese patients, 97.4% female, age 42.9+/-9.6 years, body mass index 51.4 -/+ 8.3 kg/m2) was analysed preoperative and 10-12 months after bariatric surgery (gastric bypasss). In the 6MWT patients were instructed to walk from end-to-end of a previously measured corridor, covering as much distance as possible in the allotted period of 6 min. They were allowed to stop and rest if desired, resuming walking as soon as they felt able to do so. In the fatigue rather than time-limited treadmill exercise -modified Bruce test, total distance, Borg scale of perceived exhaustion, and physical as well as cardiovascular variables were recorded. Results: Preoperative and postoperative findings for treadmill protocol were: distance 403.8-/+ 137.2 vs 691.2 /+76.3 m and time 5.5+/-1.3 and 8.7+/-1.0 min (p<0.0001). Corresponding distance during standard duration of the procedure for 6MWT was 671.2+/80.1 vs 820.3+/-92.4 m (p<0.0001). Conclusions: 1) The 6’WT was safe, inexpensive and could be conducted without specialized equipment; 2) This test is recommended for routine functional assessment of patients with severe obesity.
THURSDAY, MAY 2: PLENARIES P.M. 555-PL Will Accommodation of Persons With Obesity Promote Obesity? MARY FORHAN University Health Network, Toronto Rehabilitation Institute, Burlington, Ontario, Canada Accommodation is defined as an adjustment or modification of actions in response to something, an agreement that is acceptable to all parties in a dispute or flexibility referring to the ability to include something without major change. Accommodations in response to obesity is a hot topic because it requires a universal understanding and acceptance of the causes and consequences of obesity and paradoxical shift in thinking about energy conservation as it relates to energy expenditure and the separation of the value and meaning attributed to body size and shape. Accommodations have been perceived as ways of making life easier and enabling participation in life events for persons living with a disability. Obesity is experienced as a disability by some people yet there is resistance to applying the same principles of accommodation to persons with obesity that are applied to persons who have other chronic conditions such as spinal cord injury, musculoskeletal or neurocognitive disorders. Possible explanations for this resistance are: persons with obesity would not benefit from accommodations; persons with obesity are not disabled or; providing accommodations to persons with obesity will demonstrate acceptance of obesity. This session will address each of these arguments in order to answer the question posed by the title of this session.
S235
556-PL Is it Time to Limit Weight Gain in Pregnancy? KRISTI B. ADAMO Children’s Hospital of Eastern Ontario Research Institute, Healthy Active Living and Obesity Research Group (HALO), Ottawa, Ontario, Canada Accommodation is defined as an adjustment or modification of actions in response to something, an agreement that is acceptable to all parties in a dispute or flexibility referring to the ability to include something without major change. Accommodations in response to obesity is a hot topic because it requires a universal understanding and acceptance of the causes and consequences of obesity and paradoxical shift in thinking about energy conservation as it relates to energy expenditure and the separation of the value and meaning attributed to body size and shape. Accommodations have been perceived as ways of making life easier and enabling participation in life events for persons living with a disability. Obesity is experienced as a disability by some people yet there is resistance to applying the same principles of accommodation to persons with obesity that are applied to persons who have other chronic conditions such as spinal cord injury, musculoskeletal or neurocognitive disorders. Possible explanations for this resistance are: persons with obesity would not benefit from accommodations; persons with obesity are not disabled or; providing accommodations to persons with obesity will demonstrate acceptance of obesity. This session will address each of these arguments in order to answer the question posed by the title of this session. 