- Email: [email protected]
Overweight and obesity in their association with hypertension in schoolchildren from Maringá, Paraná, Brazil
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cANADIAN JoUrNAL oF DIAbEtEs
plants mucilage on food intake and body weight gain in rats fed highfat diet, and their putative role in modulating plasma lipid profile and oxidative stress. Methods: The monosaccharide composition of mucilage obtained after water extraction and antioxidant properties assessment was determined by Gas chromatography. Male Wistar rats were fed highfat diet and received mucilages from Triumphetta cordifolia bark and Irvingia gabonensis kernels at a daily dose of 200 mg/Kg for six weeks. Weight and food intake were monitored. On day 42, rats were fooddeprived for 12 hours and anesthetized for blood and tissue sampling for lipid profile and MDA, thiol, catalase analysis. results: T. cordifolia mucilage contained Rha (44%) and Gal (23%),I. gabonensis Gal (44%) and Ara (18%). Both showed reducing powers of 0.98 and 0.78 at 0.25mg/ml and, at 5mg/ml, chelated ferrous ions by 61.7%. The two mucilages lowered food intake, weight gain, plasma triglyceride and total cholesterol level. T. cordifolia mucilage reduced more remarkably TG: 373.7 ± 50.3 mg/ml (p<0.001) and TC (p<0.01). A significant decrease of MDA in plasma (p<0.001), but a significant increase of catalase and thiols both in the homogenates (p<0.05;p< 0.01) and plasma (p<0.05;p<0.001), were obtained. I.gabonensis and T. cordifolia mucilages increased catalase activity more than galactomanane reference fibre. conclusions: In high-fat diet rats, the mucilage would be effective in preventing increase in plasma lipid levels, improving the antioxidant enzyme levels, exerting beneficial effects on lipid metabolism, and avoiding large increase in food intake and body weigh.This is due to effect they exert on intestinal peptide involved in the regulation of food intake, and also their gel-forming and good antioxidant properties. While further investigations on structure progress, these mucilages could be proposed as interesting nutrients in the management of food intake and obesity-associated metabolic disorders.
142 sociology and the barker Hypothesis: transdisciplinary approaches to obesity R. Scott genera Research Group, Department of Sociology, Queen’s University, Kingston, Canada During development, the comingling of maternal nutrition, socioeconomic status, generational patterns of health and illness, and biological processes can predispose the fetus to later disease or predict future health. This theory, called the Barker hypothesis, evidences complex etiologies of disease and explanations for distributions of health that span biology, social class, place, and generation. In this way, the hypothesis is significant not only for clinicians and scientific researchers who study the biological processes associated with fetal programming, but for sociologists of health and illness who study the social conditions that determine access to nutritious food, prenatal care, etc. This makes the Barker hypothesis a resource for transdisciplinary collaboration between sciences and social sciences in the study of disease, lifestyle, life course, generation, social determinants of health, nutrition, and development. Transdisciplinarity is defined as an approach to research that integrates knowledge and many disciplines that do not commonly collaborate, such as sociology and reproductive sciences. I use the case of obesity to explore these points. To a significant degree for a scientific theory, The Barker hypothesis can be seen, to approach obesity as, what has been called in the sociology of science, a “natureculture.” A natureculture is a phenomenon that has both biological and social origins, which we must acknowledge and understand if we are to intervene in effective ways. This paper serves as an invitation to a transdisciplinary approach to obesity using the Barker hypothesis as an entry point.
