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Metabolic consequences of over-nutrition andweight gain in humans

Leonie K. Heilbronn ∗, P. Meikle, L.V. Campbell, D.Samocha-Bonet

Discipline of Medicine, The University of Adelaide,Adelaide, Australia

Studies in rodents have long established the earlynegative consequences of obesity on insulin sensi-tivity, ectopic lipid, and macrophage infiltration ofadipose tissue. In humans, however, it is difficultto achieve the kind of environmental perturbationsthat can be implemented in rodent models, and sothe findings discovered, whilst vital to our knowl-edge base, do not always reflect human physiology.Therefore, we examined the effects of moder-ate high fat overfeeding (5000 kJ/day) for 4-weekson metabolic health, adipose tissue inflammation,lipid metabolism and oxidative stress in 40 healthy,non-obese individuals.

Overfeeding induced significant weight and fatgains, increased fasting serum glucose and insulin,and reduced insulin sensitivity by 10%. Whilst CRPincreased, the majority of inflammatory markerswere unchanged. However, markers of oxidativestress (e.g. serum TBARS, urinary F2-ispopostanesand skeletal muscle protein carbonylation) weresignificantly increased. Protein levels of PGC1�,and subunits from complex I, II and V of the elec-tron transport chain were transiently increased,although functional measures of activity were notaltered. Initially, serum FFA reduced, and therewas preferential oxidation of glucose, as evidencedby an increase in respiratory quotient, and gly-colytic enzyme activity. Plasma and skeletal muscletriacylglycerol content was unchanged, and diacyl-glycerol content decreased, while total ceramidedid not change, Cer22:0 and Cer24:0 increased.

Overfeeding induced peripheral insulin resis-tance without inflammation, or reducing markers ofmitochondrial function, or increasing diacylglyceroland triacylglycerol within skeletal muscle. How-ever, muscle ceramide species Cer22:0 and Cer24:0increased and together with oxidative stress and

may play a pivotal role in the development ofobesity-associated insulin resistance in humans.

doi:10.1016/j.orcp.2011.08.057

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Invited Speakers Abstracts

revention of adverse outcomes and weightegain after bariatric surgery

endy A. Brown

Centre for Obesity Research and Education,onash University, Melbourne, Australia

Whilst all forms of bariatric surgery offer supe-ior weight loss to current conservative regimes,hese procedures all carry surgical risk, have longerm complications and have a failure rate asso-iated with them. These risks must be weighedp against the benefits of the procedures for aiven intervention. Strategies to minimise risk ofhort and long term complications include surgicalechnique, optimising peri-operative care, ensuringppropriate long-term follow-up and maximisingatient education through a multidisciplinary pro-ess.

The Centre for Obesity Research and Educationeceives a research grant from Allergan® and anducational grant from Applied Medical®, Australia.

oi:10.1016/j.orcp.2011.08.058

he Melbourne InFANT Program positivelympacts very young children’s lifestyle patterns

aren Campbell 1,∗, S. McNaughton 1, S. Lioret 1, D.rawford 1, J. Salmon 1, K. Ball 1, Z. McCallum 2, K.esketh 1

Centre for Physical Activity & Nutrition Research,eakin University, Melbourne, AustraliaDepartment of Paediatrics, University of Mel-ourne, Melbourne, Australia

Aim: This paper describes young children’s dietnd lifestyle patterns at the conclusion of a parent-ocused obesity prevention intervention deliveredhen infants were 3-18 months of age in Melbourne,ustralia.

Methods: The Melbourne (InFANT) Program isn on-going cluster RCT involving 542 first-timeothers and children. The program focused on pro-

iding mothers with knowledge and skills to supportevelopment of positive diet and physical activityehaviours and reduced sedentariness in infants.he effect of the intervention was assessed forhe following outcomes in children: television view-ng, physical activity, intakes of fruits, vegetables,oncore drinks, water, sweet and savoury snacks.utcomes were analysed both independently andynthesised in lifestyle patterns (principal compo-

ent analysis).