557-PL Is Brown Fat Relevant to Obesity Prevention or Treatment? ANDRÉ CARPENTIER Centre de recherche clinique Étienne-Le Bel, Centre hospitalier universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, Québec, Canada The presence of brown adipose tissue (BAT) depots has been unequivocally demonstrated in humans using positron emission tomography coupled to computed tomography (PET/CT) with 18fluoro-deoxyglucose (18FDG). Younger age, lower body mass index (BMI), absence of diabetes, and colder outdoor temperature on the day of the PET/CTexam were all independently associated with higher prevalence of metabolically active BAT. We were the first to demonstrate significant contribution of BAT to energy expenditure upon acute cold exposure in men and reduction of acute cold exposureinduced BAT metabolism in older subjects with type 2 diabetes. We found a remarkable reciprocal relationship between the need to shiver upon cold exposure and total BAT volume of metabolic activity, demonstrating the contribution of BAT to non-shivering thermogenesis. Our findings also strongly suggest that, at fasting, the energy source used by BAT-mediated thermogenesis is its own intracellular triglyceride content. Recent studies in animals suggest that BAT may take up and dissipate large amounts of energy from dietary fat. Indeed, the contribution of BAT to counter high-fat induced obesity has been proposed more than 30 years ago. Demonstrating whether BAT has the capacity to dissipate energy from meal fat and contributes to reduce both caloric balance and dietary fatty acid partitioning towards lean organs will be very important to establish BAT metabolic activation as a potential preventive and therapeutic target for the treatment of obesity and type 2 diabetes. 558-PL Is Obesity Caused by Food Addiction? ALAIN DAGHER Montreal Neurological Institute, McGill University, Montréal, Québec, Canada The view that hunger is an addiction to food was proposed 100 years ago. The rise in obesity is attributed to over-eating in an environment of cheap abundant and unhealthy food. Food-related stimuli act as conditioned cues that trigger motivation to eat. This is
6 months of 62.918.3%, with fat representing 10kg (95.2%) of the lost weight and lean tissue 0.5kg (4.8%). A repeated-measuresANOVA was used to explore longitudinal changes and found significant differences for measures of FT, AF (7.30kg to 3.62kg), FNBMD (1.1495g/cm2 to 1.1008g/cm2), and THBMD (1.2135g/cm2 to 1.1556g/cm2) (all p’s<0.001); and in lumbar spine BMD (p<0.05). For LT, there was a significant difference after 3 months (p<0.001) but no difference between 3 and 6 months (p¼0.335). This data may help health professionals seek interventions to attenuate loss of lean tissue and BMD during the first three months following metabolic surgery. 554-OR Ergometric Test or Six-Minute Walk Test in Morbidly Obese Patients? SHIRLEY FABRIS DE SOUZA, JOEL FAINTUCH, SONIA MARIA FABRIS Department of Physical Therapy, Hospital Universitário de Londrina, Londrina State University, Londrina, Paraná, Brazil Aim: To compare ergometric test and six-minute walk test in obese patients undergoing bariatric surgery. Methods: 45 morbidly obese patients, 97.4% female, age 42.9+/-9.6 years, body mass index 51.4 -/+ 8.3 kg/m2) was analysed preoperative and 10-12 months after bariatric surgery (gastric bypasss). In the 6MWT patients were instructed to walk from end-to-end of a previously measured corridor, covering as much distance as possible in the allotted period of 6 min. They were allowed to stop and rest if desired, resuming walking as soon as they felt able to do so. In the fatigue rather than time-limited treadmill exercise -modified Bruce test, total distance, Borg scale of perceived exhaustion, and physical as well as cardiovascular variables were recorded. Results: Preoperative and postoperative findings for treadmill protocol were: distance 403.8-/+ 137.2 vs 691.2 /+76.3 m and time 5.5+/-1.3 and 8.7+/-1.0 min (p<0.0001). Corresponding distance during standard duration of the procedure for 6MWT was 671.2+/80.1 vs 820.3+/-92.4 m (p<0.0001). Conclusions: 1) The 6’WT was safe, inexpensive and could be conducted without specialized equipment; 2) This test is recommended for routine functional assessment of patients with severe obesity.