141 canadian experience placing Laparoscopic adjustable Gastric bands (LaGb) using single Incision Laparoscopic surgery (sILs) at a large bariatric clinic P.S. Kundhal MD FRSC(C), J. Cyriac MD FRCS(C), S. Mueller MSc, and P. Yau, MD FRCS(C) Slimband Clinic, Toronto, Ontario, Canada Introduction: LABG is a minimally invasive restrictive form of weightloss surgery. Typically, four to five 0.5 - 1 cm incision ports are placed to insert the LAGB. There has been increasing interest in performing laparoscopic surgeries using a novel approach referred to as SILS. Little Canadian data exist on placing LAGB via SILS. The advantages of this procedure include better cosmetic results and less post-operative pain. Our aim is to describe our experience using SILS to place LAGB in an outpatient setting, and to demonstrate that it can be performed safely in obese patients. Methods: We retrospectively reviewed our experience placing LAGB using SILS at our centre. We collected demographic and operative data in a standardized fashion. Ethics was obtained using an external IRB. Data is presented as mean±SD. results: Thirty-two patients (30 females) have undergone SILS procedures at our clinic. Average age was 44.5±15 years. Average BMI was 36±7 kg/m2. Length of surgery was found to be 35±11 minutes. Estimated blood loss was 0ccs. All hiatal hernias were repaired. There were no intra-operative complications. conclusions: We have shown that LAGB using SILS can be done safely in a large outpatient bariatric clinic. Furthermore, it can be done in a timely fashion.
143 Overweight and obesity in their association with hypertension in schoolchildren from Maringá, Paraná, brazil L. Dos Santos1, C.M. Dell´Agnolo2, N.L.M. Gil3, C.D. Yañes4, and M.R. Simi5 1,4,5 River Plate Adventist University, Argentina; 2University Hospital of Maringá, Brazil; 3Health Department of Maringá. River Plate Adventist University – School of Health, 25 de Mayo, 99, Libertador San Martin – Entre Ríos, 3103, Argentina; 5MD, PhD, Assistant Professor of Preventive Medicine - School of Health Science; 4 Cardiologist, Professor of Methodology of Scientific Research; 1Seventhyear Medical Student Health Department of Maringá Prudente de Morais, 885, Maringá - Paraná, 87020-010, Brazil; 3Doctor in Tropical Diseases - UNESP-SP University Hospital of Maringá Mandacarú, 1590, Maringá Paraná, 87083-240, Brazil; 2Nurse of Intensive Care Unit Introduction: Childhood obesity is recognized as a public health problem in developed countries. However, it is also a valid public health problem in developing countries, where it has become so common that it is taking the place of malnutrition and infections as the leading cause of childhood health disorders. Objectives: To determine the prevalence of obesity and overweight, and evaluate the association between childhood obesity and elevated blood pressure in children in a public school in the city of Maringá. These data will be used to justify the implementation of preventive measures in the national health system (SUS) among children with obesity. PATIENTS AND METHODS: Cross-sectional study with 532 students ages 8 - 16 years. Height, weight, and blood pressure were evaluated. The data was analyzed according to the population curves from NCHS (2000) and pressure values with curves from NHBPEP (2004). results: 13% were obese, 15.8% were overweight, 67.1% were normal, and 4.1% had malnutrition. In males, obesity was found in 14.7%, and overweight in 13.2%. In females, obesity was found in 11.3%, and overweight in 18.4%. Arterial hypertension was detected
abstract
in 13.3% of all participants; 36.7% in obese girls and 6.7% in the eutrophic girls. Among boys, hypertension was found to be 35.9% and 9.6%, respectively. conclusion: Childhood obesity is frequent in this population and is associated with hypertension. Faced with this situation, it is necessary to initiate preventive measures. 144 Modalités des interventions efficaces dans le traitement de l’obésité chez les enfants et les adolescents P. Hua, L. Pinsonneault, et V. Déry Institut national d’excellence en santé et en services sociaux (INESSS), Montréal, Québec, Canada