Results: At intervention conclusion, compared toontrol children, intervention children had lower

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dcabeiictaetfTrnrmDatbcaappeal to mothers and fathers and maximise pro-gram benefits.

doi:10.1016/j.orcp.2011.08.061

nvited Speakers Abstracts

ntakes of sweet snacks (p = 0.02) and watched sig-ificantly less television (p = 0.04). There was noignificant difference between the groups when thether outcomes were considered separately, how-ver trends in the hypothesised directions werepparent for most outcomes. Two lifestyle pat-erns were identified using PCA, namely ‘‘Fruitsnd water’’, and ‘‘Television and non-core snacks’’.cores of the latter pattern were significantly lowern the intervention children at post-interventionp = 0.02).

Conclusions: The Melbourne InFANT Programhows a promising impact on the development ofery young children’s obesity protective lifestyleatterns.

oi:10.1016/j.orcp.2011.08.059

he NOURISH early feeding trial: An innovativepproach to child obesity prevention

ynne A. Daniels 1,2,∗, A.M. Magarey 1,2, J.M.icholson 1,3

Queensland University Technology, Brisbane,ustraliaFlinders University, Adelaide, AustraliaParenting Research Centre, Melbourne, Australia

Background: Infant feeding practices influencearly intake and eating behaviours which are asso-iated with later obesity risk. Only two smallCTs have evaluated obesity prevention interven-ions starting in infancy (Harvey-Berino, 2003; Paul,010). The aim is to present preliminary resultsrom the mid-term assessment (infants 13—16onths old) of the NOURISH study, one of the first

arge RCTs to evaluate an obesity prevention inter-ention that commences in infancy.

Methods: Participants were 698 first-time moth-rs of healthy term infants born in Adelaide orrisbane. The intervention was a skills-based pro-ram of anticipatory guidance on feeding andarenting practices that mediate children’s earlyeeding experiences. Content was delivered viawo modules consisting of six fortnightly groupessions, commencing at infant age 4—7 and3—16 months. Controls had self-directed accesso relatively limited usual child health services.aternal and child outcomes included measuredeight and length/heights and behaviours andovariates assessed by questionnaire at baselinepre-allocation) when infants were aged 4 monthsnd at 13 and 24 months.

Results: At baseline mothers were mean (sd)0.1(5.3) years, 58% university educated andnfants were 4.3(0.98) months; 49% male and there

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ere no group differences. At mid-term assessmentN = 566, mean age 13.7(1.3) months) the inter-ention group had lower BMI Z-score (0.23(0.93)s 0.43(0.86); P = 0.01), gained weight less rapidlyver the first year of life (weight gain Z-score.00(1.01) vs 0.18(1.01), P = 0.04) and reportedower frequency of undesirable feeding practices.

Conclusions: These data provide encouragingvidence that starting obesity prevention in infancys effective.

oi:10.1016/j.orcp.2011.08.060

hild obesity prevention: Interventions engagingums and dads

hillip J. Morgan

Priority Research Centre in Physical Activity andutrition, University of Newcastle, Australia

Parents have an important influence on theevelopment of positive health behaviours in theirhildren. Parents influence the food and physicalctivity home environment through their attitudes,ehaviours, and activity and feeding-related par-nting practices. While there is some consensusn the literature that child obesity preventionnterventions should involve parents as agents ofhange, systematic reviews highlight the uncer-ainty around optimal strategies to involve parents,nd many interventions have only engaged moth-rs. Family-based programs should consider ‘who’o target and ‘how’ best to engage mothers andathers to optimise the effectiveness of programs.he purpose of this presentation is to outline theationale, design and preliminary findings from aumber of family-based interventions that haveecruited fathers (Healthy Dads, Healthy Kids com-unity trial), mothers (MADE4Life — Mother Andaughters Exercising for Life) and both mothersnd fathers (Family Fit). These programs haveargeted parental physical activity and/or dietaryehaviours to influence both the parent and thehild. Insights will be provided about how to engagend recruit families and how to tailor programs to