THURSDAY, MAY 2: PLENARIES P.M. 555-PL Will Accommodation of Persons With Obesity Promote Obesity? MARY FORHAN University Health Network, Toronto Rehabilitation Institute, Burlington, Ontario, Canada Accommodation is defined as an adjustment or modification of actions in response to something, an agreement that is acceptable to all parties in a dispute or flexibility referring to the ability to include something without major change. Accommodations in response to obesity is a hot topic because it requires a universal understanding and acceptance of the causes and consequences of obesity and paradoxical shift in thinking about energy conservation as it relates to energy expenditure and the separation of the value and meaning attributed to body size and shape. Accommodations have been perceived as ways of making life easier and enabling participation in life events for persons living with a disability. Obesity is experienced as a disability by some people yet there is resistance to applying the same principles of accommodation to persons with obesity that are applied to persons who have other chronic conditions such as spinal cord injury, musculoskeletal or neurocognitive disorders. Possible explanations for this resistance are: persons with obesity would not benefit from accommodations; persons with obesity are not disabled or; providing accommodations to persons with obesity will demonstrate acceptance of obesity. This session will address each of these arguments in order to answer the question posed by the title of this session.
S235
556-PL Is it Time to Limit Weight Gain in Pregnancy? KRISTI B. ADAMO Children’s Hospital of Eastern Ontario Research Institute, Healthy Active Living and Obesity Research Group (HALO), Ottawa, Ontario, Canada Accommodation is defined as an adjustment or modification of actions in response to something, an agreement that is acceptable to all parties in a dispute or flexibility referring to the ability to include something without major change. Accommodations in response to obesity is a hot topic because it requires a universal understanding and acceptance of the causes and consequences of obesity and paradoxical shift in thinking about energy conservation as it relates to energy expenditure and the separation of the value and meaning attributed to body size and shape. Accommodations have been perceived as ways of making life easier and enabling participation in life events for persons living with a disability. Obesity is experienced as a disability by some people yet there is resistance to applying the same principles of accommodation to persons with obesity that are applied to persons who have other chronic conditions such as spinal cord injury, musculoskeletal or neurocognitive disorders. Possible explanations for this resistance are: persons with obesity would not benefit from accommodations; persons with obesity are not disabled or; providing accommodations to persons with obesity will demonstrate acceptance of obesity. This session will address each of these arguments in order to answer the question posed by the title of this session. 557-PL Is Brown Fat Relevant to Obesity Prevention or Treatment? ANDRÉ CARPENTIER Centre de recherche clinique Étienne-Le Bel, Centre hospitalier universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, Québec, Canada The presence of brown adipose tissue (BAT) depots has been unequivocally demonstrated in humans using positron emission tomography coupled to computed tomography (PET/CT) with 18fluoro-deoxyglucose (18FDG). Younger age, lower body mass index (BMI), absence of diabetes, and colder outdoor temperature on the day of the PET/CTexam were all independently associated with higher prevalence of metabolically active BAT. We were the first to demonstrate significant contribution of BAT to energy expenditure upon acute cold exposure in men and reduction of acute cold exposureinduced BAT metabolism in older subjects with type 2 diabetes. We found a remarkable reciprocal relationship between the need to shiver upon cold exposure and total BAT volume of metabolic activity, demonstrating the contribution of BAT to non-shivering thermogenesis. Our findings also strongly suggest that, at fasting, the energy source used by BAT-mediated thermogenesis is its own intracellular triglyceride content. Recent studies in animals suggest that BAT may take up and dissipate large amounts of energy from dietary fat. Indeed, the contribution of BAT to counter high-fat induced obesity has been proposed more than 30 years ago. Demonstrating whether BAT has the capacity to dissipate energy from meal fat and contributes to reduce both caloric balance and dietary fatty acid partitioning towards lean organs will be very important to establish BAT metabolic activation as a potential preventive and therapeutic target for the treatment of obesity and type 2 diabetes. 558-PL Is Obesity Caused by Food Addiction? ALAIN DAGHER Montreal Neurological Institute, McGill University, Montréal, Québec, Canada The view that hunger is an addiction to food was proposed 100 years ago. The rise in obesity is attributed to over-eating in an environment of cheap abundant and unhealthy food. Food-related stimuli act as conditioned cues that trigger motivation to eat. This is