blood proinsulin and IGF-1 levels (p=0.25). The most significant hormonal predictor of ponderal index was cord plasma proinsulin in gestational diabetic pregnancies, but cord plasma IGF-1 level in nondiabetic pregnancies. For each SD increase, the adjusted odds ratios in association with ponderal index >the 90th percentile were 1.8 for paternal BMI (p<0.05), 1.5 for cord plasma proinsulin concentration (p<0.05), and 1.3 for cord plasma IGF-l concentration (0.05 <0.10), respectively. conclusions: Paternal obesity may have a significant impact on fetal adiposity development. Higher ponderal index may be an indicator of fetal hypertrophy (associated with elevated insulin secretion) in gestational diabetic pregnancies, but fetal hyperplasia (associated with elevated IGF-1 secretion) in non-diabetic pregnancies. 146
Plusieurs revues systématiques récentes ont conclu que certaines interventions axées sur le mode de vie sont efficaces pour le traitement de l’obésité pédiatrique, notamment lorsque plusieurs approches sont combinées. Cependant, peu d’information est disponible pour déterminer des modalités organisationnelles à privilégier. L’objectif est de décrire les modalités d’organisation de soins et services des interventions efficaces. Nous avons effectué une revue systématique pour identifier les essais cliniques randomisés portant sur le traitement de l’obésité chez les jeunes. Seules les études (k=23) dans lesquelles une intervention a été démontrée efficace (n=26) ont été retenues. Les modalités de ces interventions ont été décrites pour dresser un portrait-type. La plupart des interventions impliquaient les parents (88%). Les médianes pour la durée et le temps de contact entre les intervenants et les jeunes ou leurs parents étaient de 6 mois et de 24 heures respectivement. Les interventions étaient le plus souvent faites en groupe ou combinaient des rencontres individuelles et de groupe (81%). La taille de groupe la plus fréquente était de 5-8 personnes (50%). Les interventions étaient réalisées au niveau local: milieu communautaire, scolaire ou de soins de première ligne (45%); en milieu de soins spécialisés (30%) ou de recherche (25%). Les nutritionnistes et les psychologues étaient les intervenants les plus souvent impliqués. Bien que cette revue ne permette pas de conclure que les facteurs décrits sont responsables de l’efficacité, le portrait-type d’une intervention efficace obtenu pourrait toutefois permettre d’esquisser les bases pour le développement et l’implantation d’un programme de traitement pour les jeunes obèses. 145 Understanding parental anthropometrical, maternal, and fetal metabolic determinants of fetal adiposity
Effect of motilin in preadipocyte proliferation and differentiation P. Miegueu, K. Cianflone, D. Richard, and D.H. St-Pierre Université Laval, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada Introduction: Motilin is a circulating gastrointestinal peptide and recognized for its prokinetic effects on gastrointestinal tissues. Little information is available regarding non-gastrointestinal functions, although effects on insulin-glucose homeostasis and food intake are suggested. The present study was designed to evaluate the effect of motilin on preadipocyte proliferation and differentiation, and macronutrient uptake in adipocytes. Methods: 3T3-L1 cells were treated with two different peptide concentrations (0.1 and 1.0 nM) and PBS as control for one hour to nine days, and the relevant assays measured. results: In preadipocytes, 0.1 and 1.0 nM motilin stimulated proliferation (3H-thymidine incorporation by 163±27%, p<0. 01 and 205±23%; p<0.001, respectively) and metabolic activity (141±10%; p<0.05 and 158±9.8%; p<0.01, respectively) in a concentration dependent manner. Chronic supplementation with motilin during differentiation further increased lipogenesis (Oil red O staining 191±27%, p<0.05) and was associated with greater increase in mRNA expression of PPAR- (148±8%, p<0.01) and C/EBP (142±17%, p<0.05) and Cav3 (166±20%, p<0.05). In mature 3T3-L1 adipocytes, 0.1 and 1.0 nM motilin stimulation increased both fatty acid uptake (175±18%, p<0.05 and 202±12%; p<0.01 respectively), glucose uptake (up to maximum of 146±9% p<0.05). conclusion: Taken together, these results suggest that motilin may directly influence adipocyte function by stimulating energy storage.
Z-C. Luo1, A-M. Nuyt1, E. Delvin, F. Audibert1, I. Girard2, B. Shatenstein1, E. Levy1, P. Julien3, and W.D. Fraser1 1 University of Montreal, CHU Sainte-Justine, Montreal, Quebec, Canada; 2 McGill University, Montreal, Quebec, Canada; 3Laval University, Quebec, Quebec, Canada
147
Introduction: Origins of obesity may be traced back to the perinatal period. However, the determinants of fetal adiposity development remain poorly understood. We assessed parental anthropometrical, maternal, and fetal metabolic determinants of fetal adiposity. Methods: In a prospective pregnancy cohort study of 255 singleton infants, we assessed parental anthropometrical, maternal (24-28 weeks and 32-35 weeks of gestation) and fetal metabolic (glucose, insulin, proinsulin, IGF-1) variables in association with ponderal index at birth as an indicator of fetal adiposity. results: Adjusting for gestational age, a stronger positive correlation was observed for fetal ponderal index with paternal BMI (partial r=0.19, p<0.01) than with maternal BMI (r=0.11, p=0.07). Maternal proinsulin levels in 50g oral glucose tolerance test blood at 24-28 weeks of gestation were positively correlated with ponderal index in gestational diabetic pregnancies (n=26) only (r=0.41, p<0.05). This association became not statistically significant after adjusting for cord
In contemporary medical discourse, the pathologized, scientific, “obese” body has been presented antithetically to the “fat” body as identity and site of transgression. Obesity continues to be presented as a looming epidemic, inciting a moral panic amongst Westerners. Obesity threatens to be a health care burden and, consequently, an economic burden. However, individuals are not threatened by obesity for the aforementioned reasons: individuals are nervous about being attributed with stigmas surrounding the fat body as a loss of bodily control. The social constructionist, size acceptance discourse argues that “fat” is a loaded word, brimming with stereotypes, medical prescriptions, and value assessments that are proliferated in Western society through cultural discourse. Fat studies facilitates an intersectional understanding of how individuals are socially affected by fat; medical discourse demonstrates the scientific evidence of how individuals are biologically affected by fat. In true Haraway fashion, a cyborg enmeshment/blurring of both nature (medicine) and culture
Fit, fat, fatter: towards a coherent narrative (that matters) C. Kuyvenhoven Queen’s University, Kingston, Ontario, Canada
| 177
cANADIAN JoUrNAL oF DIAbEtEs
plants mucilage on food intake and body weight gain in rats fed highfat diet, and their putative role in modulating plasma lipid profile and oxidative stress. Methods: The monosaccharide composition of mucilage obtained after water extraction and antioxidant properties assessment was determined by Gas chromatography. Male Wistar rats were fed highfat diet and received mucilages from Triumphetta cordifolia bark and Irvingia gabonensis kernels at a daily dose of 200 mg/Kg for six weeks. Weight and food intake were monitored. On day 42, rats were fooddeprived for 12 hours and anesthetized for blood and tissue sampling for lipid profile and MDA, thiol, catalase analysis. results: T. cordifolia mucilage contained Rha (44%) and Gal (23%),I. gabonensis Gal (44%) and Ara (18%). Both showed reducing powers of 0.98 and 0.78 at 0.25mg/ml and, at 5mg/ml, chelated ferrous ions by 61.7%. The two mucilages lowered food intake, weight gain, plasma triglyceride and total cholesterol level. T. cordifolia mucilage reduced more remarkably TG: 373.7 ± 50.3 mg/ml (p<0.001) and TC (p<0.01). A significant decrease of MDA in plasma (p<0.001), but a significant increase of catalase and thiols both in the homogenates (p<0.05;p< 0.01) and plasma (p<0.05;p<0.001), were obtained. I.gabonensis and T. cordifolia mucilages increased catalase activity more than galactomanane reference fibre. conclusions: In high-fat diet rats, the mucilage would be effective in preventing increase in plasma lipid levels, improving the antioxidant enzyme levels, exerting beneficial effects on lipid metabolism, and avoiding large increase in food intake and body weigh.This is due to effect they exert on intestinal peptide involved in the regulation of food intake, and also their gel-forming and good antioxidant properties. While further investigations on structure progress, these mucilages could be proposed as interesting nutrients in the management of food intake and obesity-associated metabolic disorders.
142 sociology and the barker Hypothesis: transdisciplinary approaches to obesity R. Scott genera Research Group, Department of Sociology, Queen’s University, Kingston, Canada During development, the comingling of maternal nutrition, socioeconomic status, generational patterns of health and illness, and biological processes can predispose the fetus to later disease or predict future health. This theory, called the Barker hypothesis, evidences complex etiologies of disease and explanations for distributions of health that span biology, social class, place, and generation. In this way, the hypothesis is significant not only for clinicians and scientific researchers who study the biological processes associated with fetal programming, but for sociologists of health and illness who study the social conditions that determine access to nutritious food, prenatal care, etc. This makes the Barker hypothesis a resource for transdisciplinary collaboration between sciences and social sciences in the study of disease, lifestyle, life course, generation, social determinants of health, nutrition, and development. Transdisciplinarity is defined as an approach to research that integrates knowledge and many disciplines that do not commonly collaborate, such as sociology and reproductive sciences. I use the case of obesity to explore these points. To a significant degree for a scientific theory, The Barker hypothesis can be seen, to approach obesity as, what has been called in the sociology of science, a “natureculture.” A natureculture is a phenomenon that has both biological and social origins, which we must acknowledge and understand if we are to intervene in effective ways. This paper serves as an invitation to a transdisciplinary approach to obesity using the Barker hypothesis as an entry point.
141 canadian experience placing Laparoscopic adjustable Gastric bands (LaGb) using single Incision Laparoscopic surgery (sILs) at a large bariatric clinic P.S. Kundhal MD FRSC(C), J. Cyriac MD FRCS(C), S. Mueller MSc, and P. Yau, MD FRCS(C) Slimband Clinic, Toronto, Ontario, Canada Introduction: LABG is a minimally invasive restrictive form of weightloss surgery. Typically, four to five 0.5 - 1 cm incision ports are placed to insert the LAGB. There has been increasing interest in performing laparoscopic surgeries using a novel approach referred to as SILS. Little Canadian data exist on placing LAGB via SILS. The advantages of this procedure include better cosmetic results and less post-operative pain. Our aim is to describe our experience using SILS to place LAGB in an outpatient setting, and to demonstrate that it can be performed safely in obese patients. Methods: We retrospectively reviewed our experience placing LAGB using SILS at our centre. We collected demographic and operative data in a standardized fashion. Ethics was obtained using an external IRB. Data is presented as mean±SD. results: Thirty-two patients (30 females) have undergone SILS procedures at our clinic. Average age was 44.5±15 years. Average BMI was 36±7 kg/m2. Length of surgery was found to be 35±11 minutes. Estimated blood loss was 0ccs. All hiatal hernias were repaired. There were no intra-operative complications. conclusions: We have shown that LAGB using SILS can be done safely in a large outpatient bariatric clinic. Furthermore, it can be done in a timely fashion.
143 Overweight and obesity in their association with hypertension in schoolchildren from Maringá, Paraná, brazil L. Dos Santos1, C.M. Dell´Agnolo2, N.L.M. Gil3, C.D. Yañes4, and M.R. Simi5 1,4,5 River Plate Adventist University, Argentina; 2University Hospital of Maringá, Brazil; 3Health Department of Maringá. River Plate Adventist University – School of Health, 25 de Mayo, 99, Libertador San Martin – Entre Ríos, 3103, Argentina; 5MD, PhD, Assistant Professor of Preventive Medicine - School of Health Science; 4 Cardiologist, Professor of Methodology of Scientific Research; 1Seventhyear Medical Student Health Department of Maringá Prudente de Morais, 885, Maringá - Paraná, 87020-010, Brazil; 3Doctor in Tropical Diseases - UNESP-SP University Hospital of Maringá Mandacarú, 1590, Maringá Paraná, 87083-240, Brazil; 2Nurse of Intensive Care Unit Introduction: Childhood obesity is recognized as a public health problem in developed countries. However, it is also a valid public health problem in developing countries, where it has become so common that it is taking the place of malnutrition and infections as the leading cause of childhood health disorders. Objectives: To determine the prevalence of obesity and overweight, and evaluate the association between childhood obesity and elevated blood pressure in children in a public school in the city of Maringá. These data will be used to justify the implementation of preventive measures in the national health system (SUS) among children with obesity. PATIENTS AND METHODS: Cross-sectional study with 532 students ages 8 - 16 years. Height, weight, and blood pressure were evaluated. The data was analyzed according to the population curves from NCHS (2000) and pressure values with curves from NHBPEP (2004). results: 13% were obese, 15.8% were overweight, 67.1% were normal, and 4.1% had malnutrition. In males, obesity was found in 14.7%, and overweight in 13.2%. In females, obesity was found in 11.3%, and overweight in 18.4%. Arterial hypertension was detected
abstract
in 13.3% of all participants; 36.7% in obese girls and 6.7% in the eutrophic girls. Among boys, hypertension was found to be 35.9% and 9.6%, respectively. conclusion: Childhood obesity is frequent in this population and is associated with hypertension. Faced with this situation, it is necessary to initiate preventive measures. 144 Modalités des interventions efficaces dans le traitement de l’obésité chez les enfants et les adolescents P. Hua, L. Pinsonneault, et V. Déry Institut national d’excellence en santé et en services sociaux (INESSS), Montréal, Québec, Canada
blood proinsulin and IGF-1 levels (p=0.25). The most significant hormonal predictor of ponderal index was cord plasma proinsulin in gestational diabetic pregnancies, but cord plasma IGF-1 level in nondiabetic pregnancies. For each SD increase, the adjusted odds ratios in association with ponderal index >the 90th percentile were 1.8 for paternal BMI (p<0.05), 1.5 for cord plasma proinsulin concentration (p<0.05), and 1.3 for cord plasma IGF-l concentration (0.05 <0.10), respectively. conclusions: Paternal obesity may have a significant impact on fetal adiposity development. Higher ponderal index may be an indicator of fetal hypertrophy (associated with elevated insulin secretion) in gestational diabetic pregnancies, but fetal hyperplasia (associated with elevated IGF-1 secretion) in non-diabetic pregnancies. 146
Plusieurs revues systématiques récentes ont conclu que certaines interventions axées sur le mode de vie sont efficaces pour le traitement de l’obésité pédiatrique, notamment lorsque plusieurs approches sont combinées. Cependant, peu d’information est disponible pour déterminer des modalités organisationnelles à privilégier. L’objectif est de décrire les modalités d’organisation de soins et services des interventions efficaces. Nous avons effectué une revue systématique pour identifier les essais cliniques randomisés portant sur le traitement de l’obésité chez les jeunes. Seules les études (k=23) dans lesquelles une intervention a été démontrée efficace (n=26) ont été retenues. Les modalités de ces interventions ont été décrites pour dresser un portrait-type. La plupart des interventions impliquaient les parents (88%). Les médianes pour la durée et le temps de contact entre les intervenants et les jeunes ou leurs parents étaient de 6 mois et de 24 heures respectivement. Les interventions étaient le plus souvent faites en groupe ou combinaient des rencontres individuelles et de groupe (81%). La taille de groupe la plus fréquente était de 5-8 personnes (50%). Les interventions étaient réalisées au niveau local: milieu communautaire, scolaire ou de soins de première ligne (45%); en milieu de soins spécialisés (30%) ou de recherche (25%). Les nutritionnistes et les psychologues étaient les intervenants les plus souvent impliqués. Bien que cette revue ne permette pas de conclure que les facteurs décrits sont responsables de l’efficacité, le portrait-type d’une intervention efficace obtenu pourrait toutefois permettre d’esquisser les bases pour le développement et l’implantation d’un programme de traitement pour les jeunes obèses. 145 Understanding parental anthropometrical, maternal, and fetal metabolic determinants of fetal adiposity
Effect of motilin in preadipocyte proliferation and differentiation P. Miegueu, K. Cianflone, D. Richard, and D.H. St-Pierre Université Laval, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada Introduction: Motilin is a circulating gastrointestinal peptide and recognized for its prokinetic effects on gastrointestinal tissues. Little information is available regarding non-gastrointestinal functions, although effects on insulin-glucose homeostasis and food intake are suggested. The present study was designed to evaluate the effect of motilin on preadipocyte proliferation and differentiation, and macronutrient uptake in adipocytes. Methods: 3T3-L1 cells were treated with two different peptide concentrations (0.1 and 1.0 nM) and PBS as control for one hour to nine days, and the relevant assays measured. results: In preadipocytes, 0.1 and 1.0 nM motilin stimulated proliferation (3H-thymidine incorporation by 163±27%, p<0. 01 and 205±23%; p<0.001, respectively) and metabolic activity (141±10%; p<0.05 and 158±9.8%; p<0.01, respectively) in a concentration dependent manner. Chronic supplementation with motilin during differentiation further increased lipogenesis (Oil red O staining 191±27%, p<0.05) and was associated with greater increase in mRNA expression of PPAR- (148±8%, p<0.01) and C/EBP (142±17%, p<0.05) and Cav3 (166±20%, p<0.05). In mature 3T3-L1 adipocytes, 0.1 and 1.0 nM motilin stimulation increased both fatty acid uptake (175±18%, p<0.05 and 202±12%; p<0.01 respectively), glucose uptake (up to maximum of 146±9% p<0.05). conclusion: Taken together, these results suggest that motilin may directly influence adipocyte function by stimulating energy storage.
Z-C. Luo1, A-M. Nuyt1, E. Delvin, F. Audibert1, I. Girard2, B. Shatenstein1, E. Levy1, P. Julien3, and W.D. Fraser1 1 University of Montreal, CHU Sainte-Justine, Montreal, Quebec, Canada; 2 McGill University, Montreal, Quebec, Canada; 3Laval University, Quebec, Quebec, Canada
147
Introduction: Origins of obesity may be traced back to the perinatal period. However, the determinants of fetal adiposity development remain poorly understood. We assessed parental anthropometrical, maternal, and fetal metabolic determinants of fetal adiposity. Methods: In a prospective pregnancy cohort study of 255 singleton infants, we assessed parental anthropometrical, maternal (24-28 weeks and 32-35 weeks of gestation) and fetal metabolic (glucose, insulin, proinsulin, IGF-1) variables in association with ponderal index at birth as an indicator of fetal adiposity. results: Adjusting for gestational age, a stronger positive correlation was observed for fetal ponderal index with paternal BMI (partial r=0.19, p<0.01) than with maternal BMI (r=0.11, p=0.07). Maternal proinsulin levels in 50g oral glucose tolerance test blood at 24-28 weeks of gestation were positively correlated with ponderal index in gestational diabetic pregnancies (n=26) only (r=0.41, p<0.05). This association became not statistically significant after adjusting for cord
In contemporary medical discourse, the pathologized, scientific, “obese” body has been presented antithetically to the “fat” body as identity and site of transgression. Obesity continues to be presented as a looming epidemic, inciting a moral panic amongst Westerners. Obesity threatens to be a health care burden and, consequently, an economic burden. However, individuals are not threatened by obesity for the aforementioned reasons: individuals are nervous about being attributed with stigmas surrounding the fat body as a loss of bodily control. The social constructionist, size acceptance discourse argues that “fat” is a loaded word, brimming with stereotypes, medical prescriptions, and value assessments that are proliferated in Western society through cultural discourse. Fat studies facilitates an intersectional understanding of how individuals are socially affected by fat; medical discourse demonstrates the scientific evidence of how individuals are biologically affected by fat. In true Haraway fashion, a cyborg enmeshment/blurring of both nature (medicine) and culture
Fit, fat, fatter: towards a coherent narrative (that matters) C. Kuyvenhoven Queen’s University, Kingston, Ontario, Canada
| 177